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British Medical Journal (Clinical... Dec 1981A new method of removing calculi from the renal collecting system, in which the large and traumatic incision in the loin currently used is unnecessary, was attempted in...
A new method of removing calculi from the renal collecting system, in which the large and traumatic incision in the loin currently used is unnecessary, was attempted in 31 patients. Small dilators were introduced over a guide wire through a nephrostomy tube into the renal pelvis and a catheter inserted. The track was dilated in stages and two days later the nephrostomy tube was removed and a cystoscope introduced into the interior of the kidney. A stone basket was introduced down the operating channel of the cystoscope and maneuvered to secure the stone; the cystoscope, stone basket, and stone were then removed. The procedure failed in 11 of the 31 patients, in five because the needle could not be placed accurately initially and in six because the stone could not be removed despite the establishment of a nephrostomy track. In the remaining 20 patients the procedure was successful. This procedure is far less traumatic than the conventional operation. With the development of a flexible nephroscope and an ultrasonic stone disintegrator it will be possible also to remove larger stones and stones in the peripheral calices using this method.
Topics: Cystoscopy; Humans; Kidney Calculi; Kidney Pelvis; Kidney Tubules; Kidney Tubules, Collecting; Methods
PubMed: 6796170
DOI: 10.1136/bmj.283.6306.1571 -
Hong Kong Medical Journal = Xianggang... Dec 2023
PubMed: 38130158
DOI: 10.12809/hkmj-hkmms202312 -
JSLS : Journal of the Society of... 2011Upper tract invasive urothelial carcinoma and horseshoe kidneys are familiar to the practicing urologist but relatively rare individual entities. The complication of...
Hand-assisted laparoscopic nephroureterectomy with cystoscopic en-bloc excision of the distal ureter and bladder cuff and isthmusectomy in a horseshoe kidney for invasive urothelial carcinoma of the renal pelvis.
Upper tract invasive urothelial carcinoma and horseshoe kidneys are familiar to the practicing urologist but relatively rare individual entities. The complication of managing them when they coexist in the same patient can be challenging. Herein, we present the first reported case in which an upper tract invasive urothelial carcinoma in a horseshoe kidney was successfully managed with a combined hand-assisted laparoscopic nephroureterectomy and isthmusectomy with cystoscopic en-bloc excision of the distal ureter and bladder cuff. This highlights the fact that complex anatomy can be managed in a completely minimally invasive fashion, and sound oncologic principles can still be maintained.
Topics: Cystoscopy; Hand-Assisted Laparoscopy; Humans; Kidney; Kidney Neoplasms; Kidney Pelvis; Male; Middle Aged; Neoplasm Invasiveness; Tomography, X-Ray Computed; Urothelium
PubMed: 21985737
DOI: 10.4293/108680811X13125733357197 -
MedEdPORTAL : the Journal of Teaching... 2022OB/GYN residents' preparedness to perform cystoscopy after residency may vary as the ACGME requires only 10 cystoscopic cases to be performed during training. Given...
INTRODUCTION
OB/GYN residents' preparedness to perform cystoscopy after residency may vary as the ACGME requires only 10 cystoscopic cases to be performed during training. Given residents' potentially limited exposure to cystoscopy, supplemental educational activities centered around increasing familiarity with the procedure may be useful. The objective of this workshop was to provide an opportunity for OB/GYN residents to become more comfortable with cystoscopic equipment and performing cystoscopy.
METHODS
We showed a video of common pathology seen on cystoscopy and then progressed through two hands-on stations. One station focused on equipment familiarity, with learners identifying equipment and then practicing assembling and disassembling the cystoscope. The other station allowed for simulated cystoscopy utilizing a pig bladder. We used a checklist assessment and pre- and postcourse surveys to evaluate familiarity with equipment and anxiety surrounding performing cystoscopy.
RESULTS
Twenty residents ranging from PGY 1s to PGY 4s who participated in this workshop over the past 2 years completed both pre- and postcourse evaluations. There was statistically significant improvement in ratings of familiarity with equipment and anxiety surrounding the procedure. All participants whom we assessed showed improvement in identifying and assembling equipment as well as in performing the steps of the procedure independently.
DISCUSSION
This workshop provided OB/GYN residents with an opportunity for hands-on cystoscopic experience. Through direct assessment and evaluation forms, the workshop was shown to be a beneficial activity for improving cystoscopic knowledge.
Topics: Animals; Cystoscopy; Gynecology; Humans; Internship and Residency; Obstetrics; Surveys and Questionnaires; Swine
PubMed: 35178470
DOI: 10.15766/mep_2374-8265.11220 -
BMJ Case Reports Jul 2017A 23-year-old woman presented to the emergency department after manually inserting foreign bodies into the urinary bladder through her urethra. A plain abdominal film of...
A 23-year-old woman presented to the emergency department after manually inserting foreign bodies into the urinary bladder through her urethra. A plain abdominal film of the kidneys, ureters and bladder confirmed three radio-opaque densities in the urinary bladder. She was taken to the operating room where cystourethroscopy was performed. At cystoscopy 2 'corn-on-the-cob' skewers and 1 battery were identified but were too large to be retrieved safely with a grasper through the protective sheath. The objects were grasped with a 'sponge-holding forceps' (placed alongside the cystoscope) and extracted one at a time. A psychiatric consultation was sought and the patient was diagnosed and treated for borderline personality disorder. Unusual genitourinary activity (UGUA) has been described for several centuries and is characterised by the deposition of foreign objects in the genitalia. The most common incentive for UGUA is sexual stimulation, but psychiatric disorders and intoxication are also associated. Management involves retrieval of foreign bodies and evaluation of psychosocial factors.
Topics: Adult; Borderline Personality Disorder; Cystoscopy; Female; Foreign Bodies; Genitalia, Female; Humans; Radiography, Abdominal; Urethra; Urinary Bladder; Young Adult
PubMed: 28739565
DOI: 10.1136/bcr-2017-220297 -
European Review For Medical and... Jun 2022Two main types of cystoscopes, reusable cystoscope (RC) and disposable cystoscope, (DC) are used for the removal of ureteric stents. This study aimed to prospectively... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Two main types of cystoscopes, reusable cystoscope (RC) and disposable cystoscope, (DC) are used for the removal of ureteric stents. This study aimed to prospectively compare the effectiveness of disposable and reusable cystoscopes for the removal of ureteric stents.
PATIENTS AND METHODS
Patients who recently underwent double-J stent insertion were recruited and randomly assigned to the disposable and reusable cystoscope groups. Data were collected prospectively, which included pain scores (10-point visual analog scale), operation time, complications, and a 5-point Likert scale satisfaction assessment for surgeons, nurses, and patients. A cost analysis was also performed. The association between categorical data was assessed using the Chi-square/Fisher's exact test. The t-test was used to assess the mean difference in surgery time.
RESULTS
Overall, 128 patients (mean age, 46.8 years) were included in the study; 64 procedures were completed using each cystoscope type. Stent removal satisfaction among surgeons and patients was equivalent in both groups, while nurses favored the disposable cystoscope. A significant reduction of 23% in the procedural time and 27% in the total operative time was observed in the disposable cystoscope group. Pain score was the same for both groups. Two patients in the reusable cystoscope group had UTI. No complications were reported in the disposable cystoscope group.
CONCLUSIONS
Both disposable and reusable cystoscopes are comparable in terms of pain score and surgeons' and patients' satisfaction. Disposable cystoscope is more cost effective than reusable cystoscope.
Topics: Cost-Benefit Analysis; Cystoscopes; Humans; Middle Aged; Pain; Prospective Studies; Stents
PubMed: 35776026
DOI: 10.26355/eurrev_202206_29064 -
Toxins Jan 2020Cystoscopic onabotulinumtoxinA (onaBoNTA) intradetrusor injection is an efficient and durable modality for treating sensory bladder disorders. However, the inconvenience... (Review)
Review
Cystoscopic onabotulinumtoxinA (onaBoNTA) intradetrusor injection is an efficient and durable modality for treating sensory bladder disorders. However, the inconvenience of using the cystoscopic technique and anesthesia, and the adverse effects of direct needle injection (e.g., haematuria, pain, and infections) have motivated researchers and clinicians to develop diverse injection-free procedures to improve accessibility and prevent adverse effects. However, determining suitable approaches to transfer onaBoNTA, a large molecular and hydrophilic protein, through the impermeable urothelium to reach therapeutic efficacy remains an unmet medical need. Researchers have provided potential solutions in three categories: To disrupt the barrier of the urothelium (e.g., protamine sulfate), to increase the permeability of the urothelium (e.g., electromotive drug delivery and low-energy shock wave), and to create a carrier for transportation (e.g., liposomes, thermosensitive hydrogel, and hyaluronan-phosphatidylethanolamine). Thus far, most of these novel administration techniques have not been well established in their long-term efficacy; therefore, additional clinical trials are warranted to validate the therapeutic efficacy and durability of these techniques. Finally, researchers may make progress with new combinations or biomaterials to change clinical practices in the future.
Topics: Animals; Botulinum Toxins, Type A; Drug Delivery Systems; Humans; Treatment Outcome; Urinary Bladder Diseases; Urothelium
PubMed: 31979383
DOI: 10.3390/toxins12020075 -
Journal of Indian Association of... 2021Incidence and recurrence of bladder stone in augmented exstrophy bladder rate is high. So, recurrent open cystolithotomy is not a preferred procedure; particularly...
AIMS
Incidence and recurrence of bladder stone in augmented exstrophy bladder rate is high. So, recurrent open cystolithotomy is not a preferred procedure; particularly through scarred tissues, consequence of previous surgeries. Percutaneous cystolithotomy (PCCL) is an old but standard procedure for retrieval of bladder stones in adults. We extrapolated PCCL for bladder stone in augmented bladders in children.
PATIENTS AND METHODS
In three patients, we made suprapubic (SP) needle track with initial puncture (IP) needle under cystoscopic guidance. Following that laparoscopic cannula was placed through dilated SP track that was crafted with Alken's dilators and bladder stones were removed with grasper.
RESULTS
On cystoscopy, we also observed the patches of skin tissues in native bladders. Continence and bladder capacity were not affected following PCCL.
CONCLUSION
PCCL in augmented bladder showed good outcome. High recurrence of bladder stone is possibly due to presence of keratin in dermal tissue; invaded mucosa in open bladder plate. It seems shaving or fulguration of those dermal elements during bladder reconstruction might decrease incidence of stone formation. However, we haven't attempted fulguration during PCCL.
PubMed: 34385769
DOI: 10.4103/jiaps.JIAPS_128_20