Current Urology最新文献

{"title":"Ureteroscopy during pregnancy under local anesthesia and light sedation: Technique and video.","authors":"Patrick Juliebø-Jones, Christian Beisland, Peder Gjengstø, Rachel Maheswaran, Øyvind Ulvik","doi":"10.1097/CU9.0000000000000180","DOIUrl":"10.1097/CU9.0000000000000180","url":null,"abstract":"<p><p>Ureteroscopy during pregnancy has become increasingly recognized as a safe intervention. Performing it under local anesthesia and light sedation reduces the risks associated with general or regional anesthesia, such as difficult airway scenarios, hypothermia, and hypotension. In addition, this approach reduces the total amount of fetal exposure to medications and anesthetic agents. Performing ureteroscopy in this manner requires a number of adjustments and modifications to the standard technique. This article provides a summary in a step-by-step format, as well as an accompanying video demonstration.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 3","pages":"219-220"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/41/curr-urol-17-219.PMC10337810.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged life-threatening anaphylaxis to Floseal during partial nephrectomy: A case report","authors":"G. McClintock, David Frishling, Y. Lam, P. Mancuso","doi":"10.1097/cu9.0000000000000200","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000200","url":null,"abstract":"\u0000 Floseal Hemostatic Matrix is a topical hemostatic agent used across specialties and commonly applied to the renal bed during partial nephrectomy. Here we present the first adult case of Floseal allergy in the literature and the second case of a topical gelatin hemostatic agent.\u0000 A 62-year-old man underwent partial nephrectomy for a Bosniak type IV cyst. After unclamping the kidney, the patient declined precipitously, later determined due to an anaphylactic reaction to the Floseal placed on the renal bed. The patient had a prolonged anaphylactic reaction that required ionotropic support for over 24 h, possibly due to continued exposure. His tryptase level was elevated, and allergy testing revealed an allergy to the gelatin matrix component of the Floseal.\u0000 Floseal anaphylaxis should be considered during episodes of cardiovascular collapse after drug administration. However, consideration should be given to removing it to prevent continued exposure and weighed against the risk of prolonged surgery in an anaphylactic patient.","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43819529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized comparative study of flexible ureterorenoscopy versus mini-percutaneous nephrolithotomy for treatment of renal stones 2 cm or less","authors":"A. Darwish, Alaa E. Abdel Moneim, A. I. Ahmed, S. Hamdy, H. Abolella, A. Reda","doi":"10.1097/cu9.0000000000000215","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000215","url":null,"abstract":"\u0000 \u0000 \u0000 Flexible ureterorenoscopy (fURS) and mini-percutaneous nephrolithotomy (mPCNL) have been increasingly used for the treatment of renal stones. However, current guidelines do not recommend one modality over the other. The aim of this study is to compare the safety and efficacy of treatment with fURS versus mPCNL for renal stones sized 2 cm or less.\u0000 \u0000 \u0000 \u0000 A prospective, randomized, comparative study was conducted between January 2019 and July 2021 at 3 tertiary care urology centers. Inclusion criteria were adult patients with renal stone(s) ≤ 2 cm with inappropriateness or failure of extracorporeal shock-wave lithotripsy. Subjects were assigned to 1 of 2 treatment groups, either mPCNL or fURS. Two primary outcomes were assessed: (1) initial success rate, defined as the absence of clinically significant residual fragments (>2 mm) on kidney ureter bladder x-ray and ultrasound on the first postoperative day; and (2) complications, which were reported according to the Modified Clavien-Dindo classification system. Secondary outcomes included final success rate, defined as the absence of clinically significant residual fragments on noncontrast computed tomography on the 90th postoperative day; operative time; auxiliary procedures and blood transfusion rates; hemoglobin drop; and length of hospital stay.\u0000 \u0000 \u0000 \u0000 One hundred eighteen procedures were analyzed (59 in each group). The initial success rate of the mPCNL group (93%) was significantly higher than that of the fURS group (70%). Complications occurred more frequently with mPCNL than fURS (44.1% vs. 18.6%, respectively). Final success rate, operative time, and length of hospital stay were comparable between the 2 groups.\u0000 \u0000 \u0000 \u0000 Mini-percutaneous nephrolithotomy is more effective than fURS as a single-step treatment for renal stones <2 cm because of its higher initial success rate and lower auxiliary procedure rate. However, mPCNL results in significantly higher complication rates than fURS.\u0000","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45386070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"War-related urethral and penile injuries' management and short-term outcomes: Experience from war in Yemen","authors":"A. Elkady, Abdulfattah Mohammed Abdullah, M. Lotfi, A. Rammah, Hesham Torad, M. Abdel-Rassoul, M. E. El Ghoneimy","doi":"10.1097/cu9.0000000000000211","DOIUrl":"https://doi.org/10.1097/cu9.0000000000000211","url":null,"abstract":"","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43999840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Purple urine bag syndrome: An unusual manifestation of urinary tract infection, our experience at a tertiary care center.","authors":"Vishal Kumar Neniwal,&nbsp;Samir Swain,&nbsp;Suresh Kumar Rulaniya,&nbsp;Datteswar Hota,&nbsp;Piyush Agarwal,&nbsp;Praveen Kumar Yadav","doi":"10.1097/CU9.0000000000000044","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000044","url":null,"abstract":"<p><strong>Background: </strong>Purple urine bag syndrome (PUBS) is an unusual condition in which a purple discoloration of urine and bag occurs in people with urinary catheters. People with purple urine usually do not complain of any symptoms. The purple discoloration of the urine bag is often the only finding, frequently noted by caregivers.</p><p><strong>Materials and methods: </strong>This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020. A total of 46 patients with PUBS were included in this study. The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested.</p><p><strong>Results: </strong>The mean age of PUBS patients was 67.4years and 67.4% were males. Most patients of PUBS (60.9%) had a urethral catheter, while there was percutaneous nephrostomy in 26.1% patients and 13% patients had a percutaneous suprapubic cystostomy catheter. Among the patients, 69.65% were bedridden or in an institutionalized situation, 73.9% were suffering from chronic constipation, 21.7% were associated with dementia, and 47.8% were cerebrovascular accidents with hemiparesis patients. In addition, 93.5% of patients presented with alkaline urine and 3 patients with acidic urine. The most common bacteria isolated in urine culture were E coli and Pseudomonas.</p><p><strong>Conclusions: </strong>Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females, but our study showed that it is more common in males. The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method. In addition, no correlation was found between the microorganisms isolated from the environment and patients' urine.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 2","pages":"125-129"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/55/curr-urol-17-125.PMC10489393.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing laparoscopic telesurgery: The emergence of 5G-assisted wireless endoscopy systems.","authors":"Guiting Lin,&nbsp;Tom F Lue","doi":"10.1097/CU9.0000000000000187","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000187","url":null,"abstract":"Laparoscopic surgery allows patients to undergo minimally invasive surgeries with reduced pain, shorter hospital stays","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 2","pages":"82-83"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/22/curr-urol-17-082.PMC10489199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser speckle contrast imaging compared with indocyanine green in renal perfusion of a porcine model.","authors":"Jonathan Noël,&nbsp;Anya Mascarenhas,&nbsp;Chibueze A Nwaiwu,&nbsp;Yao Liu,&nbsp;Marcio Moschovas,&nbsp;Vasiliy E Buharin,&nbsp;John Oberlin,&nbsp;Saloni Mehrotra,&nbsp;Alyson F Dechert,&nbsp;Peter C W Kim,&nbsp;Vipul Patel","doi":"10.1097/CU9.0000000000000155","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000155","url":null,"abstract":"<p><strong>Background: </strong>When viewed under near-infrared light, indocyanine green (ICG) signal for kidney perfusion can be utilized in partial nephrectomy. Laser speckle contrast imaging (LSCI) uses coherent light to detect perfusion during real-time laparoscopic surgery.</p><p><strong>Materials and methods: </strong>Laser speckle contrast imaging or ActivSight, an imaging sensor adapter, was used during laparoscopy of an anesthetized porcine kidney model. ActivSight's \"perfusion mode\" and \"quantification mode\" displayed the blood flow as a heatmap and numerical signal intensity, respectively.</p><p><strong>Results: </strong>After the upper segmental renal artery was clamped, ICG was seen in the lower pole, and LSCI showed low unit (dark color) quantification and perfusion in the upper pole. Indocyanine green was retained in the lower pole after the upper segmental artery was unclamped, and LSCI perfusion was demonstrated in the entire kidney.</p><p><strong>Conclusions: </strong>Laser speckle contrast imaging is a dye-free, repeatable, real-time adjunct for renal parenchymal perfusion assessment applicable to minimally invasive renal surgery to complement the technology of ICG near-infrared fluorescence and advance digital surgery.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 2","pages":"141-145"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/f2/curr-urol-17-141.PMC10489255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"ins and outs\" of the magnetic ureteral stent: A novel innovation in Endourology.","authors":"Vishal Damodaran,&nbsp;Brandon Els,&nbsp;Efthimia Daras,&nbsp;Tracy Kataka,&nbsp;Sadiyabanu Safiq Gulamali,&nbsp;S'babalwe Ntakana,&nbsp;Marlon Perera,&nbsp;Ahmed Adam","doi":"10.1097/CU9.0000000000000104","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000104","url":null,"abstract":"<p><strong>Background: </strong>Ureteral stents play a major role in maintaining ureteral patency. Various innovations are advocated in the design and subsequent removal of traditional double-J ureteral stents, such as the magnetic-end double-J ureteral stent (MEDJUS). This stent facilitates outpatient removal using a magnetic stent removal device. This systematic review was conducted to analyze the published role, efficacy, and outcomes of MEDJUS.</p><p><strong>Materials and methods: </strong>After PROSPERO registration (CRD42021235739), an electronic database search (PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science) was performed on December 31, 2020. The search terms were as follows: \"<i>magnetic</i>,\" \"<i>ureteric,</i>\" \"<i>stent</i>,\" <i>\"double-J,</i>\" <i>\"urotech</i>,\" and \"<i>Black-Star</i>.\"</p><p><strong>Results: </strong>Nine studies with a total of 685 patients were included in the systematic review. The total number of MEDJUS procedures used was 498 (73%) compared to the 187 (27%) traditional double-J stent method. Magnetic-end double-J ureteral stent extraction failure was reported in 8 cases (1.61%). Compared with traditional stents, MEDJUS showed a cost benefit in 5/5 studies. Better pain scores (during stent in situ) and (at stent removal) were observed in 2/3 and 3/4 of the studies, respectively.</p><p><strong>Conclusions: </strong>Magnetic-end double-J ureteral stent may serve as a viable alternative to traditional double-J stents, offering cost and pain benefits with similar rates of complications. Magnetic-end double-J ureteral stent also offers relative ease of extraction and a reduced need for inpatient removal. This ambulatory stent removal technique has forged its use in modern urological practice.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 2","pages":"92-99"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/79/curr-urol-17-092.PMC10489510.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting urine culture results in candidates for lithotripsy.","authors":"Ofer N Gofrit,&nbsp;Roey Abudi,&nbsp;Amitay Lorber,&nbsp;Mordechai Duvdevani","doi":"10.1097/CU9.0000000000000117","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000117","url":null,"abstract":"<p><strong>Background: </strong>Urological guidelines assert that \"urine culture should be obtained\" before surgical management of ureteral or kidney stones. Thus, many surgeries are delayed by 1-3 days until the results of urine culture are available. During this time, the patient frequently experience pain and possible kidney damage. We investigated the hypothesis that it is possible to predict the results of urine culture in candidates for surgical intervention using parameters that are accessible immediately upon admission.</p><p><strong>Materials and methods: </strong>A database of 1000 patients who underwent either percutaneous nephrolithotomy (PCNL) or ureteroscopy/retrograde intrarenal surgery was analyzed. Eleven parameters potentially related to urinary infections and accessible to the clinician at the emergency department were correlated with the preoperative urine culture results.</p><p><strong>Results: </strong>Of the patients, 234 (23.4 %) had positive cultures. On multivariate analysis, only sex, hydronephrosis grade, and history of previous nephrolithotomy were significantly associated with a positive preoperative urine culture. The risk of a positive culture can be easily determined from a simple table or an Excel-based calculator. This risk could be as low as 0.45% for a man without a history of PCNL and no hydronephrosis (4% in a woman with similar parameters) or as high as 79.5% in a man with a history of PCNL and hydronephrosis (85% in a woman with similar parameters).</p><p><strong>Conclusions: </strong>The risk of preoperative positive urine culture can be predicted using 3 parameters that are accessible upon admission. In low-risk cases, prompt surgical treatment can be provided, eliminating the anticipation time for urine culture results.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 2","pages":"113-117"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/ca/curr-urol-17-113.PMC10489201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelviureteric junction obstruction in adults: A systematic review of the literature.","authors":"Niall J O'Sullivan,&nbsp;Steven Anderson","doi":"10.1097/CU9.0000000000000154","DOIUrl":"https://doi.org/10.1097/CU9.0000000000000154","url":null,"abstract":"<p><strong>Background: </strong>Pelviureteric junction obstruction (PUJO) is a common urological disorder that can present at any stage of life. The underlying etiology in children has been well studied; however, a gap exists in the literature for the adult population. Herein, we performed a systematic review of the literature to evaluate the current evidence on the underlying etiologies of adult patients presenting with PUJO.</p><p><strong>Materials and methods: </strong>Four electronic databases were searched for relevant studies assessing the underlying etiologies of pelviureteric junction obstruction in adults. Studies were assessed for eligibility based on predefined inclusion and exclusion criteria, and a critical appraisal of methodological quality and risk of bias was performed. Finally, qualitative and quantitative data analyses were performed.</p><p><strong>Results: </strong>Twelve studies comprising a total of 513 patients with radiologically confirmed PUJO met the inclusion criteria and were included in our analysis. The most common finding was crossing vessels, which were observed in 50.5% of patients, followed by intrinsic ureteral stenosis (27.1%), adhesions (15.3%), and high insertion of the ureter (10.1%).</p><p><strong>Conclusions: </strong>The underlying etiologies of PUJO in adults remain unclear. This study indicated that obstruction secondary to crossing vessels is the most common cause of obstruction in adults and occurs more frequently than in the pediatric population.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"17 2","pages":"86-91"},"PeriodicalIF":1.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/21/d7/curr-urol-17-086.PMC10489243.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}