Positive preoperative cultures but not bacterial species predict postoperative urine culture results after holmium laser enucleation of the prostate.

Purpose: The purpose of this study was to evaluate risk factors associated with positive urine cultures following holmium laser enucleation of the prostate (HoLEP).

Materials And Methods: The data from a prospectively maintained database were analyzed to evaluate urine culture results following HoLEP and determine the contribution of predefined variables (age, prostate size, Charlson comorbidity score, surgical time [surrogate for case difficulty], the presence of a catheter preoperatively, postoperative urinary retention, and preoperative positive culture) on urine culture positivity at 60 days postoperatively. Statistical analyses included logistic regression and ANOVA.

Impact of Residual Stone Fragments on Risk of Unplanned Stone Events Following Percutaneous Nephrolithotomy.

Residual stone fragments are common after percutaneous nephrolithotomy (PCNL), however, there is an unclear relationship between the presence of these residual stone fragments and the risk of unplanned stone events (USE). We investigated how the size of the largest residual stone fragment (LRSF) impacts the risk of USE post-PCNL. We conducted a retrospective cohort study of PCNL between 2018 and 2022.

Predictors of Postoperative Urinary Incontinence After Holmium Laser Enucleation of the Prostate (HoLEP) for Surgeons Early in Their Experience.

Objectives: To evaluate factors impacting continence recovery following holmium laser enucleation of the prostate (HoLEP) for surgeons early in their HoLEP experience.

Methods: Predefined factors were evaluated from a prospectively maintained database for their impact on the recovery of continence after HoLEP. Both surgeons had performed fewer than 150 HoLEPs as attending physicians.

Impact of Preoperative Continence on HoLEP Symptom Recovery: A Close Investigation of Patient-Reported Outcomes.

Holmium laser enucleation of the prostate (HoLEP) is an increasingly utilized surgical intervention for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). It is unclear how pre-HoLEP voiding performance (including pre-HoLEP incontinence) affects post-HoLEP urinary symptom performance and recovery which challenges effective patient counseling. This is a single-institution retrospective analysis of 266 patients who underwent HoLEP.

Enhancing the Management of Benign Prostatic Hyperplasia: The Role of Electronic Health Record Patient Portal Distribution of the International Prostate Symptom Score.

Introduction: Recent AUA guidelines for the management of benign prostatic hyperplasia (BPH) recommend routine collection of the International Prostate Symptom Score (IPSS) data, but routine collection can be challenging to fully implement. We investigated the impact of distributing the IPSS by electronic patient portal (EPP) on IPSS completion and its impact on BPH management.

Methods: We performed a retrospective, longitudinal study of men undergoing a new patient visit (NPV) for BPH at our academic medical center.

Cochlear Implantation by Veria Technique in Abnormal Cochlea: Our Experience.

This study describes the clinical profile, operative findings, surgical technique, type of implant and complications encountered in implantation of abnormal cochlea by the transcanal (veria) technique in a tertiary care centre. This is a retrospective study done amongst 337 patients who underwent cochlear implantation by veria technique between January 2013 to August 2023. Based on pre-operative imaging with high-resolution computed tomography and magnetic resonance imaging the cochleovestibular malformations in this study were classified according to Sennaroglu classification and the cochlear ossification was graded from I to IV.

Development of UroSAM: A Machine Learning Model to Automatically Identify Kidney Stone Composition from Endoscopic Video.

Chemical composition analysis is important in prevention counseling for kidney stone disease. Advances in laser technology have made dusting techniques more prevalent, but this offers no consistent way to collect enough material to send for chemical analysis, leading many to forgo this test. We developed a novel machine learning (ML) model to effectively assess stone composition based on intraoperative endoscopic video data.

Gender Disparities in Quality of Life Outcomes Among Kidney Stone Formers.

This study investigates gender-based disparities in health-related quality of life (HRQOL) outcomes among kidney stone patients and explores potential contributing factors. A retrospective review of medical records at the University of Rochester Medical Center was conducted on 2199 new urolithiasis patients who completed the Wisconsin Stone Quality of Life Questionnaire (WISQOL) standardized on a 0 to 100 scale. Demographic and clinical data were collected.

Advancing Holmium Laser Enucleation of the Prostate Outcomes Reporting: An Assessment of Patient-Reported Outcomes in the Literature.

Holmium laser enucleation of the prostate (HoLEP) is a size-independent option for benign prostatic hyperplasia surgical management. Since lower urinary tract symptoms (LUTS) are a quality-of-life issue, studies should prioritize patient-reported outcomes (PROs). This HoLEP review assesses PROs inclusion in the top 20 cited HoLEP studies and defines their limitations.

Cystinuria Complicated by Anuria From Bilateral Obstructing Stones Requiring Bilateral Mini Percutaneous Nephrolithotomy in a 22-Month-Old.

Pediatric nephrolithiasis is increasing in incidence and presents differently compared to adults. We report a case of nephrolithiasis in a pediatric patient, presenting with complaints of emesis, anuria, hematuria, and abdominal distension, leading to a diagnosis of bilateral obstructing cystine stones requiring bilateral percutaneous nephrolithotomy. Pediatric patients with anuria should be evaluated for bilateral nephrolithiasis as an etiology.

Can Perioperative Antibiotic Choice Impact Rates of Infectious Complications After Percutaneous Nephrolithotomy? A Single-Blind, Prospective Randomized Trial.

National guidelines recommend periprocedural antibiotics before percutaneous nephrolithotomy (PCNL), yet it is not clear which is superior. We conducted a randomized trial to compare two guideline-recommended antibiotics: ciprofloxacin (cipro) cefazolin, on PCNL outcomes, focusing on the development of systemic inflammatory response syndrome (SIRS) criteria. Adult patients who were not considered high risk for surgical or infectious complications and undergoing PCNL were randomized to receive either cipro or cefazolin perioperatively.

Neighborhood Social Vulnerability Impacts Quality of Life in Kidney Stone Patients.

Introduction: This study aimed to investigate the association between social vulnerability, as measured by the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI), and the quality of life (QoL) of kidney stone patients using the validated Wisconsin Stone Quality of Life Questionnaire (WISQOL).

Methods: A retrospective analysis was conducted on medical records of new urolithiasis patients who completed the WISQOL at the University of Rochester Medical Center kidney stone clinic. The primary outcome was WISQOL score, which was measured across multiple domains.

Inflammatory markers in geriatric anemia: A study from North India.

Background: Inflammation has several effects in the geriatrics with reference to iron deficiency anemia (IDA), anemia of chronic disease (ACD), and unexplained anemia (UA). Whether hyperinflammation is part of their pathogenesis or just incidental is unknown. Data are limited regarding inflammatory patterns in IDA, ACD, and UA in anemic geriatrics and inflammation as a component of UA.

Redefining Clinically Significant Hematuria After Holmium Enucleation of the Prostate.

Holmium laser enucleation of the prostate (HoLEP) is often offered for symptomatic prostatic enlargement at high risk for bleeding. However, prior studies define clinically significant hematuria (CSH) narrowly as the need for blood transfusion or significant decrease in hemoglobin. We sought to evaluate risk factors contributing to a broader definition of CSH, which may contribute to alteration of clinical course.

Outcomes of topography-guided PRK/CXL in keratoconus using the NIDEK CXIII system-"Bharat Protocol" (Pilot study).

Purpose: Outcome of topography-guided excimer laser ablation in conjunction with accelerated, high-fluence cross-linking in corneal ecstatic disease using the NIDEK CXIII equipped with CATz algorithm from the FinalFit software-"Bharat Protocol."

Methods: Retrospective case record review of 30 eyes of 17 patients of stage 1-3 keratoconus who underwent the procedure was performed. Data collected were for visual acuity, distortion-induced eye pain, and keratometry.

Endoscopic Management of Malignant Tumors of Paranasal Sinus and Nasal Cavity: An Institutional Experience.

Malignant tumors of sinonasal region are rare and affect less than 1 in 100,000 people per year. They are histologically diverse group and potentially pose significant management problems due to their proximity to the orbit and intracranial cavity. Although squamous cell carcinoma (SCC) is most common malignant tumor of paranasal cavity, tumors like adenocarcinoma, olfactory neuroblastoma, malignant melanoma, adenoid cystic carcinoma, sarcomas, haemoproliferative tumors, e.

Low-dose fluoroscopy technique drastically decreases patient radiation exposure during percutaneous nephrolithotomy.

Fluoroscopy is essential in percutaneous nephrolithotomy (PCNL) but exposes patients and operating room staff to radiation. We investigated whether a low-dose (LD) protocol could reduce radiation exposure during fluoroscopy-guided access without compromising clinical outcomes. Patients undergoing PCNL with fluoroscopy-guided access at a tertiary care stone center between January 2019 and July 2021 were identified.

Trans-esophageal Echocardiographic Assessment of Left Atrial and Left Atrial Appendage Function in Atrial Fibrillation and Rheumatic Heart Disease.

Introduction: Rheumatic heart disease (RHD) is one of the most typical causes of atrial fibrillation in developing countries like India. The left atrial and left atrial appendage structure and function are deranged in atrial fibrillation and are a major source of thromboembolism. The goal of this study was to assess the left atrial and left atrial appendage function by transesophageal echocardiography in patients with atrial fibrillation and their comparison in patients with or without RHD.

Role of Transarterial Angiography with Embolization in Deciding Surgical Approach to Juvenile Nasopharyngeal Angiofibroma: A Step-Ladder Approach.

 This study was aimed to understand the usefulness of transarterial angiography and embolization in management of juvenile nasopharyngeal angiofibroma (JNA) and to apply the information obtained to stage the disease, select appropriate surgical approach, predict intraoperative bleeding, and prognosticate the disease.  This study represents a retrospective review of the patients of JNA with major focus on transarterial angiography and embolization findings and its clinical and surgical implications.  The study conducted at a tertiary-care super-specialty referral center.

Sulfamethoxazole stone in a patient with extensive history of urolithiasis and recurrent urinary tract infections.

Although rare, sulfamethoxazole-induced urolithiasis has been reported in patients taking trimethoprim-sulfamethoxazole (TMP/SMX). We present the case of a 79-year-old female who formed sulfamethoxazole stones in the setting of chronic indwelling catheterization with recurrent urinary tract infections (UTIs). The patient was a recurrent stone former with five prior stone composition analyses over a 10-year period varying from calcium phosphate to calcium oxalate, to struvite.

Closed-Loop Neurofeedback of α Synchrony during Goal-Directed Attention.

α Oscillations in sensory cortex, under frontal control, desynchronize during attentive preparation. Here, in a selective attention study with simultaneous EEG in humans of either sex, we first demonstrate that diminished anticipatory α synchrony between the mid-frontal region of the dorsal attention network and ventral visual sensory cortex [frontal-sensory synchrony (FSS)] significantly correlates with greater task performance. Then, in a double-blind, randomized controlled study in healthy adults, we implement closed-loop neurofeedback (NF) of the anticipatory α FSS signal over 10 d of training.

SKOPE-Study of Ketorolac vs Opioid for Pain after Endoscopy: A Double-Blinded Randomized Control Trial in Patients Undergoing Ureteroscopy.

Purpose: Pain is the leading cause of unplanned emergency department visits and readmissions after ureteroscopy, making postoperative analgesic stewardship a priority given the current opioid epidemic. We conducted a double-blinded, randomized controlled trial, with noninferiority design, comparing nonsteroidal anti-inflammatory drugs to opiates for postoperative pain control in patients undergoing ureteroscopy for urolithiasis.

Materials And Methods: Patients were randomized and blinded to either oxycodone (5 mg) or ketorolac (10 mg), taken as needed, with 3 nonblinded oxycodone rescue pills for breakthrough pain.