In-vitro comparison of different slice thicknesses and kernel settings for measurement of urinary stone size by computed tomography.

Non-contrast enhanced computed tomography (NCCT) is widely used measuring stone size in patients with urolithiasis. We performed an evaluation of the accuracy of stone size measuring via NCCT. In an in-vitro study, we analyzed a total of 38 uric acid and 38 phantom stones.

Microstructures of Randall's plaques and their interfaces with calcium oxalate monohydrate kidney stones reflect underlying mineral precipitation mechanisms.

Randall's plaques (RP) are preferred sites for the formation of calcium oxalate monohydrate (COM) kidney stones. However, although processes of interstitial calcium phosphate (CaP) plaque formation are not well understood, the potential of plaque microstructures as indicators of CaP precipitation conditions received only limited attention. We investigated RP-associated COM stones for structural details of the calcified tissues and microstructural features of plaque-stone interfaces as indicators of the initial processes of stone formation.

Minimally invasive versus conventional large-bore percutaneous nephrolithotomy in the treatment of large-sized renal calculi: Surgeon's preference?

Objective: The aim of this study was to compare the efficacy and safety of minimally invasive percutaneous nephrolithotomy (MIP) and conventional percutaneous nephrolithotomy (PCNL) in the treatment of patients with large renal stone burden. MIP has proven its efficacy and safety in the management of small renal calculi. However, conventional PCNL is still considered the standard method for treatment of large renal stones in the upper urinary tract.

Differences in renal stone treatment and outcomes for patients treated either with or without the support of a ureteral access sheath: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study.

Purpose: To describe the differences in the treatment and the outcomes of renal stones treated with flexible ureteroscopy (URS) either with or without the support of a ureteral access sheath (UAS).

Methods: The Clinical Research Office of the Endourological Society URS Global Study involved the collection of prospective data from consecutive patients treated with URS at centers around the world over a 1-year period. Baseline characteristics, stone location, treatment details, postoperative outcomes and complications were recorded.

Flexible ureterorenoscopy for lower pole stones: influence of the collecting system's anatomy.

Background: The impact of renal anatomy on the success rate of flexible ureterorenoscopy (fURS) for lower pole stones is less clear than it is on shock wave lithotripsy, for which it is a recognized influence factor. We analyzed safety and efficiency of fURS using modern endoscopes for lower pole stones dependent on the collecting system's configuration.

Patients And Methods: We retrospectively evaluated a consecutive sample of 111 fURS for lower pole stones at our tertiary care center between January 2010 and September 2012 from our prospectively kept database.

Percutaneous nephrolithotomy under combined sonographic/radiologic guided puncture: results of a learning curve using the modified Clavien grading system.

Purpose: Aim of our study was to evaluate the results of percutaneous nephrolithotomy (PNL) with sonographic/fluoroscopic guided puncture during a learning curve and to compare them to an expert.

Methods: The first 75 consecutive patients undergoing conventional PNL or Mini-PNL by a novice percutaneous surgeon without direct supervision by an expert were evaluated and divided into three groups of 25 patients each. The results were compared to 50 cases treated by an expert.

Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones.

Objectives: To review previous reports and discuss current trends in extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and ureterorenoscopy (URS). ESWL was recommended as the first-line treatment for small and intermediate-sized stones in the lower pole, while it is the standard treatment for large stones. However, the stone clearance rate after ESWL seems to be lower than that of stones in other locations.

Three-dimensional laparoscopic imaging improves surgical performance on standardized ex-vivo laparoscopic tasks.

Purpose: Conventional two-dimensional (2D) laparoscopy has been limited by the lack of depth perception and spatial orientation. This disadvantage may affect surgical performance, operative time, or morbidity. Depth perception, spatial resolution, and accuracy may be improved by three-dimensional (3D) vision.

Flexible ureterorenoscopy versus miniaturized PNL for solitary renal calculi of 10-30 mm size.

Introduction: The value of flexible ureterorenoscopy (fURS) and miniaturized PNL (mPNL) for larger renal calculi is under discussion. This non-randomized prospective study aimed to evaluate fURS and mPNL for solitary renal stones of 10-30 mm size.

Materials And Methods: fURS was carried out in 21 patients with last generation 7.

Urolithiasis through the ages: data on more than 200,000 urinary stone analyses.

Purpose: The incidence and prevalence of urolithiasis are increasing but clinicians also have the impression that gender and age distributions of stone formers are changing. Moreover, regional differences in stone occurrence and composition have been observed. We analyzed such trends based on a large series of urinary stone analyses.

Do new generation flexible ureterorenoscopes offer a higher treatment success than their predecessors?

New generation flexible ureterorenoscopes offer an improved deflection mechanism and a stiffer sheath compared to their predecessors. We aimed to determine if these improvements in design lead to a higher efficacy in the treatment of nephrolithiasis. Ninety patients with upper urinary tract calculi were included into a retrospective analysis.

Do patients benefit from miniaturized tubeless percutaneous nephrolithotomy? A comparative prospective study.

Background And Purpose: A benefit of miniaturized percutaneous nephrolithotomy (MPCNL) compared with conventional percutaneous nephrolithotomy (PCNL) has not been demonstrated as yet. Thus, the aim of this study was to evaluate the outcome of conventional vs MPCNL and to determine if MPCNL offers an advantage for the patient.

Patients And Methods: A prospective, nonrandomized series of 50 consecutive patients with solitary calculi (lower pole or the renal pelvis) were treated either by conventional PCNL (26F) or MPCNL (18F).

New alternatives for laser vaporization of the prostate: experimental evaluation of a 980-, 1,318- and 1,470-nm diode laser device.

Purpose: Several diode laser systems were introduced in recent years for the minimal-invasive surgical therapy of benign prostate enlargement. We investigated the ablation capacities, hemostatic properties and extend of tissue necrosis of different diode lasers at wavelengths of 980, 1,318 and 1,470 nm and compared the results to the 120 W GreenLight HPS laser.

Methods: The laser devices were evaluated in an ex vivo model using isolated porcine kidneys.

120 W lithium triborate laser for photoselective vaporization of the prostate: comparison with 80 W potassium-titanyl-phosphate laser in an ex-vivo model.

Purpose: To evaluate the ablative and hemostatic properties of the recently introduced 120 W lithium triborate (LBO) 532 nm laser and compare the results against the conventional 80 W potassium-titanyl-phosphate (KTP) laser.

Materials And Methods: The ex-vivo model of the isolated blood-perfused porcine kidney was used to determine the ablation capacity, hemostatic properties, and coagulation depth of the GreenLight HPS laser system (American Medical System, Minnetonka, MN) that used an output power of 120 W. The results were compared with the KTP laser that used output power levels of 30 W, 50 W, and 80 W.

Outcome of sigmoid compared to ileal orthotopic bladder substitution in terms of micturition and defecation parameters in an 8-year long-term follow-up.

Introduction: Various techniques have been described for orthotopic bladder substitution. Bladder substitution with sigma is rather classed as a useful alternative standby. We report the long-term results of sigmoid neobladder in comparison to ileal neobladder with respect to urodynamic and defecation parameters.

Does open stone surgery still play a role in the treatment of urolithiasis? Data of a primary urolithiasis center.

Objective: The introduction and continuous development of percutaneous nephrolithotomy, the achievement of extracorporeal shock-wave lithotripsy, and the advancements in ureterorenoscopy have led to a revolution in the interventional management urolithiasis. The indications for open stone surgery have been narrowed significantly making it a second- or third-line treatment option. We report on patients undergoing open stone surgery for nephrolithiasis in our department during the last 10 years to examine our indications at a primary urolithiasis center and to determine the clinical situations in which open surgery is a reasonable alternative.

Magnetic resonance imaging as a technique for assessing noninvasive tissue ablation using high-intensity ultrasound: an experimental study.

Background And Purpose: As a form of noninvasive extracorporeal application, acoustic energy offers an alternative to nephron-sparing surgery for renal masses smaller than 4 cm. The availability of a reliable tool for monitoring the therapy is a prerequisite for safe and successful high-intensity focused ultrasound (HIFU) application. The aim of this study was to evaluate the morphologic visualization of HIFU lesions using MRI.

Cellular uptake and ex vivo urothelial penetration by oligodeoxynucleotides for optimizing treatment of transitional cell carcinoma.

Objective: To evaluate cellular uptake and urothelial penetration of oligodeoxynucleotides (ODNs) in transitional cell carcinoma (TCC) cell lines and in a porcine ex vivo model, respectively.

Study Design: A panel of human TCC cell lines (RT 112, HT 1197 and UM-UC3) were exposed tofluorescein-labeled ODNs. Transfection rates were assessed byfluorescence microscopy and fluorescence-activated cell sorting (FACS).

TURP in patients with biopsy-proven prostate cancer: sensitivity for cancer detection.

Objectives: Recent laser techniques for the treatment of benign prostatic obstruction result in a significant amount of vaporization. Therefore, less tissue is retrieved for histologic evaluation. This might be an argument in favor of monopolar transurethral resection of the prostate (TURP).

Hemostatic properties of four devices for partial nephrectomy: a comparative ex vivo study.

Purpose: Laparoscopic partial nephrectomy (LPN) is a common minimally-invasive treatment modality for renal tumors, and achieving hemostasis during excision is a major challenge. The aim of our study was to investigate the hemostatic potential of four different devices for realizing this under standardized conditions.

Materials And Methods: LPN was performed on a standardized model of blood-perfused ex-vivo porcine kidneys.

Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate.

Background And Purpose: A novel 2-microm continuous wave (CW) thulium laser device for interventional treatment of benign prostatic hyperplasia was recently introduced into clinical practice and is postulated to have several advantages over more established laser devices. A systematic ex-vivo evaluation of the thulium laser was undertaken to compare the results to transurethral resection of the prostate (TURP) and the potassium-titanyl-phosphate (KTP) laser as reference standard methods.

Materials And Methods: The RevoLix CW thulium laser system was evaluated in the well-established model of the isolated blood-perfused porcine kidney to determine its tissue ablation capacity and hemostatic properties at different power settings.

Ureteroscopy for stone treatment using new 270 degrees semiflexible endoscope: in vitro, ex vivo, and clinical application.

Background And Purpose: The use of flexible ureteroscopy for diagnosis and management of upper urinary tract diseases is limited both by loss of maximum active deflection through the inserted working probes and a high frequency of damage with consequent costs. A newly developed ureteroscope (Flex-X, Karl Storz) with a maximized angle of deflection was introduced to overcome these problems. The aim of our study was to compare this new ureteroscope with an established device in vitro, ex vivo, and in a clinical approach.

Evaluation of cystine transport in cultured human kidney cells and establishment of cystinuria type I phenotype by antisense technology.

Cystinuria is a rare hereditary disease resulting in recurrent stone formation and the need for repeated invasive interventions. So far, two responsible genes have been identified which encode the two transporters, rBAT and b(0,+)AT forming a heterodimer to transport cystine in proximal tubular cells (PTC) and whose defect results in increased excretion of cystine. A human cell line mimicing the phenotype of cystinuria in vitro is yet to be developed.

Prospective evaluation of acute endocrine pancreatic injury as collateral damage of shock-wave lithotripsy for upper urinary tract stones.

Unlabelled: There has been controversy over whether extracorporeal shock wave lithotripsy (ESWL) can cause damage to the endocrine cells of the pancreas, leading to the later development of diabetes mellitus. Authors from Germany prospectively evaluated acute endocrine pancreatic injury as collateral damage caused by the ESWL for treating upper urinary tract stones. In a careful study they showed that there was no effect on serum levels of variables indicating exocrine and endocrine pancreatic tissue damage, suggesting that the idea that ESWL might lead to future diabetes mellitus is unlikely to be correct.

Improvement in mortality and morbidity in transurethral resection of the prostate over 17 years in a single center.

Background And Purpose: Various improvements in the technique of transurethral resection of the prostate (TURP) have helped to reduce morbidity and mortality over the years. In this retrospective study, developments in the perioperative course in a single center were analyzed.

Patients And Methods: A retrospective chart analysis was performed on 399 patients undergoing TURP in our institution between 1987 and 1997, summarized as group 1, and 550 patients operated on between 1997 and 2004, summarized as group 2.