Endoscopic management of upper tract urothelial carcinoma in patients with a history of bladder urothelial carcinoma.

Purpose: Endoscopic management of renal pelvis and ureteral urothelial carcinoma is gaining acceptance as a conservative treatment modality. Patients with a history of bladder urothelial carcinoma are at high risk for upper tract recurrence. We evaluate the role of endoscopic management of upper tract urothelial carcinoma in patients with a history of primary bladder urothelial carcinoma.

The current role of medical simulation in american urological residency training programs: an assessment by program directors.

Purpose: Although medical simulation opportunities are increasingly available, resident training to date has involved primarily hands-on, subjective assessments. The role of simulation and computer based training for urology residents remains unknown. We evaluated the current status of medical simulation among urological training programs in the United States.

Management of nephrolithiasis after Cohen cross-trigonal and Glenn-Anderson advancement ureteroneocystostomy.

Purpose: Ureteroneocystotomy is frequently performed for ureteral injury or vesicoureteral reflux. The Glenn-Anderson technique advances the ureteral orifice distal to its native position, while the Cohen technique crosses the orifice to the opposite trigone. Each treatment can alter access to the upper genitourinary tracts.

Long-term success of antegrade endopyelotomy compared with pyeloplasty at a single institution.

Background And Purpose: The classic standard for surgical repair of ureteropelvic junction (UPJ) obstruction has been open pyeloplasty, with a 95% success rate. Antegrade endopyelotomy is a less-invasive option with a slightly lower success rate. However, recent data call into question the long-term durability of UPJ repair.

The evolution of ureteroscopy: a modern single-institution series.

Objectives: To evaluate a modern ureteroscopy series, including the use of new technological advances, operative procedures, and potential complications, at a single institution and to compare our current experience with our prior published series and the current literature.

Material And Methods: We retrospectively reviewed 1000 consecutive ureteroscopies performed in 961 patients from December 1999 to February 2003 at our institution.

Results: Semirigid and flexible ureteroscopes were used in 60.

Diabetes mellitus and hypertension associated with shock wave lithotripsy of renal and proximal ureteral stones at 19 years of followup.

Purpose: SWL has revolutionized the management of nephrolithiasis and it is a preferred treatment for uncomplicated renal and proximal ureteral calculi. Since its introduction in 1982, conflicting reports of early adverse effects have been published. However, to our knowledge the long-term medical effects associated with SWL are unknown.

Handling and prevention of complications in stone basketing.

Objective: To review the incidence, risk factors, and treatment options of intraoperative and postoperative complications of stone basketing in urology with emphasis on certain principles that must be upheld to prevent those complications.

Methods: A literature search was performed using the MEDLINE database on stone basketing between 1970 and 2005.

Results: Iatrogenic trauma due to retrieval of a stone is well known but the exact incidence is difficult to ascertain.

Ureteroiliac artery fistula: diagnosis and treatment algorithm.

Objectives: To review the diagnosis and treatment of ureteroarterial fistulas and to develop a management algorithm. Long-term ureteral stenting, along with pelvic surgery and radiotherapy, have led to an increased incidence of ureteroarterial fistulas. Experience diagnosing and treating these fistulas has been limited to case reports.

Surgical management of ureteropelvic junction obstruction in adults.

Ureteropelvic junction (UPJ) obstruction is a well-recognized entity that may present at any time - in fetal life, infancy, childhood, or early or late adulthood. As the most common site of obstruction in the upper urinary tract, the UPJ is an area with which urologists should be well familiar. There has been an improved understanding of the pathophysiology of primary congenital UPJ obstruction that has been reflected in the evolution of surgical options, from open surgical repair to minimally invasive surgery.

Urinary matrix calculi: our experience at a single institution.

Purpose: Matrix stones are an uncommon form of urinary calculi and may be mistaken for tumors involving the renal collecting system, thereby presenting a diagnostic and therapeutic dilemma to the practicing urologist.

Materials And Methods: From 1980 to 2003 we identified 5 patients with urinary matrix stones referred to our tertiary medical center for evaluation and treatment.

Results: All 5 cases had complex clinical and radiographic features at presentation.

Detection of crossing vessels as the cause of ureteropelvic junction obstruction: the role of antegrade pyelography prior to endopyelotomy.

Purpose: To review the utility of antegrade pyelography in detecting crossing vessels as the cause of uretero-pelvic junction (UPJ) obstruction prior to planned endopyelotomy.

Materials And Methods: A retrospective review of the medical records, surgical reports, and medical images was performed in 109 consecutive adult patients in our practice who underwent antegrade pyelography just prior to planned endopyelotomy for symptomatic UPJ obstruction between January 1996 and December 2002.

Results: Fourteen patients were identified in whom a specific antegrade pyelographic appearance was detected in the diagnosis UPJ obstruction caused by crossing vessels.

Percutaneous ultrasonic lithotripsy (PUL) after shock wave lithotripsy (SWL) failure.

Objective: Shock wave lithotripsy (SWL) is an attractive initial treatment for nephrolithiasis. Unfortunately, a significant number of stones are resistant to SWL therapy and require subsequent percutaneous ultrasonic lithotripsy (PUL) for definitive treatment. Our objective was to determine if previous SWL had adverse effects on PUL success and if there were differences between the patients undergoing primary PUL and those undergoing PUL after SWL failure.

Ureteroscopy: effect of technology and technique on clinical practice.

Purpose: Technical advances in ureteroscopy allow for more aggressive management of upper tract pathology. We evaluate to what extent clinical practice and treatment efficacy have been impacted by improvements in technology and technique.

Materials And Methods: In 1998, 176 consecutive patients underwent 182 ureteroscopic procedures at our institution.

Use of a temporary ureteral drainage stent after uncomplicated ureteroscopy: results from a phase II clinical trial.

Purpose: An indwelling ureteral stent is commonly placed for 48 hours after uncomplicated ureteroscopy to maintain drainage and prevent postoperative complications. A propriety temporary ureteral drainage stent (TUDS, Boston Scientific/Microvasive, Natick, Massachusetts) was developed to satisfy this goal with the added advantages of biodegradability and spontaneous passage. We evaluated TUDS performance in a patient population.

Urinary calculi in aviation pilots: what is the best therapeutic approach?

Purpose: We reviewed treatment outcomes in a series of aviation pilots treated in the era of modern surgical techniques and provide recommendations regarding treatment in this unique group.

Materials And Methods: We retrospectively analyzed the records of all aviation pilots surgically treated for urinary calculi at our 4 tertiary stone centers from January 1988 to June 2000. Preoperative data and postoperative results were evaluated.

Incidental pelvic mass identified during ultrasound-guided transrectal needle biopsy of the prostate.

Objective: Herein we report an additional case of a seminal vesicle cyst with ipsilateral renal agenesis and ectopic ureter in an asymptomatic individual with a normal examination.

Methods: We review the literature on retrovesical mas regarding the embryology, evaluation, management and treatment..

Subjective and objective comparison of critical care pathways for open donor nephrectomy.

Purpose: In the era of minimally invasive techniques and cost containment, care pathways after donor nephrectomy are important. While open donor nephrectomy remains the established procedure, questions regarding the surgical approach, postoperative care and patient morbidity/dissatisfaction have surfaced. We compared results of standard and fast-track care pathways after donor nephrectomy.