A rare case of pancreatic adenocarcinoma metastasized to the bladder.

Pancreatic cancer is usually detected in late stages due to lack of identifiable symptoms and rapid progression. It commonly metastasizes to the liver, lung, and peritoneum, but only rarely to the bladder. We present a 41-year-old female with a history of pancreatic adenocarcinoma, asthma, gastroesophageal reflux disease, uterine fibroids, and tobacco use who presented with hematuria, polyuria, and abdominal pain.

Improving Patient Outcomes and Health Care Provider Communication with a Small, Yellow Plastic Band: the Patient URinary Catheter Extraction (PURCE) Protocol.

Introduction: Great efforts are being made to reduce catheter associated urinary tract infections as they increase patient morbidity and are costly to health care centers. Although various catheter associated urinary tract infection prevention initiatives exist, efficient communication between physicians and nurses continues to be a significant barrier. In an effort to enhance communication and reduce catheter associated urinary tract infections, we implemented a novel Patient URinary Catheter Extraction (PURCE) Protocol and in this study we evaluate the utility of the PURCE Protocol.

Lower prevalence of varicoceles in obese patients found on routine scrotal ultrasound.

Purpose: Research shows that obese patients have a lower incidence of varicoceles. Increased adipose tissue, which makes physical examination difficult, was hypothesized to be the cause. We evaluated the varicocele incidence on routine scrotal ultrasound to see whether difficult physical examination was causative.

Do nonspecific deep corticomedullary sutures performed during partial nephrectomy adequately control major vascular and collecting system injury?

Objective: To critically evaluate the effectiveness of placing nonspecific deep corticomedullary sutures in the setting of major vascular and collecting system injury during laparoscopic partial nephrectomy (LPN). We also aimed to evaluate the incidence of ischaemic injury to the remaining renal remnant because of these sutures, as many laparoscopic centres have adopted this practice.

Materials And Methods: We performed open PN on eight porcine kidneys.

A prospective, randomized, double-blinded placebo-controlled comparison of extended release oxybutynin versus phenazopyridine for the management of postoperative ureteral stent discomfort.

Objectives: Ureteral stents commonly cause lower urinary tract and flank discomfort. We evaluated the use of extended release oxybutynin versus phenazopyridine versus placebo for the management of ureteral stent discomfort after ureteroscopy.

Methods: Each of 60 patients who received a unilateral stent after ureteroscopy was given a blister pack containing 21 unmarked capsules of either extended release oxybutynin 10 mg, phenazopyridine 200 mg, or placebo in a prospective, randomized, and double-blinded fashion.

Ureteropelvic junction obliteration resulting in nephrectomy after radiofrequency ablation of small renal cell carcinoma.

Percutaneous radiofrequency ablation is a minimally invasive treatment that is currently used to treat renal tumors. Despite its minimally invasive nature, potential serious complications can occur. We report the second case of ureteropelvic junction obstruction after radiofrequency ablation that resulted in nephrectomy.

Effect of medical management on recurrent stone formation following percutaneous nephrolithotomy.

Purpose: Percutaneous nephrolithotomy is a commonly used procedure for treatment of large or complex renal calculi. In some instances postoperative residual stone fragments are an unavoidable result. Yet to our knowledge no study has examined the impact of medical management on stone formation in patients with or without residual fragments following percutaneous nephrolithotomy.

Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial.

Background And Purpose: The management of acute renal colic is a problem commonly encountered by both urologists and emergency medicine physicians. The classic approach to managing uncomplicated acute renal colic involves hydration, along with imaging and pain control. Previous studies have suggested that hydration has a significant impact on patient comfort, as well as spontaneous stone passage.

Progressive increase of lithotripter output produces better in-vivo stone comminution.

Background And Purpose: Shockwave lithotripsy (SWL) has become a first-line intervention for treatment of nephrolithiasis. However, few studies have examined the effects of modifications in the method of shockwave energy administration on comminution efficiency. We propose that a gradual increase in output voltage will produce superior stone fragmentation in comparison with a constant or a decreasing output voltage by optimizing the stress wave and cavitation erosion forces on renal calculi.

New technology for imaging and documenting urologic procedures.

Recent advances in fiber optics and digital technology have dramatically improved the ability of the urologic surgeon to accurately image and document endoscopic and laparoscopic procedures. In addition, the development of digital endoscopes has expanded the armamentarium of the endoscopic surgeon greatly. Finally, new virtual reality technology has allowed increased visualization during surgery and provides excellent training for surgeons.

Location and etiology of flexible and semirigid ureteroscope damage.

Objectives: To perform an analysis of currently available manufacturer data regarding the character of ureteroscope damage. The high costs associated with the repair of flexible and semirigid ureteroscopes are well documented. Increased knowledge of the etiology of ureteroscope damage should aid urologists in prolonging the lives of these delicate instruments.

Controlled survival study of the effects of Tisseel or a combination of FloSeal and Tisseel on major vascular injury and major collecting-system injury during partial nephrectomy in a porcine model.

Purpose: We report the results of a controlled survival study in a porcine model investigating Tisseel or a combination of FloSeal and Tisseel in dealing with vascular and collecting-system injury during partial nephrectomy.

Materials And Methods: We performed an open right lower-pole partial nephrectomy on 15 large female pigs. The defect was repaired using standard open techniques (N = 5; controls), Tisseel only (N = 6; group I), or FloSeal followed by Tisseel (N = 4; group II).

Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi.

Objective: To present early experience in managing complex renal calculi using a combined ureteroscopic and percutaneous approach, as complex and branched renal calculi often require multiple access tracts during percutaneous nephrolithotomy (PNL), and the combined use of flexible ureteroscopy and PNL has the potential to reduce the inherent morbidity of several tracts.

Patients And Methods: The study included seven patients (mean age 54 years) with multiple, branched, large-volume renal calculi suitable for management with PNL. Preoperative data, including patient demographics, stone location and stone surface area, were recorded.

Effect of ureteral access sheath on stone-free rates in patients undergoing ureteroscopic management of renal calculi.

Objectives: To evaluate the effect of ureteral access sheaths (UASs) on stone-free rates (SFRs) during ureteroscopic treatment of renal calculi. Several advantages of UASs during flexible ureteroscopy have been documented. However, no study has evaluated their impact on SFRs.

In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse nd:yag laser and the holmium:yag laser.

Purpose: The frequency doubled, double pulse Nd:YAG (FREDDY) laser (World of Medicine, Berlin, Germany) functions through the generation of a plasma bubble. Upon bubble collapse a mechanical shock wave is generated, causing stone fragmentation. This mechanism of action is in contrast to the holmium laser, which cause stone destruction by vaporization.

Hand assisted laparoscopic training for postgraduate urologists: the role of mentoring.

Purpose: Hand assisted laparoscopy (HAL) has recently been accepted as a safe alternative for nephrectomy. HAL courses have been offered at several institutions to train novice laparoscopic surgeons in this minimally invasive surgical procedure. Mentoring by a course instructor or an experienced laparoscopist provides assistance to surgeons with their initial operation.