Retrograde intrarenal surgery (RIRS) is highly successful at eliminating renal stones of various sizes and compositions. As urologists are taking on more complex procedures using RIRS, this has led to an increase in operative (OR) times. Our objective was to determine the best predictor of OR time in patients undergoing RIRS. We retrospectively reviewed the records of patients undergoing unilateral RIRS for solitary stones over a 10 year time span. Stones were fragmented and actively extracted using a basket. Variables potentially affecting OR time such as patient age, sex, BMI, lower pole stone location, volume, Hounsfield units (HU), composition, ureteral access sheath (UAS) use, and pre-operative stenting were collected. Multivariable linear and stepwise regression was used to evaluate the predictors of OR time. There were 118 patients that met inclusion criteria. The median stone volume was 282.6 mm (IQR 150.7-644.7) and the mean OR time was 50 min (±25.9 SD). On univariate linear regression, stone volume had a moderate correlation with OR time (y = 0.022x + 38.2, r = 0.363, p< 0.01). On multivariable stepwise regression, stone volume had the strongest impact on OR time, increasing time by 2.0 min for each 100 mm increase in stone volume (p < 0.001). UAS added 13.5 (SE 3.9, p = 0.001) minutes and renal lower pole location added 9 min (SE 4.3, p = 0.03) in each case they were used. Pre-operative stenting, HU, calcium oxalate stone composition, sex, and age had no significant effect on OR time. Amongst the main stone factors in RIRS, stone volume has the strongest impact on operative time. This can be used to predict the length of the procedure by roughly adding 2 min per 100 mm increase in stone volume.
from an existing database. Patients were contacted via email, directed to an online survey, then contacted again via follow-up telephone call for purposes of answering questions or providing survey clarification. 51 patients (42 females, 9 males, mean age 58.1 ± 12.7 [range, 28-76] years) completed a 22-question standardized survey comprised of consensus recommended outcome instruments for patients who undergo an intervention in the setting of chronic pain. The results were correlated with baseline values and characteristics from the medical record. The electronic medical record was further scrutinized for evaluation of procedural technical success and/or procedure related complications, as defined by the SIR. Analyses of changes in baseline pain intensity and multiple variable correlation were performed. Patients were classified as "responders" or "non-responders" for purposes of data analysis and stratification based on the Patient Global Impression of Change (PGIC) Scale and a specific survey question asking whether participants would undergo the original procedure again, if given the chance.Results: The mean time to follow-up post procedure was 1.5 ± 0.9 years (range, 63 days-3.6 years). The mean duration of patient symptoms prior to cryoablation was 8.4 years ± 7 years (range, 60 days-32 years). The overall mean change in baseline pain intensity for the entire group per Visual Analog Scale was -2.5cm [-3.2,-1.7], and the mean change in baseline pain intensity for the responder group (63%) was -3.3cm [-4.1,-2.5], both of which were statistically significant (p<0.0001). There were no procedure related complications. The incidence of potentially unwanted symptoms following pudendal nerve destruction was 12% (sexual), 10% (urinary), and 1% (fecal). Conclusions: Percutaneous CT-guided cryoablation of the pudendal nerve is safe and efficacious but is associated with potentially unwanted sequelae that should influence patient selection.
Conclusion:The quantitaive measurement of fibrinogen level during TPA therapy correlates directly with the efficacy of TPA therapy. This information would help clinicians to formulate the optimum duration of the TPA therapy, based on serial measurements of the fibrinogen level.
Results: 139 patients (33 men, 106 women, mean age 57.4 years) were analyzed. 77 (55.4%) patients had ports placed with LE; 62 (44.6%) with L. 3 ports (2.2%) were removed because of hematoma and/or infection. No significant difference in mean procedure time between the two groups (23.6 (SD 6.4) LE vs 25.1 (SD 10.4) L, P ¼ 0.30) was observed. Among operators utilizing sharp dissection techniques, significant differences in mean procedure time were observed (19.2 (SD 4.3) LE vs 25.4 (SD 8.5) L, P ¼ 0.02). No significant differences were observed in those operators utilizing blunt dissection techniques (24.5 (SD 6.4) LE vs 25.0 (SD 10.8) L, P ¼ 0.74). Conclusions: No significant differences in procedural time or procedural complications were observed in patients receiving LE compared to L. Operators utilizing sharp dissection techniques may benefit from the use of LE for local anesthesia.Purpose: Stenosis is a common complication of renal dialysis arteriovenous (AV) fistulas, leading to poor maturation, thrombosis, and loss of haemodialysis access.[1] Recent studies propose the use of drug-eluting balloon (DEB) over standard balloon angioplasty (POBA) for AV fistula stenosis.[2] We report our JVIR ▪ Scientific e-Posters S263 Scientific e-Posters
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