Limitations of overlapping cores in systematic and MRI-US fusion biopsy.

Objectives: To evaluate the clinically-significant prostate cancer (csCaP) detection rate of systematic (SBx) vs. targeted biopsy (TBx), after accounting for the overlapping systematic cores within the MRI regions of interest.

Materials And Methods: We identified 398 consecutive men who underwent both transperineal systematic and targeted biopsy between January 2015 to January 2019.

Peak stent discomfort occurs early and ureteral stent with distal loop design has less pain-A pilot prospective randomised single-blinded trial over 2 weeks.

Objectives: The Polaris™ loop ureteric stent reduces the severity of stent discomfort by minimising stent material in the bladder. Early impact of ureteral stenting on quality of life (QoL) within 1 week remains unclear. The usefulness of the patient-administered ureteral stent symptoms questionnaire (USSQ) during this period of stent insertion was assessed.

Are small renal masses all the same?

Objectives: To evaluate variables that can predict synchronous metastasis in patients presenting with small renal masses.

Methods: We reviewed our institution's prospectively maintained database of 565 patients diagnosed with small renal masses (≤4 cm) over a 16-year period. Variables associated with synchronous metastasis and subsequent relapse were analyzed using χ and logistic regression models.

Stereotactic robot-assisted transperineal prostate biopsy under local anaesthesia and sedation: moving robotic biopsy from operating theatre to clinic.

This IRB-approved prospective pilot study evaluates the safety and feasibility of performing stereotactic robot-assisted transperineal MRI-US fusion targeted prostate biopsy under local anaesthesia (LA) with sedation. 30 patients who underwent robotic transperineal prostate biopsy between September 2017 and June 2018 were recruited. All biopsies were performed with the iSR'obot Mona Lisa and BK3000 ultrasound system.

Indocyanine green - guided laparoscopic renal pedicle lymphatic disconnection: A novel, targeted treatment for chyluria.

Chyluria, or the passage of chyle into the urine from anomalous lymphatic connections, results in a characteristic milky urine. In severe cases, it can cause signifi cant morbidity from nutritional losses and immune suppression. Although predominantly associated with Wuchereria bancrofti infections, non-parasitic cases have also been described.

Evolving trends in the surgical management of renal masses over the past two decades: A contemporary picture from a large prospectively-maintained database.

Objectives: To investigate the trends in the presentation and surgical management of renal tumors at Singapore General Hospital, Singapore.

Methods: We accessed our uro-oncological registry to extract the clinicopathological data of patients with renal tumors who underwent nephrectomy from 2000 to 2015. Binary logistic regression was used to identify predictors of nephron-sparing surgery utilization, Clavien-Dindo grade ≥III complications and progression to stage ≥3 chronic kidney disease.

Two Weeks Too Long: Optimal Duration for Ureteral Prestenting and Its Physiologic Effects on the Ureter in a Yorkshire-Landrace Pig Model.

Introduction: Prestenting of the ureter is commonly performed to allow for passive dilation and better access to the urinary system during subsequent procedures. There is no level 1 evidence on the duration of prestenting and EAU guidelines suggest a 1-2 weeks duration.

Materials And Methods: Our primary aim is to investigate the optimal duration required for prestenting in a porcine model.

The effect of adjunct caudal block on postoperative analgesia in robot-assisted laparoscopic radical prostatectomy: A prospective randomized controlled, single blinded pilot study in a tertiary centre.

Objective: Caudal block provides satisfactory postoperative pain relief in lower abdominal operations. This pilot study explores its safety and effect on postoperative pain control in patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP).

Methods: From 2013 to 2014, 40 consecutive patients were randomized into two groups - one received caudal block using ropivacaine immediately after operation, the other received standard analgesia.

Role of computed tomography-calculated intraparenchymal tumor volume in assessment of patients undergoing partial nephrectomy.

Objectives: To determine the complexity of renal masses by using an objective novel imaging parameter (intraparenchymal tumor volume) based on computed tomography scans, to correlate this parameter to perioperative outcomes and to the RENAL nephrometry score.

Methods: After institutional review board approval, 87 patients who underwent partial nephrectomy between 2012 and 2016 at Singapore General Hospital, Singapore, were retrospectively analyzed. Preoperative computed tomography intravenous pyelogram scans were reviewed by a single senior radiologist who calculated the intraparenchymal tumor volume.

Robot-assisted radical cystectomy and intracorporeal urinary diversion - safe and reproducible?

Introduction: Robot-assisted radical cystectomy (RARC) plus intracorporeal urinary diversion is feasible. Few centers worldwide demonstrated comparable functional and oncologic outcomes. We reported a large series of RARC and intracorporeal diversion to assess its feasibility and reproducibility.

Intracorporeal ileal ureter replacement using laparoscopy and robotics.

Introduction: Ileal ureter is a suitable treatment option for patients with long ureteric strictures. Minimally invasive techniques have been shown to be as safe as open techniques but superior in terms of post-operative recovery. We report our experience using minimally invasive techniques for total intracorporeal ureteral replacement.

Heart failure as the first manifestation of renal cell carcinoma.

We report the rare case of a patient with advanced renal cell carcinoma (RCC) who initially presented to the hospital with symptoms of cardiac failure. Preoperative cardiac studies did not reveal any underlying ischemia. After resection of a large 14-cm left renal tumor, cardiac function was noted to improve dramatically.

Robot-assisted radical cystectomy and intracorporeal neobladder formation: on the way to a standardized procedure.

Background: Robot-assisted radical cystectomy (RARC) with intracorporeal diversion has been shown to be feasible in a few centers of excellence worldwide, with promising functional and oncologic outcomes. However, it remains unknown whether the complexity of the procedure allows its duplication in other non-pioneer centers. We attempt to address this issue by presenting our cumulative experience with RARC and intracorporeal neobladder formation.

Surgical removal of retroperitoneal tumors after chemotherapy treated testicular tumors.

In the era of chemotherapy, patients with advanced testicular tumor often presents with residual mass after completion of chemotherapy. Post chemotherapy RPLND is an important part of the multimodality treatment in these patients. According to current guidelines and recommendations, post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) is recommended in NSGCT patients with all residual lesions and normalized tumor markers.

Y pouch neobladder-a simplified method of intracorporeal neobladder after robotic cystectomy.

In recent years, robot-assisted radical cystectomy (RARC) has shown similar oncologic outcomes compared with the gold standard open radical cystectomy with the added benefit of less blood loss and shorter hospital stay. Robot-assisted cystectomy with intracorporeal ileal neobladder is a complex surgical procedure and is usually performed in centers with experienced surgeons. We propose robot-assisted cystectomy with intracorporeal neobladder using the Y pouch previously described in open radical cystectomy.

Totally intracorporeal replacement of the ureter using whole-mount ileum.

Ileal ureter is a suitable treatment option for patients with long ureteral strictures. Minimally invasive techniques have been shown to be as safe as open technique and superior in terms of postoperative recovery. We report the first case of laparoscopic totally intracorporeal replacement of ureter using whole-mount ileum in a patient with right-sided long ureteral stricture.

Occurrence of a lymphocele following renal transplantation.

Introduction: The incidence of lymphoceles - lymphatic collections around a transplanted kidney - can be as high as 20%. We aimed to review the presentation, treatment and outcome of patients with lymphoceles.

Methods: We reviewed a prospective database of 154 patients who underwent renal transplantation at our hospital from January 2005 to November 2008.