As the coronavirus disease 2019 (COVID‐19) pandemic spread across the globe, transplant programs suffered a setback. We report the first experience of COVID‐19 infection within 1 month of living donor kidney transplant (LDKT). We describe 2 LDKT recipients who were detected positive for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection at day 19 and day 7 posttransplant. They had minimal symptoms at diagnosis and did not develop any respiratory complications or allograft dysfunction. Immunosuppression was de‐escalated; however, nasopharyngeal swab real‐time reverse transcription polymerase chain reaction (rRT‐PCR) remained positive for SARS‐CoV‐2 for a prolonged time. Younger age, absence of other comorbidities, and lower dose of anti‐thymocyte globulin (ATG) used as induction possibly contributed to good outcome in our recent LDKT recipients compared with earlier published cases of recent deceased donor kidney transplant recipients with COVID‐19.
The results of this multicenter analysis demonstrate that latissimus dorsi detrusor myoplasty is an effective alternative to clean intermittent catheterization in a select group of patients with neurogenic bladder acontractility.
Introduction: Robotic-assisted pyelolithotomy (RAPL) has recently immerged as an alternative approach for the management of complex kidney stones. RAPL combines the benefits of minimally invasive surgery with the high stone clearance rates achieved by open lithotomy.
Case Description:We describe the successful combination of RAPL and Holmium laser lithotripsy for the management of a staghorn calculus in a 57-year-old man who had previously undergone a failed percutaneous nephrolithotomy.
Discussion and Conclusion:The 500-m Holmium laser fiber was navigated by the console surgeon, who also controlled the laser foot pedal, thus maximizing surgeon control of the procedure. The combination of robotically assisted laparoscopic surgery and Holmium laser lithotripsy is a feasible and safe management option for achieving clearance of complex renal stones. To the best of our knowledge, this appears to be the first reported case, confirming the safety and efficacy of this combined technique.
Introduction:The Urological Society of India guidelines panel on urinary incontinence (UI) conducted a survey among its members to determine their practice patterns in the management of UI. The results of this survey are reported in this manuscript.Methods:An anonymous online survey was carried out among members of the USI to determine their practice patterns regarding UI using a predeveloped questionnaire on using SurveyMonkey®. A second 4-question randomized telephonic survey of the nonresponders was performed after closure of the online survey. Data were analyzed by R software 3.1.3 (P < 0.05 significant).Results:A total of 468 of 2109 (22.2%) members responded to the online survey. Nearly 97% were urologists, 74.8% were working at a private, and 39.4% were in an academic institution. Almost all were managing UI. 84.2% had local access to a urodynamics (UDS) facility. 85.8% would check postvoid residual urine for all the patients. Voiding diary, symptom scores, quality of life scores, pad test, Q-tip test, stress test, uroflow, and cystoscopy were ordered as part of evaluation by 86.0%, 49.8%, 24.4%, 22.0%, 6.0%, 71.8%, 69.2%, and 34.7%, respectively. 47.6% would order a UDS for patients with urgency UI who fail conservative treatment. 36.9% would get UDS prior to all stress UI surgery. Seventy-five percent would make a diagnosis of intrinsic sphincter deficiency. Solifenacin was the first choice for urgency UI in general and darifenacin was preferred in elderly. Botulinum was the first choice for refractory urgency UI. Midurethral sling was the commonest procedure for surgical management of SUI (95.1%). 147 of the 1641 non responders were randomly sampled telephonically. Telephonic respondents had similar access to UDS facility but had performed fewer lifetime number of post-prostatectomy incontinence (PPI) surgeries. Combining data from both surveys, total number of artificial sphincters and PPI surgeries ever performed by USI members was estimated at 375 and 718 respectively.Conclusion:This survey provides important new data and elicits critical differences in management practices based on demographics.
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