Category Archives: Urology

Global Surgery, Print Release, Urology

PUBLISHED: Scrotal Hydrocelectomy Made Simple During a Surgical Mission

Scrotal Hydrocelectomy Made Simple During a Surgical Mission
Jaymie Ang Henry, MD, MPH1; Lissa Henson, MD2; Domingo Alvear, MD3
1Florida Atlantic University, G4 Alliance
2Philippine Society of Pediatric Surgeons
3World Surgical Foundation

A hydrocele is a condition characterized by the abnormal accumulation of serous fluid between the layers of the tunica vaginalis in the scrotum. While most hydroceles are typically asymptomatic or subclinical, larger ones can cause discomfort, heaviness, and cosmetic concerns. The surgical management of hydroceles aims to alleviate symptoms, improve cosmetic appearance, and prevent potential complications associated with untreated hydroceles, such as testicular ischemia or chronic pain.

This video highlights the surgeon’s expertise and attention to detail, ensuring a thorough and meticulous surgical technique. The step-by-step approach and clear communication with the surgical team facilitate a smooth and efficient procedure. The importance of this surgical technique extends beyond the individual patient. Providing a simplified and effective treatment option for hydroceles has the potential to improve patient outcomes and reduce the burden on healthcare systems, particularly in resource-limited settings or during surgical missions. Overall, the video serves as a valuable educational resource for surgical trainees and practitioners, demonstrating a simplified and effective approach to the treatment of scrotal hydroceles.

Print Release, Urology

PUBLISHED: Cystoscopy and Transurethral Resection of Bladder Tumors with Stent and Foley Catheter Placement

Cystoscopy and Transurethral Resection of Bladder Tumors with Stent and Foley Catheter Placement
Austin Bramwell, MD; Tullika Garg, MD, MPH, FACS
Penn State Health Milton S. Hershey Medical Center

Bladder cancer is the sixth most common cancer in the United States. Transurethral resection of bladder tumor (TURBT) is a common urologic surgical procedure used to diagnose, stage, and treat bladder cancer. This article presents a patient who had multiple episodes of gross hematuria and was found to have multifocal bladder tumors. In this case, TURBT was performed to confirm the diagnosis of bladder cancer, remove all visible bladder tumors, and prevent further episodes of gross hematuria.

Print Release, Urology

PUBLISHED: Ureteroscopy, Laser Lithotripsy, and Stent Replacement for an Obstructing Left Proximal Ureteral Stone with Forniceal Rupture

Ureteroscopy, Laser Lithotripsy, and Stent Replacement for an Obstructing Left Proximal Ureteral Stone with Forniceal Rupture
Ryan A. Hankins, MD1; John A. Wahl, MS2
1MedStar Georgetown University Hospital
2Georgetown University School of Medicine

The case demonstrates the use of ureteroscopy with laser lithotripsy in the treatment of an obstructed left proximal ureteral stone with forniceal rupture. The patient presented to the emergency department with the signs and symptoms of a ureteral stone and was taken for imaging and a diagnostic ureteroscopy. Following confirmation of the diagnosis, the patient was scheduled for ureteroscopy with laser lithotripsy.

A guidewire was placed, followed by visualization with a retrograde pyelogram and a subsequent flexible ureteroscopy. Laser lithotripsy was performed to fragment the stone. Following fragmentation, the renal pelvis and calyces were visualized to examine for retrograde movement of stone fragments. A confirmatory retrograde pyelogram was then performed, followed by placement of a temporary stent for fluid drainage. The patient was then discharged with opioids for pain medication and prophylactic antibiotics to prevent urinary tract infections and the subsequent risk of urosepsis.

General Surgery, Global Surgery, Pediatrics, Print Release, Urology

PUBLISHED: Right Orchiopexy to Correct Undescended Testicle and Circumcision to Correct Phimosis

Right Orchiopexy to Correct Undescended Testicle and Circumcision to Correct Phimosis
Lissa Henson, MD1; Domingo Alvear, MD2
1Capitol Medical Center, Philippine Society of Pediatric Surgeons
2World Surgical Foundation

Cryptorchidism, or undescended testis, is a condition in which one or both testes fail to descend from the abdomen into the scrotum during fetal development. Phimosis, on the other hand, is a condition characterized by the inability to retract the foreskin over the glans penis.

This video serves as a step-by-step guide on orchiopexy to correct an undescended testicle and circumcision to correct phimosis. The importance of this surgical intervention lies in the preservation of testicular function, fertility potential, and the prevention of long-term complications associated with cryptorchidism. Early treatment is crucial, as it significantly reduces the risk of testicular damage and associated complications.

Print Release, Urology

PUBLISHED: Left Ureteroscopy, Stone Retrieval with Basket, and Stent Replacement

Left Ureteroscopy, Stone Retrieval with Basket, and Stent Replacement
Ahmad N. Alzubaidi, MD; Blake Baer, MD; Tullika Garg, MD, MPH, FACS
Penn State Health Milton S. Hershey Medical Center

Urolithiasis is one of the most common and costly benign urologic conditions in the United States. While there are many options for managing urolithiasis ranging from conservative medical expulsive therapy to shockwave lithotripsy to percutaneous nephrolithotomy, ureteroscopy with laser lithotripsy is one of the most frequently performed minimally invasive urologic surgeries for treatment. In this video, we present a case of a patient with a ureteral stone that was treated with ureteroscopy, laser lithotripsy, and basket stone extraction. As part of the procedure, the patient also underwent a retrograde pyelogram and a ureteral stent exchange.

Basic Skills for the OR, Print Release, Urology

PUBLISHED: Male Foley Catheter Placement and Removal for Surgery

Male Foley Catheter Placement and Removal for Surgery
Bel Capati, RN; Shirin Towfigh, MD
Beverly Hills Hernia Center

Foley catheter insertion is a fundamental medical procedure that is routinely performed across a wide range of clinical specialties. The placement of a Foley catheter remains one of the most commonly executed interventions in the field of medicine. Foley catheter placement is a common medical procedure performed to assist in bladder drainage and management. This procedure is indicated for a variety of reasons, including the need to monitor urine output during surgery, the management of urinary retention or incontinence, and the facilitation of accurate measurement of urine output in critically ill patients.

The procedure is often performed before surgical interventions to ensure the bladder is emptied, reducing the risk of complications such as bladder distension or injury during the operation. Foley catheterization is a critical component of the care provided to patients undergoing surgical interventions. The procedure requires careful attention to detail and the implementation of proper sterile techniques to ensure patient safety and optimal outcomes. This video provides a step-by-step demonstration of Foley catheterization in a male patient, highlighting the importance of this procedure for medical personnel.

Fundamentals, Print Release, Urology

PUBLISHED: Cystoscopy and Placement of Ureteral Stents: Preoperative for HIPEC Surgery

Cystoscopy and Placement of Ureteral Stents: Preoperative for HIPEC Surgery
Francis McGovern, MD
Massachusetts General Hospital

This video provides a comprehensive overview of the prophylactic ureteral stenting and cystoscopy performed on a patient with advanced metastases of appendiceal cancer who is scheduled for cytoreduction and hyperthermic intraperitoneal chemotherapy. The video focuses on urethral instrumentation, identification of ureteral orifices, stent placement, and subsequent bladder inspection. The patient’s preoperative evaluation had revealed no evidence of ureteral involvement with the tumor.

The cystoscopic technique employed in this case allowed the surgeons to visualize the bulbar urethra, sphincter, and prostatic urethra, illustrating the step-by-step process of advancing into the bladder. Next, the vesical trigone is identified, aiding in the visualization of the ureteral orifices. The careful placement of stents into both ureters is demonstrated. No resistance was encountered in the process of stent placement, suggesting no involvement of the ureters with the tumor. A thorough bladder inspection revealed no unusual findings such as abnormal lesions, masses, or other pathology. The stents were secured with silk sutures to prevent inadvertent dislodgement.

Basic Skills for the OR, Print Release, Urology

PUBLISHED: Foley Catheter Placement: Indications, Maintenance, Complications, and Demonstration on a Preoperative Male Patient

Foley Catheter Placement: Indications, Maintenance, Complications, and Demonstration on a Preoperative Male Patient
Danielle Shibley, BSN, RN
VCU Medical Center

Foley catheterization is a frequently-employed medical procedure to treat urinary retention, aid in bladder drainage/decompression, and facilitate measurement of urine output. This article provides an overview of the indications for Foley catheterization, the steps involved in its insertion, proper care guidelines, and potential complications associated with its use. It is of utmost importance for healthcare practitioners to be comfortable with catheterization procedures to guarantee the comfort, safety, and general welfare of their patients.

Pediatrics, Print Release, Urology

PUBLISHED: Prophylactic Laparoscopic Bilateral Gonadectomy for Complete Androgen Insensitivity Syndrome

Prophylactic Laparoscopic Bilateral Gonadectomy for Complete Androgen Insensitivity Syndrome

J. Corbin Norton
Department of Urology, University of Arkansas for Medical Sciences

Amrit Singh, MD
Department of Pathology, University of Arkansas for Medical Sciences / Arkansas Children’s Hospital

Laura L. Hollenbach, MD
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences

Georgia Gamble, MD
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences

Laura A. Gonzalez-Krellwitz, MD
Department of Pathology, University of Arkansas for Medical Sciences / Arkansas Children’s Hospital

Stephen J. Canon, MD
Department of Pediatric Urology, Arkansas Children’s Hospital

The patient in this case is a 15-year-old female who presented with primary amenorrhea and who on work-up was found to have complete androgen insensitivity syndrome. Here, Dr. Canon at the University of Arkansas for Medical Sciences performs a prophylactic laparoscopic bilateral gonadectomy to reduce her future risk for intra-abdominal testicular malignancies. Final pathology results showed a rare case of bilateral germ cell neoplasia in situ and bilateral paratesticular leiomyomas and reinforced the decision to intervene early allowing for the removal of the gonads prior to their conversion to formal germ cell tumors.

Preprint Release, Urology

PREPRINT RELEASE: Ureteroscopy, Laser Lithotripsy, and Stent Replacement for an Obstructing Left Proximal Ureteral Stone with Forniceal Rupture

Ureteroscopy, Laser Lithotripsy, and Stent Replacement for an Obstructing Left Proximal Ureteral Stone with Forniceal Rupture

Ryan A. Hankins, MD
Assistant Professor of Urology
Specialty Director of Urology
MedStar Georgetown University Hospital

The patient in this case is a 76-year-old male who was admitted to the ER two weeks prior and was found to have an obstructing, 1-cm left proximal ureteral stone with a forniceal rupture. A left ureteral stent was placed, and he was started on antibiotics. In this video, Dr. Ryan Hankins at MedStar Georgetown University Hospital performs definitive management of the stone with a left ureteroscopy, laser lithotripsy, and stent replacement.