Accuracy and implications of percutaneous renal biopsy in the management of renal masses.

Introduction: Percutaneous renal biopsy in patients with renal masses is increasing. We investigated the accuracy of percutaneous renal mass biopsy results in patients undergoing evaluation of solid renal masses.

Methods: A retrospective review was performed of patients in the Kaiser Permanente Southern California Region who underwent computed tomography or ultrasound-guided percutaneous renal biopsy of a solid renal mass between January 2005 and December 2009.

Achieving proficiency with robot-assisted radical prostatectomy: Laparoscopic-trained versus robotics-trained surgeons.

Background: Initiating a robotics program is complex, in regards to achieving favourable outcomes, effectively utilizing an expensive surgical tool, and granting console privileges to surgeons. We report the implementation of a community-based robotics program among minimally-invasive surgery (MIS) urologists with and without formal robotics training.

Methods: From August 2008 to December 2010 at Kaiser Permanente Southern California, 2 groups of urologists performing robot-assisted radical prostatectomy (RARP) were followed since the time of robot acquisition at a single institution.

Differences in left and right laparoscopic adrenalectomy.

Background And Objectives: The classic belief is that right-sided laparoscopic adrenalectomy is technically more difficult to perform than left-sided. The purpose of this study was to determine whether objective outcomes are different for the right- versus left- sided operation.

Methods: A retrospective review of 163 laparoscopic adrenalectomies was performed to compare outcomes.

Obesity is a significant risk factor for prostate cancer at the time of biopsy.

Objectives: Studies suggest obesity is associated with decreased prostate cancer risk. We hypothesized obesity is biologically associated with increased risk, although this is obscured owing to hemodilution of prostate-specific antigen (PSA) and larger prostate size.

Methods: We retrospectively studied 441 consecutive men undergoing prostate biopsy between 1999 and 2003 at two equal access centers within the Veterans Affairs Greater Los Angeles Healthcare System.

Persistent mullerian duct syndrome and transverse testicular ectopia: embryology, presentation, and management.

Background: The finding of persistent mullerian duct syndrome (PMDS) with transverse testicular ectopia (TTE) is rare. We present nonidentical triplets with PMDS with TTE.

Cases: Triplet A presented with a right inguinal hernia and left nonpalpable testis at 4 months of age.

Prospective validation of an out-of-hospital decision rule to identify seriously injured children involved in motor vehicle crashes.

Objectives: To prospectively validate a previously published out-of-hospital clinical decision rule to identify seriously injured children involved in motor vehicle crashes (MVCs).

Methods: The authors selected 20 Los Angeles County Fire Department fire stations, based on pediatric MVC call volume and geographic diversity, and 21 associated hospitals for participation in the study. Immediately following an MVC call involving a pediatric patient aged 0-14 years, each engine/paramedic squad completed a data form (15 variables, including vital signs, Glasgow Coma Scale score, and vehicular and crash characteristics).