Category: Urology

No abstract provided.

The thulium fiber laser (TFL) is currently being studied as an alternative to the conventional holmium:YAG (Ho:YAG) laser for lithotripsy. The diode-pumped TFL may be electronically modulated to operate with variable parameters (e.g., pulse rate, pulse duration, and duty cycle) for studying the influence of pulse train mode on stone ablation rates. The TFL under study was operated at 1908 nm, 35-mJ pulse energy, and 500-μs pulse duration, in a train of 5 micro-pulses, with macro-pulse rates of 10 Hz, compared with conventional TFL operation at 10 to 50 Hz. TFL energy was delivered through 100-μm-core fibers ...

In this paper, we propose a novel approach for multiple surfaces segmentation based on the incorporation of physical constraints in optimal surface searching. We apply our new approach to solve the renal cortex segmentation problem, an important but not sufficiently researched issue. In this study, in order to better restrain the intensity proximity of the renal cortex and renal column, we extend the optimal surface search approach to allow for varying sampling distance and physical separation constraints, instead of the traditional fixed sampling distance and numerical separation constraints. The sampling distance of each vertex-column is computed according to the sparsity ...

This review provides an overview of emerging techniques, namely, photodynamic diagnosis (PDD), narrow band imaging (NBI), Raman spectroscopy, optical coherence tomography, virtual cystoscopy, and endoscopic microscopy for its use in the diagnosis and surveillance of bladder cancer. The technology, clinical evidence and future applications of these approaches are discussed with particular emphasis on PDD and NBI. These approaches show promise to optimise cystoscopy and transurethral resection of bladder tumours.

Introduction: The vast increase in recent publications on renal mass biopsy (RMB) suggests an increased interest in the subject. Objective: To assess the use of RMB in the current urological practice, including related factors such as indications and patterns in practice. Methods: The link to a web-based questionnaire (www.surveymonkey.com) was sent to all registered e-mail addresses (1854) of members of the Endourological Society in December 2010. The questionnaire contained 6 epidemiological questions, 10 regarding patterns of practice, one regarding the influence of literature and one on future techniques. Chi-square test (for trends) was used to assess statistical significant ...

Purpose We evaluated the feasibility of using optical coherence tomography and optical coherence microscopy technology to assess human kidney morphology. Materials and Methods A total of 35 renal specimens from 19 patients, consisting of 12 normal tissues and 23 tumors (16 clear cell renal cell carcinomas, 5 papillary renal cell carcinomas and 2 oncocytomas) were imaged ex vivo after surgical resection. Optical coherence tomography and optical coherence microscopy images were compared to corresponding hematoxylin and eosin histology to identify characteristic features of normal and pathological renal tissues. Three pathologists blinded to histology evaluated the sensitivity and specificity of optical coherence ...

Prostatic neuroanatomy is difficult to visualize intraoperatively and can be extremely variable. Damage to these nerves during prostatectomies may lead to post-operative complications such as erectile dysfunction and incontinence. This review aims to discuss the prostatic neuroanatomy, sites of potential nerve damage during a prostatectomy, and nerve mapping technologies being developed to prevent neural injury. These technologies include stimulation, dyes, and direct visualization. Nerve stimulation works by testing an area and observing a physiologic response but is limited by the long half life for an erectile response; examples include CaverMap, ProPep, and optical nerve stimulation. Few nerve dyes have been ...

No Abstract Provided.

University of Maryland Researchers received a $119,533 2011 NIH Grant for In Vivo Optical Imaging of Kidney Structure and Function.  The principal investigator is Dr. Yu Chen and this program stated in 2011 and ends in 2013.  Below is a summary of the work   The overall goal of this proposal is to develop a minimally-invasive optical imaging technology for the diagnosis of kidney diseases in vivo and in real time. Specifically, in this Pilot and Feasibility Clinical Research Grants in Kidney or Urologic Diseases (R21), we will image the ischemic injury in human subjects during laparoscopic partial nephrectomy procedures ...

Background and objective : The current standard for the diagnosis and followup of bladder cancer remains white light cystoscopy, despite its well-known limitations. The aim of this paper is to review the current literature on three optical diagnostics that have been developed to improve the performance of white light cystoscopy: photodynamic diagnosis, narrow-band imaging and optical coherence tomography. Materials and Methods : A PubMed search was performed for all articles on bladder cancer and photodynamic diagnosis, narrow-band imaging, and optical coherence tomography. Relevant papers on the working mechanism or clinical performance of the techniques were selected. Results : Photodynamic diagnosis and narrow-band imaging ...

Purpose of review: The management of nonmuscle-invasive bladder cancer is a challenge. Despite current guidelines, the treatment is suboptimal as illustrated by the high risk of recurrence and progression. Transurethral resection plays a pivotal role in the management of bladder cancer, but the quality varies dramatically. In this review, we discuss the latest developments that aim to improve the outcome of a transurethral resection such as photodynamic diagnosis, a second resection and adjuvant therapy. Recent findings: The treatment of a bladder cancer patient can be improved, for example, with a standard second resection in a subset of the patients or ...

Purpose of review: To present the recent advances in imaging for diagnosis, staging, and follow-up of bladder cancer. Recent findings: The use of multidetector 64-slice computed tomography (CT) and diffusion-weighted imaging has enabled higher-resolution imaging of bladder cancer on CT and MRI, respectively, increasing both specificity and sensitivity in the detection of bladder tumors and extravesical disease relative standard imaging. Although urinary excretion of 18F-FDG produces difficulties in the interpretation of 18F-FDG PET/CT, new techniques have been described to overcome this limitation. The use of the agent 11C-acetate with PET/CT may be another option when performing imaging for ...

Purpose of review: In bladder cancer, discrimination between benign and malignant tissue may remain tricky with current endoscopic tools. On the basis of our recent experience with high-magnification cystoscopy, compared with other tools such as optical coherence tomography or confocal laser endomicroscopy, it is suggested here that this discrimination may well be feasible endoscopically. The clinical potential of these systems that are being developed as complementary tools to the current endoscopic equipment is reviewed. Recent findings: At present, white-light cystoscopy, either assisted by fluorescence cystoscopy or narrow-band imaging, is proposed for the global cystoscopic examination of bladder cancer patients. Both ...

Study Type - Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Optical coherence tomography has been used for the diagnosis of retinal disease and has been used experimentally for imaging of vascular plaques, gastrointestinal pathology, bladder cancer, prostate cancer, and recently to examine benign kidney microanatomy. It has not been previously used to image kidney cancer. This study presents the first data on the utility of OCT in the imaging for renal neoplasms. It found that OCT was most successful in distinguishing AML and TCC from normal parenchyma. OCT had ...

Studying renal microcirculation and its dynamics is of great importance for understanding the renal function and further aiding the diagnosis, prevention and treatment of renal pathologies. In this paper, we present a potentially useful method to provide high-sensitive volumetric imaging of renal microcirculations using ultrahigh-sensitive optical microangiography (UHS-OMAG). The UHS-OMAG image system used here is based on spectral domain optical coherence tomography, which uses a broadband light source centered at 1300 nm with an imaging speed of 150 frames per second that requires ~6.7 sec to complete one 3D scan of ~2.5 × 2.5 mm2 area. The technique ...