Tubeless percutaneous nephrolithotomy: 3 years of experience with 454 patients.

Objective: To present our experience with 454 patients who had tubeless percutaneous nephrolithotomy (TPCNL) over last 3 years.

Patients And Methods: From September 2004 to August 2007, all patients aged >14 years and undergoing PCNL were considered for TPCNL. Exclusion criteria were the presence of pyonephrosis, matrix calculi, significant bleeding or residual stone burden and need for three of more percutaneous accesses.

A randomized trial evaluating type of nephrostomy drainage after percutaneous nephrolithotomy: small bore v tubeless.

Purpose: To compare the outcome of tubeless percutaneous nephrolithotomy (PCNL) with small-bore nephrostomy drainage after PCNL.

Patients And Methods: We tested the hypothesis that tubeless PCNL is superior to small-bore nephrostomy drainage after PCNL in terms of postoperative pain, analgesic requirement, and hospital stay. To show a 10% difference in these parameters, a sample size of 30 persons per group would be needed.

Endoscopic management of adult orthotopic ureterocele and associated calculi with holmium laser: experience with 16 patients over 4 years and review of literature.

Purpose: To retrospectively evaluate the safety and effectiveness of holmium laser endoscopic incision and laser lithotripsy in adults with orthotopic ureterocele and associated calculi.

Patients And Methods: From May 2003 to August 2007 at our center, 16 adults underwent transurethral incision of an ureterocele and intracorporeal holmium laser lithotripsy for associated calculi. The perioperative data of these patients were retrospectively analyzed.

Tubeless percutaneous nephrolithotomy in patients with previous ipsilateral open renal surgery: a feasibility study with review of literature.

Purpose: To present our initial experience of tubeless percutaneous nephrolithotomy (PCNL) in patients with previous ipsilateral open renal surgery.

Patients And Methods: Twenty-five patients with previous ipsilateral open renal surgery underwent tubeless PCNL at our institute. Patients with large renal and/or upper ureteral calculi, irrespective of the number and size of the stones, amount of hydronephrosis, or the renal parameters, were selected for the procedure.

Splenic injury: rare complication of percutaneous nephrolithotomy: report of two cases with review of literature.

Background: Splenic injury is an uncommon complication of percutaneous nephrolithotomy (PCNL).

Patients And Methods: We report herewith two cases of splenic injury that occurred during puncture of the 10th intercostal-space for PCNL.

Results And Conclusions: One of these patients presented with hypotension on day 5 after discharge from the hospital.

Peri-operative complications of holmium laser enucleation of the prostate: experience in the first 280 patients, and a review of literature.

Objective: To evaluate, in a prospective study, the complications in 280 patients undergoing holmium laser enucleation of the prostate (HoLEP) at our institution, and to review previous reports to determine the overall incidence and types of various complications, and analyse their causes and means of prevention.

Patients And Methods: We analysed the patients' demographic, peri-operative and follow-up data, and the complications during and after surgery.

Results: HoLEP was completed successfully in 268 patients (95.

Prospective evaluation of the learning curve for holmium laser enucleation of the prostate.

Purpose: In a prospective manner we evaluated the learning experience of an endourologist inexperienced with holmium laser prostate enucleation and its impact on surgical outcome. We also reviewed the literature to document technical features of holmium laser prostate enucleation at different institutions.

Materials And Methods: Patient demographic, perioperative and followup data were analyzed.

Safety and efficacy of supracostal access in tubeless percutaneous nephrolithotomy.

Purpose: To evaluate the feasibility and safety of supracostal access in tubeless percutaneous nephrolithotomy (PCNL).

Patients And Methods: From September 2004 to November 2005, tubeless PCNL using supracostal access was done for 72 patients at our institute. Patients requiring more than two percutaneous tracts or with significant intraoperative bleeding or residual stone burden were excluded from the study.

A prospective, randomized trial evaluating the safety and efficacy of fibrin sealant in tubeless percutaneous nephrolithotomy.

Purpose: We performed a prospective, randomized trial to assess the safety and efficacy of fibrin sealant in tubeless percutaneous nephrolithotomy.

Materials And Methods: A total of 63 patients undergoing tubeless percutaneous nephrolithotomy were randomized to receive Tisseel vapor heated sealant at the end of the procedure. Fibrin sealant was instilled under direct vision in the nephrostomy tract at the end of the procedure.

Simultaneous transurethral cystolithotripsy with holmium laser enucleation of the prostate: a prospective feasibility study and review of literature.

Objective: To report experience with holmium laser enucleation of the prostate (HoLEP) simultaneously with transurethral holmium laser cystolithotripsy (HLC) for managing bladder outlet obstruction (BOO) and associated vesical calculi; we also review previously reported cases of managing vesical calculi and associated BOO.

Patients And Methods: The high-powered holmium laser is a very efficient multifunctional endourological instrument that effectively fragments calculi of all compositions and is capable of haemostatic cutting of tissue, resulting in minimal bleeding after prostatic resection. A prospective study was conducted from April 2003 that included 32 men who underwent simultaneous HoLEP with transurethral HLC at our institution.

Sequential holmium laser enucleation of the prostate and laparoscopic extraperitoneal bladder diverticulectomy: initial experience and review of literature.

Background And Purpose: Urologic applications of laparoscopy and the holmium laser have increased exponentially in the past few years. We present our experience with sequential holmium laser enucleation of the prostate (HoLEP) and extraperitoneal laparoscopic diverticulectomy for a large symptomatic bladder diverticulum and associated bladder outlet obstruction.

Patients And Method: From June 2004 to June 2005, three patients with benign prostatic hyperplasia (BPH) and a large secondary bladder diverticulum were offered sequential HoLEP and laparoscopic extraperitoneal bladder diverticulectomy.

Initial experience with hemostatic fibrin glue as adjuvant during tubeless percutaneous nephrolithotomy.

Purpose: To report our initial experience with hemostatic fibrin glue as an adjuvant during tubeless percutaneous nephrolithotomy (PCNL).

Patients And Methods: Seventeen consecutive patients underwent tubeless PCNL with injection of 2 mL of Tisseel Vapor Heated Sealant (Baxter AG, Vienna, Austria) into the percutaneous tracts at the conclusion of the procedure. The perioperative outcomes of these patients were compared retrospectively with those of a control group of 25 consecutive patients who underwent tubeless PCNL without the use of fibrin glue.

Evaluation of fluid absorption during holmium laser enucleation of prostate by breath ethanol technique.

Purpose: In a prospective manner we studied various factors affecting fluid absorption during HoLEP. We also simultaneously evaluated changes in serum electrolytes and hemoglobin decrease during HoLEP.

Materials And Methods: This prospective study comprised of 53 patients who underwent HoLEP at our institute.

Laparoscopic nephrectomy for giant staghorn calculus with non-functioning kidneys: is associated unsuspected urothelial carcinoma responsible for conversion? Report of 2 cases.

Background: Neglected renal stones remain a major cause of morbidity in developing countries. They not only result in functional impairment of affected kidney, but also act as an important predisposing factor for development of urothelial neoplasms. It is not uncommon to miss an associated urothelial tumor in a patient of nephrolithiasis preoperatively.

Immediate endoscopic management of complete iatrogenic anterior urethral injuries: a case series with long-term results.

Background: Urethral injury produces partial or complete disruption of the urethral integrity. Advances in endourology have made endoscopic management of most of these injuries feasible without greatly compromising the final result. We report our institutional experience of immediate endoscopic realignment of complete iatrogenic anterior urethral injury.

Safety and efficacy of bilateral simultaneous tubeless percutaneous nephrolithotomy.

Objectives: To evaluate the feasibility and safety of bilateral simultaneous tubeless percutaneous nephrolithotomy (PCNL).

Methods: From August 2004 to January 2005, 10 patients underwent bilateral simultaneous tubeless PCNL. Patients needing more than two percutaneous tracts, having significant intraoperative bleeding, or a residual stone burden were excluded from the study group.

Laparoscopy-assisted transperitoneal percutaneous nephrolithotomy for recurrent calculus in isthmic calix of horseshoe kidney.

Background And Purpose: Management of urolithiasis in a horseshoe kidney (HSK) poses a unique challenge. Although most patients can be managed by a combination of percutaneous nephrolithotomy (PCNL) and extracorporeal shockwave lithotripsy (SWL), calculi in the isthmic calix remain difficult to treat, as this area is out of reach during rigid PCNL, and, owing to the poor evacuation of the fragments, the results of SWL are suboptimal.

Case Report: A 59-year-old man known to have an HSK presented with right-sided lower-abdominal pain and episodes of urinary infection.

Laparoscopically guided transperitoneal percutaneous nephrolithotomy for calculi in pelvic ectopic kidneys.

Although percutaneous nephrolithotomy is a well-established endourological modality for the management of calculi in the normally placed kidney, it is not easy to apply in the management of calculi in pelvic ectopic kidneys. We report the cases of three patients who were found to have large calculi in pelvic ectopic kidneys and subsequently underwent laparoscopically guided transperitoneal percutaneous nephrolithotomy, all with successful outcome. In all patients, complete stone clearance was achieved in a single operation with no intraoperative or postoperative morbidity.

Symptomatic small non-obstructing lower ureteric calculi: comparison of ureteroscopy and extra corporeal shock wave lithotripsy.

Objective: To compare the success, efficacy and complications of ureteroscopy (URS) and extra corporeal shock wave lithotripsy (ESWL) for the treatment of symptomatic small non obstructing lower ureteric calculi.

Subjects And Methods: This prospective non-randomised study was conducted simultaneously at two urological referral centres, included 280 patients with symptomatic small (4-10 mm) lower ureteric calculi (situated below the sacroiliac joint), with good renal function on intravenous urography. Patients were offered both the treatment options.

Nephrostomy tube after percutaneous nephrolithotomy: large-bore or pigtail catheter?

Background And Purpose: A nephrostomy tube is an integral part of any percutaneous renal surgery. Commonly, a nephrostomy tube that is 2F to 3F smaller than the percutaneous tract is used after percutaneous nephrolithotomy (PCNL). In our experience, quite a few patients have pain at the nephrostomy tube site, and many patients complain of a prolonged urinary leak after tube removal when a large nephrostomy tube is used.

Endoscopy-assisted Freyer prostatectomy: a safer technique.

Freyer prostatectomy is infrequently indicated today. One of the blind steps in this procedure is when the urethra is disconnected at the prostatic apex. There is risk of stress urinary incontinence and damage to the sphincter.

Re-establishment of dislodged percutaneous nephrostomy tube using a ureteroscope.

A simple and safe technique for the replacement of a dislodged nephrostomy tube using a ureteroscope is presented.

Inline tug on a through-and-through glidewire to reposition open-ended catheter during percutaneous nephrolithotomy.

We present a simple technique to reposition an open-ended ureteric catheter in the pelvicalyceal system during percutaneous nephrolithotomy. A through-and-through glidewire is straightened using a stone-grasping forceps. The open-ended catheter is advanced in the pelvicalyceal system over this taut glidewire.

Is antegrade ureteroscopy better than retrograde ureteroscopy for impacted large upper ureteral calculi?

Objective: This study was planned to compare the risks and advantages of antegrade and retrograde ureteroscopy for impacted large upper ureteral calculi.

Patients And Methods: From September 1996 to February 1998, ureteroscopy was offered to 43 patients. Of these, retrograde ureteroscopy was done in 20 patients, while antegrade ureteroscopy was performed in 23 patients.

Percutaneous cystolithotomy for vesical calculi: a better approach.

Vesical calculus is a common problem that is treated traditionally with open cystolithotomy or cystolithalopaxy. Open surgery has the inherent problems of a long scar, prolonged catheterization, extended hospitalization, and risk of infection. Transurethral cystolithalopaxy also requires special instruments that carry a risk of trauma, which could lead to urethral strictures.