Development and internal validation of El-Shazly-Buchholz's nomogram to predict postoperative complications after PCNL: A multicenter study.

Introduction: A model to predict the risk of surgical complications following percutaneous nephrolithotomy (PCNL) could be a useful tool to guide clinical decision-making. The aim of this study was to develop a simple and widely applicable stratification tool to be used for patient counseling, surgical planning, evaluation of outcomes, and academic reporting.

Methods: Data of patients who underwent PCNL were retrieved from the database of the collaborating centers including demographics of patients, characteristics of their stones and urinary tracts, and perioperative data.

Novel Endourological technique for a better navigation in incontinent urinary diversion (ileal conduit) during Double J stent removal.

Introduction: Assessing ileal conduit for double J stents removal after radical cystectomy is not always a straightforward task as navigation inside the ileal loop can be challenging to manage due to the difficulty to maintain a waterfilled environment and its long and tortuous aspect.

Methods: We present a novel technique using a flexible ureteroscope that aims to ease this common demand with simple and readily available tools.

Results: This technique has been successfully utilized in 2 patients now.

Evaluation of mini-PCNL and RIRS for renal stones 1-2 cm in an economically challenged setting: A prospective cohort study.

Introduction: Retrograde intrarenal surgery (RIRS) and mini-percutaneous nephrolithotomy (mPCNL) are viable options for the treatment of renal calculi 1-2 cm. Both have their pros and cons, but also vary in costs. We aimed to evaluate them in an economically challenged setting.

Is extracorporeal shockwave lithotripsy (SWL) still suitable for >1.5 cm intrarenal stones? Data analysis of 1902 SWLs.

Purpose: According to the American Urological Association and European Association of Urology guidelines, shockwave lithotripsy (SWL) is the least-invasive treatment option for kidney stones smaller than 2 cm. However, it is well known that SWL stone-free rates (SFR) decline as stone size increases. We sought to evaluate whether the size limit of 1.

Prediction of stone-free rates following extracorporeal shockwave lithotripsy in a contemporary cohort of patients with stone densities exceeding 1000 HU.

Nephrolithiasis is a common urologic problem, and its incidence is increasing. Shockwave Lithotripsy (SWL) has better results for patients with stones < 1000 HU. We attempted to identify SWL stone-free (SF) predictors for > 1000 HU stones.

Correction to: Nutrients, vitamins, probiotics and herbal products: an update of their role in urolithogenesis.

The original version of this article unfortunately contained a mistake.

Endourologic Treatment for Aggressive Angiomyxoma of the Bladder.

Aggressive angiomyxoma (AA) is a rare tumor that usually appears in the female pelvic and perineal regions. It commonly has infiltrative behavior and high local recurrence risk. We report an unusual presentation of AA, originating in a female patient's bladder.

Laparoscopic and robotic surgery for stone disease.

Treatment for stone disease has evolved drastically during the past 3-4 decades. Ureteroscopy, percutaneous nephrolithotomy along with SWL, provides the means to treat practically all urinary tract stones with minimal invasion to the patients. However, for complex stone case scenarios where open surgery is being considered, a less invasive and better tolerated option such as laparoscopy (robot assisted or not) can be performed.

Urolithiasis in pregnancy.

Urolithiasis in pregnancy is a major health concern and can potentially affect the well-being of both mother and foetus. Management of this condition often entails simultaneous multidisciplinary involvement of obstetrician, radiologist and urologist. Additionally, adverse effects with usage of anaesthesia, radiation, medications and surgery on mother and foetus, limit utilisation of the full armamentarium of diagnostic and therapeutic modalities that are commonly used in non-pregnant women.

Ureteroscopy for management of stone disease: an up to date on surgical technique and disposable devices.

The surgical management of urinary stone disease developed substantially over the past decades and advanced minimally invasive techniques have been successfully introduced into clinical practice. Retrograde ureteroscopy and ureterorrenoscopy have become the first-line option for treatment of ureteral and renal stones worldwide with high success rates allied with a low morbidity profile. In this review, we will discuss some key points in ureteroscopy for stone disease, such as the access to upper urinary tract, including balloon and catheter dilation; how to choose and use some disposable devices (hydrophilic versus PTFE guide wires, ureteral catheters, and laser fiber setting); and lastly present and compare different techniques for kidney or ureteral stone treatment (dusting versus basketing).

Update on ureteroscopy instrumentation.

The authors present an objective review of what is new in endourology instrumentation, based on up-to-date scientific data gathered from meetings, state-of-art lectures and current literature. The main scope of this review is to highlight the most recommended device options for each step of an ureteroscopy, in order to offer best care to patients.

Hyperoxaluria is a long-term consequence of Roux-en-Y Gastric bypass: a 2-year prospective longitudinal study.

Background: Recent studies suggest that patients undergoing Roux-en-Y gastric bypass (RYGB) for morbid obesity are at risk for hyperoxaluria, nephrolithiasis, and oxalate nephropathy. Our objective was to conduct a long-term prospective longitudinal study to establish the incidence, clinical progression, and severity of hyperoxaluria after RYGB.

Study Design: Patients undergoing RYGB between December 2005 and April 2007 provided 24-hour urine collections for comprehensive stone risk analysis 1 week before and 3 months and 1 and 2 years after surgery.

Use of tumor necrosis factor-alpha-coated gold nanoparticles to enhance radiofrequency ablation in a translational model of renal tumors.

Objectives: Radiofrequency ablation (RFA) has been most effective when the tumors are small, exophytic, and away from vital structures. We enlarged the size of the ablation kill zone by infusing a 30-nm tumor necrosis factor-alpha and polyethylene glycol-coated gold nanoparticle (CYT-6091, CytImmune Sciences, Inc.) before ablation in a rabbit kidney tumor model.

Kidney transplant anastomosis: internal or external iliac artery?

Introduction: We compared the best technique for arterial anastomosis in kidney transplantation, end-to-side anastomosis to the external iliac artery or end-to-end anastomosis to the internal iliac artery.

Materials And Methods: A total of 38 patients with end-stage renal disease who received a kidney transplant from a deceased donor were randomized into two groups in order to undergo either end-to-end anastomosis to the internal iliac artery or end-to-side anastomosis to the external iliac artery. Length of arterial anastomosis, cold ischemia time, hospital stay, serum creatinine level, recovery of urinary output, and surgical and clinical complications during hospitalization were evaluated.

Durability of the next-generation flexible fiberoptic ureteroscopes: a randomized prospective multi-institutional clinical trial.

Objectives: To evaluate the durability of 4 next-generation flexible ureteroscopes in a randomized, multi-institutional, prospective study.

Methods: Patients at 3 institutions were randomized to 1 of 4 flexible ureteroscopes: the Wolf Viper, Olympus URF-P5, Gyrus-ACMI DUR-8 Elite (DUR-8E), and Stryker FlexVision U-500. Each center used 1 scope from each manufacturer until it needed major repair (primary endpoint).

Upper-pole access for percutaneous nephrolithotomy.

Although the supracostal approach is thought to increase the difficulties and patient morbidity of PCNL, it facilitates the management of certain urinary infirmities, such as UPJ obstruction, staghorn stone, upper pole stone, proximal ureteral abnormalities, impacted UPJ stone and upper calix diverticulum. Hereby the authors briefly comment on the technical aspects of the supracostal approach, and also discuss the possible complications of this technique and how to avoid them.

Accessory instrumentation in flexible ureteroscopy: Evidence-based recommendation.

Instrumentation is the key to success in endourology. Indeed, endourology could be redefined as "enginurology" as the marriage between engineering and urology to develop instrumentation to improve patient outcomes is the key facilitator in the advancement of minimally invasive techniques. This review article will identify the evidence-base that supports our current recommendations for equipment used during ureteroscopy.

Systematic evaluation of ureteral occlusion devices: insertion, deployment, stone migration, and extraction.

Objectives: To compare 4 ureteral occlusion devices in terms of insertion force, maneuverability, radial dilation and extraction forces, ability to prevent stone migration, and tip stiffness.

Methods: The devices tested were the PercSys Accordion, Microvasive Stone Cone (7 and 10 mm), and Cook N-Trap. Using a ureteral model with an artificial stone in place, the insertion force, number of attempts, and time to pass the impacted stone were measured.

Maximizing stone fragmentation efficiency with ultrasonic probes: impact of probe pressure and rotation.

Purpose: We examined the effects of probe rotation and pressure on stone fragmentation in an in vitro percutaneous nephrolithotomy model.

Materials And Methods: The study was a fully randomized, factorial experiment with 20 repeat trials performed at each combination of variables, yielding a total of 300 trials per device for ultrasonic tests and 360 for ultrasonic/pneumatic combination tests. Varying masses were placed on the hand piece of each device to create a probe contact pressure of 400, 1,000 or 2,000 gm.

Comparative analysis of lighted ureteral stents: lumination and tissue effects.

Purpose: The objectives of the present study were to compare the luminescence of three types of ureteral illuminated stents and analyze their effects on urothelial histology.

Materials And Methods: Three types of illuminating ureteral stents; the Cook single illuminating catheter, Cook double illuminating catheter and Stryker illumination system stent were laparoscopically placed in nine female white pigs (50 kg), under general anesthesia. After leaving the stents illuminated for 3 hours, during which time peritoneal insufflation was maintained at 18 mm Hg, the ureter was transected and the intraluminal temperature of the ureter was measured with a digital thermometer.

Assessment of validity of an OSATS for cystoscopic and ureteroscopic cognitive and psychomotor skills.

Purpose: The purpose of the study was to assess the construct validity of an Objective Structured Assessment of Technical Skills (OSATS) developed for cystoscopic and ureteroscopic cognitive and psychomotor skills.

Materials And Methods: An OSATS was designed based on a 14-point comprehensive curriculum prepared by two experts that targeted both cognitive and psychomotor cystoscopic and ureteroscopic skills. Ten urology residents from a single institution with different levels of training were assessed on a series of stations that targeted these skills.

Alfuzosin to relieve ureteral stent discomfort: a prospective, randomized, placebo controlled study.

Purpose: We assessed the impact of alfuzosin on ureteral stent discomfort.

Materials And Methods: A total of 66 patients scheduled for unilateral retrograde ureteroscopy with stent placement provided consent for the study. Patients were randomized between placebo and the study medication, and investigators and patients were blinded to the randomization scheme.

Proximal ureteral calculi: shock wave or ureterolithotripsy?

Objective: To compare the success rates and efficiency of ureterolithotripsy (URL) and extracorporeal shock wave lithotripsy (SWL) for proximal ureteric stones. CASUISTRY AND METHODS: A prospective non-randomized study was performed between 1999 and 2004. Of a total of 235 patients, 121 underwent SWL and 114 had ureteroscopy with ultrasonic lithotripsy.

Estimation of size of distal ureteral stones: noncontrast CT scan versus actual size.

Objectives: To determine the accuracy of stone size determination by computed tomography (CT) for distal ureteral calculi.

Methods: A total of 76 patients who presented with distal ureteral stone were evaluated with CT. Of the 76 patients, 41 successfully passed the stone spontaneously and intact.