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Todd Yecies, Timothy D Averch, Michelle J Semins
INTRODUCTION: The risks of exposure to medical ionizing radiation is of increasing concern both among medical professionals and the general public. Patients with nephrolithiasis are exposed to high levels of ionizing radiation through both diagnostic and therapeutic modalities. Endourologists who perform a high-volume of fluoroscopy guided procedures are also exposed to significant quantities of ionizing radiation. The combination of judicious use of radiation-based imaging modalities, application of new imaging techniques such as ultra-low dose computed tomography (CT) scan, and modifying use of current technology such as increasing ultrasound and pulsed fluoroscopy utilization offers the possibility of significantly reducing radiation exposure...
February 2018: Canadian Journal of Urology
Braulio O Manzo, Edgar Lozada, Fabio C Vicentini, Francisco Javier Sanchez, Gildardo Manzo
PURPOSE: Although the worldwide percutaneous nephrolithotomy (PCNL) practice patterns determined via a survey sent to members of the Endourological Society have been published, differences in PCNL practice patterns among Latin American urologists based on endourological or lithiasis training have not been published. To determine the PCNL practice patterns among Latin American urologists with and without training in endourology. MATERIALS AND METHODS: The SurveyMonkey® web platform was used to develop a 27- item survey on PCNL for the treatment of renal stones, and the survey was sent via e-mail and other electronic media to 2000 urologists from 15 Latin American countries...
March 9, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Philippa R Pavia, Allyson C Berent, Chick W Weisse, Dana Neiman, Kenneth Lamb, Demetrius Bagley
OBJECTIVE To describe the technique and short- and long-term outcomes for dogs undergoing double-pigtail ureteral stent placement for treatment of benign ureteral obstruction. DESIGN Retrospective case series. ANIMALS 44 dogs (57 ureters). PROCEDURES Medical records of dogs that underwent ureteral stenting for treatment of benign ureteral obstruction between 2010 and 2013 were reviewed. Signal-ment, history, pertinent diagnostic imaging results, endourologic and post-procedural details, duration of hospitalization, complications, and outcome (short term, 7 to 30 days; long term, > 30 days) were recorded...
March 15, 2018: Journal of the American Veterinary Medical Association
Janusz Ławiński, Zbigniew Jabłonowski
The improvement of surgical care requires transparent, consistent and accurate reports concerning surgical outcomes which are assessed and documented in a standardized manner. No consensus has yet been reached as to how to define and assess postoperative complications with regard to the specificity of urological procedures. Therefore, the comparison of data from different centres is difficult. The modified Clavien-Dindo classification allows for a more uniform analysis of surgical complications. This study analyses the occurrence of perioperative complications after percutaneous nephrolithotomy assessed on the basis of the aforementioned classification...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Mehmet Sarier, Ibrahim Duman, Yucel Yuksel, Sabri Tekin, Meltem Demir, Fatih Arslan, Osman Ergun, Alim Kosar, Asuman Havva Yavuz
Allograft lithiasis is a rare urologic complication of renal transplantation (RT). Our aim is to present our experience with minimally invasive surgical treatment of allograft lithiasis in our series of live-donor renal transplant recipients. In a retrospective analysis of 3758 consecutive live-donor RTs performed in our center between November 2009 and January 2017, the results of minimally invasive surgery for the treatment of renal graft lithiasis diagnosed at follow-up were evaluated. Twenty-two (0.58%) patients underwent minimally invasive surgery for renal graft lithiasis...
February 26, 2018: Urolithiasis
Charalampos Mamoulakis, Petros Gorgoraptis, Elias Kehagias, Apostolos Karantanas
A 65-year-old male presented with an incidental magnetic resonance imaging (MRI) finding of a right renal pelvis (RP) tumor-like mass. He was subjected to nephrostomy tube (NT) placement due to hydronephrosis secondary to an impacted ureteral stone. NT was removed after successful Ho:YAG laser lithotripsy. Abdominal MRI performed 19 months later for another indication showed RP wall thickening/enhancement and an intrapelvic low-intensity linear structure presenting as a magnetic susceptibility artifact. He underwent diagnostic ureterorenoscopy/retrograde intrarenal surgery...
January 2018: Turkish Journal of Urology
Arvind P Ganpule, Abhishek G Singh, Mohammed Rafiqul Islam, Parag Sonawane, Ravindra B Sabnis, Mahesh R Desai
Ureteral stricture resulting from chronic inflammations such as tuberculosis, recurrent stone disease and multiple endourological interventions are complex in nature; these may lead to severe adhesions to surrounding structures. Endourological management of these cases is difficult with poorer outcomes. In such situations, reconstructive surgical corrections remain a reliable option. We describe the technique of onlay and inlay buccal mucosal graft ureteroplasty using a robotic platform in management of complex ureteral strictures...
February 27, 2018: Journal of Minimal Access Surgery
Zainal Adwin Zainal Abidin, Firdaus Hayati, Guan Hee Tan, Eng Hong Goh, Jasman Hafidzul, Md Zainuddin Zulkifli
A 46-year gentleman presented with a left-sided lumbar region pain without fever or dysuria. He denied episodes of acute urinary retention. There was a hard mass at the distal urethra with normal laboratory blood tests. Computed tomography urogram revealed a concurrent left renal staghorn calculus and large distal urethral stone. The urethral stone was fragmented via endourologic technique successfully. We report a case of a non-obstructing large urethral calculus in a gentleman with concurrent left renal staghorn calculus and discuss the literature review...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
P K Saha, M S Hossain, K C Ghosh, M S Alam, S Nabi, B K Saha, F H Pathan
Ureteral stent placement is a common procedure in urologic practice. Forgotten, encrusted D/J stents represent a difficult problem for urologists. The major complications are infection, impaired renal function, migration, encrustation, stone formation and multiple fragmentation of stent. A consensus on the best therapeutic approach is still lacking. Here we present our experience with endoscopic management of this challenging problem and discuss the multimodal endourologic approaches for treating forgotten, encrusted ureteral stents...
January 2018: Mymensingh Medical Journal: MMJ
Rikki Singal, Siddharth Dhar
Background: The introduction of endourological procedures such as percutaneous nephrolithotomy and ureterorenoscopy have led to a revolution in the the management of urinary stone disease. The indications for open stone surgery have been narrowed significantly, making it a second- or third-line treatment option. Aims and Objectives: To study the safety and efficacy of retroperitoneal laparoscopic pyelolithotomy in retroperitoneal renal stone. We compared the results of laparoscopic and open surgery in terms of easy accessibility, operative period, renal injuries, and early recovery...
2018: Clujul Medical (1957)
Vera Marques, Belmiro Parada, Francisco Rolo, Arnaldo Figueiredo
Double-J ureteral stent (DJUS) is an important therapeutic tool in endourology. There are well-known frequent complications associated with DJUS placement such as distal and proximal migration within the urinary tract. However, perforation and stent misplacement are uncommon but serious complications of this technique. We present a case of a 63-year-old man who had a misplacement of a DJUS into the inferior vena cava during an elective procedure of ureteral catheterisation. The stent placement was performed under fluoroscopic control and it seemed well positioned...
February 8, 2018: BMJ Case Reports
Steven M Monda, Jonathan R Weese, Barrett G Anderson, Joel M Vetter, Ramakrishna Venkatesh, Kefu Du, Gerald L Andriole, Robert S Figenshau
Objectives To provide a training tool to address the technical challenges of robot-assisted laparoscopic partial nephrectomy, we created silicone renal tumor models using 3D printed molds of a patient's kidney with a mass. In this study, we assessed the face, content, and construct validity of these models. Materials and Methods Surgeons of different training levels completed four simulations on silicone renal tumor models. Participants were surveyed on the usefulness and realism of the model as a training tool...
February 5, 2018: Urology
Angelo Territo, Bear Foerster, Shahrokh F Shariat, Morgan Rouprêt, Jose M Gaya, Joan Palou, Alberto Breda
INTRODUCTION: Conservative management of upper tract urothelial cancer (UTUC) is becoming increasingly popular: the key to success is correct selection of patients with low-risk UTUC based on size (≤ 2 cm), focality (single lesion), stage (< T2), and grade (low grade). Despite the recent growing interest in the conservative approach to UTUC, the diagnostic process is still a challenge, and kidney-sparing surgery (KSS) is traditionally reserved for patients with contraindications to radical nephroureterectomy...
February 1, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Niall F Davis, Shannon McGrath, Mark Quinlan, Gregory Jack, Nathan Lawrentschuk, Damien M Bolton
PURPOSE: There are no comparative assessments on the environmental impact of endourologic instruments. We evaluated and compared the environmental impact of single-use flexible ureteroscopes with reusable flexible ureteroscopes. PATIENTS AND METHODS: An analysis of the typical life cycle of the LithoVue™ (Boston Scientific) single-use digital flexible ureteroscope and Olympus Flexible Video Ureteroscope (URV-F) was performed. To measure the carbon footprint, data were obtained on manufacturing of single-use and reusable flexible ureteroscopes and from typical uses obtained with a reusable scope, including repairs, replacement instruments, and ultimate disposal of both ureteroscopes...
February 21, 2018: Journal of Endourology
Selcuk Sarikaya, Aurus Dourado Meneses, Giovanni Enrico Cacciamani, Juan Gómez Rivas
Urology has become more complex through the years, as it comprises increasingly sophisticated medical and surgical technologies such as advanced medical tumour therapies, and endourological, laparoscopicand robotic surgical techniques. Training in urology starts during medical school and once a medical student chooses to specialize on it, becomes life-long. Becoming a good urologist requires a highly qualified education and sufficient experience. To devise a training programme of high proficiency, several important factors must be considered...
January 2018: Archivos Españoles de Urología
Federico Soria, Felipe Villacampa, Alvaro Serrano, Jesús Moreno, Jorge Rioja, Francisco Miguel Sánchez
Current training in urological endoscopy lacks a specific training program. However, there is a clear need for a specific and uniform program, which will ensure the training, regardless of the unit where it is carried out. So, the goal is to first evaluate the current model and then bring improvements for update. The hospital training accreditation programme are only the adjustment of the official program of the urology specialty to the specific circumstances of each center, which causes variability in training of residents...
January 2018: Archivos Españoles de Urología
Oluwarotimi S Nettey, Joceline S Fuchs, Stephanie J Kielb, Edward M Schaeffer
OBJECTIVE: To examine associations between urologic subspecialization, surgeon gender and practice patterns among certifying urologists over the last 13 years. MATERIALS AND METHODS: Demographic data of certifying and recertifying urologists (2004 to 2015) was obtained from the American Board of Urology (ABU). We investigated gender-specific trends in self-reported practice type (academic practice, private practice), subspecialization, and employment as a full-time versus part-time physician, relative to certification year and cycle...
January 10, 2018: Urology
Abbas Basiri, Amir Hossein Kashi, Mahdi Zeinali, Mahmoud Reza Nasiri, Reza Valipour, Reza Sarhangnejad
PURPOSE: To evaluate the intraoperative pain score of patients who undergo percutaneous nephrolithotomy under spinal anesthesia and to evaluate surgeons' and patients' convenience with this type of anesthesia. MATERIALS AND METHODS: PCNL cases who were performed by two endourology fellows under spinal anesthesia during June to July 2014 were included. Spinal anesthesia was performed using injection of 0.25mg/kg bupivacaine 0.5% in the intrathecal space. All procedures were performed with the patient in the prone position...
January 8, 2018: Urology Journal
Sridhar Panaiyadiyan, Abhishek Shukla, Brusabhanu Nayak, Prabhjot Singh, Ashish Kumar Saini
Background: Double-J (DJ) stent is an integral part of urologic practice. DJ stents can have numerous complications such as persistent irritative symptoms, encrustations, and up and down migrations within the pelvicaliceal system (PCS), but displacement outside the urinary tract is rare. We are presenting a unique case of DJ stent lying outside the PCS for more than a decade. Case Presentation: A 46-year-old female presented with left flank pain and dysuria. She had undergone percutaneous nephrolithotomy in the left side 11 years ago...
2017: Journal of Endourology Case Reports
Panagiotis Pardalidis, Nick Andriopoulos, Eleni Kosmaoglou, Nick Pardalidis
Introduction: The incidence of urinary leakage is increased as nephron sparing surgery becomes more used for the management of small renal masses. We present an endourologic approach in a patient with a persistent urinary leak after partial nephrectomy by placing two synchronous ureteral stents to improve drainage and avoid further potential surgery. Patients and Method: A 39-year-old patient presented with a urine leak on the fifth postoperative day after an open partial nephrectomy. Initially, the leakage was managed with a placement of a 6F Double-J stent...
2017: Journal of Endourology Case Reports
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