Dr. Michael Palese and Dr. Alexander Small explain the specific risk factors, unique anatomical intricacies, and technical considerations for stone removal in a transplanted kidney. The case of a 68-year old male with end stage renal disease who presents with stones 11 months post kidney transplant is shared. Drs. Palese and Small explain the required and careful thought process to ensure the best possible outcome of this and similar transplant cases, all of which are deemed highly complex. Drs. Palese and Small also address how to treat donor-gifted lithiasis prior to implantation.
Dr. Timothy Large discusses the role of urine alkalinization in stone treatment, including as a way to reduce stone complexity, cost, morbidity and the burden of stone disease on a patient. Dr. Large shares the case of a 38-year-old female patient with comorbidities and a solitary kidney with a staghorn uric acid kidney stone compromising almost the entire renal pelvis. The patient also presented with challenges to her metabolic system for which Dr. Large discusses how a urine analysis was utilized and urine alkalinization was incorporated into post-operative treatment to reduce the risk of a reoccurring stone event.
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.
In this video, Bodo Knudsen, MD, of The Ohio State University Wexner Medical Center, Columbus, explains his step-by-step process for obtaining percutaneous access in stone patients.
Dr. Borofsky discusses the ways in which an endoscopic analysis of the renal papilla is a useful alternative to post-procedural stone analysis or 24-hour urine analysis and how it may enable urologists to characterize a patient’s stone disease in real time. He covers both Randall’s plaque and ductal plugging, including how to identify each and important insights that might be useful to understanding a patient’s stone activity. He also discusses some of the potential correlations of these abnormalities with a patient’s underlying metabolic condition and disease progression.
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.
Dr. Dangle shows that pediatric ureteroscopy is safe and feasible with good results and without long-term sequelae on the ureters.
This video shows a case of semi-rigid ureteroscopy with laser lithotripsy for ureteral stone in a child, who is rendered stone free without pre-stenting.