Stephen V. Jackman

Safety and Efficacy of Flexible Ureterorenoscopy and Holmium:YAG Lithotripsy for Intrarenal Stones in Anticoagulated Cases

PURPOSEnWe compared perioperative outcomes in patients undergoing ureterorenoscopy and Ho:YAG lithotripsy for renal calculi with or without anticoagulation.nnnMATERIALS AND METHODSnWe reviewed the records of all patients undergoing flexible ureterorenoscopy and Ho:YAG lithotripsy for renal calculi at 2 institutions from 2001 to 2007. We identified 37 patients on anticoagulation with Coumadin, clopidogrel or aspirin in whom anticoagulation therapy was not discontinued before surgery. Data on the anticoagulation group were retrospectively compared to those on a contemporary matched cohort of 37 controls without anticoagulation who underwent a similar operative procedure. The 2 groups were compared with regard to the stone-free rate, and intraoperative and postoperative complications with specific reference to bleeding and thromboembolism.nnnRESULTSnThe 2 groups were matched for stone size, stone location, number of stones, bilateral procedures and concomitant ureteral stones. Anticoagulation group patients were older (58.2 vs 50.4 years, p = 0.0209) and had a greater American Society of Anesthesiologists score (2.8 vs 1.9, p <0.0001) compared to the control group. No procedure had to be terminated in the anticoagulation group due to poor visibility from bleeding. The median postoperative hemoglobin decrease was greater in the anticoagulation group than in the control group (0.6 vs 0.2 gm/dl, p <0.0001). The stone-free rate (81.1% vs 78.4%, p = 0.7725), intraoperative complications (0% vs 3%, p = 0.3140), postoperative complications (11% vs 5%, p = 0.3943) and hemorrhagic or thromboembolic adverse events were comparable in the 2 groups.nnnCONCLUSIONSnWhen necessary, ureterorenoscopy and Ho:YAG lithotripsy can be performed safely and efficaciously for renal calculi in patients on anticoagulation therapy without the need for perioperative manipulation.

Comparative hospital cost-analysis of open and robotic-assisted radical prostatectomy.

OBJECTIVEnTo perform a contemporary comparative cost-analysis of robotic-assisted laparoscopic radical prostatectomy (RARP) and open radical retropubic prostatectomy (RRP).nnnMETHODSnAll patients undergoing RARP (n = 115) or RRP (n = 358) by 1 of 4 surgeons at a single institution during a 15-month period were retrospectively reviewed. The hospital length of stay (LOS), operative time, hospital charges, reimbursement, and direct and indirect hospital costs were analyzed and compared.nnnRESULTSnThe mean LOS between patients undergoing RARP (1.2 ± 0.6 days) and RRP (1.4 ± 0.8 days) was not significantly different. The operating room supply costs per case were almost 7 times greater for RARP (

Differential Renal Function Estimation Using Computerized Tomography Based Renal Parenchymal Volume Measurement

2852 ±

Predictors of Immediate Postoperative Outcome of Single-tract Percutaneous Nephrolithotomy

528) than for RRP (

Management of Bladder Cancer following Solid Organ Transplantation.

417 ±

Survey of Applicant Experience and Cost in the Urology Match: Opportunities for Reform

59; P < .05). The ancillary, cardiology, imaging, administrative, laboratory, and pharmacy costs were not significantly different between the 2 approaches. The mean total costs per case for RARP exceeded the total costs for RRP by 62% (

Segmental testicular infarction due to minocycline-induced antineutrophil cytoplasmic antibody--positive vasculitis.

14 006 ±

Design and challenges of a randomized clinical trial of medical expulsive therapy (tamsulosin) for urolithiasis in the emergency department.

1641 vs

Staged endourologic and endovascular repair of an infrarenal inflammatory abdominal aortic aneurysm presenting with forniceal rupture

8686 ±

Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial

1989; P < .05). Payment to the hospital from all sources was nearly equivalent: