Ever since its introduction in 1960, Light Amplification by Stimulated Emission of Radiation, in short: LASER has amplified and stimulated the hopes and imagination of patients and doctors alike. Laser even has a symbolic power that expands far beyond the walls of operation theatres. It holds a promise for the future, for technological progress and – a higher quality of treatment. Patients are not only satisfied, they are proud of being treated by laser. It means status to them and they will tell their friends about it. For doctors: let’s face it, doing that Jedi knightthing in the OR is kind of cool. Apart from that nimbus, where do we stand today, medically speaking? During the past ten years, the development of new lasers has had a substantial impact upon the landscape of surgical treatment of benign prostatic obstruction. We have seen the evolution of 60, 80, 120 and 180 W KTP lasers, Holmium laser enucleation, Thulium laser vaporesection, Thulium laser enucleation and Diode laser evaporation and enucleation to name a few. Does technological advance translate into better treatment results? It depends. From a strict functional point of view, there does not appear to be much difLasers and the prostate
{"title":"Lasers and the prostate","authors":"S. Buntrock","doi":"10.5173/ceju.2016.939","DOIUrl":"https://doi.org/10.5173/ceju.2016.939","url":null,"abstract":"Ever since its introduction in 1960, Light Amplification by Stimulated Emission of Radiation, in short: LASER has amplified and stimulated the hopes and imagination of patients and doctors alike. Laser even has a symbolic power that expands far beyond the walls of operation theatres. It holds a promise for the future, for technological progress and – a higher quality of treatment. Patients are not only satisfied, they are proud of being treated by laser. It means status to them and they will tell their friends about it. For doctors: let’s face it, doing that Jedi knightthing in the OR is kind of cool. Apart from that nimbus, where do we stand today, medically speaking? During the past ten years, the development of new lasers has had a substantial impact upon the landscape of surgical treatment of benign prostatic obstruction. We have seen the evolution of 60, 80, 120 and 180 W KTP lasers, Holmium laser enucleation, Thulium laser vaporesection, Thulium laser enucleation and Diode laser evaporation and enucleation to name a few. Does technological advance translate into better treatment results? It depends. From a strict functional point of view, there does not appear to be much difLasers and the prostate","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"396 - 396"},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70778024","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}
M. Kaynar, M. Gul, Mustafa Kucur, E. Çelik, M. Bugday, S. Goktas
Introduction Bladder neck contracture is a well-known complication following some urologic surgical procedures. Regardless of the surgical procedure, any specimen resected should be submitted for histopathological evaluation worldwide. However, the charges of histopathological evaluation may bring a heavy burden to the hospital and health care system. Also, waiting the period of the pathological evaluation process can be an anxious time for patients. Hence, we aimed to investigate the necessity of routine histopathological evaluation of bladder neck contracture bladder neck contraction specimens. Material and methods Patients undergoing bladder neck contraction resection, from 2010 to 2015 were identified. Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. We recommend that the surgeon should decide the need for histological examination on individual basis, depending on known preoperative risk factors.
{"title":"Necessity of routine histopathological evaluation subsequent to bladder neck contracture resection","authors":"M. Kaynar, M. Gul, Mustafa Kucur, E. Çelik, M. Bugday, S. Goktas","doi":"10.5173/ceju.2016.874","DOIUrl":"https://doi.org/10.5173/ceju.2016.874","url":null,"abstract":"Introduction Bladder neck contracture is a well-known complication following some urologic surgical procedures. Regardless of the surgical procedure, any specimen resected should be submitted for histopathological evaluation worldwide. However, the charges of histopathological evaluation may bring a heavy burden to the hospital and health care system. Also, waiting the period of the pathological evaluation process can be an anxious time for patients. Hence, we aimed to investigate the necessity of routine histopathological evaluation of bladder neck contracture bladder neck contraction specimens. Material and methods Patients undergoing bladder neck contraction resection, from 2010 to 2015 were identified. Patient demographics, type of surgery and histopathological diagnosis and cost of histopathological analyses of the specimens were recorded and analyzed. Results Findings of the histopathologic evaluations of 340 bladder neck specimens were reviewed. Out of these, 294 had underwent transurethral resection of the prostate, 38 open prostatectomy, and 8 radical prostatectomy. Evidence of malignant disease involving prostate cancer was present in only 2 specimens. Both of the specimens had a known preexisting history of malignant disease. The remaining 338 specimens showed chronic inflammation (n = 176), chronic active inflammation (n = 64), adenomatous hyperplasia (n = 78) or cystitis (n = 20). Conclusions Our results indicate that routine histopathological examination of bladder neck contraction specimens is clinically unnecessary. We recommend that the surgeon should decide the need for histological examination on individual basis, depending on known preoperative risk factors.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"353 - 357"},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70777385","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}
S. Kata, A. Zreik, Sarfraz Ahmad, P. Chłosta, O. Aboumarzouk
Introduction There is an ongoing debate on panurothelial changes in the upper and lower urinary tract as multifocal presentation of urothelial cancer is well recognised. Concurrent bladder cancer impacts the outcome of the upper urinary tract urothelial cancer treatment, while its detection still relies on the white light cystoscopy. Material and methods We retrospectively reviewed all patients who underwent photodynamic diagnostic ureterorenoscopy, choosing those who had synchronous bladder biopsies. Each patient received 20 mg/kg body weight of oral 5-Aminolevulinic acid around 3–4 hours before endoscopy. All procedures were performed by a single endourologist experienced in photodynamic diagnosis and flexible ureterorenoscopy. Results Between July 2009 and June 2013, 69 patients underwent bladder biopsies at the time of photodynamic diagnostic endoscopic inspection of the upper urinary tract. In total, 43.5% (30/69) patients were found to have bladder lesions, of which 43.3% (13/30) were proven to be carcinoma in situ. White light inspection of the bladder missed bladder cancer in 16 (23.1%) patients, of which 12 were carcinoma in situ. There were 14 bladder cancer lesions missed under white light which were concomitant to the upper urinary tract urothelial cancer. Twelve (17.4%) patients developed minor complications relevant to the photosensitizer. Conclusions The study raises a concern about missing small bladder cancer/carcinoma in situ lesions on the initial diagnosis or in surveillance of the upper urinary tract urothelial cancer. Higher than previously reported, the rate of concomitant bladder cancer may suggest utilisation of photodynamic diagnosis to ensure the cancer free status of the bladder, but this needs to be ratified in a multi-institutional randomised trial.
{"title":"Concurrent bladder cancer in patients undergoing photodynamic diagnostic ureterorenoscopy: how many lesions do we miss under white light cystoscopy?","authors":"S. Kata, A. Zreik, Sarfraz Ahmad, P. Chłosta, O. Aboumarzouk","doi":"10.5173/ceju.2016.896","DOIUrl":"https://doi.org/10.5173/ceju.2016.896","url":null,"abstract":"Introduction There is an ongoing debate on panurothelial changes in the upper and lower urinary tract as multifocal presentation of urothelial cancer is well recognised. Concurrent bladder cancer impacts the outcome of the upper urinary tract urothelial cancer treatment, while its detection still relies on the white light cystoscopy. Material and methods We retrospectively reviewed all patients who underwent photodynamic diagnostic ureterorenoscopy, choosing those who had synchronous bladder biopsies. Each patient received 20 mg/kg body weight of oral 5-Aminolevulinic acid around 3–4 hours before endoscopy. All procedures were performed by a single endourologist experienced in photodynamic diagnosis and flexible ureterorenoscopy. Results Between July 2009 and June 2013, 69 patients underwent bladder biopsies at the time of photodynamic diagnostic endoscopic inspection of the upper urinary tract. In total, 43.5% (30/69) patients were found to have bladder lesions, of which 43.3% (13/30) were proven to be carcinoma in situ. White light inspection of the bladder missed bladder cancer in 16 (23.1%) patients, of which 12 were carcinoma in situ. There were 14 bladder cancer lesions missed under white light which were concomitant to the upper urinary tract urothelial cancer. Twelve (17.4%) patients developed minor complications relevant to the photosensitizer. Conclusions The study raises a concern about missing small bladder cancer/carcinoma in situ lesions on the initial diagnosis or in surveillance of the upper urinary tract urothelial cancer. Higher than previously reported, the rate of concomitant bladder cancer may suggest utilisation of photodynamic diagnosis to ensure the cancer free status of the bladder, but this needs to be ratified in a multi-institutional randomised trial.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"334 - 340"},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70777550","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}
S. Piotrowicz, S. Poletajew, S. Czarniecki, F. Kowalski, G. Nowak, M. Oszczudlowski, M. Sochaj, J. Dobruch, P. Radziszewski
Lymph node dissection (LND) performed at radical cystectomy (RC) has therapeutic and staging significance. However, the extent of LND remains controversial. The aim of this study was to analyze surgical patterns and results of LND in a contemporary series of patients with bladder cancer. This is a retrospective analysis of 113 consecutive patients subjected to RC in seven urological centres in the year 2013. The mean age of the cohort was 66.6 years. There were 49 cases of organ confined and 64 cases of locally advanced disease. Study endpoints were: status and extent of LND, number of LNs removed, and number of positive LNs. LND was performed in 102 patients (90.3%). Detailed data on the anatomical extent of LND was available in 82 patients (80.4%). Limited (lLND) and extended LND (eLND) was performed in 68.3% (n = 56) and 31.7% (n = 26) of patients, respectively. Obturator fossa LNs were removed in 84.1%, external iliac in 72.0%, internal iliac in 40.2%, common iliac in 31.7%, and presacral in 15.9% of cases. The median number of LNs removed in the whole study cohort, in patients who underwent lLND, and eLND, was 8.5, 5, and 16.5, respectively. In 28 patients (27.5%), LN metastases were diagnosed, including 6 cases (12.5%) in the organ-confined cohort and 22 cases (34.4%) in the locally advanced disease cohort. LND is an integral part of radical cystectomy in patients with bladder cancer. However, in the majority of patients, the extent of the procedure was suboptimal, potentially negatively affecting the survival and adequacy of pathological staging.
{"title":"Extent of lymphadenectomy in patients with bladder cancer undergoing radical cystectomy – a multi-institutional analysis","authors":"S. Piotrowicz, S. Poletajew, S. Czarniecki, F. Kowalski, G. Nowak, M. Oszczudlowski, M. Sochaj, J. Dobruch, P. Radziszewski","doi":"10.5173/ceju.2016.902","DOIUrl":"https://doi.org/10.5173/ceju.2016.902","url":null,"abstract":"Lymph node dissection (LND) performed at radical cystectomy (RC) has therapeutic and staging significance. However, the extent of LND remains controversial. The aim of this study was to analyze surgical patterns and results of LND in a contemporary series of patients with bladder cancer. This is a retrospective analysis of 113 consecutive patients subjected to RC in seven urological centres in the year 2013. The mean age of the cohort was 66.6 years. There were 49 cases of organ confined and 64 cases of locally advanced disease. Study endpoints were: status and extent of LND, number of LNs removed, and number of positive LNs. LND was performed in 102 patients (90.3%). Detailed data on the anatomical extent of LND was available in 82 patients (80.4%). Limited (lLND) and extended LND (eLND) was performed in 68.3% (n = 56) and 31.7% (n = 26) of patients, respectively. Obturator fossa LNs were removed in 84.1%, external iliac in 72.0%, internal iliac in 40.2%, common iliac in 31.7%, and presacral in 15.9% of cases. The median number of LNs removed in the whole study cohort, in patients who underwent lLND, and eLND, was 8.5, 5, and 16.5, respectively. In 28 patients (27.5%), LN metastases were diagnosed, including 6 cases (12.5%) in the organ-confined cohort and 22 cases (34.4%) in the locally advanced disease cohort. LND is an integral part of radical cystectomy in patients with bladder cancer. However, in the majority of patients, the extent of the procedure was suboptimal, potentially negatively affecting the survival and adequacy of pathological staging.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"323 - 326"},"PeriodicalIF":0.0,"publicationDate":"2016-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70777599","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}
M. Hora, V. Eret, I. Trávníček, K. Procházková, T. Pitra, O. Dolejsova, O. Hes, F. Petersson
Introduction The aim of this article is to generally describe the roles of main surgical modalities in treatment of renal tumors, especially in the CT1a category in clinical practice. Surgical modalities include the following: laparoscopic or open resection (LR, OR) and laparoscopic or open nephrectomy (LN, ON). Representation of these methods has been changing over years due to improved operative skills and equipment and due to a shift of tumors to the lower T categories. Material and methods The sources of data were surgeries performed for renal tumors at the institution of the main author during the period 2002 to III/2016, reaching a total of 2204 cases (546 ONs, 647 LNs, 668 ORs and 343 LRs). Patients indicated for percutaneous ablative therapy or active surveillance were not included. Results During the whole period, the proportions of methods were: ONs 24.8%, LNs 29.4%, ORs 30.3%, LRs 15.6%. But during the years 2014 – III/2016, these changed to 12.6%:26.3%:31.6%:29.4% (in cT1a 1.7%:8.3%:37.8%:52.2%). Category cT1a constitutes in the years 2007 – III/2016 41.3%, in 2014 – III/2016 50.9%. Conclusions Resections and minimally invasive approaches are being performed more frequently and are the preferred methods in surgical treatment of kidney tumors. Resection is now indicated in about 60% of cases (open vs. laparoscopic resection are used nearly equally with a slight tendency for laparascopic predomination). In the cT1a category (amounting to approximately 50% of all surgically treated tumors), resection is possible in about 85–90% of cases.
{"title":"Surgical treatment of kidney tumors – contemporary trends in clinical practice","authors":"M. Hora, V. Eret, I. Trávníček, K. Procházková, T. Pitra, O. Dolejsova, O. Hes, F. Petersson","doi":"10.5173/ceju.2016.845","DOIUrl":"https://doi.org/10.5173/ceju.2016.845","url":null,"abstract":"Introduction The aim of this article is to generally describe the roles of main surgical modalities in treatment of renal tumors, especially in the CT1a category in clinical practice. Surgical modalities include the following: laparoscopic or open resection (LR, OR) and laparoscopic or open nephrectomy (LN, ON). Representation of these methods has been changing over years due to improved operative skills and equipment and due to a shift of tumors to the lower T categories. Material and methods The sources of data were surgeries performed for renal tumors at the institution of the main author during the period 2002 to III/2016, reaching a total of 2204 cases (546 ONs, 647 LNs, 668 ORs and 343 LRs). Patients indicated for percutaneous ablative therapy or active surveillance were not included. Results During the whole period, the proportions of methods were: ONs 24.8%, LNs 29.4%, ORs 30.3%, LRs 15.6%. But during the years 2014 – III/2016, these changed to 12.6%:26.3%:31.6%:29.4% (in cT1a 1.7%:8.3%:37.8%:52.2%). Category cT1a constitutes in the years 2007 – III/2016 41.3%, in 2014 – III/2016 50.9%. Conclusions Resections and minimally invasive approaches are being performed more frequently and are the preferred methods in surgical treatment of kidney tumors. Resection is now indicated in about 60% of cases (open vs. laparoscopic resection are used nearly equally with a slight tendency for laparascopic predomination). In the cT1a category (amounting to approximately 50% of all surgically treated tumors), resection is possible in about 85–90% of cases.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"341 - 346"},"PeriodicalIF":0.0,"publicationDate":"2016-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776901","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. G. Rivas, M. Socarrás, Leonardo Tortolero Blanco
Introduction Social Media (SoMe) includes a broad spectrum of public use platforms like Twitter, YouTube or Facebook that have changed the way humans interact and communicate. Considering the high usage rates for various SoMe platforms among urologists, we aimed to perform a review regarding opportunities, applications, appropriate use and new horizons of SoMe in urology. Material and methods Literature review. Results We are currently experiencing an explosion in the use of SoMe in healthcare and urology due to the clear offer of advantages in communication, information sharing, enhanced experience of meetings and conferences, as well as, for networking. However, SoMe is an open environment and recommendations should be implemented on the appropriate use in order to respect ethical considerations and not break the harmony of the doctor-patient relationship. SoMe activity has become an important part of our participation in scientific meetings. Conclusions SoMe represents a vibrant area of opportunities for the communication of knowledge in health care and so their potential applications today are unquestionable; however, its development in the urological community is still in its infancy. At present the benefits include communication between associations, urologists, residents, other health care professionals and patients. Further efforts are focusing on standardizing the language used through SoMe and finding out how we can objectively quantify the impact of the information published in SoMe.
{"title":"Social Media in Urology: opportunities, applications, appropriate use and new horizons","authors":"J. G. Rivas, M. Socarrás, Leonardo Tortolero Blanco","doi":"10.5173/ceju.2016.848","DOIUrl":"https://doi.org/10.5173/ceju.2016.848","url":null,"abstract":"Introduction Social Media (SoMe) includes a broad spectrum of public use platforms like Twitter, YouTube or Facebook that have changed the way humans interact and communicate. Considering the high usage rates for various SoMe platforms among urologists, we aimed to perform a review regarding opportunities, applications, appropriate use and new horizons of SoMe in urology. Material and methods Literature review. Results We are currently experiencing an explosion in the use of SoMe in healthcare and urology due to the clear offer of advantages in communication, information sharing, enhanced experience of meetings and conferences, as well as, for networking. However, SoMe is an open environment and recommendations should be implemented on the appropriate use in order to respect ethical considerations and not break the harmony of the doctor-patient relationship. SoMe activity has become an important part of our participation in scientific meetings. Conclusions SoMe represents a vibrant area of opportunities for the communication of knowledge in health care and so their potential applications today are unquestionable; however, its development in the urological community is still in its infancy. At present the benefits include communication between associations, urologists, residents, other health care professionals and patients. Further efforts are focusing on standardizing the language used through SoMe and finding out how we can objectively quantify the impact of the information published in SoMe.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"33 3S Suppl 1 1","pages":"293 - 298"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776970","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}
The Social Media (SoMe) has revolutionized the way we communicate, interact and live. It has evolved from a purely entertainment role, into a powerful platform for sharing information, instant messaging, networking and bringing communities and societies together. Over the last few decades, SoMe has demonstrated a growing role in medicine. With an unlimited spread of scientific knowledge, the possibility of scientific interaction during medical conferences and medical education, as well as, easy access to international medical debates has made SoMe become an important factor in medicine and especially in urology. The urology community has foreseen the tremendous potential of SoMe, especially with the use of Twitter, which has led to the rapid adaptation of SoMe for conference use, dissemination of breaking news, emerging research, education and socializing.
{"title":"Social Media – the growing role in urology","authors":"R. Sosnowski, A. Lemiński, M. van Gurp","doi":"10.5173/CEJU.2016.894","DOIUrl":"https://doi.org/10.5173/CEJU.2016.894","url":null,"abstract":"The Social Media (SoMe) has revolutionized the way we communicate, interact and live. It has evolved from a purely entertainment role, into a powerful platform for sharing information, instant messaging, networking and bringing communities and societies together. Over the last few decades, SoMe has demonstrated a growing role in medicine. With an unlimited spread of scientific knowledge, the possibility of scientific interaction during medical conferences and medical education, as well as, easy access to international medical debates has made SoMe become an important factor in medicine and especially in urology. The urology community has foreseen the tremendous potential of SoMe, especially with the use of Twitter, which has led to the rapid adaptation of SoMe for conference use, dissemination of breaking news, emerging research, education and socializing.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"299 - 300"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70777533","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}
Sławomir Gajda, T. Szopiński, A. Szczepanik, R. Sosnowski, A. M. Szczepanik
Surgery in patients with hemophilia is a serious challenge. It requires a comprehensive approach, as well as careful postoperative monitoring. We present here the first case of a transperitoneal laparoscopic radical nephrectomy (TLRN) for renal cell carcinoma, of the clear-cell type, performed in a hemophilia B patient. The level of factor IX clotting activity before surgery and on postoperative days 1–6 was maintained at 65–130% and at 30–40% on subsequent days until healing of the post-operative wound was achieved. The intraoperative and postoperative courses were uneventful. TLRN can therefore be considered safe and effective for renal cell carcinoma. In hemophilia patients, the TLRN procedure requires proper preparation, as well as adequate substitution therapy for the deficient coagulation factor provided by a multidisciplinary team in a comprehensive center.
{"title":"Laparoscopic nephrectomy in a hemophilia B patient","authors":"Sławomir Gajda, T. Szopiński, A. Szczepanik, R. Sosnowski, A. M. Szczepanik","doi":"10.5173/ceju.2016.854","DOIUrl":"https://doi.org/10.5173/ceju.2016.854","url":null,"abstract":"Surgery in patients with hemophilia is a serious challenge. It requires a comprehensive approach, as well as careful postoperative monitoring. We present here the first case of a transperitoneal laparoscopic radical nephrectomy (TLRN) for renal cell carcinoma, of the clear-cell type, performed in a hemophilia B patient. The level of factor IX clotting activity before surgery and on postoperative days 1–6 was maintained at 65–130% and at 30–40% on subsequent days until healing of the post-operative wound was achieved. The intraoperative and postoperative courses were uneventful. TLRN can therefore be considered safe and effective for renal cell carcinoma. In hemophilia patients, the TLRN procedure requires proper preparation, as well as adequate substitution therapy for the deficient coagulation factor provided by a multidisciplinary team in a comprehensive center.","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"271 - 273"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776988","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}
S. Butticè, T. E. Şener, C. Netsch, E. Emiliani, R. Pappalardo, C. Magno
Over the last 20 years new technologies have emerged in urology, while there has been an increase in the incidence of kidney stone disease with growing use of flexible ureteroscopy [1]. In 2004 Gyrus ACMI introduced the first totally digital flexible ureteroscopic system, the DUR-D Invisio platform [2]. This was a watershed moment as all the major companies began producing digital flexible ureteroscopes from that moment forward with an improved armamentarium available for the urologist [3]. In October 2015 Boston Scientific introduced the LithoVue™. This is the first single-use flexible ureteroscope developed to access the upper urinary tract. The LithoVue™ The LithoVue™ (Boston Scientific, Marlborough, MA) is a new single-use digital flexible ureteroscope (Figure 1). Figure 1 The new single use flexible ureteroscope: LithoVue™. A. The LithoVue™ external aspect in the hands of the surgeon and the LithoVue™ monitor can be seen at the back. B. Maximum deflection of the ureteroscope tip; 270° in ... The handle is extremely ergonomic, permitting the user to easily perfom the 6 principal movements in a natural way (deflection: up/down, supination/pronation, forward/backward). The deflection system has both options of standart and the reverse modes with a maximum deflection of 270˚ in both directions (Figures 1 & 2). The outer diameter is 9.5 Fr (≤3.23 mm) and the tip diameter is 7.7 Fr (Figures 1 & 2). These diameters allow endourologists to work with all of the ureteral access sheaths currently on the market. Figure 2 External view of the LithoVue™. A. The tip at maximum deflection. B. External view of the device with the tip straight. C. External view of the device with the tip at maximum deflection. The working channel width measures 3.6 Fr and allows the introduction of various endoscopic instruments such as laser fibers, baskets and different kinds of graspers (Figure 3). Figure 3 Endoscopic view from the LithoVue™ demonstrating the digital image quality during upper urinary tract endoscopy. A. Kidney stone inside the caliceal system. B. Kidney stone and a green coated 272 μm laser fiber. In order to maximize the vision it has a complementary metal-oxide-semiconductor (CMOS) imager system with a working distance of 2–50 mm (Figures 3 & 4). Figure 4 Endoscopic view from the LithoVue™ demonstrating the digital image quality during upper urinary tract endoscopy. A stenotic infundibulum and a small stone fragment can be seen. The LithoVue™ possesses chip-on-the-tip technology as the camera and light source are fully integrated in the scope, and it has a workstation monitor with the integrated image processing software mounted on a compact, rolling mobile cart. It is possible to use the LithoVue™ system alone or to connect it to the operating room’s existing DVI monitors and recording systems (Figure 5). Figure 5 Monitor station of the LithoVue™ at Tenon University Hospi
{"title":"LithoVue™: A new single-use digital flexible ureteroscope","authors":"S. Butticè, T. E. Şener, C. Netsch, E. Emiliani, R. Pappalardo, C. Magno","doi":"10.5173/ceju.2016.872","DOIUrl":"https://doi.org/10.5173/ceju.2016.872","url":null,"abstract":"Over the last 20 years new technologies have emerged in urology, while there has been an increase in the incidence of kidney stone disease with growing use of flexible ureteroscopy [1]. In 2004 Gyrus ACMI introduced the first totally digital flexible ureteroscopic system, the DUR-D Invisio platform [2]. This was a watershed moment as all the major companies began producing digital flexible ureteroscopes from that moment forward with an improved armamentarium available for the urologist [3]. In October 2015 Boston Scientific introduced the LithoVue™. This is the first single-use flexible ureteroscope developed to access the upper urinary tract. \u0000 \u0000The LithoVue™ \u0000The LithoVue™ (Boston Scientific, Marlborough, MA) is a new single-use digital flexible ureteroscope (Figure 1). \u0000 \u0000 \u0000 \u0000Figure 1 \u0000 \u0000The new single use flexible ureteroscope: LithoVue™. A. The LithoVue™ external aspect in the hands of the surgeon and the LithoVue™ monitor can be seen at the back. B. Maximum deflection of the ureteroscope tip; 270° in ... \u0000 \u0000 \u0000 \u0000The handle is extremely ergonomic, permitting the user to easily perfom the 6 principal movements in a natural way (deflection: up/down, supination/pronation, forward/backward). The deflection system has both options of standart and the reverse modes with a maximum deflection of 270˚ in both directions (Figures 1 & 2). The outer diameter is 9.5 Fr (≤3.23 mm) and the tip diameter is 7.7 Fr (Figures 1 & 2). These diameters allow endourologists to work with all of the ureteral access sheaths currently on the market. \u0000 \u0000 \u0000 \u0000Figure 2 \u0000 \u0000External view of the LithoVue™. A. The tip at maximum deflection. B. External view of the device with the tip straight. C. External view of the device with the tip at maximum deflection. \u0000 \u0000 \u0000 \u0000The working channel width measures 3.6 Fr and allows the introduction of various endoscopic instruments such as laser fibers, baskets and different kinds of graspers (Figure 3). \u0000 \u0000 \u0000 \u0000Figure 3 \u0000 \u0000Endoscopic view from the LithoVue™ demonstrating the digital image quality during upper urinary tract endoscopy. A. Kidney stone inside the caliceal system. B. Kidney stone and a green coated 272 μm laser fiber. \u0000 \u0000 \u0000 \u0000In order to maximize the vision it has a complementary metal-oxide-semiconductor (CMOS) imager system with a working distance of 2–50 mm (Figures 3 & 4). \u0000 \u0000 \u0000 \u0000Figure 4 \u0000 \u0000Endoscopic view from the LithoVue™ demonstrating the digital image quality during upper urinary tract endoscopy. A stenotic infundibulum and a small stone fragment can be seen. \u0000 \u0000 \u0000 \u0000The LithoVue™ possesses chip-on-the-tip technology as the camera and light source are fully integrated in the scope, and it has a workstation monitor with the integrated image processing software mounted on a compact, rolling mobile cart. It is possible to use the LithoVue™ system alone or to connect it to the operating room’s existing DVI monitors and recording systems (Figure 5). \u0000 \u0000 \u0000 \u0000Figure 5 \u0000 \u0000Monitor station of the LithoVue™ at Tenon University Hospi","PeriodicalId":86295,"journal":{"name":"Urologia polska","volume":"69 1","pages":"302 - 305"},"PeriodicalIF":0.0,"publicationDate":"2016-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5173/ceju.2016.872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70777193","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：