Effects of ischemia on human renal interstitial fluid metabolites.

Purpose: Microdialysis is a technique for monitoring the concentration of molecules in the interstitial fluid of living tissue. We report the effects of ischemia on human renal interstitial fluid molecules.

Materials And Methods: Ten patients with a renal mass or upper tract transitional cell carcinoma who elected laparoscopic nephrectomy or nephroureterectomy were studied with in situ renal microdialysis.

Predicting irreparable renal ischemic injury using a real-time marker in the porcine model.

Purpose: We determined the maximal renal tolerance of warm ischemia using renal cortical interstitial metabolic changes to identify a potential real-time marker of irreparable renal function.

Materials And Methods: Using a single kidney model 3 groups of 5 pigs each underwent 120, 150 and 180 minutes of warm ischemia, respectively. Microdialysis samples were collected before, during and after ischemia.

The effects of ureteral mobilization and transection on ureteral oxygenation.

Objectives: To determine the impact of ureteral transection with and without prior ureteral mobilization on ureteral oxygen partial pressure (p(u)O(2)).

Methods: Sixteen pigs underwent general anesthesia with laparoscopic transperitoneal access to the right ureter. With no dissection and minimal manipulation, a tissue oxygen probe (Licox, Kiel, Germany) was introduced via a trocar and inserted into the ureter.

Real-time analysis of renal interstitial metabolites during induced renal ischemia*.

Purpose: Microdialysis is an innovative technique used to monitor the chemistry of the interstitial fluid in living tissue. We documented changes in concentration of interstitial fluid metabolites before, during, and after induced renal ischemia.

Materials And Methods: Under general anesthesia, a microdialysis probe was laparoscopically positioned into the renal cortex of six pigs.

Lapra-Ty holding strength and slippage with various suture types and sizes.

Objectives: To investigate the holding strength and slippage of Lapra-Ty clips on various suture types and sizes.

Methods: Using an automated materials testing system with the Lapra-Ty in a fixed position, Lapra-Ty holding strength and displacement were determined with 0, 2-0, 3-0, and 4-0 Vicryl, Monocryl, and polydioxanone suture (PDS). To simulate clinical application, Lapra-Tys were also tested by applying a load to these sutures after being passed through a full-thickness layer of tautly suspended fresh porcine bladder tissue.

Shock wave lithotripsy success for renal stones based on patient and stone computed tomography characteristics.

Objectives: To determine the patient and noncontrast computed tomography (NCCT) stone characteristics that predict either of 2 extracorporeal shock wave lithotripsy (ESWL) outcomes: stone-free (SF) status or ESWL success.

Methods: The records of 200 consecutive patients with nephrolithiasis treated with ESWL were reviewed. Patient age, sex, stone laterality, body surface area, body mass index, maximal stone dimension, mean stone Hounsfield units (HU), stone Hounsfield density, skin-to-stone distance (SSD), and intrarenal stone location were studied as potential predictors.

Feasibility of laparoscopic renal cooling with near-freezing saline irrigation delivered with a standard irrigator aspirator.

Objectives: To determine the feasibility of laparoscopic renal cooling with near-freezing saline irrigation in the porcine model delivered using readily available operating room equipment.

Methods: Five pigs underwent laparoscopic renal surgery with temperature sensors placed in the medulla and upper, middle, and lower pole renal cortex. After complete occlusion of the renal artery and vein, near-freezing saline was delivered with a standard irrigator/aspirator onto the renal surface.

Transurethral collagen injections for male intrinsic sphincter deficiency: the University of Texas-Houston experience.

Purpose: Injectable agents are used to increase urethral coaptation for the treatment of intrinsic sphincter deficiency. We evaluated the long-term results and complications of transurethral collagen injections in males.

Materials And Methods: We reviewed the charts of 322 men (mean age 67.

Unusual presentation of hidradenitis suppurativa with massive enlargement of penis.

Hidradenitis suppurativa is a chronic, recurrent inflammatory disease affecting the cutaneous apocrine glands and resulting in their obstruction. This enigmatic disease causes recurrent episodes of infection, edema, scarring, and fibrosis of surrounding tissues. We present the case of a 55-year-old man with two decades of inguinal hidradenitis suppurativa that resulted in extensive penile subcutaneous lymphedema and enlargement secondary to scarring and obstructive lymphadenopathy.

The influence of finasteride on the development of prostate cancer.

Background: Androgens are involved in the development of prostate cancer. Finasteride, an inhibitor of 5alpha-reductase, inhibits the conversion of testosterone to dihydrotestosterone, the primary androgen in the prostate, and may reduce the risk of prostate cancer.

Methods: In the Prostate Cancer Prevention Trial, we randomly assigned 18,882 men 55 years of age or older with a normal digital rectal examination and a prostate-specific antigen (PSA) level of 3.

Prospective long-term results and quality-of-life assessment after Dura-II penile prosthesis placement.

Objectives: To evaluate prospectively the long-term device reliability and patient satisfaction after Dura-II malleable penile prosthesis implantation.

Methods: Between 1992 and 1996, 94 patients underwent Dura-II implantation for erectile dysfunction. Patients were prospectively examined and completed standardized questionnaires regarding sexual activity, prosthesis function, intercourse satisfaction, and overall quality of life.

Questionnaire-based outcomes of urinary incontinence and satisfaction rates after radical prostatectomy in a national study population.

Objectives: To assess the incidence of incontinence and the associated quality of life in men younger than 65 years of age after radical prostatectomy.

Methods: The TRICARE/CHAMPUS database was searched to identify 1000 patients who underwent radical prostatectomy within 2 years before study initiation. All patients were younger than 65 years of age at the time of surgery and had at least 18 months of postoperative follow-up.

Long-term results of Ingelman-Sundberg denervation procedure for urge incontinence refractory to medical therapy.

Purpose: Urge incontinence refractory to anticholinergic medication and behavioral techniques is a therapeutic challenge. We evaluated the durability of the modified Ingelman-Sundberg detrusor denervation procedure as minimally invasive surgical therapy for intractable urge incontinence.

Materials And Methods: Patients presenting with severe urge incontinence unresponsive to medical and/or behavioral therapy were injected subtrigonally with 10 ml.

Resident education outcomes and perception of a seminar format to teach female pelvic anatomy and procedures to correct pelvic prolapse.

Urologic residents need to learn basic and applied knowledge of female pelvic anatomy, a subject rarely taught beyond preclinical undergraduate medical education. This study tests the hypothesis that urologic resident knowledge of female pelvic anatomy and prolapse may be enhanced with a seminar. Twenty residents attended a one day seminar combining didactics and a cadaveric dissection related to female pelvic anatomy and female pelvic prolapse conditions.