Cell Lines These are cells subcultured from primary cells but now have been manipulated in the la... more Cell Lines These are cells subcultured from primary cells but now have been manipulated in the laboratory so that they last longer and can go through more cell passages with growth friction of 80% or more, than the original primary cells before they change their morphology. On ...
Journal of Endourology Endourological Society, Jan 29, 2009
The standard management for pelviureteral junction (PUJ) obstruction is a laparoscopic dismembere... more The standard management for pelviureteral junction (PUJ) obstruction is a laparoscopic dismembered pyeloplasty. We present the initial results of our experience of laparoscopic cranial transposition of lower-pole crossing vessels in the management of adult PUJ obstruction where crossing vessels were identified. All patients during the last 2 years who presented with PUJ obstruction caused by crossing lower-pole vessels underwent a laparoscopic transposition of the artery to a more cranial position and, in fact, plicated within the renal pelvis well above the PUJ to reduce the size of the baggy renal pelvis. Patients were followed up postoperatively with mercaptoacetyl triglycine renography as well as clinical symptom review at 3 months, 6 months, and then yearly. Seven patients have undergone this procedure so far. The mean follow-up period at present is 14 months (range 8-22 months). All patients had a nonobstructive renogram curve at 3 months and 6 months. One patient has had renography at 22 months, which still shows a nonobstructive drainage pattern. All patients have had a resolution of their pain and urinary tract infections. The mean operative time, including the retrograde study and Double-J stent insertion was 121 minutes (range 110-131 min) with a mean blood loss of 30 mL. The mean hospital stay was 2 days. There were no complications. Although currently the number of patients is small and follow-up is short, this procedure appears to be effective in relieving both symptoms and obstruction in patients with lower-pole crossing vessels. Other benefits include shorter operative time, less blood loss, as well as no risk of anastomotic stricture and urine leak when compared with a dismembered pyeloplasty. The Double-J stent can be removed within a few days (typically 5 in our hands) or even shorter where logistically feasible. This reduces stent-related complications.
Background: One of the keys to performing successful laparoscopic surgery is good retraction and ... more Background: One of the keys to performing successful laparoscopic surgery is good retraction and exposure of the operating field without too many instruments in a limited working space ‘getting in each others way’. Methods: We describe a very useful technique for retracting the ureter using a temporary suture inserted through the abdominal wall to aid dissection and mobilization of the
Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal condui... more Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal conduit formation, with a reported incidence of 3-9%. The standard management technique is open surgical revision of the anastomosis with reimplantation of the affected ureter. This is technically challenging and has potential significant morbidity for the patient. Advances in endourological techniques now offer a variety of less-invasive treatment options, like balloon dilatation or laser ureterotomy followed by stent insertion. What happens when such open and minimally invasive techniques fail? Recently, using a combined antegrade and retrograde approach, we inserted a novel, semi-permanent, dual-expansion thermo-expandable metallic alloy stent across a recurrent ileal-ureteric stricture. We describe the technique and potential advantages of this minimally invasive method. This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.
Tumors metastasizing to the glans penis are uncommon and a rare occurrence. The majority of the p... more Tumors metastasizing to the glans penis are uncommon and a rare occurrence. The majority of the primary tumors are located in the pelvis and they arise from the genitourinary tract and rectum (>75%). We report a 61-year-old man with known metastatic (lymph nodes and maxilla) esophageal cancer who was treated with chemotherapy and referred to urology with phimosis for circumcision.
ABSTRACT We present a case of a 63-year-old gentleman with intermittent macroscopic hematuria, in... more ABSTRACT We present a case of a 63-year-old gentleman with intermittent macroscopic hematuria, in whom the only abnormality was an isolated large tortuous varicosity on the posterior wall of the bladder. Vesical varices are very rare and are only reported to be associated with pregnancy, portal hypertension, retroperitoneal fibrosis, schistosomiasis and iliac vein thrombosis. This patient did not have any of these underlying pathologies. We present an up to date review of the current literature and discuss treatment options on this rare but important cause of hematuria.
The use of percutaneous renal surgery has been recently revolutionised with novel endourological ... more The use of percutaneous renal surgery has been recently revolutionised with novel endourological instruments and techniques. However, the incidence, prevention and management of severe complications such as colon perforation still lack consensus. By presenting our 10-year experience, we would like to highlight the diagnosis and management of the rare complication of colon perforation.
Perineal radical prostatectomy (PRP) is one of the oldest surgical procedures for prostate cancer... more Perineal radical prostatectomy (PRP) is one of the oldest surgical procedures for prostate cancer, but its use has declined over the past 30 years. New studies show that PRP is not only minimally invasive but beneficial from an economic perspective and should not yet be abandoned in the treatment of early prostate cancer.
Cell Lines These are cells subcultured from primary cells but now have been manipulated in the la... more Cell Lines These are cells subcultured from primary cells but now have been manipulated in the laboratory so that they last longer and can go through more cell passages with growth friction of 80% or more, than the original primary cells before they change their morphology. On ...
Journal of Endourology Endourological Society, Jan 29, 2009
The standard management for pelviureteral junction (PUJ) obstruction is a laparoscopic dismembere... more The standard management for pelviureteral junction (PUJ) obstruction is a laparoscopic dismembered pyeloplasty. We present the initial results of our experience of laparoscopic cranial transposition of lower-pole crossing vessels in the management of adult PUJ obstruction where crossing vessels were identified. All patients during the last 2 years who presented with PUJ obstruction caused by crossing lower-pole vessels underwent a laparoscopic transposition of the artery to a more cranial position and, in fact, plicated within the renal pelvis well above the PUJ to reduce the size of the baggy renal pelvis. Patients were followed up postoperatively with mercaptoacetyl triglycine renography as well as clinical symptom review at 3 months, 6 months, and then yearly. Seven patients have undergone this procedure so far. The mean follow-up period at present is 14 months (range 8-22 months). All patients had a nonobstructive renogram curve at 3 months and 6 months. One patient has had renography at 22 months, which still shows a nonobstructive drainage pattern. All patients have had a resolution of their pain and urinary tract infections. The mean operative time, including the retrograde study and Double-J stent insertion was 121 minutes (range 110-131 min) with a mean blood loss of 30 mL. The mean hospital stay was 2 days. There were no complications. Although currently the number of patients is small and follow-up is short, this procedure appears to be effective in relieving both symptoms and obstruction in patients with lower-pole crossing vessels. Other benefits include shorter operative time, less blood loss, as well as no risk of anastomotic stricture and urine leak when compared with a dismembered pyeloplasty. The Double-J stent can be removed within a few days (typically 5 in our hands) or even shorter where logistically feasible. This reduces stent-related complications.
Background: One of the keys to performing successful laparoscopic surgery is good retraction and ... more Background: One of the keys to performing successful laparoscopic surgery is good retraction and exposure of the operating field without too many instruments in a limited working space ‘getting in each others way’. Methods: We describe a very useful technique for retracting the ureter using a temporary suture inserted through the abdominal wall to aid dissection and mobilization of the
Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal condui... more Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal conduit formation, with a reported incidence of 3-9%. The standard management technique is open surgical revision of the anastomosis with reimplantation of the affected ureter. This is technically challenging and has potential significant morbidity for the patient. Advances in endourological techniques now offer a variety of less-invasive treatment options, like balloon dilatation or laser ureterotomy followed by stent insertion. What happens when such open and minimally invasive techniques fail? Recently, using a combined antegrade and retrograde approach, we inserted a novel, semi-permanent, dual-expansion thermo-expandable metallic alloy stent across a recurrent ileal-ureteric stricture. We describe the technique and potential advantages of this minimally invasive method. This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.
Tumors metastasizing to the glans penis are uncommon and a rare occurrence. The majority of the p... more Tumors metastasizing to the glans penis are uncommon and a rare occurrence. The majority of the primary tumors are located in the pelvis and they arise from the genitourinary tract and rectum (>75%). We report a 61-year-old man with known metastatic (lymph nodes and maxilla) esophageal cancer who was treated with chemotherapy and referred to urology with phimosis for circumcision.
ABSTRACT We present a case of a 63-year-old gentleman with intermittent macroscopic hematuria, in... more ABSTRACT We present a case of a 63-year-old gentleman with intermittent macroscopic hematuria, in whom the only abnormality was an isolated large tortuous varicosity on the posterior wall of the bladder. Vesical varices are very rare and are only reported to be associated with pregnancy, portal hypertension, retroperitoneal fibrosis, schistosomiasis and iliac vein thrombosis. This patient did not have any of these underlying pathologies. We present an up to date review of the current literature and discuss treatment options on this rare but important cause of hematuria.
The use of percutaneous renal surgery has been recently revolutionised with novel endourological ... more The use of percutaneous renal surgery has been recently revolutionised with novel endourological instruments and techniques. However, the incidence, prevention and management of severe complications such as colon perforation still lack consensus. By presenting our 10-year experience, we would like to highlight the diagnosis and management of the rare complication of colon perforation.
Perineal radical prostatectomy (PRP) is one of the oldest surgical procedures for prostate cancer... more Perineal radical prostatectomy (PRP) is one of the oldest surgical procedures for prostate cancer, but its use has declined over the past 30 years. New studies show that PRP is not only minimally invasive but beneficial from an economic perspective and should not yet be abandoned in the treatment of early prostate cancer.
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