The Experts below are selected from a list of 1617 Experts worldwide ranked by ideXlab platform
Bruce L Mcclennan - One of the best experts on this subject based on the ideXlab platform.
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optimal therapy for the distal ureteral stone extracorporeal shock wave lithotripsy versus ureteroscopy
The Journal of Urology, 1994Co-Authors: Kevin R Anderson, David W Keetch, David M Albala, Paramjit S Chandhoke, Bruce L McclennanAbstract:AbstractExtracorporeal shock wave lithotripsy (ESWL‡‡Dornier Medical Systems, Inc., Marietta, Georgia.) is the optimal therapy for renal calculi less than 2cm. in diameter and for proximal ureteral calculi. Controversy continues over the initial approach to distal ureteral calculi (that is below the bony pelvis): in situ ESWL versus ureteroscopy. Since February 1990, 76 distal ureteral calculi were treated at our institution using either in situ ESWL (Dornier HM3 ESWL with a Stryker frame modification in 27 patients or Siemen’s Lithostar electromagnetic ESWL in 22) or ureteroscopy (27 patients). Patient age and stone size were similar among the groups. All ESWL treatments were performed with the patient under intravenous sedation and on an outpatient basis. Stone-free rates were 96% for the HM3 device, 84% for the Lithostar and 100% for ureteroscopy. Retreatment was required in 3 Lithostar cases (14%) and 1 HM3 case (4%). When compared to ESWL ureteroscopy for distal ureteral stones was more time-consumin...
Margaret S Pearle - One of the best experts on this subject based on the ideXlab platform.
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virtual ureteroscopy predicts ureteroscopic proficiency of medical students on a cadaver
The Journal of Urology, 2004Co-Authors: Kenneth Ogan, Lucas Jacomides, Michael J Shulman, Claus G Roehrborn, Jeffrey A Cadeddu, Margaret S PearleAbstract:ABSTRACTPurpose:: Training on a virtual reality (VR) simulator has been shown to improve the performance of VR endoscopic tasks by novice endoscopists. However, to our knowledge the translation of VR skills into clinical endoscopic proficiency has not been demonstrated. We established criterion validity for a VR ureteroscopy simulator by evaluating VR trained subjects in a cadaver model.Materials and Methods:: A total of 32 participants, including 16 medical students and 16 urology residents, were evaluated at baseline on a VR ureteroscopy simulator (Uromentor, Simbionix, Lod, Israel), performing simple diagnostic ureteroscopy. The students then underwent 5 hours of supervised training on the simulator. Two weeks later all participants were reevaluated (VR2) on the simulator when repeating the initial task. Each participant was then assessed on the performance of a similar diagnostic ureteroscopy in a male cadaver.Results:: In medical students VR2 and cadaver performances correlated closely for several me...
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management of ureteral calculi a cost comparison and decision making analysis
The Journal of Urology, 2002Co-Authors: Yair Lotan, Claus G Roehrborn, Jeffrey A Cadeddu, Matthew T Gettman, Margaret S PearleAbstract:Purpose: We compared the cost of treatment strategies for ureteral calculi using a decision tree model.Materials and Methods: A comprehensive literature review was performed to determine the average success rate of each of 3 treatment modalities, namely observation, ureteroscopy and shock wave lithotripsy. Using these success rates decision analysis models were constructed using Data 3.5 software (TreeAge Software, Inc., Williamstown, Massachusetts) to estimate the cost of treatment and followup for each of the 3 treatments. One-way sensitivity analysis was performed to evaluate the effect of varying individual probabilities of success and costs, and 2-way sensitivity analysis was done to evaluate the model for a wide range of potential costs and success rates of ureteroscopy and shock wave lithotripsy. In addition, a table was constructed to enable individual surgeons and institutions to determine the cost impact of ureteroscopy and shock wave lithotripsy in their unique clinical scenarios.Results: Obser...
Kevin R Anderson - One of the best experts on this subject based on the ideXlab platform.
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optimal therapy for the distal ureteral stone extracorporeal shock wave lithotripsy versus ureteroscopy
The Journal of Urology, 1994Co-Authors: Kevin R Anderson, David W Keetch, David M Albala, Paramjit S Chandhoke, Bruce L McclennanAbstract:AbstractExtracorporeal shock wave lithotripsy (ESWL‡‡Dornier Medical Systems, Inc., Marietta, Georgia.) is the optimal therapy for renal calculi less than 2cm. in diameter and for proximal ureteral calculi. Controversy continues over the initial approach to distal ureteral calculi (that is below the bony pelvis): in situ ESWL versus ureteroscopy. Since February 1990, 76 distal ureteral calculi were treated at our institution using either in situ ESWL (Dornier HM3 ESWL with a Stryker frame modification in 27 patients or Siemen’s Lithostar electromagnetic ESWL in 22) or ureteroscopy (27 patients). Patient age and stone size were similar among the groups. All ESWL treatments were performed with the patient under intravenous sedation and on an outpatient basis. Stone-free rates were 96% for the HM3 device, 84% for the Lithostar and 100% for ureteroscopy. Retreatment was required in 3 Lithostar cases (14%) and 1 HM3 case (4%). When compared to ESWL ureteroscopy for distal ureteral stones was more time-consumin...
Mantu Gupta - One of the best experts on this subject based on the ideXlab platform.
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treatment of proximal ureteral calculi holmium yag laser ureterolithotripsy versus extracorporeal shock wave lithotripsy
The Journal of Urology, 2002Co-Authors: John S Lam, Tricia D Greene, Mantu GuptaAbstract:Purpose: We compared the safety and efficacy of ureteroscopy with intracorporeal holmium:YAG laser lithotripsy and extracorporeal shock wave lithotripsy (ESWL) (Dornier Medical Systems, Inc., Marietta, Georgia) for proximal ureteral calculi.Materials and Methods: A total of 67 patients underwent 81 primary procedures, including in situ ESWL with a DoLi 50 lithotriptor (Dornier Medical Systems, Inc.) or ureteroscopy combined with holmium:YAG laser lithotripsy for proximal ureteral calculi.Results: Of the primary procedures 81 involved proximal ureteral calculi, including 35 done for calculi 1 cm. or greater. The initial stone-free rate in patients with calculi 1 cm. or greater was 93% for ureteroscopy combined with holmium:YAG laser lithotripsy and 50% for in situ ESWL. The efficiency quotient for treating proximal ureteral calculi 1 cm. or greater was calculated as 0.76 for ureteroscopic lithotripsy and 0.43 for ESWL. For proximal ureteral calculi less than 1 cm. the initial stone-free rate was 100% and 8...
Norman H Noe - One of the best experts on this subject based on the ideXlab platform.
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Urethroscopy in small neonates with posterior urethral valves and ureteroscopy in children with ureteral calculi
Urology, 1996Co-Authors: Preston D Smith, Gerald R Jerkins, Norman H NoeAbstract:Abstract Objectives To describe our recent experience using a 6.9F cytoscope in the fulguration of posterior urethral valves (PUVs) in premature neonates and distal ureteroscopy with stone extraction in children. Methods Fulguration of PUVs was performed in S premature neonates born at 34 to 36 weeks' gestation with weights of 2480 to 2900 g. The PUVs were fulgurated during a single endoscopic procedure using a 6.9F cystoscope and a 3F bugbie electrode. In addition, 11 children (8 girls, 3 boys; mean age, 11.1 years; range 5 to 16) with symptomatic calculi underwent 15 distal ureteroscopic procedures using the 6.9F cystoscope. Results In the neonates with fulguration of PUVs, vesicostomy, the only reasonable alternative, was avoided, and each infant now voids with an excellent stream 3 to 16 months later, without evidence of stricture or residual valves. In the children with distal ureteroscopy, the ureteral calculi were retrieved using a 3F fourwire stone basket. With one exception, distal ureteroscopy was performed without dilation of the ureteral orifice. Extracorporeal shock-wave lithotripsy (ESWL) was not recommended because of stone position and difficult radiographic visualization. Nine children were rendered stone free with one procedure. Two procedures were required in 1 child and three in another. In both cases, ureteral edema was present, and the stone was embedded in the ureteral wall. One child underwent separate procedures for bilateral calculi. In all cases general anesthesia was used, with a mean duration of 63 minutes (range 28 to 96). Temporary ureteral stenting was performed in 10 (93%) patients, and 9 (81 %) were discharged home on the same day or the next morning. A mean follow-up period of 8.5 months (range, 0.5 to 22) has failed to show any problems related to ureteral stricture or injury. Conclusions Endoscopic fulguration of PUVs is now possible in small neonates and is minimally invasive compared with vesicostomy. Distal ureteroscopy with stone retrieval should be considered in children, especially those with calculi that are not suitable for ESWL.
