Emphysematous pyelonephritis: the impact of urolithiasis on disease severity.

Background: Emphysematous pyelonephritis is a severe infection of the kidney associated with formation of gas in the renal parenchyma and/or collecting system. The purpose of this study was to evaluate outcomes of patients with emphysematous pyelonephritis in a contemporary cohort and to evaluate the impact of urolithiasis on disease severity.

Methods: A search of all imaging reports at University of California San Francisco (UCSF) for the term "emphysematous pyelonephritis" was undertaken from 2003-2014.

Trends in Renal Transplantation Rates in Patients with Congenital Urinary Tract Disorders.

Purpose: Improved bladder and renal management benefit patients with congenital uropathy and congenital pediatric kidney disease. This may translate to delayed initial renal transplantation in these patients, and improved graft and patient survival. Our primary study purpose was to determine whether patients with congenital uropathy and congenital pediatric kidney disease have demonstrated later time to first transplantation and/or graft survival.

The mechanism of continence after posterior urethroplasty.

The standard of care after a pelvic fracture urethral injury is a repair via a one-stage anastomotic posterior urethroplasty using a step-wise perineal approach. The initial injury, immediate postoperative management, and surgical repair can all affect urinary continence in these patients. Proximal continence mechanisms, particularly the bladder neck, are particularly important in maintaining urinary continence in these patients.

Sports-related genitourinary injuries presenting to United States emergency departments.

Objective: To describe epidemiologic features of sports-related genitourinary (GU) injuries and determine patient cohorts and particular sporting activities associated with increased GU injury risk.

Materials And Methods: The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury-related US emergency department (ED) presentations, was analyzed to characterize GU injuries between 2002 and 2010. A total of 13,851 observations were analyzed to derive national estimates.

Bicycle-related genitourinary injuries in the USA from 2002-2010.

Among children, the incidence of bicycle-related genitourinary (GU) injuries was 448 per 100 000 (95% CI 383 to 514) and, among adults, was 53 per 100 000 (95% CI 36 to 71). Although children sustained more injuries, adults were more likely to being admitted to the hospital for the GU injury (OR 1.95, 95% CI 1.

Intratesticular abscess in a solitary testicle: the case for testicle sparing management.

We present the case of a 24-year-old immunocompromised man with an intratesticular abscess. The patient presented with one week of left scrotal pain and swelling. Workup included scrotal ultrasonography which revealed a large fluid collection within the tunica albuginea of the left testis.

Selective angioembolization for traumatic renal injuries: a survey on clinician practice.

Purpose: A variety of clinical and imaging findings are used by clinicians to determine utility of renal angioembolization (AE) in managing renal trauma. Our purpose was to investigate specific criteria that clinicians who manage high-grade renal trauma (HGRT) utilize in decision-making for primary or delayed AE.

Methods: A total of 413 urologists and interventional radiologists (IRs) who practice at level 1 or 2 trauma centers within the United States were provided an original survey via email on experience and opinions regarding the utility of AE for HGRT.

No small slam: increasing incidents of genitourinary injury from toilets and toilet seats.

Objective: To describe the epidemiology of genitourinary (GU) injury from toilets that present to USA Emergency rooms (ERs).

Materials And Methods: The National Electronic Injury Surveillance System (NEISS) is a stratified probability sample of hospital ER visits for USA consumer product-related injuries. NEISS was used to estimate total toilet- and toilet seat-related GU injury for the years 2002-2010, as well as to describe demographics and injury characteristics.

Zip-related genital injury.

Objective: To describe the epidemiology of genital injuries caused by trouser zips and to educate both consumers and the caregivers of patients who sustain such injuries.

Patients And Methods: The National Electronic Injury Surveillance System, a dataset validated to provide a probability sample of patients who present to emergency departments (EDs) in the USA with injuries, was analysed to characterize zip-related genital injuries occurring between 2002 and 2010. A total of 523 cases were analysed to obtain national estimates.

Gunshot wounds to the lower urinary tract: a single-institution experience.

Background: This study aimed to analyze characteristics and outcomes of gunshot wounds to the lower urinary tract at our Level I trauma center. Our hypothesis is that gunshot wounds to the lower urinary tract have characteristic bullet trajectories, injury patterns, and associated injuries.

Methods: Our prospective trauma database was composed of reviewed gunshot wounds to the lower urinary tract including the pelvic ureter, bladder, or urethra from 1989 through 2011.

New insights into the pathogenesis of renal calculi.

The pathophysiology of the various forms of urinary stone disease remains a complex topic. Epidemiologic research and the study of urine and serum chemistries have created an abundance of data to help drive the formulation of pathophysiologic theories. This article addresses the associations of urinary stone disease with hypertension, cardiovascular disease, atherosclerosis, obesity, dyslipidemia, diabetes, and other disease states.

Pediatric genitourinary injuries in the United States from 2002 to 2010.

Purpose: We describe the epidemiological features of pediatric genitourinary injuries, and determine the products and events that may predict an increased risk of genitourinary injury during childhood.

Materials And Methods: The National Electronic Injury Surveillance System was queried to identify children 18 years or younger who sustained genitourinary injuries and presented to emergency departments in the United States between 2002 and 2010. Demographics and injury characteristics of these children were analyzed.

Product related adult genitourinary injuries treated at emergency departments in the United States from 2002 to 2010.

Purpose: We describe the epidemiological features of adult genitourinary injuries related to consumer products and determined the patient cohorts, products and situations associated with increased genitourinary injury risk.

Materials And Methods: The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury related emergency department presentations in the United States, was analyzed to characterize genitourinary injuries from 2002 to 2010. We analyzed 3,545 observations to derive national estimates.

Pubic hair grooming injuries presenting to U.S. emergency departments.

Objective: To describe the demographics and mechanism of genitourinary (GU) injuries related to pubic hair grooming in patients who present to U.S. emergency departments (EDs).

Prostate size is not associated with recovery of sexual function after minimally invasive radical prostatectomy.

Objectives: To investigate the association of prostate weight with recovery of sexual function after minimally invasive radical prostatectomy.

Methods: Between April 2001 and September 2007, two surgeons performed 856 consecutive laparoscopic radical prostatectomies for clinically localized prostate cancer. Patients were stratified into three groups by prostate weight: <35 g, 35-70 g, and >70 g.

Status of endoscopes and instruments used during NOTES.

Natural orifice translumenal endoscopic surgery (NOTES) requires an intentional perforation of a hollow lumen to pass an endoscope into an otherwise inaccessible body cavity with diagnostic or therapeutic intent. The limitations of current flexible instruments for this purpose are outlined, including the unsuitability for NOTES of current flexible needle knives, guidewires, balloons, overtubes, grasping forceps, and scissors. The development of novel suturing instruments, trocars, articulating instruments, flexible bipolar forceps, flexible clips, magnetic devices, and staplers as well as the advent of manual mechanical manipulators for flexible accessories is outlined.

Urethral carcinosarcoma from bladder carcinosarcomatous lesions: analysis of clinicopathological features.

Carcinosarcoma (CS) of the bladder is a rare malignancy of the genitourinary tract that is highly aggressive with unfavorable prognoses. Data regarding the epidemiological and clinicopathological characteristics of CS of the urinary bladder have been limited due to the low reported incidence of the tumor. In particular, there is little evidence on recurrence patterns and surveillance after definitive surgical therapy.

The impact of prostate size on urinary quality of life indexes following laparoscopic radical prostatectomy.

Purpose: We assessed the effects of prostate size on long-term health related quality of life and functional outcomes after laparoscopic radical prostatectomy.

Materials And Methods: A total of 729 consecutive patients who underwent laparoscopic radical prostatectomy for localized prostate cancer were stratified by pathological prostate gland weight, including group 1--less than 35 gm, group 2--35 to 70 gm and group 3--greater than 70 gm. Urinary health related quality of life was assessed preoperatively and at regular intervals following laparoscopic radical prostatectomy using the validated Expanded Prostate Cancer Index Composite questionnaire.

Laparoscopic treatment of simultaneous tumors in the liver and kidney.

Background/aims: To report our experience with laparoscopic treatment of liver tumors during right-sided transperitoneal laparoscopic nephrectomy.

Methods: Two patients undergoing transperitoneal laparoscopic radical nephrectomy on the right side each had a concomitant tumor in the right lobe of the liver. The first patient was incidentally found to have a lesion suspicious for metastatic disease.

Laparoscopic heminephrectomy for renal cell carcinoma in cross-fused ectopic kidney.

Crossed renal ectopia is a rare congenital malformation. We report a case of renal cell carcinoma in a 51-year-old man with right-to-left crossed fused renal ectopia. The patient was treated with ultrasound-guided laparoscopic heminephrectomy.

Postchemotherapy laparoscopic retroperitoneal lymph node dissection: evaluation of complications.

Objectives: Initial publications on postchemotherapy laparoscopic retroperitoneal lymph node dissection (LRPLND) have described significant intraoperative and postoperative morbidities. This report reviewed the complication rate with additional experience.

Methods: A retrospective review of the medical records of 16 consecutive patients who underwent postchemotherapy LRPLND by a single surgeon from September 1996 to September 2005 was performed.

Complications of 2,775 urological laparoscopic procedures: 1993 to 2005.

Purpose: We assessed the complications associated with urological laparoscopic surgery at a single high volume center during a 12-year period.

Materials And Methods: A retrospective chart analysis was performed, focusing on complications associated with 2,775 laparoscopic surgeries occurring between 1993 and 2005. These included radical nephrectomy (549), partial nephrectomy (345), donor nephrectomy (553), simple nephrectomy (186), pyeloplasty (301), nephroureterectomy (105), retroperitoneal lymph node dissection (86), renal ablation (81), adrenalectomy (106) and radical prostatectomy (463).

Pure laparoscopic radical nephrectomy with level II vena caval thrombectomy.

Continued experience with the laparoscopic technique has allowed for controlled resection of renal neoplasms invading the renal vein and inferior vena cava. We present the case of a patient with a primary renal tumor extending into the vena cava that was completely managed with a laparoscopic approach.