Use of Mannitol for Ischemia Reperfusion Injury in Kidney Transplant and Partial Nephrectomies-Review of Literature.

Purpose Of Review: Few procedures involve the ischemia-reperfusion injury to organs purposely. Two clear examples in urologic surgery consist on kidney transplantation and partial nephrectomies.

Recent Findings: Mannitol is an osmotic diuretic that is commonly used in partial nephrectomies and kidney transplantation to increase renal blood flow and decrease warm-ischemia-related renal injury to preserve estimated glomerular filtration rate (eGFR).

Feasibility of renal transplantation after unroofing of a large renal cyst in an expanded criteria donor.

We present a case in which a deceased donor kidney with a large simple cyst was successfully unroofed and transplanted to a 61-year-old male. The donor was a 62-year-old male with a history of hypertension for 2 years; cerebral vascular accident was the cause of death. A large 8-cm cyst distorting the renal hilum was identified upon the procurement of the deceased donor kidney.

Current concepts in the management of adrenal incidentalomas.

Adrenal tumors are among the commonest incidental findings discovered. The increased incidence of diagnosing adrenal incidentalomas is due to the widespread availability and use of noninvasive imaging studies. Extensive research has been conducted to define a cost-effective diagnostic and therapeutic protocol to guide physicians in managing incidental adrenal lesions.

Development of a surgical safety checklist for the performance of radical nephrectomy and tumor thrombectomy.

Background: The surgical management of renal cell carcinoma with invasion of the renal vein or inferior vena cava is associated with significant rates of perioperative morbidity and mortality. In this report we propose a surgical checklist aimed at reducing adverse events associated with the resection of these tumors.

Methods: This review describes the development of an evidence- and experience-based surgical checklist aimed at improving the perioperative safety of patients undergoing radical nephrectomy and tumor thrombectomy.

Diagnosis and treatment of bladder cancer: how can we improve?

The majority of patients with bladder cancer will be diagnosed following an episode of hematuria. With few exceptions, these patients should be referred for a complete urologic evaluation, including a history and physical examination, flexible cystoscopy, imaging of the upper urinary tract, and optional urine cytology. Those found to have a bladder tumor should undergo transurethral resection for the combined purposes of initial staging and treatment.

Impact of body mass index and tumor location on the incidence of benign histology at the time of nephron-sparing surgery.

Purpose: Gender, smoking history, patient age, and tumor size have been found to impact the likelihood of benign histology at the time of nephron-sparing surgery (NSS). Providing external validation of these variables and evaluating the relationship between body mass index (BMI) and tumor location on the likelihood of benign histology during NSS for T1 tumors were the objectives of this study.

Methods: Data were analyzed for consecutive patients undergoing NSS for T1 disease.

Rhabdomyolysis with acute kidney injury in deceased donors is not a contraindication for kidney donation.

Purpose: Deceased patients with acute kidney injury (AKI) from rhabdomyolysis can be considered as potential kidney donors.

Methods: We performed a retrospective chart review from January 2005 to January 2011 of three donors with AKI from rhabdomyolysis and the four recipients of the donated kidneys. Three donors had AKI from rhabdomyolysis as evidenced by elevated serum creatinine levels, myoglobinuria, and plasma creatinine kinase levels greater than five times the upper limit of normal.

Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption.

Unlabelled: What's known on the subject? and What does the study add? The surgical implications of renal cell carcinoma with coexisting bland and tumour thrombi of the inferior vena cava is not well described. In this study we review our experience managing these tumours. On multivariate analysis, we found that the presence of bland thrombus was associated with an increased need for surgical interruption of the inferior vena cava.

Evaluation of current synthetic mesh materials in pelvic organ prolapse repair.

With increasing use of synthetic material in pelvic organ prolapse repair, the reporting and incidence of associated complications also have increased. The role of synthetic mesh in pelvic organ prolapse repair remains controversial and it is a therapeutic dilemma whether to continue its use in patients with poor native tissues, despite the recent public safety notification provided by the U.S.

Repeat intradetrusor injections of onabotulinum toxin a for refractory idiopathic overactive bladder patients: a single-center experience.

Objectives: : The objective of the study was to evaluate the safety and efficacy of repeat intradetrusor onabotulinum toxin A injection in patients with idiopathic overactive bladder refractory to anticholinergic medications. Furthermore, 2 doses, 100 and 150 U, were compared.

Methods: : We prospectively enrolled 60 patients in our investigator-initiated, single-center randomized trial.

Small cell carcinoma arising from the bulbar urethra: a case report and literature review.

Primary neuroendocrine carcinomas of the genitourinary tract are rare and aggressive tumors carrying a bad prognosis. With squamous cell and transitional cell carcinoma being the most commonly reported urethral malignancies, primary small cell carcinoma (SCC) of the urethra is extremely rare. To date, only 5 cases have been reported in the literature.

Molecular characterization of kidney cancer: association of hyaluronic acid family with histological subtypes and metastasis.

Background: Molecular profiling of renal cell carcinomas (RCCs) may improve the distinction between oncocytoma and malignant RCC subtypes and aid in early detection of metastasis. The hyaluronic acid (HA) family includes HA synthases (HAS1, HAS2, HAS3), hyaluronidases (HYAL-1, HYAL-2, HYAL-3, HYAL-4, PH20, HYAL-P1), and HA receptors (CD44s, CD44v, RHAMM). HA family members promote tumor growth and metastasis.

Monitoring of the upper urinary tract in patients with bladder cancer.

Upper urinary tract (UUT) transitional cell carcinoma (TCC) is relatively rare tumor. Approximately 0.7-4% of patients with primary bladder cancer develops UUT-TCC.

Single-center clinical comparison of two reinforced ureteral access sheaths for retrograde ureteroscopic treatment of urinary lithiasis.

Background: Ureteral access sheaths (UAS) are used to facilitate ureteroscopic procedures. Difficulties in use, including sheath distortion, buckling, and difficulty in placement, have been reported. However, few clinical comparisons have been performed.

Role of botulinum toxin-A in refractory idiopathic overactive bladder patients without detrusor overactivity.

Background: To evaluate the efficacy of intradetrusor botulinum toxin-A (BTX-A) in idiopathic overactive bladder patients (OAB) refractory to anti-muscarinic therapy, without detrusor overactivity (DOA) on urodynamics.

Methods: Patients with refractory idiopathic OAB without DOA on urodynamics were prospectively enrolled. Subjects completed a 3-day voiding diary (3-VD), urogenital distress inventory-6 questionnaire (UDI-6) and graded their quality of life on a 10-cm visual analog scale (VAS) prior to study enrollment and at week 12 postinjection.

Contemporary revision penile prosthesis surgery is not associated with a high risk of implant colonization or infection: a single-surgeon series.

Introduction: Revision penile prosthesis surgery has traditionally been associated with a greater risk of postoperative infection than primary implant placement. This has been attributed to the high prevalence of asymptomatic bacteria found surrounding the implant at the time of revision surgery.

Aim: To validate whether contemporary revision surgery remains associated with a high risk of asymptomatic colonization and postoperative infection.

Prospective randomized comparison of the safety, efficacy, and cosmetic outcome associated with mini-transverse and mini-longitudinal radical prostatectomy incisions.

Aims: Open radical retropubic prostatectomy (ORP) has traditionally been performed through a lower midline incision. Prior efforts to reduce pain and expedite recovery include a variety of alterations in length and the orientation of the incision. The aim of our study is to compare the safety, efficacy, and cosmetic outcomes associated with transverse and longitudinal mini-radical prostatectomy incisions.

Radical cystectomy for BCG failure: has the timing improved in recent years?

Objective: • To analyse if there is a trend in recent years towards performing radical cystectomy (RC) before muscle invasion or extravesical spread after failure of bacille Calmette-Guérin (BCG) for high grade Ta/T1 bladder cancer. Although BCG is indicated for prophylaxis after endoscopic tumour resection there is still a risk of progression.

Patients And Methods: • A retrospective analysis of our RC database (1992-2008) was performed to identify patients who underwent RC after receiving BCG.

Differentiation of oncocytoma and renal cell carcinoma in small renal masses (<4 cm): the role of 4-phase computerized tomography.

Purpose: We investigate the use of 4-phase computerized tomography with intravenous contrast to help distinguish oncocytoma from renal cell carcinoma (RCC) in tumors <4 cm.

Methods: We retrospectively identified patients who underwent surgical management for renal tumors <4 cm from 2005 to 2008. Patients who had pre-operative CT evaluation as per our institution's renal mass protocol and had confirmed pathological diagnosis of either oncocytoma or RCC were included in the study.

What is the predictive value of urodynamics to reproduce clinical findings of urinary frequency, urge urinary incontinence, and/or stress urinary incontinence?

Introduction And Hypothesis: The aim of this study was to determine the predictive value of urodynamics to reproduce clinical findings of urinary frequency (UF), urge urinary incontinence (UUI), and/or stress urinary incontinence (SUI).

Methods: We retrospectively reviewed the data of patients diagnosed with UF, UUI, and/or SUI and subsequently underwent urodynamics. Urodynamic findings were correlated with clinical findings to determine the predictive value of urodynamics.

Contemporary open partial nephrectomy is associated with diminished procedure-specific morbidity despite increasing technical challenges: a single institutional experience.

Objective: To review trends in open partial nephrectomy (OPN) at our center, concentrating on patient selection, technique and perioperative complications.

Methods: A comprehensive database was developed by chart review of consecutive patients undergoing OPN for renal masses at our center. Patient selection, technical modifications, perioperative morbidity, and histopathology were compared in patients undergoing OPN between 1992-1999, 2000-2003, and 2004-2008.