Purpose-We reviewed indications and outcomes in patients undergoing ileal ureter replacement for ureteral reconstruction. December 1989 and September 2007, 105 patients underwent ileal ureter replacement, of whom 14 were excluded from study due to incomplete data. The remaining 91 patients (99 renal units) comprised the study cohort. Materials and Methods-BetweenResults-Mean patient age was 46.8 years and mean followup was 36.0 months. Indications for an ileal ureter were stricture following genitourinary surgery in 29 cases (31.9%), radiation induced stricture in 17 (18.7%), nonurological surgery iatrogenic injury in 16 (17.6%) and retroperitoneal fibrosis in 11 (12.1%). Only 4 patients (4.4%) had primary ureteral cancer. Long-term complications included anastomotic stricture in 3 patients (3.3%) and fistula in 6 (6.6%). Serum creatinine decreased or remained stable in 68 patients (74.7%) and hyperchloremic metabolic acidosis developed in 3. No patient complained of excessive urinary mucous production.Conclusions-In 68.1% of patients indications for an ileal ureter included radiation induced stricture or iatrogenic injury. The ileal ureter is a reasonable option for long-term ureteral reconstruction with preserved renal function in carefully selected patients. Keywordsureter; ileum; reconstructive surgical procedures; iatrogenic disease SINCE its first description in 1906 by Shoemaker 1 and later popularization by Goodwin et al in the late 1950s, 2 the use of ileal segments for ureteral substitution has become a valuable procedure in reconstructive urology. Although it was initially described for tubercular obstruction, recent decades have seen the indications for its use broaden. We report a contemporary series representing changes in indications, patient selection and clinical outcomes. PATIENTS AND METHODS Study DesignAfter receiving institutional review board approval we retrospectively analyzed the records of all patients who underwent ileal ureter replacement at

Renal function preservation and complications were similar for robotic, laparoscopic, and open partial nephrectomy.

Omission of cortical renorrhaphy appears feasible with no urine leaks or bleeding complications observed. The percent renal volume loss was improved by omission of cortical renorrhaphy. Reconstruction technique is important to control for when studying renal function after partial nephrectomy.

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Objectives: To examine predictors of enucleation and morcellation time within a large cohort of men undergoing HoLEP for benign prostatic hypertrophy.Methods: Pre-operative, peri-operative, and post-operative clinical characteristics were available from men treated with HoLEP between 1998 and 2013 at Indiana University Health Methodist Hospital. Stepwise linear regression was performed to determine clinical variables which are associated with enucleation and morcellation times. Results:We identified 960 patients who underwent HoLEP. Average (range) enucleation time was 65.7 (11-245) minutes and morcellation time was 19.7 (3-260) minutes. History of anticoagulation was associated with a small decrease in enucleation time (p=0.013) while increasing HoLEP specimen weight was associated with increasing enucleation time (p<0.001).History of intermittent catheterization, urinary tract infections, presence of dense prostatic tissue (colloquially referred to as "beach balls"), and increasing specimen weight were associated with increasing morcellation time (p<0.05 each). Having HoLEP performed by a less experienced urologist was associated with longer enucleation and morcellation times. Conclusions:Prostate volume is significantly associated with increased enucleation and morcellation times during HoLEP. Additionally, history of UTI and CIC are associated with modest increases in enucleation and morcellation times. Dense enucleated prostate tissue significantly impacts the ability to morcellate effectively. Increasing surgeon experience can significantly improve both enucleation and morcellation efficiency.3

Introduction: Prostate specific antigen (PSA) screening for prostate cancer has recently been challenged due to poor sensitivity. A number of conditions elevate PSA besides prostate cancer with benign prostatic hypertrophy (BPH) being most common. The objective of this study was to assess the positive predictive value (PPV) of PSA and PSA density (PSAD) for prostate cancer risk following Holmium laser enucleation of the prostate (HoLEP). Methods: An institutional IRB-approved database of HoLEP surgeries performed at Indiana University from 1999 to 2018 was queried to identify 1147 patients with post-HoLEP PSA data. 55 post-HoLEP biopsies were recorded. Demographics, PSA, prostate volume, and oncologic details were analyzed. The primary outcome was biopsy proven prostate cancer.

Introduction: This study seeks to evaluate the incidence and associated risk factors for