A history of urolithiasis risk in space.

Introduction: The development of renal stones in space would not only impact the health of an astronaut but could critically affect the success of the mission.

Materials And Methods: We reviewed the medical literature, texts and multimedia sources regarding the careers of Dr. Abraham Cockett and Dr.

Validation of a Full-Immersion Simulation Platform for Percutaneous Nephrolithotomy Using Three-Dimensional Printing Technology.

Introduction And Objectives: The restriction of resident hours with an increasing focus on patient safety and a reduced caseload has impacted surgical training. A complex and complication prone procedure such as percutaneous nephrolithotomy (PCNL) with a steep learning curve may create an unsafe environment for hands-on resident training. In this study, we validate a high fidelity, inanimate PCNL model within a full-immersion simulation environment.

Risk Factors for Readmission after Shock Wave Lithotripsy for Urinary Stones.

Introduction: Cost saving measures have put an increased emphasis on reducing complications and rehospitalization. We analyzed the rate of readmission and presentation to emergency departments within 90 days of shock wave lithotripsy to identify prognostic risk factors for this outcome.

Methods: We retrospectively reviewed patients who underwent shock wave lithotripsy at our institution from January 2011 to May 2013 using the Modulith® SLX-F2 lithotripter for solitary ureteral or renal stones 2.

Spontaneous Ureteral Urine Extravasation From Invasion of a High-grade Angiosarcoma.

A 69 year-old male with a past medical history of hypertension, diabetes, and atrial fibrillation presented to the Urology clinic with asymptomatic microscopic hematuria. His work up for hematuria included a negative cystoscopy and a computed tomography (CT) scan, which revealed what appeared to be a fluid collection around the left kidney with a perinephric infiltrative mass and two para-aortic enlarged lymph nodes.

Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria.

Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors.

Androgen receptor enhances kidney stone-CaOx crystal formation via modulation of oxalate biosynthesis & oxidative stress.

Males develop kidney stones far more frequently than females with a ratio of 2-3:1, suggesting that androgen receptor (AR) signaling might play a key role in the development of nephrolithiasis. Using the cre-loxP system to selectively knock out AR in glyoxylate-induced calcium oxalate (CaOx) crystal mouse models, we found that the mice lacking hepatic AR had less oxalate biosynthesis, which might lead to lower CaOx crystal formation, and that the mice lacking kidney proximal or distal epithelial AR also had lower CaOx crystal formation. We found that AR could directly up-regulate hepatic glycolate oxidase and kidney epithelial NADPH oxidase subunit p22-PHOX at the transcriptional level.

Modifications to facilitate extraperitoneal robot-assisted radical prostatectomy post kidney transplant.

Introduction: Renal transplantation is the treatment of choice for patients with end-stage renal failure. With advances in immunosuppression, the short-term and long-term outcome has improved significantly. Subsequently, urologists are encountering more transplant recipients with genitourinary malignancies, and therefore urologists are becoming increasingly compelled to offer curative treatment options.

Robot-assisted partial nephrectomy: analysis of the first 100 cases from a single institution.

Robot-assisted partial nephrectomy (RAPN) is an alternative to open and laparoscopic partial nephrectomy for small renal tumors. Our objectives were to report our experience and short-term outcomes from the first 100 cases of robot-assisted partial nephrectomy (RAPN) performed at a single institution, as well as to evaluate the effect of the learning curve and identify any factors associated with adverse perioperative outcomes. Patient records of the first 100 RAPN cases performed by three surgeons between October 2007 and March 2010 were retrospectively reviewed.

Near infrared fluorescence imaging after intravenous indocyanine green: initial clinical experience with open partial nephrectomy for renal cortical tumors.

Objective: To evaluate the safety of near infrared fluorescence (NIRF) of intravenously injected indocyanine green (ICG) during open partial nephrectomy, and to demonstrate the feasibility of this technology to identify the renal vasculature and distinguish renal cortical tumors from normal parenchyma.

Methods: Patients undergoing open partial nephrectomy provided written informed consent for inclusion in this institutional review board-approved study. Perirenal fat was removed to allow visualization of the renal parenchyma and lesions to be excised.

Role of frozen section analysis of testicular/paratesticular fibrous pseudotumours: a five-case experience.

Background: Fibrous pseudotumours of the testicular and paratesticular tissues are fibroinflammatory reactive lesions that can clinically mimic neoplasms. Very little is known about the role of frozen section analysis (FSA) for these lesions in terms of intraoperative surgical management.

Methods: We recently experienced 5 patients with testicular/paratesticular fibrous pseudotumours in whom frozen sections were used to demonstrate its non-neoplastic nature prior to the decision for radical surgery.

Ergonomic evaluation and guidelines for use of the daVinci Robot system.

Introduction: The daVinci Robot system has been widely lauded for its improved ergonomic characteristics when compared with the pure laparoscopic technique. Our goal in this study was to assess for the existence of guidelines to maximize the ergonomic benefits of the daVinci system. We also compared the surgeon's console with the recommendations of similar workstations.

Bowel displacement for CT-guided tumor radiofrequency ablation: techniques and anatomic considerations.

Purpose: To describe safety and efficacy of bowel displacement techniques and determine lesion characteristics that are likely to necessitate bowel displacement.

Patients And Methods: A retrospective review of patients who underwent CT-guided renal tumor radiofrequency ablation (RFA) (January 2006-August 2008) was conducted. Techniques included hydrodissection, additional manual torquing of the RFA probe, and additional angioplasty balloon interposition.

Evaluation and management of post-shock wave lithotripsy pain with third-generation lithotriptors using rofecoxib.

Introduction: Newer generation lithotriptors have been modified to induce less pain. We evaluated factors contributing to post-shock wave lithotripsy (SWL) pain and assessed potential benefits of preemptive analgesia using Rofecoxib, a COX-II inhibitor, and potential effects on stone passage rates.

Materials And Methods: Sixty-nine patients were evaluated.

Factors associated with ureteral burn injury from an electrified guidewire.

Purpose: During ureteroscopic procedures, electrocautery is often utilized in the presence of an intra-ureteral guidewire. Inadvertent electrification of the guidewire may occur if the active electrode comes into contact with the guidewire, potentially resulting in a ureteral burn injury. This study investigates under what conditions electrification of a ureteral guidewire would result in ureteral burn injury.

Sensitivity and specificity of 24-hour urine chemistry levels for detecting elevated calcium oxalate and calcium phosphate supersaturation.

Objectives: The gold standard for determining likelihood of calcium oxalate (CaOx) and calcium phosphate (CaPhos) stone formation in urine is supersaturation of CaOx and CaPhos. Our objective was to investigate whether traditional measurement of total calcium, oxalate and phosphate in a 24-hour urine collection is sufficiently sensitive and specific for detecting elevated supersaturation to preclude the more expensive supersaturation test.

Methods: We performed a retrospective review of 150 consecutive patients with nephrolithiasis who underwent measurement of CaOx supersaturation (CaOxSS) and CaPhos supersaturation (CaPhosSS), as well as total calcium, oxalate and phosphate in a 24-hour urine collection.

Subcapsular hepatic hematoma with right hepatic vein thrombosis: a complication of shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is a well-established, safe and effective therapeutic modality for surgical treatment of urolithiasis. Hematoma is a rare complication of ESWL and, when it occurs, typically involves the kidney. We report the case of a 71-year-old woman who developed severe, persistent abdominal pain after ESWL for a 9-mm stone at the ureteropelvic junction.

Patient-reported validated functional outcome after extraperitoneal robotic-assisted nerve-sparing radical prostatectomy.

Background And Objectives: Erectile function after prostate surgery is an important criterion for patients when they are choosing a treatment modality for prostate cancer. Improved visualization, dexterity, and precision afforded by the da Vinci robot allow a precise dissection of the neurovascular bundles. We objectively assessed erectile function after robot-assisted extraperitoneal prostatectomy by using the SHIM (IIEF-5) validated questionnaire.

Is there a proper pelvic size for an extraperitoneal robot-assisted radical prostatectomy?

Background: A narrow pelvis can potentially complicate an extraperitoneal radical robot-assisted prostatectomy (RAP). We report our experience with RAP and evaluate whether a narrow pelvis can affect treatment outcomes after extraperitoneal RAP.

Materials And Methods: We prospectively evaluated 50 patients who underwent RAP during a 2-month period using the extraperitoneal approach.

Patient-reported validated functional outcome after extraperitoneal robotic-assisted nerve-sparing radical prostatectomy.

Background And Objectives: Erectile function after prostate surgery is an important criterion for patients when they are choosing a treatment modality for prostate cancer. Improved visualization, dexterity, and precision afforded by the da Vinci robot allow a precise dissection of the neurovascular bundles. We objectively assessed erectile function after robot-assisted extraperitoneal prostatectomy by using the SHIM (IIEF-5) validated questionnaire.

Impact of prostate size in robot-assisted radical prostatectomy.

Background And Purpose: A large prostate can complicate an extraperitoneal robot-assisted radical prostatectomy (RARP). We report our experience with RARP and evaluate the effects of prostate size on treatment outcomes after extraperitoneal RARP.

Patients And Methods: Information on 355 consecutive patients undergoing extraperitoneal RARP was gathered, and patients with prostate weight <75 g (N = 319) were compared with those having glands >or=75 g (N = 36).

Robot-assisted radical prostatectomy in obese patients.

Objectives: Few centers perform extraperitoneal robot assisted radical prostatectomy. The average patient weight is increasing to the mildly obese. Little is known as to the difficulty-impact, obesity may have on robot-assisted extraperitoneal prostatectomy (RAP).

Povidone-iodine sclerotherapy is ineffective in the treatment of symptomatic renal cysts.

Purpose: To evaluate the efficacy of povidone-iodine sclerotherapy after percutaneous drainage of simple renal cysts in the treatment of symptomatic patients.

Patients And Methods: Sixteen patients with symptomatic renal cysts were treated by percutaneous drainage and injection of povidone-iodine solution. The cysts were drained by a nephrostomy tube catheter, and povidone- iodine injections were repeated every 24 hours for 3 days.

Secondary polycythemia caused by ureteropelvic junction obstruction successfully treated by laparoscopic nephrectomy.

Secondary polycythemia is a condition that causes an increase in red blood cell count either because of the physiologic response to stress or inappropriate secretion of erythropoietin. We report a case of a secondary polycythemia caused by ureteropelvic junction obstruction that was successfully treated by laparoscopic nephrectomy.

Paraffinoma of the urinary bladder.

We present a rare case of paraffinoma of the urinary bladder. Paraffinomas involving the urinary tract are rare and not well described. They are usually associated with insertion of materials into the lower urinary tract by patients with psychiatric disorders.