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W N Chen, X J Ye, S J Liu, L L Xiong, X B Huang, T Xu, X F Wang
OBJECTIVE: To compare various data of open pyeloplasty, laparoscopic pyeloplasty and endopyelotomy as a treatment of ureteropelvic junction obstruction (UPJO), and to investigate and discuss the feasibility and effect of the three methods. METHODS: In the study, 109 cases of UPJO treated by different surgical approaches in Peking University People's Hospital from January 2004 to December 2014 were retrospectively investigated. The patients were divided into three groups according to the treatment they received: open peyloplasty group (32 cases), laparoscopic peyloplasty group (31 cases) and endopyelotomy group (46 cases)...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Nobuo Tsuru, Soichi Mugiya, Yutaka Kurita, Shigenori Sato, Yasuhiro Hirano
We present a case of UPJO associated with an incompletely duplicated collecting system in a horseshoe kidney that was successfully treated by laparoscopic pyeloplasty with concomitant pyelolithotomy. A 53-year-old man had three urological anomalies and urolithiasis. We performed a pyeloplasty and pyelolithotomy using a fully intracorporeal technique. Clinical and radiographic evaluation confirmed complete resolution of the patient's condition. To our knowledge, there have been no reported cases of UPJO in an incompletely duplicated collecting system with a horseshoe kidney in the same patient...
November 2016: Urology Case Reports
Sapan N Ambani, David Y Yang, J Stuart Wolf
PURPOSE: To compare our experience with salvage laparoscopic pyeloplasty, using a matched control set of primary laparoscopic pyeloplasty patients. METHODS: We retrospectively reviewed patients who underwent laparoscopic pyeloplasty from 1996 to 2014 by a single surgeon. At least 12 months of follow-up was required. Salvage patients were matched 1:3 with primary patients. Matching was based on age ±5 years, body mass index (BMI) ±5, and type of pyeloplasty (dismembered vs...
October 8, 2016: World Journal of Urology
Yuichiro Yamazaki, Woo Jin Kim, Sayaka Akiyama, Takashi Ikeda
PURPOSE: The aim of this study was to compare the results of the retroperitoneoscopic assisted pyeloplasty (RASP) using EZ access (silicone rubber cap) with open dismembered pyeloplasty (ODP) in children. METHODS: A retrospective review was performed of patients treated for ureteropelvic junction (UPJ) obstruction with either RASP or ODP from 2010 to 2015. For patients with RASP, two 5-mm trocars were placed in the EZ access. The UPJ was dissected retroperitoneoscopically and dismembered pyeloplasty was performed extracorporeally...
September 23, 2016: Journal of Pediatric Surgery
Alexander Roosen, Cagatay Dogan, H Nguyen, Markus Heiland, D Longwitz, Burkhard Ubrig
Purpose Diuretic renography (DRG) is commonly used to diagnose ureteropelvic junction obstruction (UPJO) and to evaluate the success of surgical repair (pyeloplasty). Duration, frequency and interpretation of renographic follow-ups are still under dispute. Methods We retrospectively reviewed 94 consecutive patients diagnosed with UPJO who underwent a minimally invasive, robotically assisted laparoscopic pyeloplasty at our institution between 01/2009 and 09/2015. DRG was carried out preoperatively and again routinely 4-6 weeks postoperatively the day after stent removal (early DRG)...
October 7, 2016: Journal of Endourology
Keith Francis Rourke, Andrew E MacNeily
INTRODUCTION: Urology residency training in Canada is quickly evolving from a time-based to a competency-based model. We aim to better define core surgical competencies that would comprise a surgical curriculum and assess any discrepancies in opinion nationally. METHODS: A web-based survey was validated and sent to the 536 practicing members of the Canadian Urological Association (CUA) in August and October 2014. The survey consisted of questions regarding practice demographics, fellowship training, and evaluated the 76 most common urological procedures (using a five-point Likert scale) in the context of the question, "After completion of residency training in Canada a urologist should be proficient in…" A core procedure was defined as one for which there was ≥75% agreement...
May 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Nirmish Singla, Aaron H Lay, Jeffrey A Cadeddu
INTRODUCTION: To examine if poor preoperative split renal function (SRF) and age influence pyeloplasty outcomes in adults with ureteropelvic junction obstruction (UPJO). MATERIALS AND METHODS: We retrospectively reviewed our pyeloplasty experience in adults with UPJO from 2004 to 2014. Patients with solitary kidneys or missing renal scans were excluded. Renal scans were performed at 6 weeks, 8 months, and 20-24 months postoperatively. Demographics, operative approaches, and pre and postoperative SRF and diuretic half-times (T1/2) were obtained...
October 2016: Canadian Journal of Urology
Fuminori Sato, Ken Nakagawa, Akihiro Kawauchi, Akio Matsubara, Takatsugu Okegawa, Tomonori Habuchi, Koji Yoshimura, Akio Hoshi, Hidefumi Kinoshita, Akira Miyajima, Yasuyuki Naitoh, Shogo Inoue, Naoshi Itaya, Shintaro Narita, Kazuya Hanai, Kazutoshi Okubo, Masaaki Yanishi, Tadashi Matsuda, Toshiro Terachi, Hiromitsu Mimata
OBJECTIVE: To report on a multi-institutional series of non-robotic urological laparoendoscopic single-site surgery in Japan. METHODS: Consecutive cases of laparoendoscopic single-site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates. RESULTS: Four hundred and sixty-nine cases were included in the analysis...
October 4, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Farouk M Nasser, Ahmed M Shouman, Mohammed S ElSheemy, Mohammed A Lotfi, Waseem Aboulela, Mohamed El Ghoneimy, Mohammed Abdelwahab, Ahmed I Shoukry, Waleed Ghoneima, Hany Morsi, Hesham Badawy
OBJECTIVES: To compare outcome of dismembered-pyeloplasty in infants with and without external nephro-ureteric stent (ENUS) for treatment of congenital ureteropelvic junction obstruction (UPJ-O). METHODS: This is a parallel, randomized comparative study between October 2013 and September 2014. 30 infants ≤6 months old with UPJ-O indicated for dismembered-pyeloplasty were randomly assigned (block randomization, closed envelope method) into two groups; group-A (stentless) and group-B (ENUS)...
September 28, 2016: Urology
Theodora Stasinou, Andreas Bourdoumis, Junaid Masood
OBJECTIVES: To investigate a possible causal relationship for stone formation in pelviureteric junction obstruction and to outline management options. MATERIALS AND METHODS: A literature search and evidence synthesis was conducted via electronic databases in the English language using the key words pelviureteric junction obstruction; urolithiasis; hyperoxaluria; laparoscopic pyeloplasty; flexible nephroscopy; percutaneous nephrolithotomy, alone or in combination...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Nuno Fidalgo, Hugo Pinheiro, Frederico Ferronha, Jorge Morales, Luís Campos Pinheiro
The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ) obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition...
2016: Case Reports in Urology
Robert M Sweet
BACKGROUND: The challenges of training and assessing endourologic skill have driven the development of new training systems. The Center for Research in Education and Simulation Technologies (CREST) has developed a team and a methodology to facilitate this development process. METHODS: Backwards design principles were applied. A panel of experts first defined desired clinical and educational outcomes. Outcomes were subsequently linked to learning objectives. Gross task deconstruction was performed and the primary domain was classified as primarily involving decision-making, psychomotor skill or communication...
September 15, 2016: Journal of Endourology
Morihiro Nishi, Kazumasa Matsumoto, Tetsuo Fujita, Masatsugu Iwamura
INTRODUCTION: To evaluate the efficacy of laparoscopic pyeloplasty (LPP) for lower functioning kidney, we investigated the outcome of this procedure for patients with ureteropelvic junction obstruction with decreased renal function, defined as less than 20% split renal function. PATIENTS AND METHODS: Between October 1998 and June 2015, we performed transperitoneal dismembered LPP in 224 patients. Among them, 15 patients with less than 20% split renal function were included in this study...
October 14, 2016: Journal of Endourology
Hong Mei, Xiang Zhao, Dan Li, Erhu Fang, Xiaojing Wang, Huajie Song, Jiarui Pu, Liduan Zheng, Qiangsong Tong
OBJECTIVE: To compare the efficacy of transumbilical multiport (TMLP) and standard laparoscopic pyeloplasty (SLP) for the treatment of congenital ureteropelvic junction obstruction in children. METHODS: Forty-eight patients were included in this matched-pair study. The TMLP applied three transumbilical incisions for one 5-mm and two 3-mm ports, whereas SLP was undertaken with traditional three-port technique. The demographic, perioperative, and follow-up data were retrospectively compared between TMLP (n=24) and SLP (n=24) groups...
August 31, 2016: Journal of Pediatric Surgery
A M Abdel-Karim, A Fahmy, A Moussa, H Rashad, M Elbadry, H Badawy, A Hammady
INTRODUCTION AND OBJECTIVES: Recurrent ureteropelvic junction obstruction (UPJO) in children is an operative challenge. Minimally invasive endourological treatment options for secondary UPJO have suboptimal success rates; hence, there is a re-emergence of interest about redo pyeloplasty. The present study presented experience with laparoscopic management of previously failed pyeloplasty compared with open redo pyeloplasty in children. STUDY DESIGN: Twenty-four children with recurrent UPJO who underwent transperitoneal dismembered laparoscopic pyeloplasty were studied...
July 21, 2016: Journal of Pediatric Urology
Ayşe Başak Uçan, Zehra Günyüz Temir, Arzu Şencan, Aytaç Karkıner, Hüseyin Evciler
BACKGROUND: Conservative management procedures are implemented in cases of low-grade pediatric blunt renal trauma, but procedures for grade 4 injuries are not clearly defined. The present objective was to discuss treatment procedures in patients who presented with or developed urinoma during follow-up. METHODS: Treatment procedures implemented in 8 patients (female:male ratio=1:7; average age: 6) with grade 4 renal trauma who presented to the clinic between 2003 and 2012 were retrospectively analyzed...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Luis H Braga, Melissa McGrath, Forough Farrokhyar, Kizanee Jegatheeswaran, Armando J Lorenzo
INTRODUCTION: There is limited comparative data on the predictive value of the two most commonly employed classification systems (SFU hydronephrosis[HN] grades and urinary tract dilation[UTD] risk groups) in regards to future risk for surgical intervention and the development of fUTI. Herein we explore this topic in infants with isolated HN. METHODS: After screening 938 patients with prenatal HN (2009-2016), we selected patients with UPJO-like HN(n=322). HN grades were prospectively collected at baseline, surgery and last follow-up...
August 30, 2016: Journal of Urology
David Anthony Kurz, Phillip Mucksavage
A complication of using foreign materials in surgery is potential erosion into nearby tissues. The endoscopic removal of foreign bodies that have eroded into the urinary tract is a safe and minimally invasive option that has previously been described, most commonly in the bladder and urethra. We present the case of a patient who had a remote history of a pyeloplasty and was found to have different foreign bodies eroding into the ureter causing symptoms. To our knowledge, this is the first case where a patient presented with two different types of ureteral foreign body erosions that were each effectively treated endoscopically...
2016: J Endourol Case Rep
Sean McAdams, Robert M Sweet, James Kyle Anderson
We describe a combined percutaneous and endoscopic approach to remove encrusted permanent suture in the renal pelvis that was placed during pyeloplasty repair. Our index patient had a laparoscopic dismembered pyeloplasty at an outside institution 10 years before presenting with flank pain and nondependent nephrolithiasis. This proved to be an encrusted permanent suture material. There is limited data on incidence of nephrolithiasis after ureteropelvic junction repair, but it is well documented that nonabsorbable suture lines should be avoided in the urinary tract as they may serve as a nidus for stone formation...
2016: J Endourol Case Rep
Hualin Cao, Huixia Zhou, Kan Liu, Lifei Ma, Dehong Liu, Tian Tao, Xiaolong Luo, Wei Cheng
BACKGROUND: Common causes of complications of laparoscopic pyeloplasty in children include anastomotic stricture, poor drainage due to high ureteropelvic anastomosis, and torsion of ureter. Herewith, we described our modified technique of paraumbilical three-port laparoscopic dismembered pyeloplasty (PTLDP) to minimize these complications. PATIENTS AND METHODS: Data from 62 patients (age: 1-180 months, median: 12 months) with ureteropelvic junction obstruction (UPJO) who underwent pyeloplasty using our modified technique of PTLDP between February 2014 and September 2014 at our institution were reviewed...
November 2016: Pediatric Surgery International
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