Radiating for Two: Quantifying Radiation Exposure to Pregnant Urologists During Percutaneous Nephrolithotomy.

Purpose: Current occupational recommendations limit fetal radiation dose to 1 mSv. With increased gender diversity in urology, understanding radiation exposure during pregnancy is crucial. The purpose of this study was to determine surgeon uterine radiation dose during percutaneous nephrolithotomy (PCNL) and compare effectiveness of several radiation reduction strategies in a cadaver model.

Does Blacklight Illumination Improve Speed and Accuracy of Foot Pedal Activation in the Low-Light Operating Room?

Urologists frequently activate foot pedals in a low-light operating room (OR). Pedal activation in low-light conditions poses the potential for incorrect pedal activation, potentially leading to increased radiation exposure, patient burns, or OR fires. This study compares speed, accuracy, dark adaptation, and surgeon preference for pedal activation in 4 lighting conditions.

Prone vs supine percutaneous nephrolithotomy: does position affect renal pelvic pressures?

The purpose of this study was to measure and compare renal pelvic pressure (RPP) between prone and supine percutaneous nephrolithotomy (PCNL) in a benchtop model. Six identical silicone kidney models were placed into anatomically correct prone or supine torsos constructed from patient CT scans in the corresponding positions. A 30-Fr renal access sheath was placed in either the upper, middle, or lower pole calyx for both prone and supine positions.

Do Flat Panel Detector C-Arms Decrease Radiation Exposure Compared to Conventional Image Intensifiers?

Objective: To compare the radiation dose and image quality between flat panel detector (FPD) and traditional image intensifier (II) C-arms at their lowest radiation settings.

Methods: In a ureteroscopy simulation using a cadaver model, the radiation exposure was compared between FPD and II at 4 pulses-per-second (pps) using both low dose and automatic exposure control (AEC) settings. Additionally, the lowest dose settings for each machine were compared (4 pps with low dose in the FPD and 1 pps with low dose in the II).

Reducing hand radiation during renal access for percutaneous nephrolithotomy: a comparison of radiation reduction techniques.

Percutaneous nephrolithotomy confers the highest radiation to the urologist's hands compared to other urologic procedures. This study compares radiation exposure to the surgeon's hand and patient's body when utilizing three different techniques for needle insertion during renal access. Simulated percutaneous renal access was performed using a cadaveric patient and separate cadaveric forearm representing the surgeon's hand.

Not All Flat-Panel C-Arms Are Created Equal: A Comparison of Three Major Manufacturers.

Flat-panel detector C-arms (FCs) are reported to reduce radiation exposure and improve image quality compared with conventional image intensifier C-arms (CCs). The purpose of this study was to compare radiation exposure and image quality between three commonly used FCs. A cadaver model was placed in the prone position to simulate percutaneous nephrolithotomy.

Liposomal versus plain bupivacaine for pain control following vaginal reconstruction.

Introduction: Liposomal bupivacaine (LB) is a depot formulation of bupivacaine, which releases the drug over 72 hours to prolong local pain control. This retrospective study compares the effect of using LB versus plain bupivacaine on postoperative pain control, length of hospital stay and cost among patients undergoing vaginal reconstructive surgery.

Materials And Methods: Patients who underwent vaginal reconstructive surgery with levatorplasty and received an injection of 20 cc of either plain bupivacaine or LB for pudendal nerve block were included.

Time Efficiency and Performance of Single-Use Reusable Cystoscopes: A Randomized Benchtop and Simulated Clinical Assessment.

A flexible cystoscope is an indispensable tool for urologists, facilitating a variety of procedures in both the operating room and at bedside. Single-use cystoscopes offer benefits including accessibility and decreased burden for reprocessing. The aims of this study were to compare time efficiency and performance of single-use and reusable cystoscopes.

Which Laser System Is Optimal for Cystolithotripsy of Large Bladder Calculi?

A variety of laser sources are available to treat bladder stones. The aim of this study was to compare time and cost efficiency of the thulium fiber laser (TFL) to four holmium lasers (HLs) with different powers or technologies, including MOSES™ during simulated cystolithotripsy. In a benchtop simulation of laser cystolithotripsy, 25 identical 4-cm BegoStones (calcium oxalate monohydrate consistency) were placed on a grid within a 3D-printed bladder model.

Multimodal Pain Control Utilizing Buprenorphine for Robotic-assisted Laparoscopic Prostatectomy: A Quality Improvement Comparison to Conventional Opioid Management.

Introduction: This study investigated the effectiveness of buprenorphine as an alternative to the use of conventional opioids perioperatively in an effort to help mitigate the impact of the use of perioperative conventional opioids for patients undergoing robotic-assisted laparoscopic prostatectomy.

Methods: Outcomes of patients with localized prostate cancer undergoing robotic-assisted laparoscopic prostatectomy were examined before and after implementation of novel quality improvement study that included receiving buprenorphine compared to conventional opioids for pain control intraoperatively and postoperatively. The primary end point was adequate pain control with secondary end points being analgesic consumption at home, opioid-related side effects, and patient satisfaction.

Does renal failure worsen radiation cystitis following radical prostatectomy?

Objective: To investigate the impact of renal function on the risk, severity, and management of radiation cystitis in patients who underwent postoperative radiation therapy for prostate cancer.

Methods: Retrospective data was assessed from patients treated with adjuvant/salvage radiation therapy at a single academic institution between 2006 and 2020. The incidence, severity, and management of radiation cystitis were compared between three groups: CKD 0-2, CKD 3-4, and CKD 5.

Thulium versus holmium for in situ lower pole laser lithotripsy.

Introduction: During in situ lower pole laser lithotripsy, the dependent location may result in increased challenge fragmenting stones and a risk for stone regrowth if residual fragments remain. The purpose of this study was to compare the thulium fiber laser (TFL) with the holmium laser (HL) for in situ lower pole lithotripsy.

Materials And Methods: In a 3D printed kidney benchtop model, sixty 1 cm BegoStones were placed in the lower pole and fragmented in situ until fragments passed through a 2 x 2 mm mesh.

Does the Novel Thulium Fiber Laser Have a Higher Risk of Urothelial Thermal Injury than the Conventional Holmium Laser in an Study?

The novel thulium fiber laser (TFL) has been shown to break stones more rapidly than the holmium:YAG laser (HL). However, some evidence suggests that the TFL generates more heat. The purpose of this study is to compare ureteral temperatures generated by these lasers during ureteroscopic laser lithotripsy in a benchtop model.

Evaluation of progression from first to second stage sacral neuromodulation and unplanned device removal.

Objective: Sacral neuromodulation (SNM) is an advanced treatment option for patients with refractory overactive bladder (OAB) symptoms, urinary retention, and bowel disorders; it is usually performed in 2 separate procedures. This study aims to determine a cohort's progression rate from stage 1 to 2 and predict factors for progression and unplanned device removal or revision.

Material And Methods: A retrospective review was conducted in patients who underwent SNM at a single institution between June 2012 and May 2019.

Ureteropelvic Junction Obstruction in a Polycystic Kidney with Duplicated System: Successful Outcome with Endoscopic Management.

Autosomal dominant polycystic kidney disease is the most prevalent hereditary renal disease, associated with progressive renal insufficiency, usually leading to dialysis. It is rarely diagnosed with other renal abnormalities. We present a case of a 35-year-old woman with a duplicated left polycystic kidney, who had recurrent pain and pyelonephritis because of ureteropelvic junction (UPJ) obstruction of the upper moiety.

What Guidewire Is the Best for Bypassing an Impacted Ureteral Stone?

To determine the optimal guidewire for bypassing an impacted ureteral stone. Three different benchtop models of varying impaction (300, 362, and 444 mm Hg pressure) were used to compare the ability of 13 different guidewires to bypass an impacted ureteral stone. In the first and second models, we recorded the maximum force required to bypass the stone.

The Effect of Operative Field Instrument Clutter During Intraoperative Fluoroscopy on Radiation Exposure.

Fluoroscopy units are routinely operated in the automatic brightness control (ABC) mode to optimize image quality. During ureteroscopy, objects may be placed within the fluoroscopy beam and the effect upon radiation exposure is unknown. The purpose of this study is to investigate the effects of equipment within the fluoroscopy beam during simulated ureteroscopy.

A rare complication of inguinal hernia repair: Total testicular ischemia and necrosis.

Testicular ischemia and necrosis are quite rare complications following inguinal hernia repair. There is still no consensus on the mechanism of infarction and necrosis in the literature. We present a case with total testicular ischemia and necrosis in the early period following the inguinal hernia repair with prolene mesh, ending up with orchiectomy.

Transrectal ultrasound-guided prostate rebiopsy: How many core sampling should be applied to which patient?

Background: We investigated the correlation between the sampled number of cores in rebiopsy and the cancer detection rate (CDR).

Materials And Methods: Two hundred and twelve patients with normal rectal examination who had undergone rebiopsy in the past 5 years were examined retrospectively. Moreover, 68% of them had undergone 12 cores (Group 1) while 32% had undergone 20 cores (Group 2).

Laparoscopic Dismembered Pyeloplasty in a Solitary Kidney with Intrarenal Pelvis: Two Challenges in One Case.

Laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) is one of the most appropriate surgical techniques to achieve the optimal goal of minimally invasive surgery. However, urologists hesitate to use the laparoscopic approach in UPJO with solitary kidney or intrarenal pelvis. There are a few published studies on laparoscopic pyeloplasty cases in intrarenal pelvis.

Management of urinary tract infection with intravesical amikacin may increase the risk of bladder oxidative stress in children with neurogenic bladder.

Introduction: We evaluated the bladder oxidative stress in neurogenic bladder children treated with intravesical amikacin for recurrent UTI and whether urinary isoprostane f2 alpha (F2-IsoP) is a good biomarker in this particular condition.

Methods: This prospectively designed controlled study was approved by the Adnan Menderes University institutional ethics committee (Adnan Menderes University, 2015/649). Between January 2016 and January 2017, twenty-six children with meningomyelocele who had been doing CIC were recruited.

Ureteroscopy With Holmium:Yag Laser Lithotripsy for Ureteral Stones in Preschool Children: Analysis of the Factors Affecting the Complications and Success.

Objective: To evaluate the factors that may affect the efficacy and safety of ureteroscopy with holmium:YAG laser lithotripsy in the management of ureteral stones in preschool children.

Materials And Methods: Medical records of 70 children, 32 boys and 38 girls, who were treated for ureteral stones at our clinic between 2014 and 2016 were retrospectively reviewed. Patients were grouped according to size of the instrument used as group 1 (n = 40, ultrathin 4.