Abstract:
: Introduction: Elevated intrarenal pressure (IRP) during flexible ureterorenoscopy (FURS) is a predictor of postoperative complications. The aim of this study is to evaluate IRP during FURS in a porcine kidney model to determine the safest combination of irrigation device, ureteral access sheath (UAS), and ureteroscope. Methods: Urinary tracts were harvested from Landrace pigs slaughtered for the food chain. Two flexible ureteroscopes, 8.7F and 9.5F, were evaluated. Irrigation systems evaluated included the following: TraxerFlow™ (Rocamed, France), SAPS™ single action pumping system (Boston Scientific), Pathfinder Plus™ (Utah Medical), and a manual "bag squeeze." This experiment was conducted with no UAS, followed by an 11/13F UAS and then a 12/14F UAS. IRPs were measured in the prepared porcine kidney during all possible combinations of scope, UAS, and irrigation system. Results: Pressures were significantly reduced when using 12/14F UAS compared with 11/13F UAS (16.45 ± 5.3 cmH2O vs 32.73 ± 35.66 cmH2O, p = 0.006), and when using 11/13F UAS compared with no UAS (32.73 ± 35.66 cmH2O vs 49.5 ± 29.36 cmH2O, p = 0.02). Pressures were significantly reduced with the 8.7F scope compared with the 9.5F scope (24.1 ± 21.24 cmH2O vs 41.68 ± 34.5 cmH2O, p = 0.001). SAPS generates significantly greater IRP than TraxerFlow, Pathfinder Plus, and a "bag squeeze" (p < 0.05). The most dangerous combination was using the SAPS, no UAS, and larger ureteroscope leading to an IRP of 100.6 ± 16.1 cmH2O. The safest combination was using Pathfinder Plus with a 12/14F UAS and smaller ureteroscope giving an IRP of 11.6 ± 3.65 cmH2O. Conclusion: IRPs are reduced by selecting larger UAS and a small ureteroscope. The SAPS generates significantly higher IRPs than other irrigation systems. To maintain safe IRPs during FURS, urologists should use large UAS, narrow ureteroscopes, and be cautious in the selection of an irrigation device.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
MacCraith E,Yap LC,Elamin M,Patterson K,Brady CM,Hennessey DBdoi
10.1089/end.2020.0838subject
Has Abstractpub_date
2020-11-05 00:00:00eissn
0892-7790issn
1557-900Xpub_type
杂志文章abstract:INTRODUCTION:Expert-reported outcomes and complications may not reflect the standardized coding that can be provided by independent, third-party evaluations. The goal of this article is to compare expert-reported complications with standardized coding by the National Surgical Quality Improvement Program (NSQIP). The pr...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0178
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence of preoperative anemia and the impact of preoperative anemia and blood transfusion requirement on 30- and 90-day complications in a cohort of patients undergoing robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). PATIENTS AND METHODS:IRARC was performed...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0730
更新日期:2017-02-01 00:00:00
abstract::Urologists have witnessed replacement of complex open surgical procedures with minimally invasive therapies over the past quarter century. Nothing personifies this more than an anatrophic nephrolithotomy in the management of kidney stones. The Boyce procedure, once the gold standard for staghorn calculi, is rarely per...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.1548
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Conical blunt trocar insertion may eliminate the need for fascial closure (FC) in transperitoneal laparoscopic renal surgery. This concept applies to 12-mm blunt trocar placement through muscular parts of the abdominal wall, relying on muscle splitting and eventual muscle retraction when the troc...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277902753483718
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The use of bipolar electrocautery has proven advantages over monopolar energy during transurethral surgery by limiting hyponatremia and its clinical sequelae. Percutaneous ablation of caliceal diverticula and parapelvic renal cysts has been shown to be an effective surgical approach for the manag...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0525
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To evaluate perioperative morbidity and mortality rate, a 3-year recurrence-free survival, and cancer-specific mortality rate in patients older than 80 years undergoing robot-assisted radical cystectomy (RARC). MATERIALS AND METHODS:We retrospectively collected data of 155 consecutive patients who received R...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0050
更新日期:2016-07-01 00:00:00
abstract::Pelvic organ prolapse is a common problem faced by many women, resulting in significant morbidity and negatively impacting quality of life. Sacrocolpopexy can treat women with vaginal vault prolapse, multicompartment prolapse, and/or a history of failed prolapse procedures. The transabdominal sacrocolpopexy has been s...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2012.0388
更新日期:2012-12-01 00:00:00
abstract::Using high-speed photography and acoustic emission measurements, we studied the dynamics of a transient cavitation bubble near a stone surface and the concomitant shockwaves generated during electrohydraulic lithotripsy (EHL). At each spark discharge, a vapor plasma and subsequently a cavitation bubble oscillating aro...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1997.11.55
更新日期:1997-02-01 00:00:00
abstract::Caliceal diverticulum management has been performed using various modalities, including ureteroscopy, percutaneous treatment, and laparoscopy. We present our experience with laparoscopic management of caliceal diverticulum in two patients with large caliceal diverticulum and a history of failed open surgery because of...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2012.0526
更新日期:2013-05-01 00:00:00
abstract::Extracorporal shockwave lithotripsy of lower caliceal stones is often unrewarding because of the difficulty of passing stone fragments. We report our results in SWL of lower pole stones in 219 patients and compare them with the results of SWL of middle (82 patients) and upper pole (85 patients) stones. The stone-free ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.1995.9.439
更新日期:1995-12-01 00:00:00
abstract:: Purpose: We assessed the ability of enhanced cystoscopy with CHROMA image enhancement (Karl Storz SE & Co. KG, Tuttlingen, Germany) to improve cancer detection during transurethral resection of bladder tumors (TURBT) in patients with known or suspected nonmuscle invasive b...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0821
更新日期:2020-12-04 00:00:00
abstract::Because it is still a puzzling debate whether ligation of a unilateral varicose spermatic vein is worth performing by laparoscopy, even with the two-port technique, we conducted a study in which 280 patients with palpable left varicoceles were treated with spermatic vein ligation either by open surgery (120 patients) ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1996.10.435
更新日期:1996-10-01 00:00:00
abstract::The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on all aspects of health care, including surgical procedures. For urologists, it has affected and will continue to influence how we approach the care of patients preoperatively, intraoperatively, and postoperatively. A risk-benefit assessment of ...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2020.0342
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:The improvements in flexible ureteroscopes provide efficient access to the upper urinary tract and advancements in laser technology strengthens the endourologists' armamentarium. The endourologists must be aware of the advantages and the potential complications of these powerful technological equipments. O...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0747
更新日期:2016-05-01 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:INTRODUCTION:Traditional techniques for obtaining percutaneous renal access utilize continuous fluoroscopy. In an attempt to minimize radiation exposure, we describe a novel laser direct alignment radiation reduction technique (DARRT) for percutaneous access and test it in a bench-top model. METHODS:In this randomized...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2016.0170
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Oxalobacter formigenes is an anaerobic commensal colonic bacterium capable of degrading oxalate through the enzyme oxalyl-CoA decarboxylase. It has been theorized that individuals who lack this bacterium have higher intestinal oxalate absorption, leading to a higher urinary oxalate concentration ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903321618743
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:We investigated the surgical efficiency and cutoff criteria to determine whether retrograde intrarenal surgery (RIRS) or supine miniaturized percutaneous nephrolithotomy (MPCNL) is appropriate for managing renal stones with a mean size >10 mm. MATERIALS AND METHODS:Data of a single session RIRS or supine MPC...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0244
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have developed novel iron-based microparticles (Fe-MP) that bind to calcium oxalate stone fragments, rendering them paramagnetic. Previously, we demonstrated enhanced efficiency of stone extraction in an inanimate model using magnetic instrumentation. Before in vivo stone extraction studies, w...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0419
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Creation of an optimally apposed, tension-free, well-supported vesicourethral anastomosis remains the cornerstone for anastomotic healing after radical prostatectomy. We report the effect of three techniques of bladder neck reconstruction during robot-assisted radical prostatectomy on anastomotic...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2009.0630
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Transurethral electrovaporization of the prostate (TVP) has been utilized increasingly in the therapeutic management of benign prostatic hyperplasia (BPH). The temperature profile within both prostatic and periprostatic tissue has been presented as a parameter of safety in various preliminary ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.53
更新日期:1999-02-01 00:00:00
abstract::This is a case report of a 37-year-old man with severe testicular pain unresolved after conventional investigative and therapeutic methods. On the basis of his history of abdominal trauma followed by emergency splenectomy and evidence of functioning splenic tissue on a radionuclide scan, the diagnosis of splenosis was...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.373
更新日期:1999-06-01 00:00:00
abstract::Large bladder calculi are often outside the range of treatment with conventional endoscopic lithotrites because of either anatomic factors or the mechanical limits of available instruments. Alternative methods of cystolithotripsy: ultrasonic, electrohydraulic, or laser, can prove time-consuming or even hazardous, so t...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.183
更新日期:1994-06-01 00:00:00
abstract:PURPOSE:Since the holmium:yttrium-aluminum-garnet (Ho:YAG) laser is the flexible lithotrite of choice for ureteral stones, its application to ureteral strictures associated with ureteral calculi is convenient. The results of Ho:YAG laser endoureterotomy in this specific setting have not been defined. We report our expe...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0387
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Various laparoscopic devices have been described for suture anchoring during solidorgan parenchymal closure. Application of these devices expedites the closure of parenchymal defects and minimizes ischemia time. We compared different technologies as suture anchors for parenchymal closure. MATERI...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2005.19.1221
更新日期:2005-12-01 00:00:00
abstract::A new semiflexible and steerable cannula was designed for endoscopic reflux operations on infants and children. Because of its small diameter (0.6 mm; < 2F), it fits even through the 9F infant cystoscope. ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.131
更新日期:1994-04-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVES:To examine the association of glycemic control, including strict glycemic control, with 24-hour urine risk factors for uric acid and calcium calculi. MATERIALS AND METHODS:With institutional review board (IRB) approval, we identified 183 stone formers (SFs) with 459 twenty-four-hour urine c...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2018.0376
更新日期:2018-08-01 00:00:00
abstract:INTRODUCTION:The management of patients with upper urinary tract obstruction who are not candidates for definitive reconstruction often presents a challenge. We report our initial experience with the Resonance (Cook Urological, Spencer, IN) metallic ureteral stent for the management of benign ureteral obstruction and p...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0192
更新日期:2010-03-01 00:00:00
abstract::Eighteen male patients underwent endoscopic management of urethral obliterations and severe strictures of the subprostatic urethra. Thirteen patients who performed clean urethral self-dilatation after endoscopic repair had a lower incidence of recurrent strictures (P = 0.03) and required fewer visual internal urethrot...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1996.10.385
更新日期:1996-08-01 00:00:00
abstract::Seminal vesicle cysts associated with other genitourologic abnormalities are rare. We describe the first known robot-assisted excision of a cystic seminal vesicle associated with ipsilateral renal agenesis in a symptomatic pediatric patient. The patient was discharged home on postoperative day 1 and remains symptom fr...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2006.0279
更新日期:2007-07-01 00:00:00