J. Mershon, Taylor A. Goodstein, A. Khuhro, Mary Charleton, A. Ndumele, Chase Arnold, T. Posid, Colin Kleinguetl, B. Knudsen, Michael W. Sourial
Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard for treating large or complex renal stones. Renal drainage after the procedure is most commonly via nephrostomy tube or indwelling ureteral stent, but the optimal duration of ureteral stents after PCNL is currently unknown. This study describes the post-operative events occurring with early stent removal on post-operative day one (POD1) in patients undergoing uncomplicated PCNL. Methods: We identified 336 patients from a single institution that underwent PCNL between 1/1/2020 and 6/1/2021. Of these, 106 patients with uncomplicated procedures that met inclusion criteria for early stent removal on POD1 were included. Retrospective chart review was performed to collect demographic information, operative data, and to identify adverse outcomes including additional procedures, patient telephone calls for symptoms, complications and emergency department (ED) visits. Results: Mean (SD) patient age was 54 (15.1) years and 56% of patients were morbidly obese (Body Mass Index [BMI] >30). Overall post-operative complication rate was low (18.8%) and limited primarily to Clavien I/II complications with only two Clavien III (1.9%) complications. Telephone calls or electronic messages were received from 37.7% of patients, with 16% requiring a visit to the ED or clinic. The most common reason for an ED visit was flank pain (11.1%). Conclusions: Early stent removal on POD1 may lead to pain-related telephone calls but appears to be a generally safe and effective management option in carefully selected patients undergoing uncomplicated PCNL.
{"title":"Post-operative Events with Post-operative Day One Stent Removal after Percutaneous Nephrolithotomy","authors":"J. Mershon, Taylor A. Goodstein, A. Khuhro, Mary Charleton, A. Ndumele, Chase Arnold, T. Posid, Colin Kleinguetl, B. Knudsen, Michael W. Sourial","doi":"10.22374/jeleu.v6i2.159","DOIUrl":"https://doi.org/10.22374/jeleu.v6i2.159","url":null,"abstract":"Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard for treating large or complex renal stones. Renal drainage after the procedure is most commonly via nephrostomy tube or indwelling ureteral stent, but the optimal duration of ureteral stents after PCNL is currently unknown. This study describes the post-operative events occurring with early stent removal on post-operative day one (POD1) in patients undergoing uncomplicated PCNL. \u0000 \u0000Methods: We identified 336 patients from a single institution that underwent PCNL between 1/1/2020 and 6/1/2021. Of these, 106 patients with uncomplicated procedures that met inclusion criteria for early stent removal on POD1 were included. Retrospective chart review was performed to collect demographic information, operative data, and to identify adverse outcomes including additional procedures, patient telephone calls for symptoms, complications and emergency department (ED) visits. \u0000 \u0000Results: Mean (SD) patient age was 54 (15.1) years and 56% of patients were morbidly obese (Body Mass Index [BMI] >30). Overall post-operative complication rate was low (18.8%) and limited primarily to Clavien I/II complications with only two Clavien III (1.9%) complications. Telephone calls or electronic messages were received from 37.7% of patients, with 16% requiring a visit to the ED or clinic. The most common reason for an ED visit was flank pain (11.1%). \u0000 \u0000Conclusions: Early stent removal on POD1 may lead to pain-related telephone calls but appears to be a generally safe and effective management option in carefully selected patients undergoing uncomplicated PCNL.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130984520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mini V. Sardar, Gabriella Littler, A. Pai, Amit Shetty
Duplication of the ureter and renal pelvis is a relatively common congenital anomaly with an incidence of approximately 1 in 150 births. Different anatomical variations of ureteric duplication exist. Ectopic ureters are usually associated with ureteral duplication and a duplex collecting system. Duplication of the ureter ismore common unilaterally, has a female preponderance, and occurs more commonly on the left side.We present the case of a 58-year-old male with inverted Y ureteral duplication who had distal obstructing ureteric calculi in the ectopic distal ureteral opening in the prostatic urethra.
{"title":"Inverted Y Ureteral Duplication with Distal Obstructing Calculi in the Ectopic Ureter in the Prostatic Urethra","authors":"Mini V. Sardar, Gabriella Littler, A. Pai, Amit Shetty","doi":"10.22374/jeleu.v6i1.154","DOIUrl":"https://doi.org/10.22374/jeleu.v6i1.154","url":null,"abstract":"Duplication of the ureter and renal pelvis is a relatively common congenital anomaly with an incidence of approximately 1 in 150 births. Different anatomical variations of ureteric duplication exist. Ectopic ureters are usually associated with ureteral duplication and a duplex collecting system. Duplication of the ureter ismore common unilaterally, has a female preponderance, and occurs more commonly on the left side.We present the case of a 58-year-old male with inverted Y ureteral duplication who had distal obstructing ureteric calculi in the ectopic distal ureteral opening in the prostatic urethra.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114959296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report highlights the potential diagnostic pitfalls associated with subureteral transurethral injection (STING) of non-biodegradable materials like Teflon, which has been utilised for endoscopic correction of vesicoureteral reflux (VUR). A 27-year-old female with a history of VUR presented with left-sided loin pain, vomiting, and dysuria, which were initially thought to be due to distal ureteric stones. However, non-contrast computed tomography (CT) revealed the presence of calcific densities in the region of the distal ureter and vesicoureteric junction (VUJ) bilaterally, likely as a sequelae of previous Teflon injection treatment. A conservative management approach was undertaken, and follow-up evaluations, including MAG3 renograms, showed normal drainage and stable split renal function. This case emphasises the importance of a comprehensive medical history and vigilance in avoiding unnecessary imaging or surgical interventionsfor patients with a previous history of STING.
{"title":"Teflon Injections (STING) Mimicking Distal Ureteric Stones","authors":"Wesam Al-Dhahir, Aran Nanthakumar, Priyadarshi Kumar","doi":"10.22374/jeleu.v6i1.149","DOIUrl":"https://doi.org/10.22374/jeleu.v6i1.149","url":null,"abstract":"This case report highlights the potential diagnostic pitfalls associated with subureteral transurethral injection (STING) of non-biodegradable materials like Teflon, which has been utilised for endoscopic correction of vesicoureteral reflux (VUR). A 27-year-old female with a history of VUR presented with left-sided loin pain, vomiting, and dysuria, which were initially thought to be due to distal ureteric stones. However, non-contrast computed tomography (CT) revealed the presence of calcific densities in the region of the distal ureter and vesicoureteric junction (VUJ) bilaterally, likely as a sequelae of previous Teflon injection treatment. A conservative management approach was undertaken, and follow-up evaluations, including MAG3 renograms, showed normal drainage and stable split renal function. This case emphasises the importance of a comprehensive medical history and vigilance in avoiding unnecessary imaging or surgical interventionsfor patients with a previous history of STING.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122646754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Proceedings of the Welsh Urological Society Annual Meeting
威尔士泌尿学会年会论文集
{"title":"Proceedings of the Welsh Urological Society Annual Meeting","authors":"G. Kandaswamy","doi":"10.22374/jeleu.v6i1.161","DOIUrl":"https://doi.org/10.22374/jeleu.v6i1.161","url":null,"abstract":"Proceedings of the Welsh Urological Society Annual Meeting","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124280680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Mohamed, W. Al-Dhahir, W. Mahmalji, Mohamed Farah
Over the last decade, there have been vast advancements in endourology, with innovation lead-ing to large renal stones being successfully treated with minimal to no incisions.As the elderly population is growing, we are seeing a trend of more complicated stone patients who are not suitable candidates for percutaneous nephrolithotomy (PCNL) and would require several attempts with conventional flexible ureteroscopy.We aim to share our experience using the ClearPetra Suction Access Sheath and UROFINO Disposable Ureteroscope to completely fragment a large renal stone in a frail elderly patient in a single sitting.
{"title":"The Role of the ClearPetra Suction Access Sheath and UROFINO Disposable Ureteroscope as an Alternative to PCNL/Conventional Flexible Ureteroscopy for a Large Renal Pelvis Stone","authors":"B. Mohamed, W. Al-Dhahir, W. Mahmalji, Mohamed Farah","doi":"10.22374/jeleu.v6i1.157","DOIUrl":"https://doi.org/10.22374/jeleu.v6i1.157","url":null,"abstract":"Over the last decade, there have been vast advancements in endourology, with innovation lead-ing to large renal stones being successfully treated with minimal to no incisions.As the elderly population is growing, we are seeing a trend of more complicated stone patients who are not suitable candidates for percutaneous nephrolithotomy (PCNL) and would require several attempts with conventional flexible ureteroscopy.We aim to share our experience using the ClearPetra Suction Access Sheath and UROFINO Disposable Ureteroscope to completely fragment a large renal stone in a frail elderly patient in a single sitting.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128257324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Mohamed, O. Abdalla, Banan Omer, S. Madaan, S. Sriprasad
Introduction: The leftover ureteric stump after a simple nephrectomy is rarely symptomatic. Here, we report a unique case of ureteric stump stones that likely developed de novo and patients became symptomatic. Case Report: We report the case of a 53-year-old female, who had benign right nephrectomy for a non-functioning kidney 17 years ago and presented with three years history of recurrent urinary tract infections and right-side abdominal pain. A continuous unenhanced computed tomography scan confirmed the presence of multiple de novo stones in the leftover ureteric stump, which was successfully treated by an open transperitoneal ureteric stumpectomy. She was asymptomatic at 12 months post-operative follow-up. We describe problems of leftover ureteric stumps and the possible pathophysiology of the stones formation in this group of patients. Conclusion: Albeit rare, various symptoms and complications can develop in the leftover stump, including stumpitis, urinary tract infections, and calculi. Therefore, discussion with patients of ureteric stump complications is recommended.
{"title":"De novo Stone Formation in Ureteric Stump Post-Nephrectomy","authors":"A. Mohamed, O. Abdalla, Banan Omer, S. Madaan, S. Sriprasad","doi":"10.22374/jeleu.v6i1.158","DOIUrl":"https://doi.org/10.22374/jeleu.v6i1.158","url":null,"abstract":"Introduction: The leftover ureteric stump after a simple nephrectomy is rarely symptomatic. Here, we report a unique case of ureteric stump stones that likely developed de novo and patients became symptomatic. \u0000Case Report: We report the case of a 53-year-old female, who had benign right nephrectomy for a non-functioning kidney 17 years ago and presented with three years history of recurrent urinary tract infections and right-side abdominal pain. A continuous unenhanced computed tomography scan confirmed the presence of multiple de novo stones in the leftover ureteric stump, which was successfully treated by an open transperitoneal ureteric stumpectomy. She was asymptomatic at 12 months post-operative follow-up. We describe problems of leftover ureteric stumps and the possible pathophysiology of the stones formation in this group of patients. \u0000Conclusion: Albeit rare, various symptoms and complications can develop in the leftover stump, including stumpitis, urinary tract infections, and calculi. Therefore, discussion with patients of ureteric stump complications is recommended.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127807370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To identify the best practice policy and guideline for surveillance with check cystoscopies follow up for low-risk pTa urothelial bladder tumour and to identify the recurrence rate and the progression rate of low-risk urothelial bladder tumour and how safe is it to discharge them at 1- versus 5-years of follow up.Primary outcome: The primary goal is to assess both the rate of recurrence and rate of progression of low-risk Non-muscle Invasive Bladder Carcinoma (NMIBC) during the first 5-year after initial Trans-Urethral Resection of Bladder Tumour (TURBT) and how safe is to discharge this class of group after one year versus five years of surveillance and compare it to previous reports. Secondary outcome: To estimate the cost-effectiveness of a reduced follow-up scheme, if this is deemeda safe practice to follow. Methodology: It is a single centre, retrospective review of all low-risk NMIBC patients diagnosed with low-risk bladder tumors at our Trust between 2012 and 2014 from our local urological cancer multi-disciplinary team (MDT) registry and ensured a 5-year time-lapse from diagnosis. Histology grade and staging from the first TURBT, receiving of mitomycin within 24 hrs following the initial TURBT, the timing of cystoscopy follow-up, cystoscopy findings (evidence of recurrence), further procedures (bladder biopsy, fulguration or TURBT), histology of further procedures, recurrence rate and time from the first TURBT to discharge to primary care are reviewed and analysed. Result: Our initial review revealed a high likelihood of recurrence (33.9%) in the low-risk NMIBC patients after 12 months of being cancer free. It also demonstrated that there is further progression in (23.8%) of those who had a later recurrence despite being asymptomatic. Conclusion: We would recommend a 5-year follow-up surveillance and further national collaboration to audit this patient subgroup to define a safe period of cystoscopic follow-up for these patients and bring further evidence for NICE to build up their recommendations.
{"title":"Check Cystoscopy Follow-up Practice for Low-Risk (pTa) Non-muscle Invasive Bladder Cancer in the United Kingdom","authors":"Ibrahim Al Khafaji, Omar Al-Mula Abed","doi":"10.22374/jeleu.v5i3.155","DOIUrl":"https://doi.org/10.22374/jeleu.v5i3.155","url":null,"abstract":"Objectives: To identify the best practice policy and guideline for surveillance with check cystoscopies follow up for low-risk pTa urothelial bladder tumour and to identify the recurrence rate and the progression rate of low-risk urothelial bladder tumour and how safe is it to discharge them at 1- versus 5-years of follow up.Primary outcome: The primary goal is to assess both the rate of recurrence and rate of progression of low-risk Non-muscle Invasive Bladder Carcinoma (NMIBC) during the first 5-year after initial Trans-Urethral Resection of Bladder Tumour (TURBT) and how safe is to discharge this class of group after one year versus five years of surveillance and compare it to previous reports. \u0000Secondary outcome: To estimate the cost-effectiveness of a reduced follow-up scheme, if this is deemeda safe practice to follow. \u0000Methodology: It is a single centre, retrospective review of all low-risk NMIBC patients diagnosed with low-risk bladder tumors at our Trust between 2012 and 2014 from our local urological cancer multi-disciplinary team (MDT) registry and ensured a 5-year time-lapse from diagnosis. Histology grade and staging from the first TURBT, receiving of mitomycin within 24 hrs following the initial TURBT, the timing of cystoscopy follow-up, cystoscopy findings (evidence of recurrence), further procedures (bladder biopsy, fulguration or TURBT), histology of further procedures, recurrence rate and time from the first TURBT to discharge to primary care are reviewed and analysed. \u0000Result: Our initial review revealed a high likelihood of recurrence (33.9%) in the low-risk NMIBC patients after 12 months of being cancer free. It also demonstrated that there is further progression in (23.8%) of those who had a later recurrence despite being asymptomatic. \u0000Conclusion: We would recommend a 5-year follow-up surveillance and further national collaboration to audit this patient subgroup to define a safe period of cystoscopic follow-up for these patients and bring further evidence for NICE to build up their recommendations.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115490718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Jimie, A. Kwok, F. Housami, Mahmoud Elfar, Baher Hussein
Background and Objective: Upper tract urothelial carcinoma (UTUC) is uncommon; however, at the time of diagnosis, they are usually more invasive than bladder urothelial carcinomas. Although nephroureterectomy (NU) has been the gold-standard treatment, guidelines have been set for kidney-sparing treatment in selected groups of patients. While these guidelines are aimed towards patients fit for salvage radical treatment, little has been published on managing the symptomatic patient not fit for NU. Various modalities of endoscopic ablation in managing UTUC have been described in the literature, but there is currently no reported use of the diode laser. Therefore, we aim to assess its efficacy and safety profile in the ablation of UTUC in patients unfit for major abdominal surgery in radical nephroureterectomy regardless of the tumour grade and size. Patients and method: A single centre retrospective review of patients who underwent Diode Laser treatment for UTUC over 4 years was done. Follow up through 6 monthly ureteroscopy alternating with computed tomography (CT) urogram was done to assess the need for further treatment. Results: 30 patients were identified, with mean age 76 years (64-88) and variable tumour locations, including lower and mid ureter and renal pelvis, upper and lower calyces. 76.7% were ASA 3 and 20% ASA 4. The mean tumour size was 3.8 cm (2-7 cm). The mean number of sessions was 2.1 (1-6). 63.3% of the tumours were grade 2, while 30% were grade 3. A case of metastatic renal-cell carcinoma was diagnosed as a 4 cm filling defect in the kidney where the diode laser was used for resection biopsy and ablation. 16.7% experienced Clavien-Dindo grades 1-2 complications. A total of 6.7% of patients were converted to an inpatient stay. None of the patients needed blood transfusion nor did any develop a ureteric stricture on subsequent ureteroscopies. 48.3% of patients experienced clinical recurrences of which 57.1% were at a different site. Two of the patients developed metastatic disease. One patient died 3 years after initial treatment with disease progression. Conclusion: The management of UTUC with diode laser is a safe and efficacious conservative treatment for disease and symptom control in patients unfit for radical treatment.
背景与目的:上尿路上皮癌(UTUC)并不常见;然而，在诊断时，它们通常比膀胱尿路上皮癌更具侵袭性。尽管肾输尿管切除术(NU)一直是金标准的治疗方法，但在选定的患者群体中，已经制定了保留肾脏治疗的指南。虽然这些指南是针对适合抢救根治性治疗的患者，但很少有关于管理不适合NU的有症状患者的出版物。各种内镜消融治疗UTUC的方法已经在文献中有所描述，但目前还没有使用二极管激光的报道。因此，我们的目的是评估其在不适合腹部大手术的患者根治性肾输尿管切除术中UTUC消融的有效性和安全性，而不考虑肿瘤的级别和大小。患者和方法:对4年来接受二极管激光治疗的UTUC患者进行单中心回顾性分析。随访通过6个月输尿管镜检查与计算机断层扫描(CT)尿路造影交替进行，以评估是否需要进一步治疗。结果:共发现30例患者，平均年龄76岁(64-88岁)，肿瘤部位不同，包括输尿管下、中段、肾盂、上、下肾盏。76.7%为ASA 3级，20%为ASA 4级。肿瘤平均大小为3.8 cm (2-7 cm)。平均治疗次数为2.1次(1-6次)。2级肿瘤占63.3%，3级肿瘤占30%。一例转移性肾细胞癌被诊断为肾内一个4厘米的充盈缺损，用二极管激光切除、活检和消融。16.7%出现1-2级Clavien-Dindo并发症。总共有6.7%的患者转为住院。没有患者需要输血，也没有患者在随后的输尿管镜检查中出现输尿管狭窄。48.3%的患者出现临床复发，其中57.1%在其他部位。其中两名患者出现了转移性疾病。1例患者在初始治疗3年后因疾病进展死亡。结论:二极管激光治疗UTUC是一种安全有效的保守治疗方法，对不适合根治性治疗的患者进行疾病和症状控制。
{"title":"Diode Laser for the Management of Upper Tract Urothelial Cancer (UTUC) – Case Series.","authors":"J. Jimie, A. Kwok, F. Housami, Mahmoud Elfar, Baher Hussein","doi":"10.22374/jeleu.v5i3.147","DOIUrl":"https://doi.org/10.22374/jeleu.v5i3.147","url":null,"abstract":"Background and Objective: Upper tract urothelial carcinoma (UTUC) is uncommon; however, at the time of diagnosis, they are usually more invasive than bladder urothelial carcinomas. Although nephroureterectomy (NU) has been the gold-standard treatment, guidelines have been set for kidney-sparing treatment in selected groups of patients. While these guidelines are aimed towards patients fit for salvage radical treatment, little has been published on managing the symptomatic patient not fit for NU. Various modalities of endoscopic ablation in managing UTUC have been described in the literature, but there is currently no reported use of the diode laser. Therefore, we aim to assess its efficacy and safety profile in the ablation of UTUC in patients unfit for major abdominal surgery in radical nephroureterectomy regardless of the tumour grade and size. \u0000Patients and method: A single centre retrospective review of patients who underwent Diode Laser treatment for UTUC over 4 years was done. Follow up through 6 monthly ureteroscopy alternating with computed tomography (CT) urogram was done to assess the need for further treatment. \u0000Results: 30 patients were identified, with mean age 76 years (64-88) and variable tumour locations, including lower and mid ureter and renal pelvis, upper and lower calyces. 76.7% were ASA 3 and 20% ASA 4. The mean tumour size was 3.8 cm (2-7 cm). The mean number of sessions was 2.1 (1-6). 63.3% of the tumours were grade 2, while 30% were grade 3. A case of metastatic renal-cell carcinoma was diagnosed as a 4 cm filling defect in the kidney where the diode laser was used for resection biopsy and ablation. 16.7% experienced Clavien-Dindo grades 1-2 complications. A total of 6.7% of patients were converted to an inpatient stay. None of the patients needed blood transfusion nor did any develop a ureteric stricture on subsequent ureteroscopies. 48.3% of patients experienced clinical recurrences of which 57.1% were at a different site. Two of the patients developed metastatic disease. One patient died 3 years after initial treatment with disease progression. \u0000Conclusion: The management of UTUC with diode laser is a safe and efficacious conservative treatment for disease and symptom control in patients unfit for radical treatment.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"15 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132125175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Penile fracture is a urological emergency that occurs following a traumatic rupture of the tunica albuginea. Patients experience an audible ‘pop’ and immediate detumescence during sexual activity, followed by pain, swelling and ecchymosis. It is uncommon for patients to present without these typical clinical findings. Case Presentation: This case report describes a 33-year-old male with an atypical penile fracture and associated urethral injury. He reported mild pain as his penis buckled against his partner’s thigh during sexual intercourse and a sudden detumescence. Examination was unremarkable other than gross blood at the external urethral meatus. MRI identified a 4 mm focal capsular defect at the ventral aspect of the left corpora cav-ernosum. Flexible cystoscopy identified a 2cm longitudinal tear in the distal urethra. The patient underwentsuccessful surgical repair with no long term sequalae.Conclusions: The authors of this report wish to highlight the importance of keeping a high index of suspi-cion for penile fractures in light of a typical history.
{"title":"An Atypical Presentation of Penile Fracture with Urethral Injury","authors":"S. Sarna, W. Al-Dhahir, T. Sami, Fahd R. Khan","doi":"10.22374/jeleu.v5i3.152","DOIUrl":"https://doi.org/10.22374/jeleu.v5i3.152","url":null,"abstract":"Background: Penile fracture is a urological emergency that occurs following a traumatic rupture of the tunica albuginea. Patients experience an audible ‘pop’ and immediate detumescence during sexual activity, followed by pain, swelling and ecchymosis. It is uncommon for patients to present without these typical clinical findings. Case Presentation: This case report describes a 33-year-old male with an atypical penile fracture and associated urethral injury. He reported mild pain as his penis buckled against his partner’s thigh during sexual intercourse and a sudden detumescence. Examination was unremarkable other than gross blood at the external urethral meatus. MRI identified a 4 mm focal capsular defect at the ventral aspect of the left corpora cav-ernosum. Flexible cystoscopy identified a 2cm longitudinal tear in the distal urethra. The patient underwentsuccessful surgical repair with no long term sequalae.Conclusions: The authors of this report wish to highlight the importance of keeping a high index of suspi-cion for penile fractures in light of a typical history.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125332317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: This study aims to evaluate the interpretation accuracy of urology trainees in reporting computed tomography of the kidneys, ureters, and bladder (CT-KUB) compared with the formal radiology reports inpatients with suspected acute nephrolithiasis. Methods: A sample of 12 consecutive CT-KUB scans for suspected acute nephrolithiasis was prospectively compiled and displayed using a software PACS viewer. 11 urology trainees, with an average of 24 months of urology specialist training, interpreted each scan. A total of 132 urology trainees’ reports were compared to the formal radiology reports for agreement in detecting key findings (presence or absence of stone disease), signs of urinary tract obstruction, clinically significant findings, and clinically non-significant findings. Results: There was a high level of agreement between urology trainees and radiologists for detecting key findings (98.4%) and clinically significant abnormalities (72.7%). There was less agreement in detecting all signs of urinary tract obstruction (56.2%) and non-clinically significant findings (36.8%). Conclusion: This study shows that urology trainees can accurately report CT KUB studies for key findings and clinically significant abnormalities. This may improve ongoing acute management and early patient discharge. However, their findings should be verified against formal radiological reports.
{"title":"Evaluating the Accuracy of Computed Tomography of the Kidneys, Ureters, and Bladder Interpretation by Urology Trainees for Suspected Acute Nephrolithiasis","authors":"A. Daggamseh, R. Robinson, I. Dukić","doi":"10.22374/jeleu.v5i2.145","DOIUrl":"https://doi.org/10.22374/jeleu.v5i2.145","url":null,"abstract":"Aim: This study aims to evaluate the interpretation accuracy of urology trainees in reporting computed tomography of the kidneys, ureters, and bladder (CT-KUB) compared with the formal radiology reports inpatients with suspected acute nephrolithiasis. \u0000Methods: A sample of 12 consecutive CT-KUB scans for suspected acute nephrolithiasis was prospectively compiled and displayed using a software PACS viewer. 11 urology trainees, with an average of 24 months of urology specialist training, interpreted each scan. A total of 132 urology trainees’ reports were compared to the formal radiology reports for agreement in detecting key findings (presence or absence of stone disease), signs of urinary tract obstruction, clinically significant findings, and clinically non-significant findings. \u0000Results: There was a high level of agreement between urology trainees and radiologists for detecting key findings (98.4%) and clinically significant abnormalities (72.7%). There was less agreement in detecting all signs of urinary tract obstruction (56.2%) and non-clinically significant findings (36.8%). \u0000Conclusion: This study shows that urology trainees can accurately report CT KUB studies for key findings and clinically significant abnormalities. This may improve ongoing acute management and early patient discharge. However, their findings should be verified against formal radiological reports.","PeriodicalId":136362,"journal":{"name":"Journal of Endoluminal Endourology","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133655546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：