Endourologic procedures combined with other surgical and urologic interventions--early experience.
OBJECTIVE
To assess the feasibility of performing endourologic interventions combined with other operations during the same operative session.


METHODS
Eighteen patients underwent simultaneous operations endourologically for upper urinary tract pathologic findings and other surgical and urologic indications. The operating time, technical feasibility, operative success, complications, hospital stay, and patient satisfaction were analyzed.


RESULTS
The average patient age was 63 years (range 40 to 83). Five patients underwent percutaneous nephrolithotomy combined with either contralateral laparoscopic nephrectomy, contralateral open nephrectomy, radical retropubic prostatectomy, inguinal/umbilical hernia repair, transurethral resection of prostate, or cystolithotripsy. Thirteen patients underwent 15 retrograde endoscopic procedures (13 for stone disease and 2 for diagnostic purposes) that were combined with open contralateral nephrectomy, inguinal hernia repair, circumcision, closure of ileostomy, transurethral resection of bladder tumor, excision of lymphoma of thigh, drainage and sclerozation of hydrocele, or percutaneous gastrostomy. All procedures were successfully completed without complications. The average hospital stay was 5 days (range 3 to 6) in the percutaneous nephrolithotomy group and 2 days (range 1 to 5) in the retrograde endoscopic procedure group. The duration of hospitalization was related to the more complex operation; combining the procedures did not prolong it. The average follow-up was 11 months (range 3 to 24). All patients were highly satisfied because they were spared the need for more than one surgical session.


CONCLUSIONS
Our results support the concept of performing simultaneous endourologic procedures and other operations during one surgical session. This approach obviates the need for repeated anesthesia, patient inconvenience, the psychological stress related to multiple operations, and reduces the total hospital stay.
Sofer
Mario
M
Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel.
Kaver
Issac
I
Chen
Juza
J
Nadu
Andrei
A
Beri
Avi
A
Mabjeesh
Nicola J
NJ
Greenstein
Alexander
A
Matzkin
Haim
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000601:surgery; D007902:Length of Stay; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009403:Nephrostomy, Percutaneous; D013997:Time Factors; D020728:Transurethral Resection of Prostate; D014513:Ureter / Q000601:surgery; D018666:Ureteroscopy; D014570:Urologic Diseases / Q000453:epidemiology / Q000601:surgery*; D013520:Urologic Surgical Procedures