Ureterorenoscopy training on cadavers embalmed by Thiel's method: simulation or a further step towards reality? Initial report.

Introduction: The technique of ureterorenoscopy has a significant learning curve. Cadavers embalmed by the Thiel method have been successfully used for simulation training in a number of surgical specialties. Here we present our experience of the first use of Thiel cadavers in a formal ureteroscopy training course.

Unmet Supportive Care Needs of Men With Locally Advanced and Metastatic Prostate Cancer on Hormonal Treatment: A Mixed Methods Study.

Background: Men affected by prostate cancer who are undergoing hormone therapy can endure a range of symptoms that can adversely affect quality of life. Little research has been conducted to date, to understand the specific unmet supportive care needs of this patient group within the context of current service delivery.

Objective: The aim of this study was to understand the experiences of unmet supportive care needs of men affected by prostate cancer on hormone therapy in the United Kingdom.

Concurrent bladder cancer in patients undergoing photodynamic diagnostic ureterorenoscopy: how many lesions do we miss under white light cystoscopy?

Introduction: There is an ongoing debate on panurothelial changes in the upper and lower urinary tract as multifocal presentation of urothelial cancer is well recognised. Concurrent bladder cancer impacts the outcome of the upper urinary tract urothelial cancer treatment, while its detection still relies on the white light cystoscopy.

Material And Methods: We retrospectively reviewed all patients who underwent photodynamic diagnostic ureterorenoscopy, choosing those who had synchronous bladder biopsies.

Are we closer to seeing carcinoma in situ in the upper urinary tract?

Introduction: There is observed increase in detection rate of upper urinary tract urothelial cancer worldwide. This is a result of improved imaging as well as implementation of novel technologies of direct visualization of upper urinary tract. Standard techniques still remain insufficient to diagnose flat urothelial lesions.

Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature.

Introduction And Objectives: The management of urolithiasis in patients with horseshoe kidney (HSK) is difficult. Stone formation occurred in 1:5 patients with HSK due to impaired urinary drainage and infections. Percutaneous nephrolithotomy and shock wave lithotripsy can be technically challenging due to altered anatomy.

Photodynamic diagnostic ureterorenoscopy: A valuable tool in the detection of upper urinary tract tumour.

Background: Photodynamic diagnosis increases the detection rate and hence decreases recurrence rates of urothelial cancer (UC) of the bladder. This technique has been implemented in the upper urinary tract and like in the bladder, has shown to increase the detection rate of urothelial lesions.

Objectives: To determine the sensitivity, specificity, and detection rates for photodynamic diagnostic flexible ureterorenoscopy (PDD-FURS) and white light ureterorenoscopy (WL-FURS).

Laser-induced autofluorescence spectroscopy: can it be of importance in detection of bladder lesions?

Background: Non-muscle invasive bladder cancer can be missed during white light endoscopy in up to 50% of cases. We aimed to test whether or not we could find a difference between benign and cancerous tissue wavelengths using laser induced autofluorescence spectroscopy can increase cancer detection.

Materials And Methods: We analysed 67 tissue samples using spectral analysis.

Photodynamic diagnostic ureterorenoscopy with orally administered 5-aminolaevulinic acid as photosensitiser: how I do it.

Objective: To explain our use of photodynamic diagnostic ureterorenoscopy, we provide a detailed description of the choice of photosensitiser, equipment needed, a safety profile, and pointers on our technique.

Technique: Patients are given oral 5-aminolaevulinic acid (5-ALA) as a photosensitiser 3-4 h pre-operatively, and by using a Xenon blue light source, an eyepiece which blocks light below 450 nm which is fitted onto the ureterorenoscope, we are able to conduct a thorough photodiagnosis of the upper urinary tract.

Conclusion: Our technique of photodynamic diagnostic ureterorenoscopy has shown that the sensitivity, specificity and detection rates of upper urinary tract lesions can be significantly increased with the use of oral 5-ALA.

Mitomycin C instillation following ureterorenoscopic laser ablation of upper urinary tract carcinoma.

Introduction: Instillation of Mitomycin C (MMC) should prevent implantation of cancer cells released during endoscopic treatment and prevent recurrences as seen in carcinoma of the bladder.

Aim: TO DEVELOP AND EVALUATE A PROTOCOL FOR A SINGLE DOSE MMC INSTILLATION FOLLOWING HOLMIUM: YAG laser ablation of upper urinary tract transitional cell carcinoma (UUT-TCC).

Setting And Design: A single institute prospective study.

Diagnosis of upper urinary tract tumours: is photodynamic diagnosis assisted ureterorenoscopy required as an addition to modern imaging and ureterorenoscopy?

Objectives: We aimed to assess the diagnostic accuracy of photodynamic diagnostic ureterorenoscopy (PDD-FURS) in detection of UUT-TCC in comparison with CT Urogram (CTU) and WL-FURS.

Material And Methods: Between June 2009 and August 2011, 30 patients underwent PDD-FURS after CTU for suspicion of UUT-TCC. Ureterorenoscopy was performed for abnormal upper urinary tract on imaging.

Oral 5-aminolevulinic acid in simultaneous photodynamic diagnosis of upper and lower urinary tract transitional cell carcinoma - a prospective audit.

Unlabelled: What's known on the subject? and What does the study add? The idea of using photosensitizing agents to enhance visualization of cancer tissue dates back to 1900. 5-Aminolevulinic acid (5-ALA) was first suggested for photodynamic diagnosis (PDD) of transitional cell cancer (TCC) of the bladder in 1992. Since then, PDD with intravesical application of 5-ALA or its ester hexaminolevulinate (Hexvix) has proven to be superior over standard white-light cystoscopy in detection of carcinoma in situ and dysplasia as well as enhancing margins of TCC.

Accuracy of photodynamic diagnosis in the detection and follow-up of patients with upper urinary tract lesions: Initial 3-year experience.

Objective: To assess the diagnostic accuracy of photodynamic diagnostic (PDD) ureterorenoscopy for detecting upper-urinary tract transitional cell carcinoma (UUT-TCC) in our initial 3 years, and compare the results with that of white light ureterorenoscopy (WLU).

Patients And Methods: Between August 2007 and March 2010, 32 patients underwent PDD flexible ureterorenoscopy for UUT-TCC. Oral 5-aminolaevulinic acid (5-ALA) was used as the photosensitiser.

Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis.

Background And Purpose: Urinary stones >2 cm are traditionally managed with percutaneous nephrolithotomy (PCNL). Recently, flexible ureteroscopy and laser lithotripsy) (FURSL) has been used to manage them with comparable results. In a comparative study of renal stones between 2 and 3 cm, FURSL was reported to need less second-stage procedures and be just as effective as PCNL.

Extracorporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi.

Background: Ureteral stones frequently cause renal colic, and if left untreated, can lead to obstructive uropathy. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy, with or without intracorporeal lithotripsy, are the most common interventions used to treat ureteral stones. ESWL treatment is less invasive than ureteroscopy, but has some limitations such as a high retreatment rate, and is not available in all centres.

Extracorporeal shock wave lithotripsy (ESWL) versus ureteroscopic management for ureteric calculi.

Background: Ureteral stones frequently cause renal colic, and if left untreated, can lead to obstructive uropathy. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy, with or without intracorporeal lithotripsy, are the most common interventions used to treat ureteral stones. ESWL treatment is less invasive than ureteroscopy, but has some limitations such as a high retreatment rate, and is not available in all centres.

Decreasing the cost of flexible ureterorenoscopic procedures.

Objective: To treat calculus disease, perform diagnostic procedures, for endoscopic management of upper tract tumours and in selected cases for laser guided endopyelotomy there is an increase in the use of Flexible Ureterorenoscopy (FURS).

Methods: We wanted to prospectively audit the cost of flexible ureterorenoscopic procedures undertaken in our department between March 2009 and March 2010.

Results: Based on our business model, the cost of diagnostic FURS is £131 (equivalent to €157 or $196.