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Egor Parkhomenko, Renai Yoon, Zhamshid Okhunov, Roshan M Patel, Benjamin Dolan, Kamaljot Kaler, Michael J Schwartz, Paras H Shah, Hannah Bierwiler, Aldrin Joseph Gamboa, Roberto Miano, Stefano Germani, Dario Del Fabbro, Alessio Zordani, Salvatore Micali, Louis R Kavoussi, Ralph V Clayman, Jaime Landman
OBJECTIVE: To create, distribute, and evaluate the efficacy of a portable, cost effective 3D-printed laparoscopic trainer for surgical skills development. METHODS: The UCI Trainer (UCiT) laparoscopic simulator was developed via computer-aided designs (CAD), which were used to 3D-print the UCiT. Once assembled, a tablet computer with a rear-facing camera was attached for video and optics. Four institutions were sent the UCiT CAD files with a 3D-printer and instructions for UCiT assembly...
November 9, 2018: Urology
Katherine J Cockerill, Stacy Young, Colleen S Thomas, Kaitlynn Custer, C Burcin Taner, Dana K Perry, David D Thiel
OBJECTIVE: To assess whether donor kidney Mayo Adhesive probability (MAP) score is associated with (total operative time) ORT in patients undergoing hand-assisted laparoscopic donor nephrectomy (HALDN). METHODS: 331 patients undergoing HALDN were reviewed. Donor kidney MAP scores were recorded based on pre-operative CT or MRI. Single variable and multiple variable regression analysis were used to evaluate the correlation between MAP score and ORT. RESULTS: 331 patients underwent HALDN between January 2007 and April 2017...
November 8, 2018: Urology
Elisabeth M Sebesta, Kimberly L Cooper, Gina M Badalato
OBJECTIVES: To assess the application and perceived usefulness of the Accreditation Council for Graduation Medical Education (ACGME) Milestones system for resident evaluation among urology program directors (PDs). MATERIALS AND METHODS: We conducted an online survey of 133 urology PDs. The survey addressed several domains: (1) demographic information, (2) logistics and implementation of the faculty Clinical Competency Committee (CCC) meetings, and (3) perceived overall effectiveness and usefulness of the Milestones assessments...
November 8, 2018: Urology
Pedro Espino-Grosso, Christopher Monsour, Benjamin K Canales
OBJECTIVES: To test the effect of calcium and vitamin B6 therapies on urinary oxalate excretion in a rodent model of enteric hyperoxaluria (EH) after Roux-en Y gastric bypass (RYGB) surgery. METHODS: Obese male Sprague-Dawley rats underwent sham (n=7) or RYGB (n=10). Animals were maintained on low oxalate (1.5%) and fat (10%; LOF), normal calcium (0.6 %; NC) diet for 8 weeks and then completed a 2-phase crossover metabolic study. In the first 2-week phase, animals were fed a LOF, high calcium (2...
November 6, 2018: Urology
Elizabeth V Dray, Marybeth Hall, Diana Covalschi, Ann P Cameron
OBJECTIVES: To evaluate the efficacy of urethral bulking agents for stress urinary incontinence in the setting of prior failed sling. METHODS: This is a retrospective review of patients who underwent urethral bulking agent injections for a primary complaint of stress urinary incontinence following prior failed sling surgery. The outcomes assessed were patient reported improvement, need for further interventions for incontinence and validated questionnaires. Values for questionnaires were obtained from the patient's pre-procedure visit, at the first visit following their last injection and at their most recent visit within our system...
November 6, 2018: Urology
Youjian Li, Xuefeng Qiu, Weijian Li, Yang Yang, Rong Yang, Xiaozhi Zhao, Hongqian Guo, Xiaogong Li
Type 2 papillary renal cell carcinoma (PRCC) is a malignant tumor originated from renal tubular epithelial cells. Here we present a rare case of extra-renal type 2 PRCC which located at the right lateral side of the retroperitoneal inferior vena cava. No suspicious lesions were detected in the bilateral kidneys. The diagnosis was confirmed by histopathological examination after complete excision of the tumor. No recurrence was observed five months of follow-up after surgery.
November 2, 2018: Urology
Tomy Y Perez, Michelle C Chen, Paul H Chung, Patrick J Shenot
OBJECTIVES: To examine trends in the financial relationship between biomedical companies and leaders in urologic education during the first three full calendar years since implementation of the Sunshine Act. METHODS: All accredited American Urological Association (AUA) residency programs were identified using the AUA website. Urology program directors and department chairs of the affiliated institutions were identified using residency program or urology department websites...
November 1, 2018: Urology
Chloe Michel, John Michael DiBianco, Vikram Sabarwal, Daniel M Stein
Hidradenitis suppurativa (HS) is a chronic inflammatory condition affecting the axilla, genitals, perineum, and perianal regions. The pathophysiology of HS is complex and requires a multidisciplinary approach to treatment involving medical and surgical management when indicated. We describe our multidisciplinary protocol for treatment, which includes: rheumatology monitored immunotherapy, medical management, wide surgical resection, wound care and reconstruction. The multidisciplinary care team includes: rheumatology, wound care, and reconstructive urologic surgery...
November 1, 2018: Urology
Nadya E York, Mengmeng Zheng, Hazem M Elmansy, Marcelino E Rivera, Amy E Krambeck, James E Lingeman
OBJECTIVES: To assess stone free rates following URS for renal calculi at our institution using low dose renal only CT (LDCT). METHODS: A retrospective review of patients undergoing flexible URS for renal stones only with subsequent CT scan within 3 months. Meticulous basketing of all stone fragments was performed whenever possible. A "true" zero fragment SFR was determined by reviewing the CT scan and radiologist's report. Patients with nephrocalcinosis (as determined by visual inspection of papilla at the time of URS) were assigned the "stone free" category...
November 1, 2018: Urology
Esther Han, Laura Nguyen, Jason Gilleran, Jamie Bartley, Kim A Killinger, Judith A Boura, Larry T Sirls
OBJECTIVE: To evaluate the effect of different surgical procedures on Pelvic Floor Distress Index (PFDI) scores in women with pelvic organ prolapse (POP). MATERIALS AND METHODS: Women with prolapse were enrolled from 2008-2014. Baseline data and outcomes at one year were collected including subscales of the PFDI (UDI: Urinary Distress Inventory; POPDI: Pelvic Organ Prolapse Distress Inventory; CRADI: Colorectal and Anal Distress Inventory). Patients who had surgery (SGY) within the first year were compared to those who did not (N-SGY)...
October 31, 2018: Urology
Spyridon Kampantais, Anthony Young, Sidath H Liyanage
Renal replacement lipomatosis is a rare disease characterised by renal parenchymal atrophy and proliferation of inflammatory and fatty cells within the renal sinus, hilum, and perirenal region. The exact pathogenesis is unknown, however more than 75% of cases are associated with renal stones. Here, we provide images from a case with 10 years of follow-up, outlining the radiographic progression of the disease through time. Although only histopathology can confirm the diagnosis, high clinical suspicion in combination with the radiographic findings can differentiate the disease from other fat-containing entities...
October 30, 2018: Urology
Swarnendu Mandal, Prasant Nayak, Suvendu Purkait, Manoj Das, Rjesh Mahalingam
No abstract text is available yet for this article.
October 30, 2018: Urology
Scott O Quarrier, Jubin E Matloubieh, Guan Wu
OBJECTIVE: To present a robot-assisted surgical technique for overcoming challenges of a patient with prior pelvic surgeries and bowel in the radiation target. METHODS: A 72-year-old male required treatment for biochemically recurrent prostate cancer. In 2006, he presented with PSA 5.74 ng/ml, Gleason 3+3 prostate cancer. He underwent a robot-assisted radical prostatectomy for pT2aNx adenocarcinoma with negative margins. In 2008, he was found to have muscle invasive high-grade papillary urothelial carcinoma and underwent robot-assisted radical cystectomy and ileal conduit for pT2bN0 urothelial carcinoma...
October 29, 2018: Urology
Michael A Liss, Yidong Chen, Ronald Rodriguez, Deepak Pruthi, Teresa Johnson-Pais, Hanzhang Wang, Ahmed Mansour, Dharam Kaushik
OBJECTIVE: To perform immune-cell enumeration and PD-L1 expression in clear cell renal cell carcinoma (cc-RCC) with tumor thrombus (TT) to guide therapeutic decisions. METHODS: After obtaining IRB approval and surgical consent, six patients underwent radical nephrectomy (RN) with venous tumor thrombectomy. We utilized RNA Sequencing to obtain RNAseq expression profiles. Computational calculation and enumeration of immune cells were performed using CIBERSORT, xCell, and ingenuity pathway analysis (IPA) software...
October 29, 2018: Urology
Nicholas C Arpey, Matthew J Sloan, Amy Hahn, Philip Polgreen, Bradley A Erickson
OBJECTIVE: To qualify and quantify unscheduled clinical encounters (UCEs) in post-operative urologic patients and to identify patient and procedural risk factors for UCEs. MATERIALS AND METHODS: All UCEs, including phone calls, emails, patient portal messages, clinic visits, ER visits and hospital readmissions, were analyzed, including the reason for the interaction (e.g. pain, infection, etc.) were assessed retrospectively for consecutive surgical patients over a three-month period...
October 29, 2018: Urology
Daniel S Han, Gina Cambareri, Madhu Alagiri, George Chiang
OBJECTIVE: To determine whether vesicoureteral reflux (VUR) that occurs during either the filling or voiding phase on voiding cystourethrogram (VCUG) has prognostic significance on successful endoscopic treatment. MATERIALS AND METHODS: A retrospective review was performed of 299 patients (438 ureters) with VUR who underwent endoscopic treatment with dextranomer/hyaluronic acid copolymer (Deflux) at a single institution from 2010-2013. Success was defined as absence of VUR on 3-month follow-up VCUG...
October 29, 2018: Urology
Amir Paster, Sabrina Shlain, Yazeed Barghouthy, Alex Liberzon, Galit Aviram, Mario Sofer
OBJECTIVES: To analyze the intrarenal hydrodynamic processes and clearance of stone fragments during percutaneous nephrolithotomy (PCNL) using numerical and physical models. MATERIALS AND METHODS: COMSOL Multiphysics® software was used to simulate irrigation flows and transport of particles in a kidney model based on computerized tomographic acquisition. A similarly shaped physical model with solid particles was constructed, and PCNL was simulated using nephroscopes...
October 29, 2018: Urology
Brian P Calio, Andrej Lyshchik, Jingzhi Li, Maria Stanczak, Collette M Shaw, Robert Adamo, Ji-Bin Liu, Flemming Forsberg, Costas D Lallas, Edouard J Trabulsi, John R Eisenbrey
OBJECTIVE: To evaluate efficacy of using 2D and 3D contrast enhanced ultrasound (CEUS) for surveillance of RCC recurrence in patients post-ablation and identify imaging hallmarks of recurrence. METHODS: 53 patients >8 months post ablation of RCC provided informed consent for this IRB approved study. Patients received 2D and 3D CEUS examinations with Optison (GE Healthcare). Three radiologists of varying CEUS experience described enhancement characteristics, made a diagnosis of recurrence/no-recurrence, and quantified their diagnostic confidence levels...
October 29, 2018: Urology
Paige E Nichols, Kelly T Harris, Aaron Brant, Madeleine G Manka, Nora Haney, Michael H Johnson, Amin Herati, Mohamed E Allaf, Phillip M Pierorazio
OBJECTIVES: To better understand patient decision-making and genital satisfaction associated with post-orchiectomy testicular prosthesis implantation in patients with germ cell tumors of the testicle. MATERIALS AND METHODS: An electronic survey to assess testicular prosthesis decision-making and genital satisfaction was distributed to patients via an institutional database (n=70) and social media outlets (n=167). Statistical analyses were performed using chi-square tests for categorical variables, Wilcoxon-Mann-Whitney tests for continuous variables, and multivariate regression analyses to identify independent predictors of receiving a prosthesis, genital satisfaction, and prosthesis satisfaction...
October 28, 2018: Urology
H Henry Lai, Margaret E Helmuth, Abigail R Smith, Jonathan B Wiseman, Brenda W Gillespie, Ziya Kirkali
OBJECTIVES: To describe the relationship between metabolic factors and lower urinary tract symptoms (LUTS), overactive bladder syndrome (OAB) and urinary incontinence (UI). METHODS: Adult male and female patients who presented to a clinician from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) were recruited. Urinary symptoms (presence of OAB, any UI, stress UI (SUI), urgency UI (UUI), urgency, frequency, and nocturia) were assessed with the LUTS Tool...
October 27, 2018: Urology
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