Cost-Effectiveness Analysis of a Novel Fetal Vesicoamniotic Shunt-The Vortex Shunt.

Objective: We estimated the potential outcomes, costs, and cost-effectiveness of the Vortex shunt, a novel fetal vesicoamniotic shunt (VAS), compared to standard shunts for treating fetal lower urinary tract obstruction (LUTO).

Method: We designed a decision-analytic model comparing the Vortex shunt to current shunts using a theoretical cohort of 1000 pregnancies equivalent to the annual U.S.

Automated detection of posterior urethral valves in voiding cystourethrography images: A novel AI-Based pipeline for enhanced diagnosis and classification.

Introduction: Posterior Urethral Valves (PUV) are rare congenital anomalies of the male urinary tract that can lead to urethral obstruction and increased risk of kidney disease. Traditional diagnosis relies on subjective interpretation of imaging techniques. This study aimed to automate and increase accuracy of PUV detection in voiding cystourethrography (VCUG) images using an AI-based pipeline.

Small bowel obstruction caused by transmesenteric hernia in a patient with complex medical history: a case report.

This case report presents a rare instance of small bowel obstruction due to a transmesenteric hernia in a 47-year-old male with a complex medical history. The patient presented with acute abdominal pain, constipation, and urinary retention. Diagnostic laparoscopy revealed bowel ischemia, and open laparotomy confirmed a transmesenteric hernia with necrotic small bowel requiring resection.

Reversal of Endometriosis-Induced Unilateral Ureteral Obstruction and Hydronephrosis With Medical Therapy.

Endometriosis is a common condition among women of reproductive age worldwide, with the urinary tract being the second most frequently affected extragenital organ system, particularly the bladder and ureters. Ureteral endometriosis (UE) is relatively rare, often asymptomatic, and can lead to progressive renal function loss if not addressed promptly. Early diagnosis and intervention are essential, requiring a high index of suspicion.

Initial experience of a novel ureteral silicon-covered metallic mesh stent in malignant ureteric obstruction: a single-center retrospective study.

Background: This study aimed to investigate initial experiences and outcomes of a retrograde inserted new silicone-covered metallic ureteric stent (Urexel™) for malignant ureteric obstruction.

Methods: We retrospectively reviewed the medical records for 12 consecutive patients who underwent Urexel™ stent placement for malignant ureteric obstruction from March 2020 to March 2021. The Urexel™ stent is a segmental metallic ureteric stent composed of a nitinol mesh covered with a silicone membrane.

The use of a percutaneous cystostomy tube as an adjunctive treatment option for dogs with idiopathic functional outflow tract obstruction.

Background: Functional outflow tract obstruction (FOO) remains a challenging disease to manage in male dogs. Cystostomy tubes have been used to relieve urethral obstruction while allowing time to achieve effective medical management, avoiding the need for emergency visits and repeat urinary catheterizations.

Objectives: To describe a series of dogs with FOO and categorize the most successful management strategies including medical management alone or with the support of cystostomy tubes for urinary diversion.

Evaluating the efficacy of low-kV X-ray intraoperative radiotherapy in the treatment of locally advanced rectal cancer: a retrospective cohort study.

Background: Patients with locally advanced rectal cancer (LARC) treated with surgery have a high risk of local recurrence. Intraoperative radiotherapy (IORT) is a promising method for treating locally advanced solid tumors, but there is limited research on the efficacy of IORT in treating LARC. This study aimed to evaluate the long-term efficacy of low-kV X-ray IORT in the treatment of LARC.

Polyethylene glycol loxenatide protects diabetic kidneys by inhibiting GRP78/PERK/eIF2α pathway, and improves cardiac injury by suppressing TLR4/NF-κB inflammatory pathway.

Background: Cardiovascular and renal complications of type 2 diabetes are the main causes of death in diabetic patients. Clinical studies have found that polyethylene glycol loxenatide (PEG-Loxe), a GLP-1 analog widely used to treat type 2 diabetes, boosts renal and cardiac functions in diabetic patients. However, its mechanism of action remains to be elucidated.

Indications and Outcomes of Fetal Cystoscopy for Lower Urinary Tract Obstruction: A Comprehensive Review.

Fetal lower urinary tract obstruction (LUTO) encompasses a spectrum of rare congenital anomalies affecting the fetal urinary system, leading to significant morbidity and mortality. This condition, arising from various anatomical anomalies such as posterior urethral valves (PUV), urethral atresia, and cloacal malformations, disrupts normal urine flow, resulting in secondary complications such as pulmonary hypoplasia and renal impairment. Current management strategies, including fetal vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to alleviate obstruction and mitigate associated risks.

Renal artery thrombosis with deterioration of kidney function.

Renal artery thrombosis is an uncommon but serious cause of acute kidney injury that can result in permanent loss of function. It is frequently misdiagnosed due to its non-specific appearance, which can mimic renal colic and other more common causes of abdominal pain. There is no agreement on the first-line treatment and no prospective studies comparing thrombolysis, anticoagulation and embolectomy.

Robot-Assisted Retroperitoneoscopic Traction-Aligned Suture Repair of Failed Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction.

A case of redo pyeloplasty using robot-assisted retroperitoneoscopic pyeloplasty (RARP) for failed primary laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) is reported. A 12-year-old boy had LP elsewhere. He was referred for management of persistent left hydronephrosis, but was managed conservatively due to minimal symptoms and stable radioisotopic renography.

Female Pelvic Conditions: Urinary Incontinence.

Urinary incontinence is the involuntary loss of urine. It is a prevalent and bothersome condition in females, with subtypes including stress, urge, mixed stress/urge, and overflow. Evaluation begins with a history to identify symptoms of the different subtypes and information about comorbid conditions, incontinence frequency and severity, and effect on quality of life.

At the Scrub Sink: Evaluation of Ureteric Patency During Cystoscopy.

At the scrub sink, we discussed the best ways to evaluate for ureteric patency during cystoscopy. For decades, surgeons have been using intravenous indigo carmine for evaluating ureteric patency. Ten years ago, a shortage of indigo carmine halted production.

Seminal Vesiculitis: A Rare Cause of Unilateral Ureteric Obstruction.

The seminal vesicles are an accessory structure of the male reproductive system. The most common pathology associated with the seminal vesicles is infective, and patients may present with haematospermia, pain, and subfertility. Patients presenting with unilateral ureteric obstruction secondary to seminal vesiculitis are rare, and there are very few reported cases in the literature.

[Bladder dysfunction in patients with stages I-III of Parkinson's disease].

Objective: To evaluate bladder dysfunction (BD) and its relationship with Parkinson's disease (PD) symptoms and dopaminergic therapy.

Material And Methods: One hundred and thirteen patients with PD of I-III H&Y stages were examined using the following scales: IPSS, including irritative and obstructive symptom indices, UPDRS I-IV, Sch&En, PDQ-39, BDI, STAI, PFS-16, GDSS, GSRS, MMSE, FAB and NMSQ.

Results: Most of the patients (89.

Lichtenstein repair for giant inguinoscrotal hernia: a retrospective case-control study.

Purpose: Giant inguinoscrotal hernia (GISH) is a rare condition in high-income regions, and the management presents a significant challenge for surgeons. A retrospective analysis was conducted of a single center's experience in treating GISH by Lichtenstein approach. The objective was to gain insight into the characteristics of GISH and assess the clinical efficacy of the Lichtenstein approach, as well as the degree of improvement in patient quality of life (QoL).

A successful case of vascular hitch procedure in adulthood: A simpler alternative for the vascular obstruction of the pyelo-ureteral junction.

Congenital obstruction of the upper urinary tract is often caused by the pyeloureteral junction syndrome, the lower polar vessel being the most common extrinsic etiology. We report on a case that was successfully treated using the Vascular HITCH, an alternative method with lower morbidity than Anderson and Hynes pyeloplasty considered the gold standard procedure. Our objective is to outline the aforementioned method and illustrate its ease of use and possible efficacy in carefully chosen adult patients.

Second Generation I-Body AD-214 Attenuates Unilateral Ureteral Obstruction (UUO)-Induced Kidney Fibrosis Through Inhibiting Leukocyte Infiltration and Macrophage Migration.

Kidney fibrosis is the common pathological pathway in progressive chronic kidney disease (CKD), and current treatments are largely ineffective. The C-X-C chemokine receptor 4 (CXCR4) is crucial to fibrosis development. By using neural cell adhesion molecules as scaffolds with binding loops that mimic the shape of shark antibodies, fully humanized single-domain i-bodies have been developed.

Renal Epithelial Complement C3 Expression Affects Kidney Fibrosis Progression.

Kidney fibrosis is a hallmark of chronic kidney diseases. Evidence shows that genetic variability and complement component 3 (C3) might influence tubulointerstitial fibrosis. Still, the role of renal C3 production in the epithelial-to-mesenchymal transition (EMT) and genetically determined fibrosis progression remains undiscovered.

Bladder Outlet Obstruction Due to Recurrent Complete Labial Fusion in Postmenopausal Woman-Case Report.

Background: Labial fusion is a rare condition typically observed in prepubescent girls, but it can also occur in postmenopausal women due to estrogen deficiency.

Methods: Our case report presents a unique instance of recurrent complete labial fusion causing bladder outlet obstruction in a postmenopausal woman.

Results: The 84-year-old patient presented with dysuria and intermittent urine leakage.

Cardiac Autonomic Modulation in Domestic Cats with Obstructive Lower Urinary Tract Disease.

Obstructive feline lower urinary tract disease (OFLUTD) is the most common complication of the urinary system, as metabolic and electrolyte changes can alter the functioning of the autonomic nervous system (ANS). The objective of this study was to describe the indices of heart rate variability (HRV) and their correlations with the observed alterations in Systolic Blood Pressure (SBP) and electrocardiographic, biochemical, and haemogasometric indices in cats diagnosed with OFLUTD. Sixty-five male cats up to 10 years of age were divided into two groups.

PPARγ Promotes Urothelial Remodeling During Urinary Tract Obstruction.

Urinary tract obstruction (UTO) is a common cause of kidney injury that can result in chronic kidney disease and end-stage renal disease. Heterogeneity in the extent of obstructive renal damage in humans with UTO implies the existence of unknown mechanisms that protect against or accelerate kidney injury. Prior studies show that congenital and acquired UTO initiate a conserved, protective program of renal urothelium remodeling that culminates in expansion of uroplakin (UPK)+ cells to promote renal structural integrity.

An Incidental Finding of a Large Pheochromocytoma in an Asymptomatic Male: A Case Report.

Pheochromocytoma is a rare neuroendocrine tumor that secretes excess catecholamines. Patients present with a classical triad of headache, palpitations, and sweating. If untreated, pheochromocytoma can result in life-threatening cardiovascular complications.

Single-port robotic laparoscopic ureterocalicostomy: surgical technique and clinical outcomes.

Introduction: We describe a method of robotic ureterocalicostomy (RALUC) with the Da Vinci Single Port (SP) platform and present clinical outcomes in our cohort of patients.

Materials And Methods: We retrospectively reviewed all patients undergoing RALUC with the SP platform in a single-institution, IRB-approved database between 2020-2023. Demographics, preoperative, intraoperative, and postoperative outcomes were collated.

Urethra-preserving and dorsal capsule fenestration with robot-assisted simple prostatectomy for severe LUTS in small prostate: a case report.

Background: Small prostates (volume <30 ml) induce bladder outlet obstruction with pathophysiological changes distinct from those associated with large prostates. Treatment options often include transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Existing treatments have issues with high recurrence and complication rates.