Urolithiasis is climate-sensitive and increasingly prevalent, but the environmental impact of its care remains poorly defined. The aim of the study is to map existing evidence on the environmental footprint of urolithiasis care and identify gaps for future research.
A scoping review was conducted in accordance with the PRISMA-ScR guidelines. PubMed, Ovid MEDLINE, and the Cochrane Library were searched to March 20th, 2025. Studies were eligible if they provided quantitative estimates of the environmental footprint using life cycle assessment or clinical audit methodologies. Two reviewers screened and extracted data independently.
Six studies were included. Endoscopic analyses reported comparable footprints for single-use and reusable ureteroscopes, with emissions primarily from manufacturing in disposables and from sterilization in reusables. Imaging studies showed substantial variation across modalities, with ultrasound lowest, CT intermediate, and MRI highest. Surgical audits indicated that reusable drapes and gowns reduced emissions by nearly one-fifth, while cystoscopy drapes and irrigation fluid disposal represented additional hotspots.
Evidence on the environmental impact of stone disease care is limited and fragmented. No studies addressed Percutaneous Nephrolithotomy, Extracorporeal Shock Wave Lithotripsy, or laser interventions. Patient-centered outcomes and system-level strategies remain underexplored. Standardized, multicenter life cycle assessments and evaluation of decarbonization strategies (including anesthetic choice, energy-efficient operating theatres, and pathway redesign) are priorities for guiding climate-smart stone care.
Minerva urology and nephrology. 2026 Jun [Epub]
Muhidin H Ibrahim, Atinc Tozsin, Yuhong Yuan, Hakan Akdere, Cristian Fiori, Kamran Ahmed, Selcuk Guven
Department of Urology, Trakya University School of Medicine, Edirne, Türkiye., Şırnak Silopi State Hospital, Şırnak, Türkiye., Division of Gastroenterology, McMaster University Medical Centre, Hamilton, ON, Canada., Division of Urology, Department of Oncology, San Luigi Teaching Hospital, University of Turin, Orbassano, Turin, Italy., Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Department of Urology, Necmettin Erbakan University, School of Medicine, Konya, Türkiye - .