785 research outputs found
Current status of prostate artery embolization for lower urinary tract symptoms: review of world literature
No full textProstate artery embolization has emerged as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. However, although it has gained increasing attention in radiology literature, it remains under-reported from a urologic perspective. We aim at providing an up-to-date review of this minimally invasive technique. Evidence suggests it is a promising and effective option for patients with large prostate volumes, multiple comorbidities, and suboptimal results from pharmacotherapy. Larger, randomized studies with longer follow-up periods are needed for this technique to be formally established in the urology community.</p
UroLift: a new minimally-invasive treatment for benign prostatic hyperplasia
No full text'UroLift' has emerged as a new minimally-invasive nonablative surgical technique for benign prostatic hyperplasia (BPH). We discuss the procedure, cost, evidence, advantages and disadvantages of this procedure. It is a novel technology suitable for a selected group of patients that allows for a bespoke treatment for men with BPH.</p
Treatment options for calyceal diverticula
No full textPURPOSE OF REVIEW: Calyceal diverticula are rare entities that can pose a significant challenge when it comes to their management. We analyse and summarise the literature with a focus on recent advances in the management of calyceal diverticula and discuss the advantages and disadvantages of each surgical technique.RECENT FINDINGS: The identification of calyceal diverticula requires a certain level of suspicion and contrast-enhanced imaging. Conventional techniques of imaging the renal collecting system such as the classic intravenous urography are now superseded by the ease of access to contrast-enhanced CT imaging. Conventional surgical techniques for managing calyceal diverticula are not being superseded by new techniques but rather being progressively enhanced and improved through the amelioration of existing technology. Debate still exists over the best treatment approach for the management of symptomatic calyceal diverticula, the choice of which still very much depends on the location and anatomy of the diverticulum itself. The most significant advance in the management of calyceal diverticula and indeed stones, in general, seems to be the progressive miniaturisation of percutaneous nephrolithotomy (PCNL) equipment allowing effective treatment with a reduction in associated risks of conventional PCNL. The increasing accessibility of robotics has a role to play in the management of this condition but is not likely surpass flexible ureteroscopic (fURS) or percutaneous approaches. The future of surgical management for this condition lies in striking a balance between treatment efficacy and invasiveness. More recent identification of metabolic disturbances in patients with calyceal diverticular stones may provide further insights into the underlying pathology of this condition and is likely to play a role in future research of diverticular stones.</p
Outcomes of ureteroscopy for patients with stones in a solitary kidney: evidence from a systematic review
No full textIntroduction: management of urolithiasis in a solitary functioning kidney can be clinically challenging. The aim of this article was to review the outcomes of URS for patients with stone disease in a solitary kidney and critically appraise the existing evidence and outcome reporting standards.Material and methods: we conducted a systematic review in line with PRISMA checklist and Cochrane guidelines between January 1980 and February 2015. Our inclusion criteria were all English language articles reporting on a minimum of 10 patients with a solitary kidney undergoing ureteroscopy for stone disease.Results: a total of 116 patients (mean age 50 years) underwent URS for stones in solitary kidney. For a mean stone size of 16.8 mm (range: 5-60 mm) and 1.23 procedures/patient, the mean stone free rate was 87%. No significant change in renal function was recorded in any of the studies although a transient elevation in creatinine was reported in 10 (8.6%) patients. A total of 33 (28%) complications were recorded a majority (n = 21) of which were Clavien grade I. The Clavien grade II/III complications as reported by authors were urosepsis, steinstrasse and renal colic. None of the procedures required conversion to open surgery with no cases of renal haematoma or ureteric perforation.Conclusions: this contemporary review highlights URS as a viable treatment option for stone disease in patients with a solitary kidney. It is associated with superior clearance rates to SWL and fewer high-risk complications compared to PCNL.</p
sj-docx-1-tau-10.1177_17562872221086999 – Supplemental material for Is there a role for stem cell therapy in erectile dysfunction secondary to cavernous nerve injury? Network meta-analysis from animal studies and human trials
No full textSupplemental material, sj-docx-1-tau-10.1177_17562872221086999 for Is there a role for stem cell therapy in erectile dysfunction secondary to cavernous nerve injury? Network meta-analysis from animal studies and human trials by Mudassir M. Wani, Bhavan P. Rai, William Richard Webb and Sanjeev Madaan in Therapeutic Advances in Urology</p
Outcome of ureteroscopy for stone disease in patients with horseshoe kidney: Review of world literature
No full textIntroduction and Objectives: The management of urolithiasis in patients with horseshoe kidney (HSK) is difficult. Stone formation occurred in 1:5 patients with HSK due to impaired urinary drainage and infections. Percutaneous nephrolithotomy and shock wave lithotripsy can be technically challenging due to altered anatomy.
Materials and Methods: We conducted a systematic review of the literature to look at the role of ureteroscopy for stone management in these patients. We searched MEDLINE, PubMed and the Cochrane Library from January 1990 to April 2013 for results of ureteroscopy and stone treatment in HSK patients. Inclusion criteria were all English language articles reporting on ureteroscopy in patients with HSK. Data were extracted on the outcomes and complications.
Results: A total of 3 studies was identified during this period. Forty-one patients with HSK underwent flexible ureteroscopy and stone treatment. The mean age was 42 with a male:female ratio nearly 3:1. The mean stone size was 16 mm (range: 3-35 mm). The mean operating time was 86 min with multiple stones seen in 15 patients. All 41 patients had a ureteral access sheath used and flexible ureteroscopy and holmium laser fragmentation done. Thirty-two (78%) patients were stone-free with a mean hospital stay of 1-day. Minor complications (Clavien I or II) were seen in 13 (32%) of which 6 had stent discomfort, 3 needed intravenous antibiotics for <24 h, 3 had hematuria of which 2 needed blood transfusion and one had pyelonephritis needing re-admission and antibiotics. There were no major complications found in the review.
Conclusions: Retrograde stone treatment using ureteroscopy and lasertripsy in HSK patients can be performed with good stone clearance rate, but with a slightly higher complication rate. This procedure should, therefore, be done in high volume stone center with an experienced stone surgeon/team
Rezum: a new transurethral water vapour therapy for benign prostatic hyperplasia
No full textRezum is a minimally invasive transurethral water vapour therapy for benign prostatic enlargement which uses thermal energy for treatment. The short-term results show it to have good outcomes with a potential for outpatient-based treatment preserving sexual function. This review serves to provide an overview of the technique and evaluate its safety and efficacy
Efficacy and safety of ureteroscopy for stone disease in a solitary kidney: Findings from a systematic review
No full textManagement of stone disease in solitary kidney remains a difficult treatment entity for the urologist. The challenge exists to deliver high clearance while maintaining strong safety profile. Twelve eligible studies were included, comprising a total of 693 patients with a male:female ratio of 2:1. Overall, 114 (16.4%) complications were reported. No fatalities were reported in any of the studies. Clavien III complications were recorded in less than 0.5% of the patients. This review confirms the effectiveness, safety, and reliability of this technique for this unique cohort of patients.</p
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