Endoscopic lysis of bladder scar associated with Hunner's lesions: A new technique.

Objective: Five to ten percent of interstitial cystitis/bladder pain syndrome (IC/BPS) patients have Hunner's lesions (HL), areas of non-specific inflammation and scarring. The poor quality of life of patients with HL is entwined in associated pain and loss of bladder capacity. Although the decrease in bladder capacity is usually dependent on pain, it may also be dependent upon scarring and associated compliance changes produced by the inflammatory process.

Diagnosis and Management of a Prolapsing Intravesical Ureterocele in a Man.

Given the low incidence and delayed diagnosis, ureterocele management in the adult population is poorly described in the literature. Moreover, there is only one case report characterizing the condition with prolapse in an adult male. Approaches to therapy include transurethral incision or puncture with or without a combined percutaneous approach, and excision with or without partial nephrectomy for a duplicated system with a nonfunctioning upper pole moiety.

Continuing aspirin therapy during percutaneous nephrolithotomy: unsafe or under-utilized?

Introduction: Aspirin, as an inhibitor of platelets, is traditionally discontinued prior to percutaneous nephrolithotomy (PCNL) given the concern for increased surgical hemorrhage. However, this practice is based on expert opinion only, and mounting evidence suggests holding aspirin perioperatively can be more harmful than once thought. We sought to compared PCNL outcomes and complications in patients continuing aspirin to those stopping aspirin perioperatively.

Robotic assisted laparoscopic simple suprapubic prostatectomy - The Smith Institute for Urology experience with an evolving technique.

Objective: Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement, open simple prostatectomy (OSP) remains the standard for large prostates (typically greater than 100 g). OSP, however, is associated with significant morbidity. Recently, a few reports touting robotic application to simple prostatectomy have been published.

Symptoms after removal of ureteral stents.

Background And Purpose: Urology practices frequently encounter individuals who experience various degrees of pain/discomfort after ureteral stent removal. These symptoms have been previously proved to greatly affect functionality, convalescence time, quality of life, and healthcare costs. The etiology is unclear, but the condition is often self-limiting.

Acute bladder and small bowel perforation as a complication of Foley catheterization.

The complications of chronic urethral catheterization are well documented in the medical published data. Chronic urethral catheterization has been demonstrated to cause inflammatory changes within the bladder wall, promoting perforation and small bowel fistualization. In this report, we document the clinical course of a patient who presented with acute perforation of the bladder and small bowel as a result of Foley catheterization.

Penile sonoelastography for the localization of a non-palpable, non-sonographically visualized lesion in a patient with penile curvature from Peyronie's disease.

Introduction: Sonoelastography is an emerging ultrasound-based technique that allows characterization of tissue stiffness.

Aim: The aim of this report is to present a case of significant penile curvature with a non-palpable, non-sonographically visualized plaque that was demonstrable with sonoelastography.

Methods: A 60-year-old male presented with significant left penile curvature during erections.

Off-clamp laparoscopic partial nephrectomy for hilar tumors: oncologic and renal functional outcomes.

Objectives: To present our experience demonstrating the feasibility of off-clamp laparoscopic partial nephrectomy (LPN) for hilar tumors and evaluate intermediate oncologic and renal functional outcomes.

Patients And Methods: A retrospective review of LPN cases in nine patients was performed. Hilar lesions were defined as renal cortical tumors in direct physical contact with the renal artery, vein, or both as identified on preoperative imaging and confirmed intraoperatively.

Evaluation of perirenal fat as a predictor of cT 1a renal cortical neoplasm histopathology and surgical outcomes.

Background And Purpose: With the increasing detection of small renal cortical neoplasms (RCNs), the preoperative prediction of histopathology has become increasingly important. Because perirenal fat (PF) is known to be metabolically active, we evaluated PF as a predictor of renal tumor histopathology.

Patients And Methods: We retrospectively evaluated patients who underwent laparoscopic nephron-sparing procedures for cT(1a) RCN at two institutions.

Minimally invasive retroperitoneal lymph node dissection for testicular cancer.

Testicular cancer is the most common solid organ malignancy in young men between the ages of 15 and 35. Although much of this increase in survival can be attributed to improvements in systemic chemotherapy, surgery retains a critical role in the diagnostic and therapeutic management of testicular cancer. Laparoscopic retroperitoneal lymph node dissection is an effective staging and therapeutic procedure in patients with low-stage testicular cancer.

Management of urolithiasis in patients after urinary diversions.

After urinary diversion patients are at increased risk of long-term complications, including stones of the upper urinary tract and reservoir or conduit. Advances in instrumentation and techniques have expanded treatment options, while minimizing morbidity. Minimally invasive treatment methods include shockwave lithotripsy, antegrade and retrograde ureteroscopic lithotripsy and percutaneous nephrolithotomy.

Laparo-endoscopic single-site radical prostatectomy: Feasibility and technique.

Background: As laparoscopy becomes a standard approach in many urological procedures, researchers strive to make minimally invasive surgery less invasive. Our objective was to apply recent innovations in equipment and surgical approaches to develop the technique and perform laparo-endoscopic single site radical prostatectomy (LESS-RP).

Methods: The technique for LESS-RP was derived by combining existing techniques of standard laparoscopic RP and developing techniques of urological LESS.

Eye metrics as an objective assessment of surgical skill.

Objective: Currently, surgical skills assessment relies almost exclusively on subjective measures, which are susceptible to multiple biases. We investigate the use of eye metrics as an objective tool for assessment of surgical skill.

Summary Background Data: Eye tracking has helped elucidate relationships between eye movements, visual attention, and insight, all of which are employed during complex task performance (Kowler and Martins, Science.

Laparoscopic versus robotic pyeloplasty: man versus machine.

With all its different presentations and etiologies, ureteropelvic junction obstruction has been a topic for much research and debate. For several decades, the 'gold standard' of treatment was unequivocally an Anderson-Hynes dismembered pyeloplasty. Various surgical modifications and minimally invasive alternatives have been studied.

First Prize (tie): Hemorrhage following percutaneous renal surgery: characterization of angiographic findings.

Purpose: Percutaneous surgery is an established approach to a spectrum of renal pathology, and hemorrhage is the most concerning complication of this technique. We determined the frequency of postoperative hemorrhage requiring selective angioembolization (sae), the efficacy of this approach, and characterized the angiographic findings.

Methods: We reviewed our database of 4695 patients who underwent percutaneous renal surgery and identified patients requiring SAE for postoperative hemorrhage.

Is the biopsy Gleason score important in predicting outcomes for patients after radical prostatectomy once the pathological Gleason score is known?

Objective: To evaluate whether specific preoperative variables might better predict the concordance between biopsy and radical prostatectomy (RP) Gleason grade, and to assess the effect of the biopsy Gleason score (bGS) when controlling for the pathological GS (pGS) on clinical outcomes in patients undergoing RP.

Patients And Methods: Between 1989 and 1998, 1088 men had RP at our institution, with a median follow-up of 56 months. To evaluate the independent effect of bGS within categories of pGS, we stratified the sample by pGS (three categories; View Article and Find Full Text PDF

Radical prostatectomy in men aged >or=70 years: effect of age on upgrading, upstaging, and the accuracy of a preoperative nomogram.

Objectives: To determine the effect of age on clinicopathological features, the accuracy of the preoperative nomogram, and survival after radical retropubic prostatectomy (RRP), as there are limited data on elderly men undergoing RRP.

Patients And Methods: A database of 258 men aged >or=70 years and 3777 aged <70 years who had RRP was reviewed to compare the clinicopathological features and survival between the age groups. The effect of age on the frequency of upgrading from biopsy Gleason sum 2-6 to pathology Gleason sum >or=7, and upstaging from clinical T1-T2 to pathological stage T3-T4 was also evaluated.