Herniorrhaphy mesh as nidus for bladder calculi.

Mesh erosion into the urinary bladder resulting in a bladder calculus is an uncommon, but significant, complication of herniorrhaphy. We present the operative and radiographic images of a 76-year-old woman who presented with inguinal drainage, urgency, frequency, recurrent urinary tract infections, and a large bladder calculus 3 years after femoral herniorrhaphy. Open cystolithotomy revealed the herniorrhaphy mesh had eroded into the bladder, causing the draining inguinal fistula tract and bladder calculi.

Gender differences in subcutaneous and perirenal fat distribution.

Purpose: Body mass index (BMI) has been shown to influence the outcome of various surgical procedures. The purpose of this study is to assess the relationship between BMI, gender, and the distribution of subcutaneous and perirenal fat.

Methods: A retrospective review was performed for 123 patients who underwent radical or partial nephrectomy.

Increased expression of histone deacetylaces (HDACs) and inhibition of prostate cancer growth and invasion by HDAC inhibitor SAHA.

Histone deacetetylases (HDACs) are a group of corepressors of transcriptional activators and their levels of expression are potentially dysregulated in prostate cancer. Certain inhibitors of histone deacetylases show anti-tumor activity in prostate cancer cell lines. Here, we systemically studied the expression of HDACs in human prostate cancer and the suppression of prostate cancer growth and invasion by HDAC inhibitor SAHA.

An ex-vivo evaluation of the application and strength of a novel laparoscopic knot substitute device.

Background And Purpose: Intracorporeal suturing can be challenging, especially in the case of laparoscopic partial nephrectomy. During these procedures, suturing must reapproximate renal tissue to achieve hemostasis but not tear through tissue. We present a new device, the ANPA Suturelock, which can be adjusted to increase or decrease suture tension, optimizing tissue apposition.

Patients with primary hyperparathyroidism--why do some form stones?

Purpose: Primary hyperparathyroidism is a common cause of hypercalcemia with resulting hypercalciuria and a subset of these patients with primary hyperparathyroidism present with urolithiasis. We evaluated the metabolic stone profile in patients presenting for parathyroid surgery and determined whether there were differences between those with and without a history of urinary stones.

Materials And Methods: A total of 60 patients with primary hyperparathyroidism presenting for parathyroid surgery were prospectively enrolled in the study, of whom 54 completed a preoperative 24-hour urine collection.

Robotic dismembered pyeloplasty: a 6-year, multi-institutional experience.

Purpose: The introduction of the da Vinci Surgical System to perform complex reconstructive procedures, such as repair of ureteropelvic junction obstruction, has helped to overcome some of the technical challenges associated with laparoscopy. We review our large multi-institutional experience with long-term followup of robotic dismembered pyeloplasty.

Materials And Methods: A total of 140 patients from 3 university medical centers underwent robotic dismembered pyeloplasty.

Percutaneous management of stones in transplanted kidneys.

Objectives: Stone disease is a rare complication after renal transplantation, and the management of these stones can be difficult. In many cases, the best modality to treat stones in transplanted kidneys/ureters is with a percutaneous approach. The goal of this study was to review our series of percutaneous nephrolithotomy (PNL) to evaluate the success rates and present the key technical points to achieve a successful outcome.

Transperitoneal laparoscopic radical nephrectomy for large (more than 7 cm) renal masses.

Objectives: To evaluate our laparoscopic radical nephrectomy (LRN) series to determine whether any significant increases have occurred in operative morbidity when resecting large (7 cm or greater) renal masses. LRN is becoming the reference standard for treating suspicious renal masses not amenable to nephron-sparing surgery.

Methods: We retrospectively reviewed the charts of 164 consecutive patients who had undergone laparoscopic radical nephrectomy performed for suspicious renal masses by two surgeons from February 2000 and December 2006.

Robotic reconstruction of the upper urinary tract.

Purpose: Reconstructive surgery of the upper urinary tract can be complicated. During the last 2 decades minimally invasive techniques have emerged as viable options for these complex procedures. We reviewed our experience with robotic surgery for upper urinary tract reconstruction.

A matched-cohort comparison of laparoscopic cryoablation and laparoscopic partial nephrectomy for treating renal masses.

Objective: To compare the surgical outcomes of elderly patients with renal masses treated with laparoscopic partial nephrectomy (LPN) or laparoscopic cryoablation (LCA).

Patients And Methods: All 15 patients who had LCA at the authors' institution between May 2003 and July 2005 were included, and compared with a matched cohort of 15 patients selected by patient age and tumour size, from a pre-existing database of 104 patients who had LPN from July 2002 to July 2005. The two groups were compared for gender, number of comorbidities, American Society of Anesthesiologists status (ASA), body mass index (BMI), baseline renal function and haematocrit, location and size of lesion, length of stay, operative time, estimated blood loss (EBL), transfusion rate, number and type of complications, conversion rate, and postoperative renal function and haematocrit.

Novel mutations of epidermal growth factor receptor in localized prostate cancer.

We recently demonstrated that EGFR protein overexpression is more common in African American (AA) prostate cancer patients compared to Caucasian patients. We further examine EGFR dysregulation by determining EGFR mutation status in the tyrosine kinase (TK) domain in prostate cancer patients of different ethnicity. Normal and tumor DNA from 89 radical prostatectomy cases were studied for mutations in the EGFR TK domain using genomic DNA sequencing.

Differences in clinicopathologic features of prostate cancer between black and white patients treated in the 1990s and 2000s.

Objectives: We have previously reported on the disparity in the clinicopathologic features of prostate cancer between black and white patients at our equal-access institution during the 1990s. The goal of this study was to determine whether the worse clinicopathologic features of prostate cancer in black patients have persisted in the 2000s.

Methods: We examined 362 men (224 black and 138 white) treated with radical prostatectomy at the Veterans Affairs Medical Center in New York.