Predictors of Postoperative Urinary Incontinence After Holmium Laser Enucleation of the Prostate: 12 Months Follow-Up.

Objective: To identify pre- and perioperative factors associated with incontinence after holmium laser enucleation of the prostate for benign prostatic hyperplasia.

Methods: Retrospective review of our single-surgeon database identified 88 patients with 12 months' follow-up who underwent surgery between December 2014 and November 2016. Postoperative urinary incontinence was defined as 1 or more pads per day.

Sensitivity of Noncontrast Computed Tomography for Small Renal Calculi With Endoscopy as the Gold Standard.

Objective: To compare the sensitivity of noncontrast computed tomography (CT) with endoscopy for detection of renal calculi. Imaging modalities for detection of nephrolithiasis have centered on abdominal x-ray, ultrasound, and noncontrast CT. Sensitivities of 58%-62% (abdominal x-ray), 45% (ultrasound), and 95%-100% (CT) have been previously reported.

Addition of Sodium Bicarbonate to Irrigation Solution May Assist in Dissolution of Uric Acid Fragments During Ureteroscopy.

Introduction: We hypothesized that adding sodium bicarbonate (bicarb) to normal saline (NS) irrigation during ureteroscopy in patients with uric acid (UA) nephrolithiasis may assist in dissolving small stone fragments produced during laser lithotripsy. In vitro testing was performed to determine whether dissolution of UA fragments could be accomplished within 1 hour.

Materials And Methods: In total 100% UA renal calculi were fragmented, filtered, and separated by size.

A Survey Regarding Preference in the Management of Bilateral Stone Disease and a Comparison of Clavien Complication Rates in Bilateral vs Unilateral Percutaneous Nephrolithotomy.

Objective: To discuss complications of simultaneous bilateral percutaneous nephrolithotomy (SB-PCNL) when compared with unilateral percutaneous nephrolithotomy and survey surgeon preference in bilateral stone disease management.

Patients And Methods: A database of all participating percutaneous nephrolithotomy (PCNL) patients who underwent treatment at Indiana University Health Methodist Hospital within a 10-year period from 2006 to 2015 by a single surgeon (JL) was utilized. Perioperative data, as well as complications, defined according to the Clavien grading system, were recorded.

Preoperative Bladder Urine Culture as a Predictor of Intraoperative Stone Culture Results: Clinical Implications and Relationship to Stone Composition.

Purpose: We examine the relationship between urine and stone cultures in a large cohort of patients undergoing percutaneous stone removal and compare the findings in infectious vs metabolic calculi.

Materials And Methods: A total of 776 patients treated with percutaneous nephrolithotomy who had preoperative urine cultures and intraoperative stone cultures were included in the study. Statistical analysis used chi-square or logistic fit analysis as appropriate.

Introduction of a Renal Papillary Grading System for Patients with Nephrolithiasis.

An overlooked finding at the time of renal endoscopy for patients with nephrolithiasis is the appearance of the renal papillae. Recent work has demonstrated that it is possible to distinguish specific stone-forming phenotypes by endoscopic patterns of papillary appearance alone. These variable expressions are likely to have clinical significance; yet, the ability to pursue such research efforts remains limited by the lack of a standardized system to describe these findings.

A Proposed Grading System to Standardize the Description of Renal Papillary Appearance at the Time of Endoscopy in Patients with Nephrolithiasis.

Background And Purpose: The appearance of the renal papillae in patients with nephrolithiasis can be quite variable and can range from entirely healthy to markedly diseased. The implications of such findings remain unknown. One potential reason is the lack of a standardized system to describe such features.

Wolf Piranha Versus Lumenis VersaCut Prostate Morcellation Devices: A Prospective Randomized Trial.

Purpose: Holmium laser enucleation of the prostate for the management of benign prostatic hyperplasia involves the 2 steps of enucleation and morcellation. Few prostate morcellation devices are available. In this study we compare the Wolf Piranha and Lumenis® VersaCut™ prostate morcellation devices.

Initial Experience and Comparative Efficacy of the UreTron: A New Intracorporeal Ultrasonic Lithotriptor.

Objective: To describe the initial clinical experience with the UreTron (Med-Sonics, Erie, PA), a new ultrasonic lithotriptor. Historically, ultrasound-only intracorporeal lithotriptors have been considered the gold standard for stone removal during percutaneous nephrolithotomy. Recently, they have lost favor to newer dual and combination devices believed by many to be more efficient.

Nephrocalcinosis in Calcium Stone Formers Who Do Not have Systemic Disease.

Purpose: Nephrocalcinosis is commonly present in primary hyperparathyroidism, distal renal tubular acidosis and medullary sponge kidney disease. To our knowledge it has not been studied in patients with calcium phosphate stones who do not have systemic disease.

Materials And Methods: We studied patients undergoing percutaneous nephrolithotomy who had calcium phosphate or calcium oxalate stones and did not have hyperparathyroidism, distal renal tubular acidosis or medullary sponge kidney disease.

Vascular complications after percutaneous nephrolithotomy: 10 years of experience.

Objective: To provide a contemporary look at vascular complications after percutaneous nephrolithotomy (PNL) with access performed solely by a urologist using fluoroscopic guidance.

Methods: A retrospective review of 2792 patients who had 3338 PNLs at Indiana University Health Methodist Hospital and Mayo Clinic Rochester was performed. Patients who experienced significant bleeding requiring diagnostic renal angiography and superselective embolization (SSE) were reviewed and compared with the overall database.