Analysis of 24-hour urine parameters as it relates to age of onset of cystine stone formation.

Introduction: Cystinuria is an inherited disorder characterized by the impaired reabsorption of the dibasic amino acid, cystine, in the proximal tubule of the nephron. Cystine stones most frequently occur in the first through third decades of life with a decreased incidence in old age. We hypothesize that patients presenting with first stone event at an older age would have more favorable 24-hour urine parameters compared with those patients who present early.

A sealed bladder cuff technique during laparoscopic nephroureterectomy utilizing the LigaSure electrosurgical device: laboratory and clinical experience.

Introduction: Laparoscopic nephroureterectomy (LNU) is a safe, minimally invasive approach for management of upper tract urothelial tumors. Controversy exists over the optimal technique for the distal ureter and bladder cuff (DUBC) excision. We examined the novel technique of using the LigaSure bipolar electrosurgical device in laboratory investigations and during clinical LNU to manage the DUBC.

Effect of escalating versus fixed voltage treatment on stone comminution and renal injury during extracorporeal shock wave lithotripsy: a prospective randomized trial.

Purpose: ESWL is a minimally invasive, efficacious therapy for most renal stones. However, an optimal voltage treatment protocol ensuring effective stone comminution while minimizing tissue injury is not well established. We performed a prospective, randomized trial of the stone-free rate and renoprotective effect of an escalating vs a fixed voltage treatment strategy during ESWL.

Comparison of the histologic accuracy of needle biopsy before and after renal cryoablation: laboratory and initial clinical experience.

Objectives: To minimize the risk of needle biopsy, including tumor seeding and hemorrhage, we examined the feasibility of needle biopsy after renal cryoablation.

Methods: Four cryolesions were created bilaterally on normal porcine renal tissue with an 8-minute double-freeze cycle using a single 17-gauge cryoprobe. Biopsies were obtained with a 16G biopsy needle before and after cryoablation under direct vision.

Focal cryosurgery: encouraging health outcomes for unifocal prostate cancer.

Objectives: Owing to the ability to better detect small-volume tumors, we have seen an increasing population of men with low-risk unifocal prostate cancer. We report our safety and efficacy experience of focal cryoablation of the prostate to maintain potency and preserve genitourinary function in men with localized, unifocal disease.

Methods: From June 2002 to December 2005, 25 patients with primary unifocal prostate cancer were treated with focal cryoablation of the prostate.

Prognostic risk stratification and clinical outcomes in patients undergoing surgical treatment for renal cell carcinoma with vascular tumor thrombus.

Objectives: Approximately 4% to 10% of patients with renal cell carcinoma (RCC) present with vascular tumor thrombus. Often, these patients also present with metastatic disease. This study examined the clinical outcome and morbidity of patients with RCC and vascular tumor thrombus treated with aggressive surgical therapy.

The increasing use of intravesical therapies for stage T1 bladder cancer coincides with decreasing survival after cystectomy.

Objective: Intravesical therapy (IVT), chemo and immunotherapy, has made conservative, bladder-sparing strategies a viable option for managing patients with high grade T1 bladder cancer. However, many of these patients will have recurrence and occasionally progression, questioning delayed intervention. This study examines the patterns of use of IVT in high-grade T1 bladder cancer and the subsequent impact on survival for patients ultimately proceeding to radical cystectomy (RC).