Medicine and Health Sciences Commons^™

Selection Of Best Videos Of The Year For 2016, Philippe E. Spiess

Urology Faculty Publications

No abstract provided.

Editorial Comment: Laparoscopic Single Port Cystolithotomy Using Pneumovesicum, Trushar Patel

Urology Faculty Publications

No abstract provided.

Retroperitoneoscopic Pyelolithotomy: A Good Alternative Treatment For Renal Pelvic Calculi In Children, Lucas Wiegand

Urology Faculty Publications

No abstract provided.

A Rare Case Of The Simultaneous, Multifocal, Metastatic Renal Cell Carcinoma To The Ipsilateral Left Testes, Bladder, And Stomach, Michael Kongnyuy, Samuel Lawindy, Daniel Martinez, Mary Hall

Urology Faculty Publications

We describe the rare case of a 68-year-old gentleman with the history of a hand-assisted laparoscopic left radical nephrectomy for a T2bN0M1 clear cell renal cell carcinoma (RCC). Seven years after surgery and with clean surveillance imaging for metastasis/recurrence the patient presented with three separate tumors suspicious for malignancy. A bladder lesion was found during workup for hematuria, a stomach lesion during diagnostic endoscopy, and a testicular lesion during self-exam. He underwent transurethral resection of bladder tumor, left inguinal orchiectomy, and upper endoscopic ensnarement. All specimens surprisingly showed RCC by histology and immunostaining. These three sites are rare for RCC …

Randomized, Placebo-Controlled Trial Evaluating The Safety Of One-Year Administration Of Green Tea Catechins, Nagi B. Kumar, Julio Pow-Sang, Philippe E. Spiess, Jong Park, Raoul Salup, Christopher R. Williams, Howard Parnes, Michael J. Schell

Urology Faculty Publications

Purpose: Although preclinical, epidemiological and prior clinical trial data suggest that green tea catechins (GTCs) may reduce prostate cancer (PCa) risk, several preclinical studies and case reports have reported liver toxicities and acute gastrointestinal bleeding. Based on these observations, regulatory bodies have required stringent inclusion criteria with frequent, excessive toxicity monitoring and early stopping rules in clinical trials. These requirements have impeded recruitment and retention of subjects in chemoprevention trials and subsequent progress in agent development efforts.

Experimental Design: We conducted a placebo-controlled, randomized clinical trial of Polyphenon E® (PolyE®), a proprietary mixture of decaffeinated GTCs, containing 400 mg (−)-epigallocatechin-3-gallate …

Effect Of Utilization Of Veno-Venous Bypass Vs. Cardiopulmonary Bypass On Complications For High Level Inferior Vena Cava Tumor Thrombectomy And Concomitant Radical Nephrectomy, Ross M. Simon, Timothy Kim, Patrick Espiritu, Tony Kurian, Wade J. Sexton, Julio M. Pow-Sang, Einar Sverrisson, Philippe E. Spiess

Urology Faculty Publications

Purpose: To determine if patients with renal cell carcinoma (RCC) with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB) over cardiopulmonary bypass (CPB) for high level (III/IV) inferior vena cava (IVC) tumor thrombectomy and concomitant radical nephrectomy.

Materials and Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16) or VVB (n=5). We retrospectively reviewed our study population for complication rates and perioperative characteristics.

Results: Our results are reported using the validated …

Partial Priapism Treated With Pentoxifylline, Meghan A. Cooper, Rafael E. Carrion, Christopher Yang

Urology Faculty Publications

Main findings: A 26-year-old man suffering from partial priapism was successfully treated with a regimen including pentoxifylline, a nonspecific phosphodiesterase inhibitor that is often used to conservatively treat Peyronie's disease.

Case hypothesis: Partial priapism is an extremely rare urological condition that is characterized by thrombosis within the proximal segment of a single corpus cavernosum. There have only been 36 reported cases to date. Although several factors have been associated with this unusual disorder, such as trauma or bicycle riding, the etiology is still not completely understood. Treatment is usually conservative and consists of a non-steroidal anti-inflammatory and anti-thrombotic.

Promising future …

Reduction Corporoplasty, Tariq S. Hakky, Daniel Martinez, Christopher Yang, Rafael E. Carrion

Urology Faculty Publications

Objective: Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism.

Introduction: Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement.

Results: The patient tolerated the procedure well and has resolution of his corporal disfigurement.

Conclusions: Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation …

A Novel Approach For The Treatment Of Radiation-Induced Hemorrhagic Cystitis With The Greenlight™ Xps Laser, Daniel Roberto Martinez, Cesar E. Ercole, Juan Gabriel Lopez, Justin Parker, Mary K. Hall

Urology Faculty Publications

Introduction: The treatment of pelvic malignancies with radiotherapy can develop severe sequelae, especially radiation-induced hemorrhagic cystitis. It is a progressive disease that can lead to the need for blood transfusion, hospitalizations, and surgical interventions. This tends to affect the quality of life of these patients, and management can at times be difficult. We have evaluated the GreenLight Xcelerated Performance System (XPS) with TruCoag, although primarily used for management of benign prostatic hypertrophy (BPH), for the treatment of radiation-induced hemorrhagic cystitis.

Materials and Methods: After International Review Board (IRB) approval, a retrospective chart review was performed in addition to a literature …

Distal Spermatic Cord Peritoneal Stripping: An Adjunct Technique During Inguinal Orchiopexy, Hubert S. Swana, Rikin Patel, Mark A. Rich

Urology Faculty Publications

No abstract provided.

Bilateral Ureteral-Iliac Artery Fistula In A Patient With Chronic Indwelling Ureteral Stents: A Case Report And Review, Arash Rafiei, Timothy A. Weber, Michael Kongnyuy, Raul Ordorica

Urology Faculty Publications

Ureteral-arterial fistula (UAF) is an exceedingly rare but life-threatening condition warranting emergent intervention. Prompt recognition and management of UAF in suspect patients presenting with gross hematuria are required for a successful outcome. We report a rare subset of UAF involving the bilateral common iliac arteries. The patient underwent successful endovascular stent-grafting to correct the arterial defect and delayed open repair of the ureteral strictures. Timely management has benefited from the collaboration of the involved medical teams, which included emergency medicine, urology, and interventional radiology.

A Rare Case Of A Renal Cell Carcinoma Confined To The Isthmus Of A Horseshoe Kidney, Michael Kongnyuy, Daniel Martinez, Anthony Park, Barrett Mccormick, Justin Parker, Mary Hall

Urology Faculty Publications

Horseshoe kidney (HSK) is the most common renal anomaly. Reports of the incidence of renal cell carcinoma (RCC) in HSK are conflicting. Very few cases of isthmus-located RCC have been reported in the literature. We report a unique case of an isthmus-located RCC. Proper vascular and tumor imaging prior to surgery is key to successful tumor removal.

A Single-Institution Experience With Metallic Ureteral Stents: A Cost-Effective Method Of Managing Deficiencies In Ureteral Drainage, Adam S. Baumgarten, Tariq S. Hakky, Rafael E. Carrion, Jorge L. Lockhart, Philippe E. Spiess

Urology Faculty Publications

Introduction: The limitations of traditional ureteral stents in patients with deficiencies in ureteral drainage have resulted in frequent stent exchanges. The implementation of metallic stents was introduced to improve the patency rates of patients with chronic upper urinary tract obstruction, obviating the need for frequent stent exchanges. We report our clinical experiences with the use of metallic ureteral stents in the management of poor ureteral drainage.

Materials and Methods: Fifty patients underwent metallic ureteral stent placement from 2009 to 2012. Stent failure was defined as an unplanned stent exchange, need for nephrostomy tube placement, increasing hydronephrosis with stent in place, …

Surgical Management Of A Locally Advanced Symptomatic Recurrence Of Penile Sarcoma Secondary To Prostate Brachytherapy, Tariq S. Hakky, Patrick Espiritu, Alejandro R. Rodriguez, Nicholas Gould, Philippe E. Spiess

Urology Faculty Publications

Background: The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy.

Materials and Methods: A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the …

Laparo-Endoscopic Single Site Retroperitoneal Partial Nephrectomy: A Novel Concept, Alejandro R. Rodriguez, Tariq Hakky, Philippe E. Spiess

Urology Faculty Publications

Purpose: Various treatment options are available for small incidentally detected kidney masses, including surveillance, partial nephrectomy and probe ablative therapies. When partial nephrectomy is considered, the procedure can be safely approached laparoscopically, either pure or robot assisted, in experienced hands. Laparo-endoscopic single site (LESS) surgery is a novel approach for partial nephrectomies in well selected cases. In this video, we present our experience with the LESS retroperitoneal partial nephrectomy using the Gelpoint device.

Material and Methods: A 63 year old male patient with a BMI of 31, and a history of a T1c prostate cancer, had a 1.5 cm right …

Radical Nephrectomy With Ivc Thrombectomy (Level-Iii) Conducted On Veno-Veno Bypass, Tariq S. Hakky, Lucas R. Wiegand, Devannand Mangar, Angel Alsina, Philippe E. Spiess

Urology Faculty Publications

Introduction: We report a 43 year old man who was diagnosed with a level-I thrombus and was managed on oral sunitinib for two months by a community Urologist. The thrombus progressed to a level-III and he subsequently developed a pulmonary embolus, which required oral anticoagulation. He was then referred to our facility for definitive surgical care. A computed tomography scan demonstrated a 12 by 15 centimeter right renal mass and on magnetic resonance venography of the abdomen a tumor-thrombus extending into the infradiaphragmatic inferior vena cava was noted. Pre-operatively consults with hepatobiliary, vascular, and chest surgeons were obtained.

Methods: The …