The role of laparoscopic surgery for renal calculi management

To date, most cases of renal calculi have been managed with extracorporeal shockwave lithotripsy and endoscopic procedures. However, for complex renal stone conditions, these minimally invasive procedures may require multiple operative sessions. Open surgery is usually reserved as a salvage procedure, although it is invasive in nature. Laparoscopic treatment is well accepted in renal surgery. For stone disease, it can duplicate open surgical techniques such as pyelolithotomy, pyeloplasty, anatrophic nephrolithotomy, caliceal diverticulectomy and nephrectomy. Although the laparoscopic techniques for stone treatment are quite challenging, it is both feasible and safe. Laparoscopic treatment is a viable option for large renal stone treatment with an excellent stone-free rate, especially when patients require their stones to be treated within a single session. However, it is more invasive in nature than endourology procedures and so should be reserved as the last resort option for renal stone management in the modern endourology era

Clinical utility of "blind placement" prostatic stent in patients with benign prostate obstruction: a prospective study

Objectives To assess the efficacy and safety of two versions of a blind placement temporary prostatic stent in the treatment of patients with benign prostatic obstruction. Methods Two versions of a prostatic stent (blind placement stent 1 [BPS-1] and BPS-2) were blindly inserted in an outpatient setting under local anesthesia. An assessment of voiding function, symptom scores, and complications was performed at baseline, directly after stent insertion, and at 14 and 28 days after stent placement. Results A total of 55 men were enrolled in the trial. Most stents of both types were successfully placed. Spontaneous voiding was achieved in all patients immediately after stent insertion, with improvements in voiding parameters and symptom scores. In patients with the BPS-1, migration occurred in 85%. In patients with the BPS-2, migration occurred in 5%. The median indwelling time of the stent was 16 and 38 days for the BPS-1 and BPS-2, respectively. Removal was successful in all but 1 case (BPS-2). Conclusions The BPS-1 is not suitable for clinical practice because of the significantly high migration rate. The bulbar segment of the BPS-2 can prevent stent migration. However, patients experienced significant discomfort after insertion of the BPS-2. The voiding parameters and symptom scores of the BPS-2 were not significantly improved. Therefore, the BPS-2 is also not useful for clinical practice. Additional adjustment in the design of the BPS is needed to overcome these problems