Endoscopic Stone Composition Identification: Is Accuracy Improved by Stone Appearance During Laser Lithotripsy?

Objective: To evaluate if videos during laser lithotripsy increase accuracy and confidence of stone identification by urologists compared to still pictures.

Methods: We obtained representative pictures and videos of 4 major stone types from 8 different patients during ureteroscopy with holmium laser lithotripsy. A REDCap survey was created and emailed to members of the Endourological Society.

Outcomes and Costs Following Mini-percutaneous Nephrolithotomy or Flexible Ureteroscopic Lithotripsy for 1-2-cm Renal Stones: Data From a Prospective, Randomized Clinical Trial.

Purpose: We evaluate the outcomes of ureteroscopy vs prone mini-percutaneous nephrolithotomy for 1-2-cm renal stones using a 2-group parallel randomized control trial.

Materials And Methods: Adult patients presenting with renal stones between 1 and 2 cm were randomized. Exclusion criteria included solitary kidney, multiple stones, and comorbidities precluding prone positioning.

Comparative outcomes and cost of ambulatory PCNL in select kidney stone patients.

Limited hospital resources and access to care during the COVID-19 pandemic led us to implement a quality-improvement study investigating the feasibility, safety, and costs of same-day discharge after PCNL. The outcomes of 53 consecutive first-look PCNL patients included in a same-day discharge protocol during COVID-19 were compared to 54 first-look PCNL patients admitted for overnight observation. Control group had a similar comorbidity profile.

A PEDOT nano-composite for hyperthermia and elimination of urological bacteria.

Novel modalities for overcoming recurrent urinary tract infections associated with indwelling urinary catheters are needed, and rapidly induced hyperthermia is one potential solution. PEDOT nanotubes are a class of photothermal particles that can easily be incorporated into silicone to produce thin, uniform coating on medical grade silicone catheters; subsequent laser stimulation therein imparts temperature elevations that can eliminate bacteria and biofilms. PEDOT silicone coatings are stable following thermal sterilization and repeated heating and cooling cycles.

Photothermal nanoparticles for ablation of bacteria associated with kidney stones.

Objective: To determine whether photothermal polymer nanoparticles (NPs) can interface with bacteria associated with kidney stones, generate heat when stimulated with near infrared (NIR) light, and aid in reducing bacterial burden.

Methods: Two types of kidney stones, artificial, and those removed during percutaneous nephrolithotomy (PCNL), were inoculated with () and then incubated with NPs composed of FITC-labeled Poly[4,4-bis(2-ethylhexyl)-cyclopenta[2,1-b;3,4-b']-dithiophene-2,6-diyl-alt-2,1,3-benzoselenadiazole-4,7-diyl] (PCPDTBSe). Association of the PCPDTBSe NPs was evaluated using fluorescence microscopy.

Preoperative imaging in staghorn calculi, planning and decision making in management of staghorn calculi.

Objective: Staghorn calculi present a particular and challenging entity of stone morphology. Treatment is associated with lower stone-free rates and higher complication rates compared to non-staghorn stones. In this review we looked for the most relevant data on preoperative imaging and access planning to help decision making for percutaneous surgery with this complex condition.

Evaluation of Clinical Use and Cost-Effectiveness of a Flexible Cystoscope System with a Disposable Sheath: A Randomized Clinical Trial.

Introduction: Flexible cystoscopy is routinely performed as an outpatient procedure. The use of disposable sheaths can increase cystoscope life span and reduce staff costs. The primary end point of this study was to evaluate procedure related discomfort and pain, physician maneuverability, residual bioburden and reprocessing time.

Robotic-assisted radical prostatectomy: The teaching.

Objective Of The Review: Robot assisted Radical prostatectomy (RARP) has generated a new trend in the binomial teaching/learning, grouping these techniques in training modules such as theoretical learning, practice, personalized counseling, and modern tools like simulation and practice in virtual models. This review summarizes the current trend in the teaching process of RARP. RECENT FINDINGS: Current trends in the acquisition of the RARP learning curve is to provide the Urologist with a well-structured teaching process, implementing gradual training modules, which make possible to understand all aspects of the development of prostate surgery with a robotic system.

The role of extracorporeal shock wave lithotripsy in the future of stone management.

Purpose Of Review: The most relevant recent findings on the use of extracorporeal shock wave lithotripsy (ESWL) in adult population to provide an insight of its role in the current and future of stone treatment. Comparing ESWL with other modalities is not in the scope of this review.

Recent Findings: We conducted a PubMed/Embase search and reviewed recent publications that include relevant information on the development of ESWL.

Comparative Outcomes of Conventional and Miniaturized Percutaneous Nephrostolithotomy for the Treatment of Kidney Stones-Does a Miniaturized Tract Improve Quality of Care?

Introduction: Percutaneous nephrostolithotomy is the method of choice to treat renal stones larger than 2 cm due to its high stone-free rates but it has potentially increased blood loss, postoperative pain and hospital stay compared to other treatments. Miniaturizing the percutaneous tract has recently gained interest. We performed a quality improvement study to investigate whether mini percutaneous nephrostolithotomy would reduce postoperative analgesic use, blood loss, operative time and/or hospital stay relative to the conventional approach while maintaining stone-free rates in our patient population.

[Current status of urological training in Latin America.].

Objective: Achieving residents' medical training of quality is a constant concern in the Confederación Americana de Urología (CAU), the third Urological Society worldwide. We aim to analyze the diversity of state training programs, with the intention to identify opportunities for global improvement within them and also to analyse the professional reality in different countries.

Methods: Data from 2nd and 3rd Foro Educativo CAU regarding postgraduate training and labour implications are reviewed.

Factors Associated with Trial Outcomes in the Management of Nephrolithiasis: A Legal Database Review.

Introduction: Domestically the estimated annual cost of medical malpractice is $55.6 billion. As surgical providers in a high risk subspecialty, urologists are at particularly high risk.

Ureteroscopic Urinary Stone Treatment Among Patients With Renal Anomalies: Patient Characteristics and Treatment Outcomes.

Objective: To evaluate patients' characteristics, surgical procedure data, and outcomes of ureterorenoscopy (URS) stone treatment in patients with a horseshoe kidney (HSK), ectopic kidney (EK), and malrotated kidney (MK).

Materials And Methods: This study is a subanalysis of the Clinical Research Office of the Endourological Society URS Global Study, which was a prospective multicenter observational study, collecting data on URS stone treatment from consecutive patients over a 1-year period. A total of 114 centers in 32 countries participated.

Evaluation of Renal Function after Percutaneous Nephrolithotomy-Does the Number of Percutaneous Access Tracts Matter?

Purpose: Renal function following percutaneous nephrolithotomy has long been a concern to urologists, especially in the setting of multi-tract access. We determined whether the risk of renal injury after multi-tract percutaneous nephrolithotomy was greater than after a single access approach.

Materials And Methods: We retrospectively reviewed the records of 307 consecutive patients treated with percutaneous nephrolithotomy from 2011 to 2012 at Wake Forest Health.

Percutaneous renal access: the learning curve of a simplified approach.

Background And Purpose: Fluoroscopically guided techniques to access the kidney percutaneously with low exposure to radiation have been used successfully for many years in our training center. The purpose of this study was to analyze the learning process and to establish the number of procedures necessary for a nonexperienced urologist to achieve competence at performing percutaneous renal access.

Materials And Methods: Eighty-two percutaneous renal accesses in patients with renal stones or ureteropelvic junction obstruction were evaluated.

Management of infectious complications in percutaneous nephrolithotomy.

Infectious complications are one of the most frequent and feared adverse medical events in percutaneous nephrolithotomy. They represent a dangerous and life-threatening condition, especially when postoperative septicemia or severe sepsis develops. In order to limit morbidity and mortality it is crucial to recognize preoperative and intraoperative risk factors that could be clear contributors to an adverse infectious event; those factors are mainly immunosuppression caused by some comorbidities, presence of urinary infection or colonization, stone characteristics, obstruction, long-lasting operation, and high intrapelvic pressure during nephrolithotomy.

Interaction of intracorporeal lithotripters with Proteus mirabilis inoculated inside artificial calcium and struvite stones.

Background And Purpose: Renal calculi may contain bacteria that can remain active inside the stone and produce bacteremia and/or endotoxemia after lithotripsy. Urinary tract infection associated with urinary stones represents high morbidity. The purpose of this research was to use novel artificial struvite stones inoculated with living bacteria and to study the effect of four different intracorporeal lithotripters on bacterial inactivation after in vitro lithotripsy.

Proposed urodynamic pressure-flow nomogram to diagnose female bladder outlet obstruction.

Objective: To investigate female bladder outlet obstruction by urodynamics and create a nomogram to propose in clinical applications.

Patients And Methods: We investigated by urodynamic studies 200 women referred for lower urinary tract symptoms. A total of 179 patients were available for analysis: 136 served as control and 43 as obstructed.