TFE3-rearranged RCC with osseous metaplasia found on bone mass densitometry.

Introduction And Importance: Renal cell carcinoma (RCC) is the most common primary renal malignancy in patients between the ages of 50 and 70. A rare described variant of RCC is transcription factor for immunoglobulin heavy-chain enhancer 3 (TFE3) rearranged RCC. Osseous metaplasia, which refers to the occurrence of normal bone tissue in soft tissue, has been observed in all subtypes of renal cell carcinoma (RCC); however, only three previous case reports have documented the occurrence of osseous metaplasia in TFE3-rearranged RCC.

The impact of AirSeal on complications and pain management during robotic-assisted radical prostatectomy: a single-tertiary center study.

Purpose: We aimed to compare perioperative outcomes, post-operative complications, and opioid use between AirSeal and non-AirSeal robotic-assisted radical prostatectomy (RARP).

Methods: We retrospectively collected data on 326 patients who underwent elective RARP at our institution either with or without AirSeal. The first 60 cases were excluded accounting for the institutions' learning curve of RARP.

Comparative analysis of partial versus radical nephrectomy for renal cell carcinoma: Is oncologic safety compromised during nephron sparing in higher stage disease?

Objectives: Over the past 20 years, the utility of partial nephrectomy (PN), compared to radical nephrectomy (RN), for the management of localized renal cell carcinoma (RCC) has progressively increased, particularly for larger and more complex masses. We sought to compare the recurrence-free survival (RFS) outcomes of PN versus RN in a single-institution cohort.

Methods: Between 2002 and 2017, 228 patients underwent RN or PN for lcT1a-T2b, N0M0 RCC at a single tertiary referral center, performed by five surgeons.

Impact of Obstructive Sleep Apnea Syndrome on Time to Complete Recovery of Continence After Robot-Assisted Radical Prostatectomy: A Propensity Score Matching Analysis.

Postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP) represents a bothersome side effect, which may permanently affect patient's quality of life. Several studies have demonstrated that obstructive sleep apnea syndrome (OSAS) is associated with urinary symptoms such as urge incontinence, overactive bladder, and nocturia. In this study, we sought to further explore the effect of OSAS on urinary continence after RARP.

The 5-item frailty index predicts 30-day morbidity and mortality in radical nephrectomy patients: A propensity matched analysis.

Purpose: To assess the ability of the 5-item frailty index (5-IFi) score to predict 30-day morbidity and mortality post-radical nephrectomy (RN).

Methods: ACS-NSQIP database was used to select patients who underwent RN from 2011 to 2020. 5-IFi score was calculated by assigning a point for each of the following comorbidities: chronic obstructive pulmonary disease or pneumonia, congestive heart failure, dependent functional status, hypertension, and diabetes.

A novel nephrectomy-specific respiratory failure index using the ACS-NSQIP dataset.

Purpose: Post-operative pulmonary failure is a major complication of nephrectomy that may lead to severe morbidity and mortality. Hence, we aimed to derive a nephrectomy-specific post-operative respiratory failure index.

Methods: Our cohort was derived from The American College of Surgeons-National Surgical Quality Improvement Program database between 2005 and 2019.

Surgical Complications Requiring Reoperation in Open Versus Minimally Invasive Radical Nephrectomy: A Contemporary Analysis of the National Surgical Quality Improvement Program.

Background: To explore reoperation rates for different radical nephrectomy (RN) approaches that are experiencing a shift from open radical nephrectomy (ORN) toward minimally invasive surgery (MIS), we aimed to compare reoperation rates along with their culprit etiologies between the different types of surgical approaches for RN.

Methods: The national surgical quality improvement program dataset was used to select patients who underwent RN between the years 2012-2019. A 1:1 propensity score matched analysis was used.

Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program.

Background: The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures.

Objectives: We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy.

Design And Methods: Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017.

A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery.

Purpose: Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to derive a prostatectomy specific index (PSI) for patients undergoing RP and compare its performance to universally used indices.

The R.E.N.A.L score's relevance in determining perioperative and oncological outcomes: a Middle-Eastern tertiary care center experience.

Objective: The aim of this study is to evaluate the significance of the R.E.N.

Telemedicine and Telementoring in Urology: A Glimpse of the Past and a Leap Into the Future.

Telemedicine is the process of utilizing telecommunications and digital relay to perform, teach, or share medical knowledge. The digital era eased the incorporation of telemedicine to different areas of medical care, including the surgical care of Urologic patient mainly through telementoring, telesurgery, and telerobotics. Over the years, Telemedicine has played an integral part in a physicians' ability to provide high quality medical care to remote patients, as well as serve as an educational tool for trainee physicians, in the form of telementoring.

Outcomes of active surveillance for clinically localized prostate cancer in a middle eastern tertiary care center.

Background: The aim of our study was to evaluate the outcome of active surveillance (AS) for prostate cancer for a cohort of patients at our institution.

Methods: A total of 43 patients with low risk prostate cancer were enrolled in an active surveillance pilot program at our institution between 2008 and 2018. Follow up protocols included: periodic prostate specific antigen (PSA), digital rectal examination (DRE), multiparametric MRI, and prostate biopsy at one year.

Use of Bariatric Ports in 4-Arm Robotic Partial Nephrectomy: A Comparative Study With the Standard 3-Arm Technique.

Objectives We aim to compare the outcomes of a 3-arm versus a 4-arm robotic assisted partial nephrectomy (RAPN) using the da Vinci Si model; as well as, illustrate the deployment of long ports to decrease arm collision during the 4-arm approach. Patients and Methods Results of RAPN in a Middle Eastern tertiary referral center from August 2013 to December 2017 are reported. Comparison between 3 versus 4-arm robotic approaches was done in regards to patient and tumor characteristics, operative parameters, and postoperative outcomes.

Comparative analysis of histopathological subtypes of renal cell carcinoma in the Middle East compared to other world regions.

Introduction: Renal cell carcinoma (RCC) has various histopathological tumor subtypes which have a significant implication on the oncological outcome of these patients. We aimed to evaluate the distribution of RCC subtypes presenting at a tertiary care center in the Middle East, in comparison to the distribution reported in different geographic areas worldwide.

Methods: A retrospective chart review was conducted on all patients who underwent partial or radical nephrectomy for RCC at the American University of Beirut Medical Center between January 2012 and January 2018.

Integration of aquablation through telemetry: an alternative to onsite proctoring?

Purpose: To evaluate the feasibility of telementoring for aquablation by comparing the outcomes of onsite versus telemetry proctoring.

Methods: The telemetry device of choice was Proximie, an innovative digital platform that uses live video stream with an augmented reality technology. Our study retrospectively reviewed outcomes from our IRB approved prospective Aquablation database from March 2018 till October 2019.

Is age an independent risk factor for perioperative mortality and morbidity after radical prostatectomy? Analysis of the American college of surgeons national surgical quality improvement program database.

Objectives: To assess the safety and surgical outcomes of radical prostatectomy (RP) when looking at age as an independent risk factor of perioperative mortality and morbidity.

Patients And Methods: A retrospective cohort study was performed using American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent a RP from 2008 to 2015 were identified.

Development of a novel nomogram incorporating platelet-to-lymphocyte ratio for the prediction of lymph node involvement in prostate carcinoma.

Objective: The available nomograms used to predict lymph node involvement (LNI) are not comprehensive. We sought to derive a novel nomogram incorporating the platelet to lymphocyte ratio (PLR) to predict LNI and compare its performance to validated preoperative risk nomograms in a cohort of men undergoing robotic-assisted radical prostatectomy at our institution.

Methods: Our electronic health record was queried for patients who underwent robotic-assisted radical prostatectomy with bilateral pelvic lymphadenectomy between 2013 and 2019.

Differentiation of Urothelial Carcinoma into Two Distinct Subtypes, Glandular and Squamous, in Three Different Organs.

Urothelial carcinoma (UC) is a unique entity with different histological variants: squamous, glandular, small cell, micropapillary, sarcomatoid, and plasmacytoid. Each of those subtypes behaves differently. As such, and in many scenarios, an accurate histological diagnosis is of paramount importance to dictate the therapeutic approach.

Surgical Treatment of Amiodarone-Induced Thyrotoxicosis in an Adult with Congenital Heart Disease: An Anesthetists Perspective.

BACKGROUND Amiodarone-induced thyrotoxicosis can be refractory to medical treatment seldom requiring surgical intervention. Herewith, we present the first case to date of amiodarone-induced thyrotoxicosis in a congenital heart disease post-Senning procedure requiring emergent surgical management. CASE REPORT A 19-year-old-male patient with a history of a complex congenital heart disease developed severe pulmonary baffle stenosis and atrial fibrillation that was medically treated with amiodarone, upon which he developed.

Isolated Testicular Metastasis Diagnosed More than a Decade and a Half Post Primary Treatment for Prostate Cancer.

Prostate cancer is the most common visceral malignancy among men. It rarely metastasizes to the testicles. We herein present the case of a male patient who underwent a radical prostatectomy for a grade group 3 Gleason score 7 (4 + 3) prostate adenocarcinoma followed by adjuvant radiation therapy and continuous androgen deprivation therapy after his first biochemical recurrence.

Seldom Differential of Dysuria in Northern America.

Human schistosomiasis or bilharzia is a parasitic disease that highly impacts a country's health and economic systems specifically when it affects individuals residing in underdeveloped countries. Daughter eggs produced by colonized Schistosoma can lead to multisystem immune-mediated response, one of them is an intravesicular granulomatous reaction leading to intramural lesions. Such outcome is directly related to the incubation of adult worms within the perivesical urogenital venous plexus.

Adrenal Cystic Lymphangioma: An Unexpected Pathological Finding in a Constellation of Uncontrolled Hypertension and Hypercalcemia.

Adrenal cysts are rarely observed lesions. Adrenal cystic lymphangiomas are asymptomatic benign lesions of the lymphatic vessels with the vast majority occurring in women. We herein present a rare case of a middle-aged gentleman with labile blood pressure associated with an incidental finding of an adrenal mass of 4 x 3 x 3 cm.

A yellow-colored lipomatous lesion of the bladder: An unorthodox finding seen upon investigation for microscopic hematuria.

Bladder lesions are almost always malignant where only 5% turn out to be benign. Among the benign lesions, bladder lipomas are rarely reported in the literature. Typically, they are incidentally discovered, after endoscopic resection, during an investigation for hematuria or other urinary tract symptoms.

Penile hair strangulation: A prodigious cause of pediatric agitation.

Penile hair strangulation is secondary to a hair tourniquet effect. Albeit a rare presentation in pediatric emergency units, penile hair strangulation must be cautiously noted in any penile pain and edema, to avoid inevitable damage to external genitalia, including penile necrosis, urethrocutaneous fistula, and even amputation.

Multimodality approach to imaging giant multilocular cystadenoma of the prostate: A rare entity.

Giant multilocular cystadenomas of the prostate or seminal vesicles are rarely reported in literature. We present a case of a 76-year-old male presenting with lower urinary tract symptoms initially perceived as symptoms of benign prostatic hyperplasia. The patient was investigated by employing a multimodality imaging approach of the prostate that included ultrasound, computed tomography, and magnetic resonance imaging, which resulted in an incidental finding of large multiloculated benign cysts originating from the prostate, confirmed by pathological study.