Nephrometry scores: a validation of three systems for peri-operative outcomes in retroperitoneal robot-assisted partial nephrectomy.

Objective: To externally validate the RENAL, PADUA and SPARE nephrometry scoring systems for use in retroperitoneal robot-assisted partial nephrectomy (RAPN).

Materials And Methods: Nephrometry scores were calculated for 322 consecutive patients receiving retroperitoneal RAPN at a tertiary referral centre from 2017. Patients with multiple tumours were excluded.

Renal Function Loss After Cryoablation of Small Renal Masses in Solitary Kidneys: European Registry for Renal Cryoablation Multi-Institutional Study.

To estimate and quantify the loss of kidney function in solitary kidneys with small renal masses (SRMs) after laparoscopy-assisted renal cryoablation (LARC), from the European Registry for Renal Cryoablation (EuRECA) database. Of the 808 patients from eight European centers in the database, 102 patients had SRMs in solitary kidneys. Patient demographics, body mass index (BMI), American Society of Anesthesiologists (ASA) grade, Charlson comorbidity index, and tumor characteristics including nephrometry (PADUA) score where available were collected.

Oncological outcomes and complication rates after laparoscopic-assisted cryoablation: a European Registry for Renal Cryoablation (EuRECA) multi-institutional study.

Objective: To assess complication rates and intermediate oncological outcomes of laparoscopic-assisted cryoablation (LCA) in patients with small renal masses (SRMs).

Patients And Methods: A retrospective review of 808 patients treated with LCA for T1a SRMs from 2005 to 2015 at eight European institutions. Complications were analysed according to the Clavien-Dindo classification.

Assessment of energy density usage during 180W lithium triborate laser photoselective vaporization of the prostate for benign prostatic hyperplasia. Is there an optimum amount of kilo-Joules per gram of prostate?

Objectives: To assess the effect of energy density (kJ/mL) applied on adenoma during photoselective vaporization of the prostate (PVP) treatment for benign prostate hyperplasia (BPH) on functional outcomes, prostate-specific antigen (PSA) reduction and complications.

Patients And Methods: After exclusions, a total of 440 patients who underwent GreenLight (tm) laser XPS-180W lithium triborate PVP for the treatment of BPH were retrospectively reviewed. Data were collected from seven different international centres (Canada, USA, UK and France).

Current Status of Hemostatic Agents and Sealants in Urologic Surgical Practice.

There has been a recent and near exponential increase in the use of hemostatic agents and sealants to supplement the rapidly evolving methods in the surgical management of urologic patients. This article reviews the use of hemostatic agents and sealants in current urologic practice.

Prospective, randomized, multinational study of prostatic urethral lift versus transurethral resection of the prostate: 12-month results from the BPH6 study.

Background: Transurethral resection of the prostate (TURP) is considered the gold standard for male lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). However, TURP may lead to sexual dysfunction and incontinence, and has a long recovery period. Prostatic urethral lift (PUL) is a treatment option that may overcome these limitations.

Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia Using the 180 Watt System: Multicenter Study of the Impact of Prostate Size on Safety and Outcomes.

Purpose: We evaluated photoselective vaporization of the prostate using the GreenLight™ XPS™ 180 W system for benign prostatic hyperplasia treatment in a large multi-institutional cohort at 2 years. We particularly examined safety, outcomes and the re-treatment rate in larger prostates, defined as a prostate volume of 80 cc or greater, to assess the potential of photoselective vaporization of the prostate as a size independent procedure.

Materials And Methods: A total of 1,196 patients were treated at 6 international centers in Canada, the United States, France and England.

Determination of optimal drug dose and light dose index to achieve minimally invasive focal ablation of localised prostate cancer using WST11-vascular-targeted photodynamic (VTP) therapy.

Objective: To determine the optimal drug and light dose for prostate ablation using WST11 (TOOKAD Soluble) for vascular-targeted photodynamic (VTP) therapy in men with low-risk prostate cancer.

Patients And Methods: In all, 42 men with low-risk prostate cancer were enrolled in the study but two who underwent anaesthesia for the procedure did not receive the drug or light dose. Thus, 40 men received a single dose of 2, 4 or 6 mg/kg WST11 activated by 200 J/cm light at 753 nm.

Robot-assisted partial nephrectomy vs laparoscopic cryoablation for the small renal mass: redefining the minimally invasive 'gold standard'.

Objective: To identify differences between the ablative and extirpative minimally invasive techniques of laparoscopic cryoablation (LC) and robot-assisted laparoscopic partial nephrectomy (RPN), respectively, in treating small renal tumours in terms of safety, peri-operative morbidity and early oncological outcomes.

Patients And Methods: Between June 2008 and April 2012 56 patients underwent LC and from October 2010 to April 2012, 47 patients underwent RPN using the Da Vinci robotic platform (Intuitive Surgical, Sunnyvale, CA, USA). Data on intra-operative, postoperative and oncological outcomes were collected prospectively, and were analysed and compared for both groups.

TOOKAD(®) Soluble vascular-targeted photodynamic (VTP) therapy: determination of optimal treatment conditions and assessment of effects in patients with localised prostate cancer.

Objectives: To evaluate the optimal treatment conditions and effects of TOOKAD(®) Soluble vascular-targeted photodynamic (VTP) therapy in patients with localised prostate cancer. To evaluate the safety and quality of life after TOOKAD(®) Soluble VTP treatment in patients with localised prostate cancer.

Patients And Methods: Men (aged >18 years) diagnosed with localised prostate cancer, who were suitable for active surveillance, were invited to take part in the study.

The continuous evolution of the Greenlight laser; the XPS generator and the MoXy laser fiber, expanding the indications for photoselective vaporization of the prostate.

Objective: To report our early experience with new GreenLight XPS™ generator using the new MoXy laser fiber, examining its efficacy and safety and also its ability to effectively treat the larger prostate gland.

Patients And Methods: From July 2010 until August 2012, 131 patients, with an average age of 72.6 years (range 49-92), were treated using the XPS/MoXy system in a single U.

Robot-assisted partial nephrectomy: a comparison of the transperitoneal and retroperitoneal approaches.

Purpose: To present the oncologic and functional outcomes of robot-assisted partial nephrectomy (RAPN) and analyze retroperitoneal and transperitoneal approaches.

Patients And Methods: RAPN was performed on 103 patients; 44 patients underwent a retroperitoneal and 59 a transperitoneal approach. Demographic, operative, and postoperative data was collected and retrospectively analyzed on all patients.

The role of transperineal template prostate biopsies in restaging men with prostate cancer managed by active surveillance.

Objective: To evaluate the role of transperineal template prostate biopsies in men on active surveillance.

Patients And Methods: In all, 101 men on active surveillance for prostate cancer underwent restaging transperineal template prostate biopsies at a single centre. Criteria for active surveillance were ≤75 years, Gleason ≤3+3, prostate-specific antigen (PSA) ≤15 ng/mL, clinical stage T1-2a and ≤50% ultrasound-guided transrectal biopsy cores positive for cancer with ≤10 mm of disease in a single core.

Laparoscopic cytoreductive nephrectomy: a three-center retrospective analysis.

Introduction: Metastatic renal cell carcinoma is associated with a poor prognosis. Given the current lack of effective systemic therapies and data suggesting a survival benefit from cytoreductive nephrectomy (CRN) before systemic therapy, we have retrospectively analyzed the experience of laparoscopic cytoreductive nephrectomy (LCRN) in three U.K.

The Eastbourne extraction: forceps removal of large laparoscopic nephrectomy specimens without morcellation.

Intact specimen retrieval after laparoscopic nephrectomy for renal tumors is considered the gold standard. Removal of large specimens can be a challenge. A technique to aid large bagged specimen removal using Wrigley's obstetric forceps is described.

Photoselective vaporization of the prostate with the potassium-titanyl-phosphate laser in men with prostates of >100 mL.

Objectives: To assess the efficacy of photoselective vaporization of the prostate (PVP) in men with prostates of >100 mL and causing bladder outlet obstruction (BOO), using the high-power 80 W potassium-titanyl-phosphate laser (GreenLight PV, Laserscope, San Jose, CA, USA), which offers rapid tissue ablation with minimal bleeding.

Patients And Methods: We assessed 54 consecutive patients with prostates of >100 mL (mean 135, SD 42, range 100-300) who had PVP between May 2003 and August 2005. Evaluations before PVP included urine flowmetry, the International Prostate Symptom Score (IPSS), a quality-of life (QoL) score, prostate-specific antigen (PSA) level, and prostate volume measured by transrectal ultrasonography (TRUS).

Basic laparoscopic surgical training: examination of a low-cost alternative.

Objective: "Dry lab" facilities are integral to laparoscopy training, but access is often limited due to the high costs of video-laparoscopy equipment. We assessed the effectiveness of a cheap and simple training model compared to conventional video-laparoscopy for basic training using a randomised, blinded study.

Methods: Thirty-six third-year medical students without previous surgical skills were randomised into two groups: group A students were taught basic laparoscopy skills using a conventional video-laparoscopy pelvic trainer and group B students were taught similar techniques using a cardboard box with a cut-out top to allow light and visualisation.

Ease of removal of thermo-expandable prostate stents.

Objective: To report the ease of removal of the Memokath 028 prostatic stent (Engineers & Doctors A/S, Hornbaek, Denmark), an important attribute of the 'ideal' prostatic stent.

Patients And Methods: Data on patients who had had a Memokath 028 stent removed in three different centres in Europe over an 8-year period were collected retrospectively. Standardized forms were used to record relevant information from each physician's patient files.

High-power KTP laser prostatectomy: the new challenge to transurethral resection of the prostate.

Purpose Of Review: The quest for a successful surgical modality that can be used in the day-case setting, with minimal risk of complications and without the need for postoperative catheter drainage, may finally be fulfilled in the form of the new-generation, high-power potassium titanyl phosphate (KTP) lasers. In this review we will trace the development of KTP laser technology and its use by urologists over the years and describe why its physical properties make it so different from the lasers of the past.

Recent Findings: The most high powered (80 W) incarnation has a relatively short history, particularly in terms of peer-reviewed publications.