Are Nephrostomy and Ureteral Stent Necessary after Multi-Access Percutaneous Nephrolithotomy?

Introduction: Totally tubeless percutaneous nephrolithotomy (PCNL) is a well-established technique used in single -access procedure nevertheless these results challenge the multi-access PCNL as a contra-indication to application of this technique.

Aims: To compare complication rates and safety of use of this technique after multi-access PCNL.

Methods: A Total of 130 patients with renal stones were enrolled in this cohort study.

Trainee-Associated Factors and Proficiency at Percutaneous Nephrolithotomy.

Percutaneous nephrolithotomy (PNL) is a complicated procedure for urology trainees. This study was designed to investigate the effect of trainees' ages and previous experience, as well as the number of operated cases, on proficiency at PNL by using patient outcomes. A cross sectional observational study was designed during a five-year period.

Totally tubeless percutaneous nephrolithotomy is feasible in morbidly obese patients.

Objective: Regarding technical difficulties that obese body habitus might impose to percutaneous nephrolithotomy (PNL) success and higher risk of peri-operative complications in this group of patients, we decided to retrospectively gather data from our patients during past 8 years to determine the stone free and complication rates.

Material And Methods: Between January 2007-December 2015, seventy-eight obese patients with body mass index over 35 who had indication for PNL including stones larger than 2 cm in pelvi-calyceal system or smaller extracorporeal shock wave lithotripsy (ESWL) resistant stones or who were not a fit candidate for ESWL due to increased skin to target distance, with no contraindication of PNL (including bleeding diathesis, inability to be positioned in prone) were enrolled. They were randomly assigned to group 1 (standard PNL with nephrostomy and ureteral stent) or group 2 (totally tubeless PNL with no ureteral stent and no nephrostomy).

Primary Report of Totally Tubeless Percutaneous Nephrolithotomy Despite Pelvi-calyceal Perforations.

Purpose: Nephrostomy tube insertion and/or a ureteral stent placement is advised when pelvi-calyceal perforations are encountered during percutaneous nephrolithotomy (PNL) nevertheless totally tubeless PNL is a possible exit strategy in percutaneous renal surgery therefore case series on the short term clinical outcomes of noninvasive management of iatrogenic pelvicalyceal perforations encountered during PNL is presented.

Patients And Methods: During retrospective analysis of 1271 PNL procedures, 25 incidents of accidental ureteral catheter/ jj stent dislodgement during first 24 post-operative hours were identified in patient who had pelvi calyceal perforations and had no nephrostomy tube (tubeless). Thirteen patients could not be re-stented nor a nephrostomytube could have been placed for them mainly due to patient refusal or comorbid conditions.

Endovisually guided zero radiation ureteral access sheath placement during ureterorenoscopy.

Background: Almost all endourologic procedures use fluoroscopic imaging in some steps, which exposes both the patient and the surgical team to considerable amounts of radiation. Primary reports on results of a simple direct visual endoscopic access sheath placement technique which does not use fluoroscopy at all are presented.

Material And Methods: First a semi-rigid ureteroscopy was carried out up to the renal pelvis, then the access sheath (36 cm, 11/13 Fr) without the obturator was placed over a 7.

A pilot randomized study on use of oral acetazolamide in patients with refractory dysuria.

Purpose: Assessment of daily oral acetazolamide in treatment of refractory dysuria.

Methods: Forty-one patients were randomly allocated to either be treated with acetazolamide (250 mg twice daily) or to receive placebo. The irritative voiding symptoms and urinary pH were recorded before and after treatment.

Is Serum Uric Acid Level Correlated with Erectile Dysfunction in Coronary Artery Disease Patients?

Coronary artery disease (CAD) and vascular insufficiency are consequences of modern lifestyle, and vasogenic erectile dysfunction (ED) is one of the leading causes of sexual dysfunction which could be prevented like ischemic heart disease if the risk factors are discovered and managed. Seventy-five men scheduled for coronary angiography were asked to fill out the IIEF5 questionnaire and underwent serum lipoprotein-a, uric acid, lipid profile, testosterone, Sex Hormone Binding Globulin (SHBG), dehyderoepiandrostendion sulfate (DHEAS) tests; and the results were compared with those of erectile dysfunction patients with and without coronary artery disease. Ten out of 32 CAD patients (30%) and 6 of 43 normal coronary men had ED Prevalence (P=0.

Comparing Bleeding Complications of Double and Single Access Totally Tubeless PCNL: Is It Safe to Obtain More Accesses?

Purpose: To assess bleeding complications in totally tubeless double-access percutaneous nephrolithotomy (PCNL) and compare it with the single-access method.

Methods: One hundred and seven patients with large or scattered renal stones were enrolled in this cohort study. Totally tubeless PCNL with one access (group A, 70 cases) or two accesses (group B, 37 cases) was done and bleeding was assessed by measuring the hemoglobin drop of the patients, blood transfusion rate and need for performing angioembolization.

Concomitant anterior and posterior urethral valves in pediatrics: A single center experience over 12 years and long-term follow up after endoscopic treatment.

Objective: To report our 12-year experience with endoscopic management of patients with concomitant anterior and posterior urethral valves.

Methods: We retrospectively reviewed the charts of patients referred to us for management of urethral valves from 2000 to 2012 to find cases with concomitant anterior and posterior valves. The diagnosis of valves was first suspected on voiding cystourethrography and confirmed by urethrocystoscopy.

Does bone marrow-derived mesenchymal stem cell transfusion prevent antisperm antibody production after traumatic testis rupture?

Objective: To determine whether transfusion of mesenchymal stem cells (MSCs) could prevent humoral immune response and autoimmunization against sperms after traumatic testis rupture.

Methods: Immunomodulatory properties of MSCs have been evaluated by a prospective cohort on 50 adult BALB/c mice. In each interventional arms of study, controlled testis rupture and surgical repair were exerted.

Surgically treated bladder hemangiopericytoma/solitary fibrous tumor: report of a 12-year asymptomatic follow-up.

Hemangiopericytoma (HPC)/solitary fibrous tumor (SFT) is an uncommon vascular tumor suggested to be originating from pericytes. There are few reports on bladder HPC/SFT. We present a case of huge bladder HPC/SFT measuring 13.

Ureterocele associated with renal agenesia presented as a pelvic mass in an adult.

Adult ureteroceles are generally known as simple ureteroceles with minimal obstructive effects 1 that can usually be managed endoscopically. Such pathology presented with acute abdominal pain and fever in a 32-year-old man with left renal agenesia, a cranial blind left ureter and left obstructed ureterocele. The retained secretions were suppurative.

Role of frenular web preservation on ejaculation latency time.

Premature ejaculation (PE) is one of prevalent male sexual dysfunctions worldwide. Despite many psychiatric backgrounds, yet there are speculations about organic etiologies considering both anatomic and physiologic points of view. This survey assesses effect of frenular web preservation on premature ejaculation.

Is intravenous urography required when ultrasonography and KUB evidence a ureteroscopy plan?

Purpose: To determine whether pre-ureteroscopic stone extraction (USE) evaluation by intravenous urography (IVU) can change the clinical decision made on the basis of a plain X-ray of the kidneys, ureters, and bladder (KUB) plus an ultrasonography in the case of ureteral calculi.

Materials And Methods: From October 2005 to November 2007, 139 USE candidates were selected based on ultrasonography and KUB, and were randomly divided into two groups. Each group was assessed by an expert urologist to decide about the treatment plans.

Feasibility of totally tubeless percutaneous nephrolithotomy under the age of 14 years: a randomized clinical trial.

Objective: To assess the outcome and safety of the totally tubeless percutaneous nephrolithotomy (PCNL) in comparison with standard PCNL in the children under the age of 14 years.

Patients And Methods: Twenty-three patients under the age of 14 with renal stones were enrolled in a prospective randomized clinical trial during March 2010 to June 2011. The inclusion criteria were existence of renal stone larger than 2.

Is antibiotic prophylaxis necessary in patients undergoing ureterolithotripsy?

Transurethral Ureterolithotripsy (TUL) is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. This study was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL.

A 75-year old man complaining of flank pain and obstructive urinary symptoms: a case report.

Benign renal cystic adenoma with out malignant features is a very rare entity. A 75 year old male with obstructive Lower tract symptoms and vague flank pain was admitted and planned for nephrectomy of non functional kidney -due to long term nephrolithiasis- intra operative finding was a cystic hydronephrotic kidney filled by thick mucous secretions which turned out to be a cyst adenoma of kidney with no malignant features.

Prevalence of selected sexually and blood-borne infections in Injecting drug abuser inmates of bandar abbas and roodan correction facilities, Iran, 2002.

Human Immunodeficiency Virus (HIV) and other blood borne viral infections like hepatitis B virus (HBV) and hepatitis C virus (HCV) are major health issues especially in young and growing population of developing countries. All around the globe correctional facilities are known as potential source of spreading such disease. During summer 2002, HIV, HCV antibodies, hepatitis B surface (HBs) antigen and rapid plasma reagin (RPR) test were checked in venous blood samples of 252 injecting drug abuser prisoners from correctional facilities in southern Iran.