Abstract:
: Introduction: Ionizing radiation is used throughout urologic surgery and is known to cause a greater cancer risk with increasing exposure. The International Commission on Radiological Protection states that "it is the control of radiation dose that is important, no matter the source." However, there are few reports on the amount of radiation used by urology residents during ureteroscopy (URS). We present the largest database evaluating fluoroscopy (fluoro) use during URS at a resident training program. Our objective is to assess the amount of fluoro use at varying levels of experience and to identify factors that lead to increased fluoro use. Methods: Retrospective data from 242 URSs performed at two resident training sites were collected. In total, 105 surgeries were done by two attending physicians without and 137 surgeries with residents (Uro1-Uro3). Patient data were collected from the electronic medical record. Statistical analyses included analysis of variance, Spearman correlations, and multiple linear regression (MLR). Results: Comparisons between years 1 and 2 revealed significantly (p < 0.05) decreased fluoro time (20.0 seconds) and operative time (OT) (12.2 minutes) for the year 2 resident. Total OT was significantly (p < 0.05) decreased (11.1 minutes) for attending physicians operating on their own compared with a year 1 resident. Significant (p < 0.05) correlations with fluoro time were demonstrated for OT, stone size, ureteral dilation, ureteral access sheath use, presence of a preoperative stent, resident year, and resident month. OT, ureteral dilation, and a preoperative stent placement were significant predictors of fluoro time on MLR (p < 0.05). Conclusion: Fluoro time during retrograde URS was significantly reduced as residents gained more experience in the operating room. An increase in fluoro time was also associated with ureteral dilation, access sheath use, increasing stone size, and lack of prestenting. With knowledge of these factors, emphasis can be placed on using and teaching techniques that limit radiation exposure.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Hager SP,Balouch B,Desai S,Buckley M,Amster M,Belkoff L,May Ndoi
10.1089/end.2020.0333subject
Has Abstractpub_date
2021-01-01 00:00:00pages
25-29issue
1eissn
0892-7790issn
1557-900Xjournal_volume
35pub_type
杂志文章abstract:BACKGROUND AND PURPOSE:Renal mass protocol CT (RMP-CT) using multiphase abdomen and pelvis CT imaging is the mainstay for diagnosis, characterization, and follow-up for renal masses; however, it is associated with ionizing radiation to the patient. We sought to quantify the effective dose associated with RMP-CT and to ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0111
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the efficacy of short-duration use of finasteride and dutasteride before transurethral resection of the prostate (TURP) on intraoperative blood loss and microvessel density (MVD) of prostate stroma and suburethral tissues in benign prostatic hyperplasia (BPH). METHODS:T...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2016.0696-rev
更新日期:2017-09-01 00:00:00
abstract:: Purpose: To report on the safety, technical results, and oncologic outcomes of computed tomography guided percutaneous microwave ablation of stage cT1b renal cell carcinoma. Materials and Methods: This single-center retrospecti...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0382
更新日期:2020-10-01 00:00:00
abstract::We describe what appears to be the first case of a port-site hernia at the site of insertion of a 10-mm non-bladed trocar, which was discovered 4 days after laparoscopic live-donor nephrectomy. We now close all 10-mm port sites in adults and all 5-mm port sites in children; this can be done easily using the Carter-Tho...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903769013649
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:As the indications for topical hemostatic agents increase in urology, the question arises: what happens to these agents when they enter the urinary collecting system? To answer this question, we performed a series of in-vitro experiments mixing three hemostatic agents with normal and sanguineous ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.312
更新日期:2005-04-01 00:00:00
abstract:PURPOSE:To assess the efficacy and safety of laparoendoscopic single-site adrenalectomy (LESS-A) and conventional laparoscopic adrenalectomy (LA) as a systematic review and meta-analysis of current evidence. METHODS:We conducted a thorough search for comparative studies that compared LESS-A and conventional LA in the ...
journal_title:Journal of endourology
pub_type: 杂志文章,meta分析,评审
doi:10.1089/end.2012.0687
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:Semirigid and flexible ureterorenoscopy (URS) procedures are safe and efficient treatment options for urolithiasis of all localizations. Sometimes, a Double-J stent is placed in preparation of definitive treatment. The aim of our study was to evaluate the influence of prestenting on the outcome of URS. PA...
journal_title:Journal of endourology
pub_type: 杂志文章,多中心研究
doi:10.1089/end.2015.0109
更新日期:2016-03-01 00:00:00
abstract:: Introduction: There has been a surge in robotic surgery research publications over the past 20 years. However, to date, there has been no characterization of urology's contribution to the robotic field, and there is a lack of bibliometric literature to guide future investi...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2018.0866
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the role of the fascial dilators modified with a scale marker in reducing fluoroscopy time during percutaneous nephrolithotomy (PCNL). METHOD:In a randomized clinical trial, eligible 100 consecutive patients anticipated to undergo single-tract PCNL were randomly assigned into two groups by the cl...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2012.0671
更新日期:2013-11-01 00:00:00
abstract:PURPOSE:We analyzed the results of patients who underwent percutaneous nephrolithotomy (PCNL) for management of kidney stone disease under combined spinal-epidural anesthesia and compared surgical parameters and outcomes with a matched control group who underwent PCNL under general anesthesia. PATIENTS AND METHODS:A t...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2009.0261
更新日期:2009-11-01 00:00:00
abstract::The authors have developed an ultrasonic aspirator to assist in urologic endoscopic surgery. It appeared that ultrasonic aspiration of bladder tumors was clinically efficient in transurethral surgery. Tumors 1 to 2 cm in diameter could be aspirated completely with this instrument alone. The application of the ultrason...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.285
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:It is known that extracorporeal shock wave lithotripsy (SWL) may be improved by increasing cavitation using tandem shock waves. However, fluid is needed for the cavitation to work. The purpose of this research was to evaluate the importance of a fluid-filled expansion chamber in enhancing stone f...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0334
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:To report our experience with congenital inferior vena cava (IVC) anomalies found during laparoscopic retroperitoneal lymph node dissection (LRPLND). PATIENTS AND METHODS:Two men with a mean age of 31.5 years (range 26-37 years) underwent LRPLND because of nonseminomatous germ-cell tumors (NSGCT) between Decem...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0112
更新日期:2008-02-01 00:00:00
abstract::This review focuses on the biomaterials used in urology, in particular, the properties of urethral catheters and ureteral stents currently being used in clinical practice. The importance of biomaterial type, biocompatibility, and encrustations are discussed and explained. Current management of bacterial infection and ...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.1998.12.493
更新日期:1998-12-01 00:00:00
abstract:PURPOSE:In this study, we tried to design a scheme for performing transrectal ultrasonographic (TRUS)-biopsies that would be accurate and include the optimal number of cores. PATIENTS AND METHODS:We included in this study 600 consecutive patients with suspicious findings on a per-rectum examination and/or an elevated ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2008.0260
更新日期:2009-06-01 00:00:00
abstract:AIM:To analyze the impact of slowing the shockwave delivery during extracorporeal shockwave lithotripsy (SWL) on the clinical patient outcome and the cost of delivering this service in a community practice. PATIENTS AND METHODS:The data from 1745 consecutive SWL procedures were analyzed at a freestanding surgery cente...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0656
更新日期:2010-09-01 00:00:00
abstract::Growing data suggest that lymphadenectomy is a critical component of the surgical management of urologic malignancies with both diagnostic and therapeutic benefit. The increased use of minimally invasive approaches for the management of urologic malignancies may be in conflict with the need for more extensive lymphade...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.0562
更新日期:2010-08-01 00:00:00
abstract:INTRODUCTION:With the evolution of endourologic technology, bilateral synchronous percutaneous nephrolithotomy (BS-PCNL) has emerged as a potentially practical intervention for patients with bilateral lithiasis. Although tradition has favored a staged approach, an increasing number of original studies have reported the...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2016.0851
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Bleeding is a major concern during percutaneous nephrolithotomy (PCNL), especially with the use of multiple tracts. This prospective study aimed to identify factors affecting blood loss during PCNL. PATIENTS AND METHODS:Data were collected prospectively from 236 patients undergoing 301 PCNL proc...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2004.18.715
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND PURPOSE:Restricture after internal urethrotomy is the major limitation to the long-term success of the procedure. The objective of this study was to evaluate the effect of intraurethral brachytherapy after internal urethrotomy or transurethral scar resection on recurrent urethral stricture. PATIENTS AND MET...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277901753205906
更新日期:2001-10-01 00:00:00
abstract:INTRODUCTION:Clinical studies have shown beneficial role of oral alpha-blockers for ureteral stent-related morbidity. However, the in vivo effects of oral alpha-blockers on a stented ureter are unclear. We evaluated the effects of alpha-blockade on ureteral dynamics in a stented porcine ureter. METHODS:Twenty-seven fe...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0251
更新日期:2016-04-01 00:00:00
abstract::In a 14-year-old boy with bladder augmentation, Mitrofanoff appendicovesicostomy, Malone antegrade enema stoma, and bladder neck reconstruction, urinary continence was restored by injection of Teflon with a Veress needle and the aid of a 2-mm laparoscopic port. The method has since been used for nine treatments in six...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903765444401
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:Vesicovaginal fistula (VVF) is a common condition that physically and mentally debilitates the patient. In the developing countries such as India, it results mainly due to neglected obstetric care. Options for surgical repair of VVF consist of transvaginal, transvesical, laparoscopic repair. Endoscopic manag...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0557
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Secondary vesicoureteral reflux (SVUR) after renal transplantation may cause recurrent urinary-tract infections (UTI) and loss of renal function. There are only a few reports on the endoscopic treatment of SVUR by transurethral injection therapy. This is the first report of transurethral injectio...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0020
更新日期:2007-11-01 00:00:00
abstract:PURPOSE:To assess whether our ureteroscopic real-time navigation system has the possibility to reduce radiation exposure and improve performance of ureteroscopic maneuvers in surgeons of various ages and experience levels. MATERIALS AND METHODS:Our novel ureteroscopic navigation system used a magnetic tracking device ...
journal_title:Journal of endourology
pub_type: 杂志文章,多中心研究
doi:10.1089/end.2015.0054
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:To determine whether minimally invasive PCNL (MPCNL) is as safe and effective in the management of complex renal caliceal stones as it is for simple renal stones. PATIENTS AND METHODS:We retrospectively reviewed 5761(41.2%) simple caliceal stones (isolated renal pelvis including isolated calix) and 8223 (58.8%...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0061
更新日期:2013-10-01 00:00:00
abstract::Abstract Since the first description of percutaneous nephrolithotripsy (PNL) over 30 years ago, the indications for this procedure in the management of upper tract urinary stones has greatly expanded. Despite recent advances in shock wave lithotripsy and ureteroscopic technologies, PNL maintains a dominant role in the...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.1518
更新日期:2009-10-01 00:00:00
abstract::Four techniques of intracorporeal lithotripsy are now available: ballistic, ultrasonic, electrohydraulic, and laser. Their therapeutic efficacies have generally been evaluated and compared, but very few data have been available on their relative risks of iatrogenic trauma to the urothelial wall. We conducted a compara...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.293
更新日期:1994-08-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Despite guidelines, routine 24-hour urine testing is completed in <10% of high-risk, recurrent stone formers. Using surrogates for metabolic testing, such as key patient characteristics, could obviate the cost and burden of this test while providing information needed for proper stone prevent...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0352
更新日期:2017-12-01 00:00:00
abstract::We report the ureteroscopic unroofing of a symptomatic peripelvic cyst with a holmium laser in a 37-year-old woman. At 1-year follow-up, the patient remains symptom free. Endoscopic management of peripelvic cysts is durable and can be performed safely. ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0469
更新日期:2007-12-01 00:00:00