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Introduction: We aimed to assess complications and stone-free rate of flexible ureteroscopy (FU) reusing disposable scopes (RDS) after repeated sterilization. Methods: Data from adults from 11 centers were retrospectively reviewed (January 2020-December 2022). Inclusion criteria were proximal ureteral/renal stone(s). All cases were performed using an RDS to save costs for patients who come from economically challenged environments. Residual fragments (RFs) were defined as single fragment ≥4 mm or multiple fragments of any size within 3 months. Continuous variables are presented as median and interquartile range. Results: Two thousand one hundred and eighty-three patients were included, of whom 67.0 were male. Median age was 48.0 (36-59) years. The median stone diameter was 10.2 (9-14) mm. Flash sterilization was used in 90.2 (plasma in 60.5). Approximately, 88 had FU with an RDS used ≤2 times (12: 3-5 times). RDS needed to be changed intraoperatively in 3.9 of cases due to its malfunction. Commonly, defects in RDS function were reported in upward (1.6) and downward deflection (6.5) and image quality on white balancing (4.7). Fever >38C was seen in 13.7 of cases, and sepsis in 0.5. RFs were found in 31.4 of cases. Lower pole (odds ratio [OR] 5.63) or pelvis stone (OR 4.67), faulty scopes (OR 12.8), and total operation time (OR 1.05) were factors associated with higher odds of RFs. Stone size (OR 1.09), positive urine culture (OR 1.67), interpolar stone (OR 1.68), and prestenting (OR 1.37) were factors associated with higher odds of fever/sepsis. Conclusions: RDS was used as a cost-conscious approach with a low rate of serious infections but with a high rate of RFs., Author(s): Vineet Gauhar [1]; Olivier Traxer [2]; Ravindra B Sabnis [3]; Khi Yung Fong [4]; Parimalsinh Gharia [5]; Rishi Grover [5]; Deepak Ragoori [6]; Ee Jean Lim [7]; Yiloren Tanidir [...]

Background: There is a need to reliably render urolithiasis patients completely stone free with minimal morbidity. We report on the initial safety and feasibility with steerable ureteroscopic renal evacuation (SURE) in a prospective study using basket extraction as a comparison. Materials and Methods: A pilot randomized controlled study was conducted comparing SURE with basket extraction postlaser lithotripsy. SURE is performed using the CVAC™ Aspiration System, a steerable catheter (with introducer). The safety and feasibility of steering CVAC throughout the collecting system under fluoroscopy and aspirating stone fragments as it was designed to do were evaluated. Fluoroscopy time, change in hemoglobin, adverse events through 30 days, total and proportion of stone volume removed at 1 day, intraoperative stone removal rate, and stone-free rate (SFR) at 30 days through CT were compared. Results: Seventeen patients were treated (n = 9 SURE, n = 8 Basket). Baseline demographics and stone parameters were not significantly different between groups. One adverse event occurred in each group (self-limiting ileus for SURE and urinary tract infection for Basket). No mucosal injury and no contrast extravasation were observed in either group. The CVAC catheter was steered throughout the collecting system and aspirated fragments. There was no significant difference in fluoroscopy time, procedure time, change in hemoglobin, or stone removal rate between groups. SURE removed more and a greater proportion of stone volume at day 1 vs baskets (202 mm3 vs 91 mm3, p

Introduction: We aim to share the experience of a single center in the management of eight cases of renal primitive neuroectodermal tumor (PNET) which are uncommon, aggressive tumors. The objectives were to study the presentation of the disease, the treatment offered and its outcomes, and the comparison of the treatment with published literature. Methods: The single-center renal PNET data of all patients were retrospectively reviewed from 2011 to 2022. Renal PNET was seen in eight patients. Minimum follow-up period of 1 year was required. Results: Male-to-female ratio was 7:1. The mean age was 26.5 years. All were locally advanced tumors on presentation. One patient had an inferior vena cava thrombus, one patient had metastases on presentation, and two patients had tumor extending to paranephric space. The diagnosis was made by histopathology supported by immunohistochemistry showing CD99 positivity. All patients were treated with radical nephrectomy, followed by chemotherapy in all and radiotherapy in three patients. Two patients expired at 3% and 6 years after surgery, the remaining six are alive at a median follow-up period of 34.5 months. Conclusion: Renal PNET is an uncommon renal tumor which is aggressive and requires multimodal therapy for prolonged survival. [ABSTRACT FROM AUTHOR]

Byline: Niramya. Pathak, Pavan. Surwase, U. Karthik, Abhijit. Patil, Abhijit. Konnur, Shailesh. Soni, Abhishek. Singh, Arvind. Ganpule, Ravindra. Sabnis, Mahesh. Desai Introduction: COVID-19 pandemic is associated with secondary opportunistic fungal [...]

Byline: Pavan. Surwase, Suhas. Lele, Ravindra. Sabnis, Arvind. Ganpule Pseudoaneurysm of corpora cavernosa is rare and its presentation as acute urinary retention has not been reported in the literature so [...]

Byline: Ravindra. Sabnis, Prashant. Mulawkar, Rohit. Joshi Introduction These guidelines have been drafted by the Urological Society of India benign prostatic hyperplasia/obstruction ((BPH//BPO) guidelines panel and address management of BPH/BPO. [...]

Byline: Chaitanya. Deshmukh, Arvind. Ganpule, Mohammad. Islam, Ravindra. Sabnis, Mahesh. Desai Aim: To construct and validate a cost-effective indigenously made retrieval system (Modified Nadiad bag) in minimal access urology. Method: [...]

Byline: Ashwin. Tamhankar, Ravindra. Sabnis, Gagan. GautamIntroduction: In the current era, every broad specialty has diversified into many subspecialties including urology, which is one of the most dynamic fields. The [...]

Background: Chikungunya is a viral infection often associated with lower urinary tract dysfunction. This study evaluates the urological squeal of Chikungunya fever in a single centre after an epidemic in 2006-2007 in India. Materials and Methods: Retrospective analysis of medical records of 13 patients with lower urinary tract symptoms after Chikungunya fever was evaluated and outcome following intervention assessed. Results: A total of 13 patients (M:F=9:4), with age ranging from 30 to 72 years, were included in the study. They presented with chronic urinary retention (n=9, 69.23%) of which two had paraparesis, voiding symptoms alone (n=7, 53.8%), storage symptoms alone (n=3, 23%), and acute urinary retention (n=1, 7.6%). Presentation with lower urinary tract symptoms after an episode of Chikungunya fever was after a mean period of 163 days (range 30-360 days). Mean serum creatinine on presentation was 1.8 mg/dl (0.6-6.5 mg/dl). Evaluation revealed dilated upper tract in four (30.7%) patients. Cystometrography showed acontractile detrusor (n=3, 37.5%), hypocontractile detrusor (n=3, 37.5%), overactive detrusor (n=1, 12.5%) and normal study (n=1, 12.5%). At the mean follow up of 11 months, 11 patients (84.6%) had satisfactory functional outcome after intervention, namely supra pubic diversion and bladder training (n=5, 38.4%), alpha blocker (n=3, 23%), timed frequent voiding (n=2, 15.3%), clean intermittent catheterization (n=2, 15.3%), trial void with alpha blocker (n=1, 7.6%) while two are on continuing supra pubic diversion due to persistent neurological deficit. Conclusions: Chikungunya fever is an uncommon entity in urological practice, often associated with urinary symptoms. An accurate assessment of the symptoms and timely intervention prevents upper tract deterioration and improves the quality of life.

Byline: Arvind. Ganpule, Abhishek. Singh, Mohammed. Islam, Parag. Sonawane, Ravindra. Sabnis, Mahesh. Desai Ureteral stricture resulting from chronic inflammations such as tuberculosis, recurrent stone disease and multiple endourological interventions are [...]

Byline: Abhishek. Singh, Shrikant. Jai, Arvind. Ganpule, Mohankumar. Vijayakumar, Ravindra. Sabnis, Mahesh. Desai Introduction: Simulation-based training in laparoscopic urology is essential, as these surgeries require a different skill set. We [...]

Byline: Murali. Vinodh, Vijaykumar. Mohankumar, Arvind. Ganpule, Banibrata. Mukhopadhyay, Ravindra. Sabnis, Mahesh. Desai Context: Although the technical feasibility of laparoscopic donor nephrectomy (LDN) has been established, concerns have been raised [...]

Byline: Ravindra. Sabnis, Abhishek. Singh, Arvind. Ganpule, Jaspreet. Chhabra, Gopal. Tak, Jaimin. Shah Introduction: In the past, urological complications after renal transplantation were associated with significant morbidity. With the development [...]

Byline: Abhishek. Laddha, Arvind. Ganpule, Sahshikant. Mishra, Ravindra. Sabnis, Mahesh. Desai Management of distal ureter by en block resection during radical nephrectomy for upper urinary tract transitional cell carcinoma (TCC) [...]

Renal cell cancer (RCC) in renal allograft is a rare entity. We report a case of RCC successfully diagnosed in a 42-year-old renal allograft recipient which developed 13 years after engraftment. The patient was initially evaluated using ultrasound for two episodes of hematuria followed by contrast-enhanced CT scan revealing 9.7 cm x 8.6 cm x 6.5 cm heterogeneously enhancing mass at mid-pole with involvement of renal sinus. Allograft nephrectomy was performed. A genetic study with DNA microsatellite analysis showed de novo RCC from donor origin. Seven months after surgery, the patient is alive with no evidence of tumor recurrence and is now planned for a second renal transplant. To the best of our knowledge, this is the largest allograft RCC reported in the Indian scenario. [ABSTRACT FROM AUTHOR]

Byline: Arvind. Ganpule, Ashish. Goti, Shashikant. Mishra, Ravindra. Sabnis, Mihir. Desai, Mahesh. Desai Background: We summarise our experience with RPN emphasising on learning curve, techniques and outcomes. Patients and Methods: [...]

Graft artery aneurysms though rare, may have devastating consequences. We present a case of an aneurysm involving the lower polar artery anastomosed to external iliac artery using a gonadal vein graft. The patient presented with sudden onset graft fossa swelling, pain, and decreased urine output. Color Doppler and computed tomography angiography helped in diagnosis and management. Since the majority of the graft was well‑perfused by the upper polar artery, the patient underwent excision of the lower polar artery aneurysm. The prompt diagnosis and management salvaged the graft. This aneurysm presented after 10 years of the underlying importance of long‑term surveillance. [ABSTRACT FROM AUTHOR]