Safety and efficacy of sequential balloon dilation prior to ureteral access sheath insertion in nonstented patients undergoing ureteroscopy.

Techniques such as ureteral access sheath placement and balloon dilation are utilized to facilitate ureteroscopy. A retrospective review was performed to evaluate the efficacy and complications from ureteral access sheath (UAS) placement with or without sequential ureteral balloon dilation (SBD) in non-prestented patients who underwent ureteroscopy with UAS with or without SBD for renal or proximal ureteral stones from February 2014 to April 2017. This was a two-surgeon series of 124 patients divided into groups of SBD + UAS or direct UAS placement.

Prophylactic ureteral catheter placement for minimally invasive colorectal surgery.

Ureteral catheter placement for identification of ureters during colorectal surgery has been a controversial subject with ill-defined indications. We present a case of ureteral catheter placement wherein the patient required readmission for renal failure with intervention under local anesthesia. This case highlights the importance of patient selection for catheter placement and clinical follow-up, as well as the need for prospective studies to determine the risk-benefit ratio of preoperative catheters.

Selection of abstracts from Baylor Scott & White Health Central Texas Scholars Day.

Baylor Scott & White Health Central Texas displayed the diversity and growth of scholarly pursuits during Scholars Day on May 3, 2019. Residents and fellows, medical students, nurses, and research staff were among those showcasing their scholarly activity in areas such as medical innovation, clinical vignettes, research, and quality improvement. A selection committee chose 32 abstracts-12 select podium, 20 rapid fire.

Preoperative ureteral stenting prior to ureteroscopy for management of urolithiasis does not impact the postoperative return for unplanned care.

Introduction: Return for unplanned postoperative care is an important quality metric in the United States. Most of our postoperative return visits occur after ureteroscopy. Routine preoperative ureteral stenting is not recommended by the American Urological Association due to its impact on the quality of life, despite its proposed operative advantages.

Relation of postoperative pain medication to return for unplanned care after ureteroscopy.

To determine whether the US Drug Enforcement Agency (DEA) class of narcotics prescribed to patients after ureteroscopy impacts their rate of return for unplanned care, a retrospective analysis of patients from February 2014 through March 2016 was performed. Data were collected for the first 90 days after surgery. Patients were divided into groups based on the narcotics schedule prescribed after surgery.

Comparison of Recurrence and Postoperative Complications Between 3 Different Techniques for Surgical Repair of Idiopathic Hydrocele.

Objective: To determine if recurrence rates and complication rates differ between 3 different techniques for treatment of idiopathic hydrocele: Jaboulay's bottleneck, hydrocelectomy, or Lord's technique.

Methods: All surgeries for idiopathic hydrocele in the health system were reviewed from 2000 to 2011. Recurrence rate, complication rate, and other surgical data were collected and analyzed.

Ex-vivo ureteroscopy of deceased donor kidneys.

Introduction: When encountered, the ideal management of lithiasis in deceased donor kidneys is not well-defined. With advances in endourological techniques, minimally invasive treatments are becoming an increasingly viable option. We set out to describe our experience performing ex-vivo ureteroscopy on cadaveric donor kidneys, including one in which the procedure was completed on-pump.

Comparison of Perioperative Outcomes Between Holmium Laser Enucleation of the Prostate and Robot-Assisted Simple Prostatectomy.

Objectives: To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH).

Methods: Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015.

Results: Patients undergoing HoLEP and RSP had comparable ages (71 vs 71, p = 0.

Management of a renal fungal bezoar caused by multidrug-resistant .

We describe our management of an immunocompetent individual who developed obstructive uropathy and candidemia as a result of a fungal bezoar in the kidney. These sequelae arose from candiduria, provoked after several courses of antibiotics. Successful treatment included therapy with both culture-appropriate intravenous antifungals and operative intervention, including direct irrigation of the affected kidney with amphotericin B, relief of renal obstruction with a ureteral stent, a percutaneous nephrostomy tube, and ultimately endoscopic removal of the fungal bezoar.

Robot-assisted posterior retroperitoneoscopic adrenalectomy.

Background And Purpose: Minimally invasive adrenalectomy is the preferred surgical approach for small, benign adrenal neoplasms. Posterior retroperitoneoscopic adrenalectomy is associated with potential surgical advantages. We sought to investigate the feasibility and early outcomes for robot-assisted posterior adrenalectomy, which has not been previously reported.

Obstruction alters the effect of prostaglandin E2 on ureteral contractility.

Background And Purpose: Although our understanding of ureteral physiology during acute obstruction remains limited, we believe that prostanoids (prostaglandins [PGs], thromboxanes, prostacyclins) play a major role in modulation of ureteral contractility and that inhibition of prostanoid synthesis causes substantial reduction in in-vitro and in-vivo ureteral contractility rates. The purpose of this study was to determine the in-vitro effects of PGE2 on chronically obstructed human and acutely obstructed porcine ureters.

Materials And Methods: Female pigs underwent unilateral laparoscopic ureteral obstruction.

Efficiency and cost of treating proximal ureteral stones: shock wave lithotripsy versus ureteroscopy plus holmium:yttrium-aluminum-garnet laser.

Objectives: To compare the success rates, cost effectiveness, and efficiency of ureteroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL) for proximal ureteral stones.

Methods: In a retrospective manner, 220 patients who underwent treatment for proximal ureteral stones were included in the study. The patient records, radiographs, and billing statements of all patients treated for upper ureteral stones between January 1997 and June 2001 at Scott and White Memorial Hospital were reviewed.

Clinical utility of dual active deflection flexible ureteroscope during upper tract ureteropyeloscopy.

Objectives: To evaluate the clinical utility of a dual active deflection ACMI DUR-8 Elite ureteroscope in a referral endourology practice.

Methods: Retrospective chart review was performed on 54 consecutive patients who underwent flexible ureteroscopy by a single surgeon (S.Y.

Hand-assisted laparoscopic radical nephrectomy.

Laparoscopic radical nephrectomy is the new standard of care for localized renal cancer. Hand assistance makes the procedure less daunting by providing tactile feedback. The authors consider the indications, contraindications, and technique for this operation, which provides the patient with the benefits of minimally invasive surgery while shortening the learning curve for the surgeon and allowing experienced laparoscopists to carry out more complex and challenging operations.

Hand-assisted laparoscopic renal surgery in the morbidly and profoundly obese.

Background And Purpose: Obesity has been regarded as a relative contraindication to standard laparoscopic procedures. We evaluated the impact of morbid (body mass index [BMI] >30 kg/m2) and profound (BMI > 40 kg/m2) obesity on the results of hand-assisted laparoscopic renal surgery (HALRS).

Patients And Methods: From September 1996 until October 2002, a total of 30 patients among 105 on whom HALRS was performed at our institution were morbidly obese, with a mean BMI of 35.

Symptomatic port-site hernia associated with a non-bladed trocar after laparoscopic live-donor nephrectomy.

We describe what appears to be the first case of a port-site hernia at the site of insertion of a 10-mm non-bladed trocar, which was discovered 4 days after laparoscopic live-donor nephrectomy. We now close all 10-mm port sites in adults and all 5-mm port sites in children; this can be done easily using the Carter-Thomason device.

University of Wisconsin experience using the Doli S lithotriptor.

Objectives: To present our initial results using the Dornier Doli S lithotriptor with the 220 electromagnetic shock wave emitter to treat urinary calculi. At present, there is no published report of the efficacy of this instrument in service in the United States.

Methods: We retrospectively reviewed the outcome of shock wave lithotripsy in 270 consecutive patients with solitary renal and/or ureteral stones treated from September 1998 to October 2001 with the Dornier Doli S lithotriptor.

Renal cryotherapy: 2003 clinical status.

Purpose Of Review: Traditionally, curative therapy for most renal cancers involved open radical nephrectomy. However, as increased radiological monitoring has led to more incidentally discovered small renal masses, the optimal treatment has evolved. Nephron-sparing surgery, initially developed for patients with solitary kidneys or compromised renal function, emerged as the treatment of choice for small renal masses.