Specimen processing during laparoscopic renal surgery: a review of techniques and technologies

Laparoscopic surgery has well-defined benefits for patients and has become accepted over time as a standard access strategy for the management of benign and malignant urologic diseases. Unlike in open surgery, the surgeon is often faced with the additional challenges of specimen retrieval and extraction at the end of laparoscopic extirpative procedures. This final step often requires significant laparoscopic skill to entrap and safely extract the laparoscopic specimens. Failure to apply safe exit steps at the end of a laparoscopic procedure may lead to significant morbidity. The aim of this review is to explore the different techniques and technologies available for laparoscopic kidney retrieval, entrapment and safe extraction.     

Interplay between toothbrush stiffness and dentifrice abrasivity on the development of non-carious cervical lesions

Objective

This study investigated the effect of toothbrush stiffness and dentifrice slurry abrasivity on the development and progression of simulated non-carious cervical lesions (NCCLs).

Materials and methods

Human maxillary premolars were allocated to 12 groups generated by the association between toothbrushes, soft, medium, and hard stiffness, and simulated dentifrice slurries, lower, medium, and higher; deionized water (DI) served as negative control. Teeth were mounted on acrylic blocks, and their root surfaces partially covered with acrylic resin to simulate gingiva, leaving a 2-mm area apical to the cemento-enamel junction exposed to toothbrushing. Specimens were brushed with the test slurries for 35,000 and 65,000 double strokes. Impressions taken at baseline and after both brushing periods were scanned by a 3D optical profilometer. Dentin volume loss (mm³) was calculated by image subtraction. Data were analyzed using three-way ANOVA and Fisher’s PLSD tests.

Results

All toothbrushes caused higher volume loss when associated to higher abrasive slurry, compared to medium- and lower-abrasive slurries. Medium caused more volume loss than lower-abrasive slurry, which led to more volume loss than DI. Hard and medium toothbrushes were not different when used with medium- or higher-abrasive slurries. There were no differences among toothbrushes when used with DI and lower-abrasive slurry. Overall, 35,000 brushing strokes resulted in significantly less volume loss than 65,000.

Conclusions

Toothbrush stiffness was an important factor on NCCL development, especially when brushing with medium- and higher-abrasive slurries.

Clinical relevance

Medium and hard toothbrushes associated with medium- and high-abrasive toothpastes can yield more severe NCCLs.

     

Diagnosis and treatment of prostate cancer in renal-transplant recipients

Introduction  

The incidence and treatment of prostate cancer in male renal-transplant patients has not been extensively evaluated. With the aging of the renal-transplant population, the diagnosis and management of prostate cancer in these patients needs further evaluation.     

Varicocelectomy may benefit men with a sertoli cell-only pattern on microsurgical testicular sperm extraction: a case report

Men with testicular failure (TF) often undergo an extensive microsurgical dissection of the testicles to identify sperm (TESE procedure). Frequently no sperm is found. Although a varicocelectomy results in improved spermatogenesis in some men with TF, the role of varicocelectomy in the setting of a failed TESE is unknown. We present a case of recovery of spermatogenesis after varicocelectomy in a man who had a previous failed TESE. This case demonstrates that patients with a failed TESE may gain some benefit from a varicocelectomy and that this procedure may be offered as an alternative to donor insemination or adoption.     

Bipolar vaporization of the prostate may cause higher complication rates compared to bipolar loop resection: a randomized prospective trial

International Urology and Nephrology - Transurethral resection of the prostate (TURP) by resection loop or vaporization button is becoming a standard of care due to its better safety profile (less...     

Bellini duct carcinoma with ovarian metastasis

We report a case of collecting duct carcinoma presenting as pyelonephritis with hypercalcemia and metastasis to the ovary. Case management and literature review being presented.