Renal cell carcinoma in patients with end-stage renal disease is associated with more favourable histological features and prognosis.

Objective: End-stage renal disease (ESRD) patients with acquired cystic kidney disease are at higher risk of developing renal cell carcinoma (RCC) than the general population. The aim of this study was to investigate the clinical and histopathological differences between ESRD patients and the general population with RCC.

Materials And Methods: Data were retrospectively collected from all nephrectomies performed for localized RCC from 2000 to 2010.

Laparoscopic partial nephrectomy for renal tumours: early experience in Singapore general hospital.

Introduction: To review the perioperative and short-term outcome of all laparoscopic partial nephrectomies (LPN) performed in a single institution.

Materials And Methods: Thirteen consecutive patients who underwent LPN since the beginning of the programme in March 2002 to January 2008 were enrolled. Demographic, perioperative and follow-up data were retrospectively collected.

Intramuscular gentamicin improves the efficacy of ciprofloxacin as an antibiotic prophylaxis for transrectal prostate biopsy.

Introduction: Infection-related complications after transrectal ultrasound guided prostatic biopsy (TRPB) could be life threatening. Our centre observed sepsis after TRPB despite prophylactic oral ciprofloxacin. We reviewed all cases of post-TRPB sepsis with their bacteriology and evaluated if the addition of intramuscular (I/M) gentamicin to standard prophylaxis before TRPB could reduce its incidence.

[Clinical research about balloon dilation before incision for patients with ureteric stricture].

Objective: To study the use about balloon dilatation before incision for the patients with ureteric stricture.

Methods: Sixteen patients with ureteric stricture were included in our study. The cases were reviewed retrospectively with regards to the etiological factor, the site of stricture, symptom and diagnosis.

Team-based approach reduces learning curve in robot-assisted laparoscopic radical prostatectomy.

Aim: We assessed the team approach in reducing the learning curve during our 2-year experience transiting from open to robot-assisted laparoscopic radical prostatectomy (rLRP).

Methods: A team of three urologists progressed through assistant phase to console phase to obtain competency in robotic prostatectomy. One hundred patients underwent rLRP by this team using the da Vinci robotic surgical system from 1 February 2003 to 15 May 2005.

Use of Stone Cone minimizes stone migration during percutaneous nephrolithotomy.

We describe a simple and effective method using the Stone Cone to prevent migration of stone fragments into the ureter during percutaneous nephrolithotomy. This maneuver may reduce the need for antegrade ureteroscopy to remove residual fragments, thereby saving time and obviating the need for placement of an occlusion balloon.

Location and etiology of flexible and semirigid ureteroscope damage.

Objectives: To perform an analysis of currently available manufacturer data regarding the character of ureteroscope damage. The high costs associated with the repair of flexible and semirigid ureteroscopes are well documented. Increased knowledge of the etiology of ureteroscope damage should aid urologists in prolonging the lives of these delicate instruments.

Laparoscopic nephrectomy: new standard of care?

Objective: The pace of implementation of a laparoscopic nephrectomy programme is affected by factors including surgical expertise, case load, learning curves and outcome audits. We report our experience in introducing a laparoscopic nephrectomy programme over a 3-year period.

Methods: From January 2001 to December 2003, 187 nephrectomies were performed (105 by conventional surgery, 82 by laparoscopy).

Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi.

Objective: To present early experience in managing complex renal calculi using a combined ureteroscopic and percutaneous approach, as complex and branched renal calculi often require multiple access tracts during percutaneous nephrolithotomy (PNL), and the combined use of flexible ureteroscopy and PNL has the potential to reduce the inherent morbidity of several tracts.

Patients And Methods: The study included seven patients (mean age 54 years) with multiple, branched, large-volume renal calculi suitable for management with PNL. Preoperative data, including patient demographics, stone location and stone surface area, were recorded.

Laparoscopic heminephrectomy for tumor.

Objectives: To present our experience with laparoscopic heminephrectomy. We defined heminephrectomy as excision of 30% or more of the renal parenchyma. Laparoscopic partial nephrectomy has typically been performed for smaller, exophytic tumors.

How significant are clinically insignificant residual fragments following lithotripsy?

Purpose Of Review: Extracorporeal shock-wave lithotripsy had revolutionized the treatment of kidney stones. Residual fragments smaller than 4 or 5 mm which are asymptomatic and likely to pass spontaneously are termed as clinically insignificant residual fragments. This article reviews the current literature with regards to the management of clinically insignificant residual fragments.

Ureteroscopic management of renal calculi in anomalous kidneys.

Objectives: To review our experience with ureteroscopy in treating patients with renal calculi in anomalous kidneys and to evaluate the efficacy of this approach.

Methods: Eight patients with renal calculi in anomalous kidneys who were managed by ureteroscopic procedures were identified. Demographic information, preoperative stone burden, operative information (ureteroscope size, lithotrite used, instruments used, duration of surgery, complications, stenting), follow-up imaging, and complications were obtained from the medical record.

Hand-assisted laparoscopic partial nephrectomy without hilar vascular clamping using a saline-cooled, high-density monopolar radiofrequency device.

Background And Purpose: Nephron-sparing surgery is now accepted as an alternative treatment option for small renal tumors. However, hemostasis during laparoscopic partial nephrectomy can be technically challenging, especially without hilar vascular clamping. The aim of our study was to evaluate the technique of hand-assisted laparoscopic partial nephrectomy using the TissueLink (TissueLink Medical, Dover, NH), a saline-cooled monopolar radiofrequency device, without hilar vascular clamping.

Hand-assisted laparoscopic nephrectomy for inflammatory renal conditions.

Purpose: Laparoscopic surgery for large renal lesion or kidneys with chronic inflammation has proved to be technically challenging. Hand-assisted laparoscopic surgery might be useful in these complex cases, as it provides surgeons the benefits of tactile feedback, digital retraction, and facilitated dissection of the renal hilar vessels.

Patients And Methods: Twenty-two patients undergoing hand-assisted laparoscopic (HAL) nephrectomy for benign conditions were compared with patients who underwent HAL radical nephrectomy during the same period.

Hand-assisted laparoscopic heminephrectomy in horseshoe kidney.

Background And Purpose: Horseshoe kidneys are the most common renal fusion anomalies. In surgery on normal kidneys, the use of minimally invasive techniques has decreased morbidity and improved postoperative care. However, aberrant vasculature, abnormal kidney location, and the renal isthmus present technical challenges to the laparoscopic management of horseshoe kidneys.

Hand assisted laparoscopic training for postgraduate urologists: the role of mentoring.

Purpose: Hand assisted laparoscopy (HAL) has recently been accepted as a safe alternative for nephrectomy. HAL courses have been offered at several institutions to train novice laparoscopic surgeons in this minimally invasive surgical procedure. Mentoring by a course instructor or an experienced laparoscopist provides assistance to surgeons with their initial operation.

Advances in video and imaging in ureteroscopy.

Advances in image processing and display technologies, such as digital imaging, HDTV, and virtual reality, will ultimately allow integration of endoscopic imaging with diagnosis and therapy during ureteroscopic procedures. Further improvements in simulation technology and telemedicine should improve surgical training and greatly benefit patient care.

Intravesical prostatic protrusion predicts the outcome of a trial without catheter following acute urine retention.

Purpose: We prospectively evaluated a simple, noninvasive method to predict the outcome of a voiding trial following acute urine retention (ARU) based on intravesical prostatic protrusion (IPP) using transabdominal ultrasound.

Materials And Methods: Males older than 50 years presenting with an initial episode of ARU were included in the study. Patients with prostatic cancer, urinary tract infection, bilateral hydronephrosis or neurological disease were excluded.