Endourological Management of Renal Stones: A Systematic Review, Bayesian Network Meta-analysis and Meta-regression.

Objective: To compare stone-free rates (SFRs), operative times, and transfusion rates of various endoscopic techniques for kidney stone management.

Methods: A systematic review was performed, identifying studies comparing the different endoscopic techniques in patients with renal stones. Studies were grouped by location and size of stones (lower pole, 1-2cm, and >2 cm).

Complete Intraureteral Stents Decrease Urinary Symptoms Compared with Conventional Ureteral Stents: A Systematic Review and Meta-Analysis.

Up to 80% of stent patients report urinary discomfort, negatively impacting their daily activities and quality of life. Conventional Double-J ureteral stents (DJSs) can cause adverse kidney and bladder-related symptoms. Complete intraureteral stents (CISs) may reduce bothersome bladder symptoms by reducing foreign material in the bladder.

The Microbiome and Urolithiasis: Current Advancements and Future Challenges.

Purpose Of Review: The aim of this review is to explore the effect of the microbiome on urolithiasis and explore recent advances and challenges in microbiome research for urolithiasis.

Recent Findings: Lack of standardization and shortcomings in study design for urinary microbiome research on urolithiasis has hampered the generalizability of results and weakened the impact of findings on clinical practice. Important study limitations include sample heterogenicity, specimen contamination, poor culture yields, and lack of shared datasets for meta-analysis.

Para-aortic haemangioma mimics paraganglioma on MRI.

Here, we report a case of a 70-year-old man referred for an incidentally discovered left renal lesion with peri-aortic lymphadenopathy following a CT scan for back pain. A follow-up MRI scan demonstrated a Bosniak IIF left renal cyst and a T2-hyperintense para-aortic lesion concerning for extra-adrenal paraganglioma (EAP). [I] Metaiodobenzylguanidine scintigraphy of the para-aortic lesion and urine catecholamines were equivocal.

Does Solid Organ Transplantation Affect Male Reproduction?

Patients undergoing solid organ transplantation have experienced increased graft survival rates over the past several decades. With increased longevity making fatherhood a viable option, many patients desire to pursue this path. However, many patients and practitioners are likely unaware of the feasibility and safety for a man on a transplant immunosuppression regimen to safely pursue fatherhood.

Patient-specific Virtual Simulation-A State of the Art Approach to Teach Renal Tumor Localization.

Objective: To test whether a novel visuospatial testing platform improves trainee ability to convert two-dimensional to three-dimensional (3D) space.

Methods: Medical students were recruited from Baylor College of Medicine and McGovern Medical School (Houston, TX). We 3D reconstructed 3 partial nephrectomy cases using a novel, rapid, and highly accurate edge-detection algorithm.

To Dust or Not To Dust: a Systematic Review of Ureteroscopic Laser Lithotripsy Techniques.

Purpose Of Review: This review discusses factors affecting outcomes during ureteroscopy (URS) with laser lithotripsy (LL), explores specific clinical challenges to the efficacy of URS LL, and reviews the available literature comparing the dusting and basketing approaches to URS LL.

Recent Findings: Data show high stone-free rates with URS LL in all locations of the urinary tract and with all stone types and sizes. Recent data comparing LL with dusting versus basketing suggest higher rates of residual fragments with dusting but less utilization of ureteral access sheaths and potentially shorter operative times.

Percent of Tracer Clearance at 40 Minutes in MAG3 Renal Scans Is More Sensitive Than T for Symptomatic Ureteropelvic Junction Obstruction.

Objective: To increase the diagnostic sensitivity of standard MAG3 diuretic renal scans for ureteropelvic junction obstruction (UPJO) by exploring the utility of an alternative measurement P the percentage of maximal tracer counts present at 40 minutes.

Materials And Methods: Patients with strong clinical and anatomic evidence for UPJO may have a normal T, making definitive diagnosis difficult. We reviewed the charts of 142 consecutive patients who underwent successful laparoscopic or robotic-assisted laparoscopic pyeloplasty for UPJO between 2005 and 2015.

Poor Sleep Quality Predicts Hypogonadal Symptoms and Sexual Dysfunction in Male Nonstandard Shift Workers.

Objective: To investigate the impact of sleep quality in hypogonadal symptoms and sexual function in men working nonstandard shifts.

Materials And Methods: Men treated at a single andrology clinic between July and October 2014 completed questionnaires assessing sleep quality, hypogonadal symptoms (Androgen Deficiency in the Aging Male [ADAM/qADAM]), and sexual function (International Index of Erectile Function [IIEF]). Serum hormone levels were assessed at the time of survey completion.

Utility of patient-specific silicone renal models for planning and rehearsal of complex tumour resections prior to robot-assisted laparoscopic partial nephrectomy.

Objective: To describe our experience using patient-specific tissue-like kidney models created with advanced three-dimensional (3D)-printing technology for preoperative planning and surgical rehearsal prior to robot-assisted laparoscopic partial nephrectomy (RALPN).

Patients And Methods: A feasibility study of 10 patients with solid renal masses who underwent RALPN after preoperative rehearsal using 3D-print kidney models. A single surgeon performed all surgical rehearsals and procedures.

Impaired Sleep Quality is Associated With More Significant Lower Urinary Tract Symptoms in Male Shift Workers.

Objective: To determine the association between sleep quality and severity of lower urinary tract symptoms (LUTS) in men working nonstandard shifts, a population at risk of poor sleep quality.

Methods: Men who presented to a single andrology clinic between July and October 2014 and worked nonstandard shifts completed the International Prostate Symptom Score (IPSS) and responded to questions regarding their work habits, sleep quality, and physical or cognitive function. We assessed the relationship between age, sleep quality, physical or cognitive function, and severity of LUTS.

Solitary colon metastasis from renal cell carcinoma nine years after nephrectomy: A case report.

Introduction: Renal cell carcinoma (RCC) is the most common renal malignancy in adults. Metastatic disease is relatively common at presentation and frequently involves the lung, bone, brain, liver and adrenal glands. After curative resection, there is a 30-40% risk of recurrence, and a 10% risk of developing metastatic disease after 5 years.

Laparoscopic Nephron-sparing Treatment of Upper Pole Infundibular Obstruction due to Fraley's Syndrome.

Fraley's syndrome results from a rare anatomic variant of the renal vasculature leading to compression of the upper pole infundibulum, caliectasis, hematuria, and flank pain. To date there have been few reported cases in which this condition was treated using a minimally invasive approach. Here, we report a case in which a patient with Fraley's syndrome was successfully treated by performing a laparoscopic YV-infundibulo-pyeloplasty with vasculopexy of a posterior segmental renal artery.

A nephropleural fistula complicated by distal ureteral obstruction results in tension hydrothorax after percutaneous nephrostolithotomy.

We present the case of a patient with nephrocalcinosis and chronic kidney disease who underwent percutaneous nephrostolithotomy via a mid-pole access. After nephroureteral stent removal, the patient developed a tension hydrothorax due to the rare combination of a nephropleural fistula and ipsilateral distal ureteral obstruction. This complication was managed by percutaneous nephrostomy and thoracostomy placement and subsequent thoracoscopic surgery without further sequelae.

Recurrent symptoms following pyeloplasty with a normal endoscopic evaluation: assessment and outcomes of a challenging patient cohort.

Objective: To aid in counseling and managing a challenging patient cohort, we review our experience using a structured endoscopic approach to assess individuals with recurrent symptoms but a normal anatomic evaluation after pyeloplasty.

Methods: From 2008 to 2012, all patients presenting with recurrent symptoms after pyeloplasty for ureteropelvic junction (UPJ) obstruction were retrospectively evaluated. After baseline renal scanning, all underwent retrograde ureteropyelography, flexible ureteroscopy, UPJ balloon calibration, and provocative ureteral stenting.

Laparoscopic needle-retrieval device for improving quality of care in minimally invasive surgery.

Background: Loss of a needle during laparoscopic surgery is a rare but potentially serious adverse event that can cause prolonged operative time and patient harm. Standard recovery techniques currently include instrument count, standard visual search, and plain abdominal x-rays. We developed a laparoscopic instrument to speed the retrieval of lost needles in the abdomen and pelvis.

Comparison of laparoendoscopic single site (LESS) and conventional laparoscopic donor nephrectomy at a single institution.

Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Most transplant centres harvest living donor kidneys via a conventional laparoscopic surgical approach. Laparoendoscopic single-site donor nephrectomy (LESS-DN) is a relatively novel minimally invasive approach that allows the surgery to be performed via a single incision. This technique may be advantageous in decreasing surgical morbidity and improving cosmetic outcomes, thus plausibly reducing the barriers to kidney donation.

Higher RENAL Nephrometry Score is predictive of longer warm ischemia time and collecting system entry during laparoscopic and robotic-assisted partial nephrectomy.

Objective: To investigate the predictive value of the RENAL Nephrometry Score (RNS) on operative outcomes during both laparoscopic partial nephrectomy (LPN) and robotic-assisted partial nephrectomy (RPN).

Methods: We reviewed 67 consecutive patients with suspicious renal lesions and available radiographic data who underwent LPN or RPN by a single surgeon. Data included operative type, body mass index (BMI), gender, age, and side of tumor.