Ureteropelvic Junction Obstruction in a Polycystic Kidney with Duplicated System: Successful Outcome with Endoscopic Management.

Autosomal dominant polycystic kidney disease is the most prevalent hereditary renal disease, associated with progressive renal insufficiency, usually leading to dialysis. It is rarely diagnosed with other renal abnormalities. We present a case of a 35-year-old woman with a duplicated left polycystic kidney, who had recurrent pain and pyelonephritis because of ureteropelvic junction (UPJ) obstruction of the upper moiety.

Impact of a Wireless System Upon Verbal Communication in a Simulated Robotic Operating Theater.

Objective: To compare the efficacy of communication via the standard Da Vinci Si speaker system with a wireless, hands-free audio system in a prospective blinded study.

Methods: Nine hundred and sixty surgical phrases were spoken in a simulated robotic operating room (OR), including 480 phrases expressed via the Da Vinci Si speakers and 480 phrases expressed through a wireless, hands-free system. Using a dual console robotic system, communication was evaluated.

Do Illuminated Foot Pedals Improve the Speed and Accuracy of Pedal Activation During Endoscopic Procedures?

Purpose: Endourologic procedures such as percutaneous nephrolithotomy (PCNL) employ the use of foot pedals in low-light operating room (OR) settings. These pedals can be especially difficult to locate or distinguish when several pedals are present during a single operation. Improper instrument activation in the OR has led to serious complications ranging from unintentional electrocautery to patient burns and even an intraoperative explosion.

Efficacy of antegrade and retrograde warm saline pyeloperfusion during renal cryoablation for ureteral preservation.

Objective: Cryoablation of renal tumors adjacent to the ureter or pelvicalyceal system carries risks for thermal injury of the collecting system. Although cold antegrade perfusion has been described for radiofrequency ablation, warm saline perfusion for renal cryoablation has not been well-characterized. The purpose of this study was to determine the safety and feasibility of antegrade and retrograde warm saline perfusions during percutaneous renal cryoablation.

Conventional vs Computer-Assisted Stereoscopic Ultrasound Needle Guidance for Renal Access: A Randomized Crossover Bench-Top Trial.

Purpose: Ultrasound (US) guidance during renal access and mass biopsy reduces radiation exposure, but can be technically challenging. A needle guidance system might simplify these procedures. The purpose of this randomized crossover trial was to compare conventional and computer-assisted US needle guidance systems for renal access and mass biopsy.

Elevated Renal Pelvic Pressures during Percutaneous Nephrolithotomy Risk Higher Postoperative Pain and Longer Hospital Stay.

Purpose: Renal pelvic pressure may vary during percutaneous nephrolithotomy. We sought to determine the relationship of postoperative pain to endoscope caliber, renal pelvic pressure and hospital stay.

Materials And Methods: We reviewed the records of 20 percutaneous nephrolithotomies done under ureteroscopic guidance with renal pelvic pressure monitoring.

Renal Pelvic Pressure in Percutaneous Nephrolithotomy: The Effect of Multiple Tracts.

Introduction: During percutaneous nephrolithotomy (PCNL), elevated renal pelvic pressures (RPPs) may spread infection through pyelovenous backflow whereas decreased pressures can hinder observation and increase bleeding. The purpose of this study was to evaluate the effects of multiple access tracts and different sized endoscopic equipment on RPP in a porcine model.

Materials And Methods: RPP was measured in one- vs two-tract access, rigid vs flexible nephroscopy, and suction vs no suction.

Jackets Off: The Impact of Laser Fiber Stripping on Power Output and Stone Degradation.

Purpose: To investigate the effect of laser fiber stripping on stone fragmentation and laser fiber power output.

Materials And Methods: In a benchtop simulation of laser lithotripsy, 20 BegoStone phantoms were positioned within a ureteral model and irradiated for 10 minutes at 8 Hz and 0.8 J.

Predictors of narcotic use after percutaneous nephrolithotomy.

Introduction: Percutaneous nephrolithotomy (PCNL) is associated with significant variability in postoperative pain and subsequent narcotic use. The purpose of this study was to determine the factors associated with high narcotic use following PCNL.

Materials And Methods: A single-center retrospective review of patients undergoing initial PCNL between 2004 and 2014 was performed.

High-Frequency Dusting Versus Conventional Holmium Laser Lithotripsy for Intrarenal and Ureteral Calculi.

Introduction: The efficiency of holmium laser lithotripsy for urolithiasis depends upon several factors, including laser pulse energy and frequency and stone composition and retropulsion. This study investigates the complex interplay between these factors and quantifies lithotripsy efficiency using different laser settings in a benchtop kidney and ureter model.

Materials And Methods: In vitro caliceal and ex vivo porcine ureteral models were constructed.

Percutaneous Externally Assembled Laparoscopic vs Laparoendoscopic Single-Site Nephrectomy in a Porcine Model: A Prospective, Randomized, Blinded, Study.

Objective: To compare the outcomes between laparoendoscopic single-site (LESS) and a novel percutaneous externally assembled laparoscopic (PEAL) nephrectomy in an in vivo porcine model.

Materials And Methods: Ten female farm pigs were randomized to LESS nephrectomy (5) or PEAL nephrectomy (5). Operative times, estimated blood loss, and intraoperative and postoperative complications were compared.

Kidney, Ureter, and Bladder (KUB): A Novel Grading System for Encrusted Ureteral Stents.

Objective: To introduce a grading system (kidney, ureter, and bladder [KUB]) to identify encrusted stents that may require multiple surgeries, multimodal surgery, and operative time > 180 minutes for successful removal.

Methods: One hundred ten retained encrusted ureteral stents were retrospectively scored using the KUB grading system and this score was correlated with operative time, need for multiple surgeries or multimodal surgery, and stone-free rate. Data analysis was performed with t test, Mann-Whitney U test, and chi-square tests.

Enhanced recovery pathway for radical prostatectomy: Implementation and evaluation in a universal healthcare system.

Introduction: Enhanced recovery pathways are standardized, multidisciplinary, consensus-based tools that provide guidelines for evidence-based decision-making. This study evaluates the impact of the implementation of a clinical care pathway on patient outcomes following radical prostatectomy in a universal healthcare system.

Methods: Medical charts of 200 patients with prostate cancer who underwent open and minimally invasive radical prostatectomy at a single academic hospital from 2009 to 2012 were reviewed.

Aldehyde dehydrogenase 1 expression in primary and metastatic renal cell carcinoma: an immunohistochemistry study.

Background: ALDH1 has been shown to be a cancer stem cell marker, and its expression correlates with prognosis in a number of malignancies. We aimed to evaluate the expression of ALDH1 in a cohort of primary and metastatic RCC specimens, and to correlate expression with pathological outcomes such as tumor stage and grade, and clinical outcomes such as progression free survival.

Methods: Three tissue microarrays were constructed from 244 RCC specimens, taken from 1985 to 2006.

Enhancer of zeste homolog 2 expression is associated with metastasis and adverse clinical outcome in clear cell renal cell carcinoma: a comparative study and review of the literature.

Context: Enhancer of zeste homolog 2 (EZH2), a histone methyltransferase mediating chromatin condensation and epigenetic modulation, is overexpressed in various human carcinomas and is associated with adverse clinicopathologic characteristics and biologic behavior. The expression of EZH2 in renal cell carcinomas (RCCs) has not been fully characterized yet.

Objective: To evaluate the prognostic role of EZH2 in RCC by analyzing the immunohistochemical staining pattern of the marker in relation to pathologic features and clinical outcome.

Diagnostic and prognostic role of immunohistochemical expression of napsin-A aspartic peptidase in clear cell and papillary renal cell carcinoma: a study including 233 primary and metastatic cases.

Napsin-A aspartic peptidase (napsin-A) is an aspartic protease that is predominantly expressed in the proximal renal tubules and type II pneumocytes of the lung. Recently, napsin-A was reported to be present in a proportion of renal cell carcinomas (RCCs). However, the utilization of napsin-A immunohistochemistry as a routine diagnostic tool for RCC, and the correlation of the level of napsin-A expression with histologic features have not yet been established.

Extensive renal infarction following percutaneous biopsy of a small renal mass: A case report.

Percutaneous renal biopsy has become increasingly used particularly in patients undergoing active surveillance for small renal masses. We present a patient, who was recently diagnosed with laryngeal squamous cell carcinoma, with significant complication following biopsy of a solid renal mass. The patient was planned for nephron-sparing surgery that was converted to radical nephrectomy due to extensive renal infarction secondary to significant subcapsular hemorrhage inflicted by the biopsy.

Solitary solid renal mass: can we predict malignancy?

Unlabelled: What's known on the subject? and What does the study add? It is known that the majority (80%) of solid renal masses are malignant. Most of the literature suggests that smaller tumour size is associated with a higher incidence of benign disease. We have confirmed that decreased tumour size is associated with benign disease, particularly for lesions <2 cm.

Effect of fibrates on lipid profiles and cardiovascular outcomes: a systematic review.

Objective: Fibrates might represent a viable treatment option for patients who do not meet their target low-density lipoprotein levels on statins or who are resistant or intolerant to statins. New data from fibrate trials can be synthesized with the existing literature to better estimate their effects.

Methods: We systematically searched the literature to identify randomized, double-blind, placebo-controlled trials examining the effect of fibrates on lipid profiles or cardiovascular outcomes.