Journal of endourology
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Journal of endourology · Dec 2010
Is there a difference in outcomes between digital and fiberoptic flexible ureterorenoscopy procedures?
We aimed to compare the outcomes of patients who were treated using digital and fiberoptic flexible ureterorenoscopy (urs) for kidney stones. ⋯ Although the DFU have more limited maneuverability, comparable success rates can be achieved with both conventional and digital instruments. On the other hand, the DFU significantly reduced the operative time compared with the conventional one.
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Journal of endourology · Oct 2010
Multicenter StudyFlexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm: a multi-institutional experience.
Percutaneous nephrostolithotomy (PCNL) is the current standard of care for management of large renal stones (>2 cm). Recent studies have evaluated flexible ureterorenoscopy (URS)/holmium laser lithotripsy as an alternative treatment for patients with contraindications to or preference against PCNL. Stones in an intermediate size range (2-3 cm) may be most amenable to URS/laser lithotripsy as definitive treatment in a single stage. We report a multi-institutional series of URS/laser lithotripsy for renal stone burdens that measure 2 to 3 cm. ⋯ We demonstrate that single-stage URS/holmium laser lithotripsy is effective for management of renal stones that measure 2 to 3 cm through intermediate follow-up. Staged procedures can be used selectively for technical reasons or disease factors. Although PCNL achieves superior stone clearance overall, URS/laser lithotripsy is a viable treatment option for selected patients.
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Journal of endourology · Oct 2010
Randomized Controlled TrialTransvesical blockade of the obturator nerve to prevent adductor contraction in transurethral bladder surgery.
To evaluate the efficacy of transvesical obturator nerve block (ONB) in the prevention of obturator nerve reflex and leg jerking during transurethral resection of bladder tumors (TURBT). ⋯ Local blockade of the obturator nerve during cystoscopy is an effective method to avoid its stimulation in TURBT. It can be performed easily, and we did not experience any serious complication.
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Journal of endourology · Sep 2010
The effect of argon gas pressure on ice ball size and rate of formation.
Contemporary cryoablation technology utilizes the Joule-Thomson effect, defined as a change in temperature that results from expansion of a nonideal gas through an orifice or other restriction. We evaluated the effect of initial gas tank pressures on freezing dynamics in a single-probe model and in a multiprobe model using contemporary cryoablation technology. ⋯ In accordance with the Joule-Thomson effect, higher initial gas pressures used for cryoablation in a transparent gel model demonstrate statistically significant lower temperatures, faster decreases in temperature, and formation of larger ice balls than lower gas pressures do. With contemporary technology, multiple simultaneous cryoprobe deployment does not compromise individual probe efficacy. The use of higher initial tank pressures will theoretically help future cryoprobes be more effective, creating a greater volume of cell necrosis and a smaller indeterminate zone.
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Journal of endourology · Aug 2010
Randomized Controlled Trial Comparative StudyUltrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study.
Gaining access to the pyelocaliceal system in percutaneous nephrolithotomy (PCNL) is routinely performed using fluoroscopic guidance with the patient in a prone position. We compared ultrasonography-guided access for PCNL with the patient in the flank position with conventional fluoroscopy-guided access. ⋯ Ultrasonography has a high ability to access calculi more easily through the pyelocaliceal system with the patient in the flank position. It is convenient for urologists, and the return to the supine position is possible easily when necessary. Besides, PCNL under ultrasonography guidance and with the patient in the flank position has high success rates and limited complications; hence, we recommend this technique as an alternative procedure for fluoroscopy-guided PCNL.