Dr. Chew discusses several patient presentations, including a ureteric or a UPJ obstruction, a tortuous ureter, and a drooping kidney, for which it may be challenging to place a stent. Dr. Chew demonstrates four different techniques to successfully place and position the stent depending on the situation. He offers advantages, watch-outs, tips and tricks and describes the specific steps of each approach.
Dr. Oliver Wiseman discusses his use of detailed imaging techniques, including contrast CT and reconstructed models, in a 58-year-old patient with left loin pain and a duplex system. An initial non-contrast CT seemed to indicate a calcification in the interpolar area, yet no stone was found during the initial ureteroscopic intervention. Dr. Wiseman discusses how the use of more detailed imaging better equipped him to identify the location and size of a calyceal diverticulum. He also discusses how this imaging helped him to recognize a very narrow infundibula, which informed his treatment strategy and selection of the right intervention modality for this patient.
Documentation must support performance of ‘unusual services,’ according to Ray Painter, MD, and Mark Painter.
A study presented at the AUA annual meeting in Chicago shows higher rates of emergency department (ED) visits when ureteral access sheaths are used during ureteroscopy to remove kidney stones.
Dr. Igor Sorokin describes his medical treatment goal for four patients presenting with clinical hypercalciuria: one with Medullary Sponge Disease, one taking Topamax, one with a solitary kidney and one with hyperparathyroidism.
In this interview, Juan Calle, MD, discusses how he follows patients once they are stone free and how he utilizes dietary/lifestyle modification and medical management.
In this video, Juan Calle, MD, of Cleveland Clinic, explains what he would tell a young urologist who wants to become an expert in stone prevention and minimizing recurrence.
Dr. Krambeck discusses a percutaneous nephrolithotomy procedure in a 54-year-old woman with a large upper pole stone completely obstructing the upper pole system.
Dr. Kaplan discusses the advantages of robotic surgery in urology, and presents a hard-to-reach complex stone location for which a robotic approach is warranted. He describes the step-by-step technique to perform a robotic-assisted nephrolithotomy and calyceal diverticulectomy in a 65-year-old patient with a 2.4 cm right renal stone.
The Painters also answer coding questions regarding prostate needle biopsy and InterStim.