Build your own all-virtual multidisciplinary kidney stone clinic.

Background: With the dramatic rise of telemedicine in the post coronavirus disease 2019 (COVID-19) pandemic, our objective was to develop a totally virtual multidisciplinary kidney stone clinic and assess patient satisfaction of this format.

Methods: The virtual multidisciplinary stone clinic began July 2021 and continued monthly. Prior to the beginning of each clinic, providers from the urology, nephrology, and dietitian teams meet virtually to discuss the patients.

Using ChatGPT-4 to Analyze 24-Hour Urine Results and Generate Custom Dietary Recommendations for Nephrolithiasis.

The increasing incidence of nephrolithiasis underscores the need for effective, accessible tools to aid urologists in preventing recurrence. Despite dietary modification's crucial role in prevention, targeted dietary counseling using 24-hour urine collections is underutilized. This study evaluates ChatGPT-4, a multimodal large language model, in analyzing urine collection results and providing custom dietary advice, exploring the potential for artificial intelligence-assisted analysis and counseling.

Heterogeneity in stone culture protocols and endourologist practice patterns: a multi-institutional survey.

Kidney stone cultures can be beneficial in identifying bacteria not detected in urine, yet how stone cultures are performed among endourologists, under what conditions, and by what laboratory methods remain largely unknown. Stone cultures are not addressed by current clinical guidelines. A comprehensive REDCap electronic survey sought responses from directed (n = 20) and listserv elicited (n = 108) endourologists specializing in kidney stone disease.

Obstetric outcomes of pregnancy complicated by urolithiasis: a retrospective cohort study.

Objectives: Evaluate the association between urolithiasis during pregnancy and obstetric outcomes outside the context of urological intervention.

Methods: We conducted a retrospective cohort study of singleton, non-anomalous gestations delivered at 23-42 weeks in California from 2007 to 2011. Maternal outcomes (preterm delivery [early (<32 weeks) and late (<37 weeks)], preeclampsia, gestational diabetes, cesarean deliveries, urinary tract infection [UTI] at delivery, chorioamnionitis, endomyometritis, and maternal sepsis) and newborn outcomes (seizure, respiratory distress syndrome, hypoglycemia, jaundice, and neonatal abstinence syndrome [NAS]) were compared using χ2-tests and multivariable logistic regression.

Patterns of Industry Payments to Urologists From 2014-2018.

Objectives: To evaluate the patterns of financial transaction between industry and urologists in the first 5 years of reporting in the Open Payments Program (OPP) by comparing transactions over time, between academic and nonacademic urologists, and by provider characteristics among academic urologists.

Methods: The Center for Medicare & Medicaid Services OPP database was queried for General Payments to urologists from 2014-2018. Faculty at ACGME-accredited urology training programs were identified and characterized via publicly available websites.

Cost-Effectiveness of Urolithiasis Management in Pregnancy.

Introduction: Urolithiasis complicating pregnancy presents a challenge for urology and obstetric teams. The management options of ureteral stenting, percutaneous nephrostomy and ureteroscopy vary significantly with regard to efficacy, complications, impact on quality of life and costs. This analytic model compares these factors to determine an optimal strategy per gestational age at presentation.

Computed Tomography Radiation Exposure Among Referred Kidney Stone Patients: Results from the Registry for Stones of the Kidney and Ureter.

Kidney stone patients routinely have CT scans during diagnostic work-up before being referred to a tertiary center. How often these patients exceed the recommended dose limits for occupational radiation exposure of >100 mSv for 5 years and >50 mSv in a single year from CT alone remains unknown. This study aimed to quantify radiation doses from CTs received by stone patients before their evaluation at a tertiary care stone clinic.

The Morbidity of Ureteral Strictures in Patients with Prior Ureteroscopic Stone Surgery: Multi-Institutional Outcomes.

Purpose: Nephrolithiasis is an increasingly common ailment in the United States. Ureteroscopic management has supplanted shockwave lithotripsy as the most common treatment of upper tract stone disease. Ureteral stricture is a rare but serious complication of stone disease and its management.

Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study.

Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability.

Variation in Radiologic and Urologic Computed Tomography Interpretation of Urinary Tract Stone Burden: Results From the Registry for Stones of the Kidney and Ureter.

Objective: To compare the measured stone burden recorded between urologists and radiologists, and examine how these differences could potentially impact stone management. As current urologic stone surgery guideline recommendations are based on stone size, accurate stone measurements are crucial to direct appropriate treatment. This study investigated the discrepant interpretation that often exists between urologic surgeons and radiologists' estimation of patient urinary stone burden.

Rationale and Design of the Registry for Stones of the Kidney and Ureter (ReSKU): A Prospective Observational Registry to Study the Natural History of Urolithiasis Patients.

Objectives: Registry-based clinical research in nephrolithiasis is critical to advancing quality in urinary stone disease management and ultimately reducing stone recurrence. A need exists to develop Health Insurance Portability and Accountability Act (HIPAA)-compliant registries that comprise integrated electronic health record (EHR) data using prospectively defined variables. An EHR-based standardized patient database-the Registry for Stones of the Kidney and Ureter (ReSKU™)-was developed, and herein we describe our implementation outcomes.

Diagnosis and management of ureteral complications following renal transplantation.

When compared with maintenance dialysis, renal transplantation affords patients with end-stage renal disease better long-term survival and a better quality of life. Approximately 9% of patients will develop a major urologic complication following kidney transplantation. Ureteral complications are most common and include obstruction (intrinsic and extrinsic), urine leak and vesicoureteral reflux.

Renal Autotransplantation: 27-Year Experience at 2 Institutions.

Purpose: Renal autotransplantation is an infrequently performed procedure. It has been used to manage complex ureteral disease, vascular anomalies and chronic kidney pain. We reviewed our 27-year experience with this procedure.

Performing in the surgical amphitheater of today: perception of urologists conducting live case demonstrations.

Purpose: To evaluate the perception of urologists who have participated in live case demonstrations (LCDs) regarding safety, educational value/benefits, and ethics.

Methods: A 19-question anonymous survey was sent to urologists who performed and/or moderated LCDs at the World Congress of Endourology meetings from 2008 to 2012. E-survey was distributed via e-mail, and automatic reminders were sent 2 weeks after original distribution if no response was obtained.

Review of appendiceal onlay flap in the management of complex ureteric strictures in six patients.

Objectives: To evaluate appendiceal onlay flap ureteroplasty for repairing complex right proximal and mid-ureteric strictures.

Patients And Methods: Between August 2006 and August 2012 four women and two men (mean age 34.2 years) underwent right laparoscopic appendiceal onlay flap ureteroplasty.

The surgical spectacle: a survey of urologists viewing live case demonstrations.

Objective: To evaluate perspectives of urologists viewing live case demonstrations (LCD) and taped case demonstrations (TCD).

Method: A 15-question anonymous survey was distributed to attendees of the live surgery session at the American Urological Association 2012 national meeting (Atlanta) and the second International Challenges in Endourology meeting (Paris).

Results: Of 1000 surveys distributed, 253 were returned completed (response rate 25%).

The current role of endourologic management of renal transplantation complications.

Introduction. Complications following renal transplantation include ureteral obstruction, urinary leak and fistula, urinary retention, urolithiasis, and vesicoureteral reflux. These complications have traditionally been managed with open surgical correction, but minimally invasive techniques are being utilized frequently.

S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi.

Objective: To, first, propose a novel scoring system to standardize reporting for percutaneous nephrolithotomy because the instruments currently available to predict the percutaneous nephrolithotomy outcomes are cumbersome, not validated, and of limited clinical utility; and, second, assess and predict the stone-free rates and perioperative parameters applying S.T.O.

Variability of transrectal ultrasound-guided prostate biopsy prophylactic measures.

Introduction: To assess the variability of pre-prostate biopsy prophylaxis among American urologists.

Materials And Methods: A survey was electronically mailed to 3355 urologists around the country. Urologists were surveyed on their antibiotic prophylaxis choice, the route and duration of antimicrobial prophylaxis.

Supracostal tubeless percutaneous nephrolithotomy: a retrospective cohort study.

Purpose: To evaluate the safety of tubeless percutaneous nephrolithotomy in patients undergoing supracostal percutaneous renal access.

Patients And Methods: Between October 1999 and October 2010, 302 patients underwent percutaneous nephrolithotomy via a supracostal access tract. Two hundred forty-eight (82.

Percutaneous nephrostolithotomy: an assessment of costs for prone and Galdakao-modified supine Valdivia positioning.

Objective: To examine the relative costs of prone percutaneous nephrostolithotomy (PCNL) versus PCNL performed with the patient in the Galdakao-modified supine Valdivia (GMSV) position to determine whether a cost differential exists.

Methods: We compared prone PCNL with PCNL using GMSV positioning. Cost data were obtained from the urology departmental and hospital billing offices at our institution and from the 2011 local Medicare reimbursement scales.

Correlation of laparoscopic experience with differential functional brain activation: a positron emission tomography study with oxygen 15-labeled water.

Hypothesis: Regions of functional brain activation differ between novice and expert laparoscopists.

Design: We compared novice and expert laparoscopists using positron emission tomography (PET) during the peg transfer task of the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) protocol. The first scan (rest) was performed with the subject's eyes closed.

Clinical evaluation of a novel bipolar radiofrequency ablation system for renal masses.

Unlabelled: What's known on the subject? and What does the study add? With the advancement of minimally invasive surgery, the management of small renal masses (SRM) has dramatically changed. Ablative technology such as radiofrequency ablation (RFA) and cryoablation have emerged as viable alternative modalities to extirpative surgery. RFA is one of the most studied and applied energy-based, needle-ablative treatment modalities, with encouraging mid- and long-term oncological outcomes.

Laparoscopic retroperitoneal lymph node dissection for testicular cancer.

Objectives: Laparoscopic retroperitoneal lymph node dissection (L-RPLND) was introduced over 20 years ago as a less invasive alternative to open node dissection. In this review we summarise the indications, surgical technique and outcomes of L-RPLND in the treatment of testicular cancer.

Methods: We searched MEDLINE using the terms 'laparoscopy', 'laparoscopic', 'retroperitoneal lymph node dissection', 'RPLND' and 'testicular neoplasms'.