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Article ; Online: Comparative study of renal drainage with different ureteral stents subject to extrinsic ureteral obstruction using an in vitro ureter-stent model.

Shilo, Yaniv / Modai, Jonathan / Leibovici, Dan / Dror, Ishai / Berkowitz, Brian

2021 Volume 21, Issue 1, Page(s) 100

Abstract: Background: To compare the efficacy of different ureteral stents subject to extrinsic ureteral obstruction (EUO), in a controlled in vitro stented ureter experiment.: Methods: We employ an in vitro ureter-stent experimental set-up, with latex tubing ... ...

Abstract	Background: To compare the efficacy of different ureteral stents subject to extrinsic ureteral obstruction (EUO), in a controlled in vitro stented ureter experiment. Methods: We employ an in vitro ureter-stent experimental set-up, with latex tubing simulating flexible ureters attached to vessels simulating renal units and bladders. The flow behavior of five ureteral stents-polymeric 8F, tandem 6F, tandem 7F, endopyelotomy and metal-was tested under a ureteral deformation configuration of 40°, with 2000 g external force over a 3.5 cm length of the ureter. A constant fluid flow was applied through the ureter-stent configurations, and pressure fluctuations in the renal unit were monitored. We considered a renal unit pressure of 10 cmH Results: Of all assessed ureteral stents, under EUO conditions, only the single 8F stents remained patent throughout the length of the experiment. All other stents-tandem 6F and 7F, single 7F, metal and endopyelotomy-displayed limitations. Conclusions: Tandem and metal stents show no superiority over large luminal polymeric stents for EUO treatment in this in vitro model. Larger luminal stents offer excellent resistance to external pressure and allow adequate colloidal flow. The need for frequent exchange and bladder irritation should also be considered in the choice of stent configuration for treatment of kidney drainage under EUO.
MeSH term(s)	Drainage/instrumentation ; Humans ; In Vitro Techniques ; Kidney ; Materials Testing ; Prosthesis Design ; Stents ; Ureteral Obstruction/therapy
Language	English
Publishing date	2021-07-14
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2059857-9
ISSN	1471-2490 ; 1471-2490
ISSN (online)	1471-2490
ISSN	1471-2490
DOI	10.1186/s12894-021-00865-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Potential Markers to Reduce Non-Contrast Computed Tomography Use for Symptomatic Patients with Suspected Ureterolithiasis.

Avda, Yuval / Shpunt, Igal / Modai, Jonathan / Leibovici, Dan / Berkowitz, Brian / Shilo, Yaniv

Journal of personalized medicine

2022 Volume 12, Issue 8

Abstract: Most patients with ureterolithiasis are managed successfully with conservative treatment. In this context, delineation of clinical risk factors that identify patients with low risk for surgical intervention may reduce use of Non-Contrast Computed ... ...

Abstract	Most patients with ureterolithiasis are managed successfully with conservative treatment. In this context, delineation of clinical risk factors that identify patients with low risk for surgical intervention may reduce use of Non-Contrast Computed Tomography (NCCT). Here, emergency department patient files from a 14-month period were reviewed retrospectively, to identify patients who underwent NCCT and showed a ureteral stone. Demographic, clinical and laboratory information was collected. Patients were grouped to either requiring surgical intervention (Group 1) or having successful conservative management (Group 2). The cohort included 368 patients; 36.1% ultimately required surgical intervention (Group 1) and 63.9% were successfully treated conservatively (Group 2). On univariate analysis, patients who required surgical intervention were older, had longer duration of symptoms, had history of urolithiasis and surgical intervention for urolithiasis and had higher serum creatinine levels. Multivariate analysis identified the following risk factors associated with surgical intervention: creatinine >1.5 mg/dL, duration of symptoms ≥ 1.5 days and age > 45 years. Patients with 0, 1, 2 or 3 of the identified risk factors had 19%, 32%, 53% and 73% likelihood, respectively, of surgical intervention. Incorporating these data may reduce the use of NCCT scans in patients who are likely to pass a stone via conservative management.
Language	English
Publishing date	2022-08-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm12081350
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Article ; Online: Drainage of infected kidneys with ureteral stents: does size matter?

Modai, Jonathan / Shilo, Yaniv / Leibovici, Dan / Dror, Ishai / Kalchenko, Vyacheslav / Berkowitz, Brian

World journal of urology

2022 Volume 40, Issue 8, Page(s) 2041–2046

Abstract: Purpose: The purpose of our study was to evaluate the ability of ureteral stents with different diameters to drain pus that accumulates in an obstructed kidney using an in vitro model.: Methods: We developed an in vitro model of an obstructed kidney ... ...

Abstract	Purpose: The purpose of our study was to evaluate the ability of ureteral stents with different diameters to drain pus that accumulates in an obstructed kidney using an in vitro model. Methods: We developed an in vitro model of an obstructed kidney filled with pus. The model included a silicon kidney unit based on computed tomography (CT) data, a 3D printed ureteral stone based on a real extracted ureteral stone, a latex ureter model, a bladder vessel, and a fluid with qualities resembling pus. Identical printed stones were inserted into four ureter models containing stents with varying diameters (4.8F, 6F, 7F, 8F), each of which was connected to the kidney unit and the bladder vessel. The kidney unit was filled with artificial pus to pressures of 30 cmH Results: The rate of pressure drop and the final pressure measured in the kidney were unaffected by the diameter of the stent. For all stent diameters, the pressure reached non-obstructed levels within 30 s, final pressure was reached within 90-120 s, and minimal amounts of pus remained in the kidney after 120 min. Conclusions: In vitro experiments demonstrate that all stent diameters drain pus-filled, obstructed kidneys with the same efficacy. The common perception that larger diameter tubes are more effective under such circumstances should be re-examined.
MeSH term(s)	Drainage ; Humans ; Kidney ; Stents ; Suppuration ; Ureter/surgery ; Ureteral Obstruction/surgery
Language	English
Publishing date	2022-06-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-022-04070-8
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Zs.A 1832: Show issues

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Article ; Online: Letter to the Editor RE:

Shilo, Yaniv / Modai, Jonathan / Leibovici, Dan / Dror, Ishai / Berkowitz, Brian

Journal of endourology

2020 Volume 34, Issue 1, Page(s) 75

MeSH term(s)	Humans ; Research Design ; Stents ; Ureter ; Ureteral Calculi ; Ureteral Obstruction
Language	English
Publishing date	2020-01-02
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	356931-7
ISSN	1557-900X ; 0892-7790
ISSN (online)	1557-900X
ISSN	0892-7790
DOI	10.1089/end.2020.29073.ysh
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Zs.A 2628: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Impact of Colloidal Fluid on Stent Failure Under Extrinsic Ureteral Obstruction: An

Shilo, Yaniv / Modai, Jonathan / Leibovici, Dan / Dror, Ishai / Berkowitz, Brian

Journal of endourology

2020 Volume 34, Issue 9, Page(s) 987–992

Abstract: Background and Purpose: ...

Abstract	Background and Purpose:
MeSH term(s)	Drainage ; Humans ; Kidney ; Stents ; Ureter/surgery ; Ureteral Obstruction/surgery
Language	English
Publishing date	2020-07-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	356931-7
ISSN	1557-900X ; 0892-7790
ISSN (online)	1557-900X
ISSN	0892-7790
DOI	10.1089/end.2020.0330
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Zs.A 2628: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 208: Show issues

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Article: When should we give up on expectant management for patients with proximal ureteral stones?

Shpunt, Igal / Elbaz, Etay / Avda, Yuval / Modai, Jonathan / Leibovici, Dan / Berkowitz, Brian / Shilo, Yaniv

Current urology

2021 Volume 16, Issue 1, Page(s) 9–14

Abstract: Background: Proximal ureteral stones (PUS) have relatively low rates of spontaneous expulsion. However, some patients do well on expectant management. Our aim was to compare risk factors for surgical intervention in patients with PUS who underwent ... ...

Abstract	Background: Proximal ureteral stones (PUS) have relatively low rates of spontaneous expulsion. However, some patients do well on expectant management. Our aim was to compare risk factors for surgical intervention in patients with PUS who underwent primary intervention to those subjected to expectant management. Materials and methods: We retrospectively reviewed the medical charts of patients presented to the emergency room with symptoms of renal colic and underwent computerized tomography between August 2016 and August 2017. A total of 97 consecutive patients were identified with up to 10mm PUS. We collected patient demographics, clinical, and imaging data, and performed binary regression analysis for risk of intervention. Results: The average age was 49years (range 17-97) and average stone size was 7.1mm (range 3-10). Forty-one patients underwent immediate intervention while the remaining 56 patients were treated conservatively. Of the 56 patients treated conservatively, 26 underwent delayed intervention while 30 reported spontaneous stone expulsion. On univariate analysis of all 97 patients, statistically significant risk factors for intervention were found based on stone size, age, serum lymphocyte, platelet counts, and stone density. Of these risk factors, stone size ≥ 7mm ( Conclusion: Stone size and platelet count were found to be risk factors for surgical intervention in patients with up to 10mm PUS. These findings may assist in identifying patients who are more suitable for conservative approach.
Language	English
Publishing date	2021-12-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2253664-4
ISSN	1661-7657 ; 1661-7649
ISSN (online)	1661-7657
ISSN	1661-7649
DOI	10.1097/CU9.0000000000000074
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Zs.A 6628: Show issues

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Article ; Online: Do organic substances act as a degradable binding matrix in calcium oxalate kidney stones?

Adelman, Adi / Shilo, Yaniv / Modai, Jonathan / Leibovici, Dan / Dror, Ishai / Berkowitz, Brian

BMC urology

2021 Volume 21, Issue 1, Page(s) 46

Abstract: Background: Calcium oxalate (CaOx) stones are considered to be highly resistant to chemolysis. While significant organic matter has been identified within these stones, which is presumed to bind (inorganic) CaOx particles and aggregates, most chemolysis ...

Abstract	Background: Calcium oxalate (CaOx) stones are considered to be highly resistant to chemolysis. While significant organic matter has been identified within these stones, which is presumed to bind (inorganic) CaOx particles and aggregates, most chemolysis efforts have focused on methods to attack the CaOx components of a stone. We examine the feasibility of inducing chemolysis of CaOx kidney stones, within hours, by specifically attacking the organic matrix present in these stones. Methods: In contrast to previous studies, we focused on the possible "brick and mortar" stone configuration. We systematically tested, via in vitro experiments, the ability of an extensive range of 26 potential chemolysis agents to induce relatively fast disintegration (and/or dissolution) of a large set of natural CaOx stone fragments, extracted during endourological procedures, without regard to immediate clinical application. Each stone fragment was monitored for reduction in weight and other changes over 72 h. Results: We find that agents known to attack organic material have little, if any, effect on stone chemolysis. Similarly, protein and enzymatic agents, and oral additive medical treatments, have little immediate effect. Conclusions: These findings suggest that the organic and inorganic constituents present in CaOx stones are not structured as "brick and mortar" configurations in terms of inorganic and organic components.
MeSH term(s)	Calcium Oxalate/analysis ; Feasibility Studies ; Humans ; Kidney Calculi/chemistry ; Kidney Calculi/drug therapy
Chemical Substances	Calcium Oxalate (2612HC57YE)
Language	English
Publishing date	2021-03-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2059857-9
ISSN	1471-2490 ; 1471-2490
ISSN (online)	1471-2490
ISSN	1471-2490
DOI	10.1186/s12894-021-00818-3
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Article: Do patients with ureterolithiasis treated conservatively return to follow up?

Modai, Jonathan / Barda, Noam / Avda, Yuval / Shpunt, Igal / Leibovici, Dan / Shilo, Yaniv

The Canadian journal of urology

2021 Volume 28, Issue 1, Page(s) 10536–10541

Abstract: INTRODUCTION Distal ureteral stones (DUS) are common in patients presenting to the emergency department (ED) with renal colic. The majority of DUS will pass spontaneously and therefore conservative care is common. Follow up is imperative as some of these ...

Abstract	INTRODUCTION Distal ureteral stones (DUS) are common in patients presenting to the emergency department (ED) with renal colic. The majority of DUS will pass spontaneously and therefore conservative care is common. Follow up is imperative as some of these stones might not pass and potentially lead to complications. The aim of our study was to evaluate the rate of compliance with follow up and to find predictive variables for it. Materials and methods: We retrospectively surveyed the medical records of all patients who had a non-contrast computed tomography (NCCT) at our ED between 01/03/16 and 31/5/17. We included patients with a DUS smaller than 10 mm that were treated conservatively. We obtained demographic, clinical, laboratory and imaging data. Compliance to follow up was evaluated by surveying the medical records and by calling the patients. We then compared the characteristics of patients who returned for follow up to those who did not. Results: A total of 230 consecutive patients were included in our cohort: 194 (84%) patients were male and the average age was 46 y (21-82); 138 patients (60%) returned for a follow up visit while 92 patients (40%) did not. Univariate analysis revealed stone size and admission to hospital to be predictive of compliance to follow up while multivariate analysis revealed only hospital admission to be predictive of compliance. Conclusions: Only 60% of the patients with DUS treated conservatively return for a follow up visit. Hospital admission, which likely reflects appropriate patients counseling by a urologist and adequate follow up scheduling, was found to be associated with increased compliance with follow up.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Conservative Treatment ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ureteral Calculi/therapy ; Young Adult
Language	English
Publishing date	2021-02-24
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2064475-9
ISSN	1195-9479
ISSN	1195-9479
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Zs.A 5607: Show issues

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Article: Adjuvant chemotherapy after radical cystectomy: Do all patients who need chemotherapy after surgery actually receive it?

Croock, Roy / Modai, Jonathan / Avda, Yuval / Shpunt, Igal / Jaber, Morad / Peretz, Yamit / Shilo, Yaniv / Leibovici, Dan

Current urology

2022 Volume 17, Issue 2, Page(s) 109–112

Abstract: Background: Compliance with the guideline recommendations for neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer is incomplete. The adjuvant chemotherapy approach has the advantage of pathology-based decision-making, allowing for ... ...

Abstract	Background: Compliance with the guideline recommendations for neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer is incomplete. The adjuvant chemotherapy approach has the advantage of pathology-based decision-making, allowing for patient selection. In addition, radical surgery is not delayed and treatment-related toxicity does not impair surgical fitness. The proportion of patients who completed chemotherapy after cystectomy among those who were fit and in need of treatment were evaluated. The reasons for not completing adjuvant chemotherapy were determined. Materials and methods: We retrospectively evaluated all patients who had undergone radical cystectomy at our center over the last 7 years. Indications for adjuvant chemotherapy included pathological T > 2, any node+, or surgical margin involvement. Only patients who were fit for chemotherapy before surgery were included in the study. Results: Of the 52 patients with muscle-invasive bladder cancer, 14 received neoadjuvant chemotherapy or unfit for chemotherapy were excluded. Of the remaining 38 patients, 14 (37%) had bladder-confined cancers and did not require additional chemotherapy. Of the 24 patients who needed chemotherapy and were fit to receive it, 8 patients completed treatment (33%), and 3 discontinued treatment due to toxicity. Twelve patients (50%) declined chemotherapy, whereas 1 patient became unfit for chemotherapy after surgery. Conclusions: While the adjuvant chemotherapy approach could save unnecessary treatment in 37% of patients, two-thirds of those who needed chemotherapy did not complete it. Patient refusal was the primary reason for not receiving treatment.
Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2253664-4
ISSN	1661-7657 ; 1661-7649
ISSN (online)	1661-7657
ISSN	1661-7649
DOI	10.1097/CU9.0000000000000099
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Zs.A 6628: Show issues

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Article ; Online: The Impact of Ureteral Deformation and External Ureteral Pressure on Stent Failure in Extrinsic Ureteral Obstruction: An

Shilo, Yaniv / Modai, Jonathan / Leibovici, Dan / Dror, Ishai / Berkowitz, Brian

Journal of endourology

2019 Volume 34, Issue 1, Page(s) 68–73

Abstract: Background and Purpose: ...

Abstract	Background and Purpose:
MeSH term(s)	Cystoscopy ; Humans ; Hydrodynamics ; In Vitro Techniques/methods ; Kidney/physiology ; Pressure/adverse effects ; Prosthesis Failure/etiology ; Research Design ; Stents ; Ureter/physiopathology ; Ureteral Obstruction/surgery
Language	English
Publishing date	2019-08-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	356931-7
ISSN	1557-900X ; 0892-7790
ISSN (online)	1557-900X
ISSN	0892-7790
DOI	10.1089/end.2019.0465
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Zs.A 2628: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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