Collector systems with kidney midzone drained by minor calices that are dependent on the superior or on the inferior caliceal groups presented at least two restrictive anatomical features. The mid-renal-zone classification was predictive of anatomical risk factors for lower pole ureteroscopy difficulties.
Objective: Renal tubular damage can be assessed with the aid of urinary dosing of N-acetylbeta-glucosaminidase (NAG) and it is possible to demonstrate a significant correlation between shock wave and damage to renal parenchyma. The objective of this study was to assess the effect of shock wave reapplication over urinary NAG in canine kidney.Materials and Methods: The authors submitted 10 crossbred dogs to 2 applications of 2000 shock waves in a 24-hour interval in order to assess urinary NAG values after 12, 24, 36 and 48 hours.Results: Twelve hours following the first shockwave application there was an increase in NAG of 6.47 ± 5.44 u/g creatinine (p < 0.05). Twelve hours and 24 h following the second application there was no increase in the urinary enzyme, -2.56 ± -7.36 u/g creatinine and 2.89 ± -7.27 u/g creatinine, respectively (p > 0.05).Conclusion: Shock wave reapplication with a 24-hour interval did not cause any increase in urinary NAG.
Introduction and objectives: Flexible ureteroscopy is a common procedure nowadays. Most of the training programs use virtual reality simulators. The aim of this study was to standardize the building of a three-dimensional silicone mold (cavity) of the collecting system, on the basis of polyester resin endocasts, which can be used in surgical training programs. Materials and Methods: A yellow polyester resin was injected into the ureter to fill the collecting system of 24 cadaveric fresh human kidneys. After setting off the resin, the kidneys were immersed in hydrochloric acid until total corrosion of the organic matter was achieved and the collecting system endocasts obtained. The endocasts were used to prepare white color two-part silicone molds, which after endocasts withdrawn, enabled a ureteroscope insertion into the collecting system molds (cavities). Also, the minor calices were painted with different colors in order to map the access to the different caliceal groups. The cost of the materials used in the molds is $30.00 and two days are needed to build them. Results: Flexible ureteroscope could be inserted into all molds and the entire collecting system could be examined. Since some anatomical features, as infundular length, acute angle, and perpendicular minor calices may difficult the access to some minor calices, especially in the lower caliceal group, surgical training in models leads to better surgical results. Conclusions: The two-part silicone mold is feasible, cheap and allows its use for flexible ureteroscopy surgical training.
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