Interventional Management of Urological Diseases (eBook)

Preface 5
Contents 6
Contributors 8
Access Techniques for Percutaneous Renal Surgery 9
Introduction 9
Indications 10
Preoperative Evaluation 13
Access Techniques 14
Standard Lower Pole 14
Calyceal Diverticulum/Obstructed Calyx 17
Supracostal or Upper Pole 20
Nondilated Puncture 22
Postoperative Considerations Nephrostomy Tube Selection 23
Pain Control 24
Complications 24
Conclusion 25
References 26
Percutaneous Access for Urological Disease 32
Introduction 33
Anatomy for Percutaneous Surgery 33
Renal Vascular Anatomy 33
Percutaneous Nephrolithotomy 34
Technique 34
Complications 36
Effects on Renal Function 38
Percutaneous Endopyelotomy 39
Calyceal Diverticulum 40
Infundibular Stenosis 42
References 43
Minimally Invasive Percutaneous Nephrolithotomy ( MPCNL) According to the Chinese Method 47
Introduction 47
History of Minimally Invasive Percutaneous Nephrolithotomy ( MPCNL) 48
Chinese MPCNL 48
Surgical Technique of MPCNL According to the Chinese Method 51
Local Experience in Hong Kong 53
Equipment for MPCNL 55
The Working Sheath 57
The Endoscope 59
Options of Lithotripsy Devices in MPCNL 59
Unique Features of Chinese MPCNL The Use of Pressurized Pulsatile Irrigation Through the Endoscope and the Use of Irrigant Flushing for Stone Fragment Removal 61
Access Site and the Preference for Middle Calyceal Puncture 62
Summary of Advantages of the Chinese Method of MPCNL 64
Is MPCNL a Less Invasive Procedure than PCNL? Clinical Outcome, Bleeding, and Complication Rate 64
Issue of Renal Function Preservation 65
Conclusions 66
References 67
Cryoablation for Renal Cell Carcinoma 70
Introduction 70
Cryoablation Technology and Cryobiology 71
Clinical Cryoablation Series 73
Laparoscopic Renal Cryoablation 73
Percutaneous Cryoablation 76
Conclusion 76
References 78
Ureteral Stent for Ureteral Stricture 80
Introduction 81
Treatment of Ureteral Stricture 83
Stent History and Etymology 84
Stent Biomaterials 84
Stent Flow 85
Metal Stents 85
Stent Types: Indwelling and External 87
Stent Duration 88
Conclusion 89
References 89
Endoscopic Treatment of Vesicoureteral Reflux 93
Introduction 94
Injection Technique 94
Materials Polytetrafluoroethylene (Teflon Dupont, Wilmington, Delaware)
Bovine Collagen (Zyplast, Contigen Collagen Corporation, Palo Alto, CA, USA)
Polydimethysiloxane (Macroplastique Uroplasty Ltd, Reading, UK)
Chondrocytes 97
Calcium Hydroxylapatite (Coaptite BioForm Medical, San Mateo, CA, USA)
Dextranomer/Hyaluronic Acid Copolymer (Deflux Q-Med, Uppsala, Sweden)
Our 20-Year Experience: Patients and Methods 97
Results 98
Discussion 100
Materials 100
Instruments 100
Technique 101
Failure 101
Indications to ET 101
Cost-Effectiveness Considerations 102
Conclusions 102
References 103
Photoselective KTP Laser Vaporization of Obstructive BPH ( PVP) 106
Introduction 107
Scientific Basis of Laser Prostatectomy 108
Experimental Foundation of PVP 111
Clinical Development of PVP 112
Surgical Principles of PVP 113
Major New Studies of Outcomes and Durability of PVP 115
PVP Versus TURP 117
PVP Applications Under Adverse Clinical Circumstances 119
PVP and Carcinoma of the Prostate 121
Cost of PVP 122
References 122
Holmium Laser Prostatectomy Versus Transurethral Resection of the Prostate 126
Introduction 126
History and Evolving Technique of Holmium Laser Prostatectomy Combined Endoscopic Laser Prostatectomy ( CELAP) 127
Holmium Laser Ablation of Prostate (HoLAP) 127
Holmium Laser Resection of the Prostate (HoLRP) 128
Holmium Laser Enucleation of the Prostate (HoLEP) 128
Holmium Bladder Neck Incision (HoBNI) 129
Equipment for HoLEP 129
Procedure 130
Clinical Outcome Comparison Between Holmium Laser Prostatectomy and TURP 131
Efficacy Outcomes 131
Safety/Adverse Effects 133
Other Adverse Effects 134
Other Outcomes of Holmium Laser Prostatectomy Versus TURP Cost Effectiveness 135
Day-Case Surgery 136
Histology 136
Learning Curve 136
Large Prostate Size and Comparison to Open Prostatectomy 137
Conclusions 137
References 138
Transurethral Microwave Thermotherapy for Benign Prostatic Obstruction 141
Introduction 141
Mechanism of Action 142
TUMT Devices 142
Efficacy of TUMT 143
TUMT Versus TURP 144
TUMT Versus Medical Therapy 147
TUMT in Patients in Urinary Retention 147
Durability 148
Outcome Predictors 150
Safety and Morbidity 150
Cost 152
Current Position of TUMT in the Urological Community 153
Conclusions 153
References 154
Transurethral Bipolar Electrosurgery in the Lower Urinary Tract 158
Introduction 159
Bipolar Electrosurgical Prostate Technology 160
Bipolar Electrosurgical Clinical Experience 171
Training and Morbidity 176
Transitional Cell Tumour Resection 177
Cost 177
Conclusion 178
References 178
Ethanol Injection Therapy of the Prostate for Benign Prostatic Hyperplasia 180
Ethanol Injection Therapy of the Prostate 180
Transurethral Ethanol Ablation of the Prostate 181
Collection of Relevant Publications 181
Histopathological Changes of the Prostate after TEAP 182
Anesthesia 183
Safety of the Injection Procedure 183
Efficacy of TEAP 185
Cost-Effectiveness 187
Conclusions 188
References 188
Urethral Stents: Review of Technology and Clinical Applications 191
Introduction 191
Indications and Contraindications for Urethral Stent Placement 192
Stents for the Treatment of Obstructing Prostate Tissue: Benign Prostatic Hyperplasia ( BPH) and Prostate Cancer 193
Urethral Stricture 193
Detrusor Sphincter Dyssynergia (DSD) 194
Types of Urethral Stents 194
Temporary Stents 194
Memokath 197
Permanent Stents 198
Clinical Results with Urethral Stents Stents for the Treatment of Benign Prostatic Hyperplasia ( BPH) 200
Urethral Stricture 200
Detrusor Sphincter Dyssynergia (DSD) 202
Complications 203
Conclusions 203
References 203
Index 207