The impact of retrograde intrarenal surgery for asymptomatic renal stones in patients undergoing ureteroscopy for a symptomatic ureteral stone.

Background And Purpose: In the era of rigid ureteroscopy (URS) for ureteral stones, asymptomatic renal stones were often left in place. With the advent of flexible URS, however, the treatment of such renal stones became an attractive option. Data are scarce regarding the impact of retrograde intrarenal surgery (RIRS) performed at the time of URS for a symptomatic ureteral stone in comparison with ureteral stone removal alone.

Transurethral resection of bladder tumour complicated by perforation requiring open surgical repair - clinical characteristics and oncological outcomes.

Objective: • To examine the clinical characteristics and long-term outcomes of patients with bladder perforation requiring open surgical repair as a complication of transurethral resection of bladder tumour (TURBT).

Patient And Methods: • A search of our institutional database yielded 4144 patients who underwent TURBT from 1996 to 2008, of whom 15 (0.36%) required open surgical intervention to repair a large bladder perforation.

Predictors of nocturia quality of life before and shortly after prostatectomy.

Objectives: To evaluate the predictors of nocturia-related quality of life and to assess the early effect of prostatectomy on these parameters in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction.

Methods: The study group included 56 consecutive patients scheduled for prostatectomy to treat medical treatment-refractory lower urinary tract symptoms. Nocturia severity was assessed preoperatively and 2 to 3 months after prostatectomy by the number of nocturia events, time from falling sleep to first awakening to void (hours of undisturbed sleep [HUS]), longest sleep interval between voids, and score on the nocturia quality-of-life (N-QOL) questionnaire (range 0 to 48).

Early initiation of aspirin after prostate and transurethral bladder surgeries is not associated with increased incidence of postoperative bleeding: a prospective, randomized trial.

Purpose: Lower urinary tract operations are being increasingly performed in elderly patients, in whom aspirin intake is common for preventing cardiovascular disease. We determined the safety of early aspirin re-initiation after lower urinary tract surgeries.

Materials And Methods: A randomized, open label clinical trial was done.

Expanding use of ureteral access sheath for stones larger than access sheath's internal diameter.

The internal diameter of the ureteral access sheath limits the size of stones that can be removed during flexible ureteroscopy. We describe a technique that allows removal of larger stones, which are entrapped and removed en bloc with the access sheath. This new technique was shown to be efficient and safe.

Retrograde intrarenal surgery as second-line therapy yields a lower success rate.

Background And Purpose: Retrograde intrarenal surgery (RIRS) is a recent addition to the treatment options for renal calculi. Therefore, the indications, as well as the predictors of success, are still being studied. Herein, we report a retrospective comparison of RIRS performed as the primary treatment and as second-line therapy, mostly after shockwave lithotripsy (SWL) failure.

Clinical implication of routine stone culture in percutaneous nephrolithotomy--a prospective study.

Objectives: To evaluate the correlation between preoperative urine culture (UC) and intraoperative stone culture (SC) and the impact of SC findings on clinical decisions.

Methods: UC and intraoperative fragmented SC were prospectively obtained in all patients undergoing percutaneous nephrolithotomy between January 2004 and March 2005. Patients with a positive UC received a full course of antibiotics before surgery.

Percutaneous nephrolithotomy in patients who previously underwent open nephrolithotomy.

Background And Purpose: Open stone surgery nowdays is rare. However, some patients who are treated today have in the past undergone open nephrolithotomy. The aim of this study was to determine the possible impact of open nephrolithotomy on the efficacy and morbidity of subsequent percutaneous nephrolithotomy (PCNL).

Ureteral ultrasonic lithotripsy revisited: a neglected tool?

Background And Purpose: Ultrasonic lithotripsy was one of the first modalities used for treating renal and ureteral stones. However, in recent years, it has been largely replaced by newer techniques such as laser lithotripsy with rigid as well as flexible ureteroscopes. The aim of this study was to review the results and our current indications for ureteroscopic ultrasonic lithotripsy (UUL).

Abdominal compartment syndrome: urological aspects.

ACS is prevalent in various surgical conditions and in a large percentage of critically ill patients. Measuring the IAP is important in the early diagnosis of ACS and can be easily done by measuring the intravesical pressure. ACS adversely affects many organ systems; the pathogenesis of renal dysfunction is probably multifactorial, from a combination of reduced cardiac output, reduced GFR mediated by secretion of renin and angiotensin, aldosterone-mediated water reabsorption, increased renal parenchymal pressure and direct compression of the renal vein.

Urinary tract infection in men younger than 45 years of age: is there a need for urologic investigation?

Objectives: To determine in a prospective study whether urinary tract infection (UTI) in men younger than 45 years of age is associated with anomalies of the genitourinary tract that necessitate additional urologic evaluation. UTI in young men is uncommon. In these patients, it is customary to follow the same policy as that for children or older men and to routinely perform urologic investigations.

Intrarenal foreign body presenting as a solid tumor.

A 45-year-old man underwent radical nephrectomy for an asymptomatic solid renal mass radiographically interpreted as a tumor. The pathologic examination revealed an intrarenal sponge forgotten during nephrolithotomy performed 5 years previously. The sponge was surrounded by a thick fibrous capsule.

Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy.

Purpose: Although urinary tract infection is a recognized complication of transrectal ultrasound guided prostate biopsy, to our knowledge there are no recommendations in the literature for its management. We studied the unique features of this infection and provide management recommendations.

Materials And Methods: A prospective design was used.

Metastatic renal carcinoid: case report and review of the literature.

Primary renal carcinoid tumor is a rare tumor of the kidney. Metastatic renal carcinoid tumor has not been described in the medical literature. We report a case of renal metastasis of a primary bronchial carcinoid tumor and review the literature about renal carcinoid tumors.

Leiomyoma of the urinary bladder.

Leiomyoma of the urinary bladder is a rarity but should be considered in the differential diagnosis of intramural neoplasm. We report a case illustrating clinical and pathological features in particular the immunohistochemistry. Etiology and differential diagnosis are discussed.

Lymph-node revealing solution: a new method for detecting minute lymph nodes in cystectomy specimens.

Objective: To describe the use of a new lymph-node revealing solution (LNRS) for detecting lymph node involvement in total cystectomy specimens from patients with locally confined invasive transitional cell carcinoma (TCC) of the bladder, and to compare the results obtained with those using the conventional method (palpation and sectioning perivesical fat) that may fail to detect very small lymph nodes.

Materials And Methods: Of 12 cystectomy specimens obtained from patients with TCC, six in which 0-3 metastatic nodes were identified by the conventional method were further investigated using LNRS. The revealing solution comprised 95% ethanol, diethyl ether, glacial acetic acid and buffered formalin (65:20:5:10 v/v) prepared under a fume-hood.

Transvesical prostatectomy in elderly patients.

Purpose: We assessed the results of transvesical prostatectomy in patients older than 80 years.

Materials And Methods: We studied 98 patients 80 to 90 years old who underwent transvesical prostatectomy between 1986 and 1993, including those with a large prostate (preoperative estimated weight more than 80 gm.), numerous or large cystolithiasis and large bladder diverticulum, which are indications for open prostatectomy.

The clinical and histological features of transitional cell carcinoma of the bladder with microcysts: analysis of 12 cases.

Objective: To describe the clinical course and histological features of transitional cell carcinoma (TCC) of the bladder with microcysts.

Patients And Methods: Among 940 patients with bladder TCC diagnosed at our institution during a 5 year period. 12 (1.

The role of external sphincterotomy for patients with a spinal cord lesion.

For the last three decades external sphincterotomy has been well accepted as a treatment for bladder outlet obstruction in patients with a spinal cord lesions. Recently, however, its value has been brought into question. To assess the current place of this procedure in the treatment of the neuropathic bladder of spinal origin, we studied the outcomes of sphincterotomy in 32 patients.

[Anterior vaginal wall and pelvic floor sling for stress incontinence].

There is considerable doubt as to whether the intra-abdominal position of the urethra is the critical factor in maintenance of continence. Recent studies have suggested that a firm, supportive, suburethral layer is required for urethral closure during effort. The surgical procedure we describe is performed by vaginal approach and involves creation of a sling from the vaginal wall and underlying musculofascial layer, that provides compression and support for the urethra and resuspends the bladder neck.

The pattern of radionuclide scrotal scan in torsion of testicular appendages.

The aim of this study was to define the radionuclide scrotal imaging (RSI) pattern in cases of torsion of testicular appendages and to correlate it with the duration of symptoms. Two hundred and seventeen patients with acute scrotal pain were evaluated prospectively during the past 13 years. Two groups of patients were defined according to the interval between the onset of symptoms and the performance of RSI: group A comprised patients in whom RSI was performed within 5 h after the onset of symptoms, while group B comprised patients in whom RSI was performed between 5 and 24 h after the onset of symptoms.

The value of radionuclide scrotal imaging in the diagnosis of acute testicular torsion.

Objective: To assess the accuracy of radionuclide scrotal imaging (RSI) in the diagnosis of testicular torsion and torsion of testicular appendages.

Patients And Methods: Eighty-seven patients (mean age 30.1 years, range 8-65) who presented with acute scrotal pain were evaluated by RSI and the results correlated with the clinical and surgical findings.