Hazards make finding the right laser sheath critical
Amsterdam, Netherlands--A protective polyamide laser sheath for use during flexible ureteroscopy and laser lithotripsy showed little effect on deflection characteristics but markedly impaired irrigation flow in a new study from Canada.
Amsterdam, Netherlands-A protective polyamide laser sheath for use during flexible ureteroscopy and laser lithotripsy showed little effect on deflection characteristics but markedly impaired irrigation flow in a new study from Canada.
Researchers measured the deflection angles for each scope using a protractor. They administered irrigant flow with a constant pressure infusion pump and measured it by the volume of fluid administered in 1 minute.
Fiber requires caution
Although technical advances have greatly improved the functionality and durability of flexible fiber optic ureteroscopes, they remain fragile instruments, Dr. Razvi pointed out, and working channel damage is not uncommon.
"The most frequent cause of ureteroscope damage in over 40% of cases at our high-volume endourology center is to the working channel, with damage to other components of the ureteroscope (eg, angulation wires, outer core, lens, defection cover) following. Virtually all sources of damage to the working channel are due to the laser," he said.
Urologists attending Dr. Razvi's presentation at the World Congress on Endourology were curious as to the choice of material selected for the sheath. Some asked whether other materials might work better. Others believed that material was less of an issue than were the mechanical properties of the working channel.
"Polyamide was readily available and was relatively laser resistant. The study showed us that maybe we should think about other strategies or other types of materials," Dr. Razvi said. "In terms of the mechanical effects of the sheath, however, it did not significantly affect deflectibility, but definitely did affect irrigation flow."
He described the use of small-diameter catheters as a possible method of protecting the working channel and reducing the potential for laser fiber damage. With most flexible uteroscope working channels in the 3F to 4F size range, identifying a protective sheath that will not significantly impair irrigant flow or reduce deflectibility remains the challenge, he said.
Seeds vs. prostatectomy: Long- and short-term side effects differ slightly
March 15th 2007For men with prostate cancer, radiation seed implants may yield a better short-term side effect profile than surgery, but surgery may offer slightly better long-term outcomes, new research from French radiation oncologists indicates.
Brachytherapy offers high 8-year prostate Ca survival rates
February 15th 2007More than 90% of men who receive appropriate radiation dose levels with permanent radiation seed implants to treat their prostate cancer are cured of the disease 8 years after diagnosis, according to a recent study in the International Journal for Radiation Oncology Biology Physics (2007; 67:327-33).
Research on bladder tissue regeneration progresses
February 1st 2007Atlanta-Tissue engineering research has grown by leaps and bounds in the past decade and a half, yielding findings that may someday have a profound impact on the field of pediatric urology. At the 2006 American Academy of Pediatrics Section on Urology annual meeting here, several groups presented cutting-edge data on novel systems for organ generation, including research demonstrating the feasibility of generating a functioning bladder from stem cells.
Radiation therapy combination prolongs long-term cure rate in men with PCa
January 18th 2007Three-fourths of men treated with a combination of radiation seed implants and external beam radiation therapy for prostate cancer are cured of their disease 15 years following their treatment, according to a study published in the International Journal of Radiation Oncology*Biology*Physics (2007; 67:57-64).
Cystectomy outcomes: Does surgeon's age matter?
October 1st 2006Ann Arbor, MI-Surgeon age is not a significant predictor of risk of mortality after cystectomy, according to the results of a recently published study from researchers at the University of Michigan, Ann Arbor (Ann Surg 2006; 244:353-62).
