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Objective: To develop a contemporary complication profile for supracostal upper pole endoscopic-guided prone tubeless “maxi-PCNL” to evaluate the need for change. Materials/Methods: We ide...

Introduction: A number of clinical and radiological predictors of either stone impaction or ureteral stone passage (SP) have been proposed. We aimed at identifying the key predictors of successful ...

Ureteral duplication is the most common ureteral anomaly, occurring in 0.6%-0.7% of the population. Our objective was to compare urolithiasis treatment outcomes in patients with and without ureteral duplication.Patients with ureteral duplication who underwent ureteroscopy (URS) were identified in a stone registry at a high-volume, tertiary care center from 1998 to 2015. Preoperative, intraoperative, and postoperative data were collected retrospectively. A 1:1 control cohort of patients without duplication was identified, matched by stone location and size, as well as age, body mass index (BMI), and gender. Clinical data and outcomes were compared between duplication and control groups, between partial and complete duplication groups, and between patients in whom duplication was identified intraoperatively vs known preoperatively.Fifty patients with ureteral duplication who underwent URS were identified and were matched to 50 control patients. Patients with ureteral duplication required longer operative time (55 minutes vs 38.5 minutes, p = 0.022). Ureteral duplication had no effect on stone-free rates or need for additional procedures. High-grade (Clavien 4-5) complications were similar in both groups (4% vs 4%). Location of ureteral duplication and preoperative knowledge of ureteral duplication did not affect operative time or stone-free rates.Patients with ureteral duplication undergoing URS for urinary stone disease have longer operative times. Preoperative knowledge of ureteral duplication appears to have no significant effect on URS's safety or efficacy. In patients without a prior diagnosis of ureteral duplication, our data suggest that intraoperative detection via endoscopy and fluoroscopy is sufficient to safely and completely treat stone disease.

To compare the accuracy and reliability of stone volume estimated by ellipsoid formula (EFv) and CT-based algorithm (CTv) to true volume (TV) by water displacement in an in vitro model.Ninety stone phantoms were created using clay (0.5-40 cmMean TV, CTv, and EFv were 6.42 cmAn automated CT-based algorithm more accurately and reliably estimates stone volume than does the ellipsoid formula. While further research is necessary to validate stone volume as a surrogate for stone burden, CT-based algorithmic volume measurement of urinary stones is a promising technology.

To explore the relationship between operative time, approach, and length of stay (LOS) in partial nephrectomy (PN), radical prostatectomy (RP), and adrenalectomy (AD).Using the National Surgical Quality Improvement Program database, we identified all PN, RP, and AD from 2010 to 2012. Non-prostate cancer RP were excluded. The primary outcome was LOS. Descriptive comparisons were drawn between open and minimally invasive surgery (MIS) for each surgery. Multiple linear regression assessed the impact of open versus MIS and operative time on LOS when controlling for confounders.We identified 3760 PN (60% MIS), 12,081 RP (82% MIS), and 1684 AD (76% MIS) cases for inclusion. Differences in operative time were identified. In PN and RP, MIS mean operative time was 10 to 23 minutes longer (p0.001 each); while for AD, open was 35 minutes longer (p0.001). Open procedures had consistently longer median LOS (p0.001 all). Results of the linear regression are given next.Operative time and surgical approach are directly associated with LOS, independent of complications and patient comorbidities.