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Morozov A, Chuvalov L, Taratkin M, Enikeev M, Rapoport L, Singla N, Barret E, Poddubskaya E, Borodina M, Salomon G, Rivas JG, Enikeev D. A systematic review of cytoreductive prostatectomy outcomes and complications in oligometastatic disease. Asian J Urol 2024; 11:208-220. [PMID: 38680575 PMCID: PMC11053306 DOI: 10.1016/j.ajur.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/07/2022] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To analyze outcomes and complications of cytoreductive prostatectomy (CRP) for oligometastatic prostate cancer (PCa) in order to elucidate its role in this space. Methods We performed a systematic literature search using three databases (Medline, Scopus, and Web of Science). The primary endpoints were oncologic outcomes. The secondary endpoints were complication rates and functional results. Results In all studies, overall survival was better or at least comparable variable in the groups with CRP compared to no local treatment. The greatest benefit from CRP in 5-year overall survival in one study was 67.4% for CRP versus 22.5% for no local treatment. Cancer-specific survival (CSS) showed the same trend. Several authors found significant benefits from CSS in the CRP group: from 79% vs. 46% to 100% vs. 61%. CRP was a predictor of better CSS (hazard ratio 0.264, p=0.004). Positive surgical margin rates differed widely from 28.6% to 100.0%. Urinary continence in CRP versus RP for localized PCa was significantly lower (57.4% vs. 90.8%, p<0.0001). Severe incontinence occurred seldom (2.5%-18.6%). Total complication rates after CRP differed widely, from 7.0% to 43.6%. Rates of grades 1 and 2 events prevailed. Patients on ADT alone also showed a considerable number of complications varying from 5.9% to 57.7%. Conclusion CRP improves medium-term cancer control in patients with oligometastatic PCa. The morbidity and complication rates of this surgery are comparable with other approaches, but postoperative incontinence rate is higher compared with RP for localized disease.
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Affiliation(s)
- Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Chuvalov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Young Academic Urologists, EAU, the Netherlands
| | - Mikhail Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Nirmish Singla
- Department of Urology, James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Eric Barret
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | | | - Maria Borodina
- Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - Georg Salomon
- Martini Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Juan Gomez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, Medical University of Vienna, Vienna, Austria
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Dymov A, Shpot E, Proskura A, Sukhanov R, Lekarev V, Karakotov T, Lee Y, Rapoport L. Thulium fiber laser for bladder leiomyoma treatment. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01283-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Enikeev D, Taratkin M, Azilgareeva C, Shpikina A, Rapoport L, Sukhanov R, Glybochko P. Thulium Fiber Laser: A Universal Device in Urology. From bench to bedside. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Taratkin M, Azilgareeva C, Taratkina D, Goryacheva E, Rapoport L, Enikeev D. Laser endoscopic procedures on the prostate: it is the small details that count. Curr Opin Urol 2021; 31:468-472. [PMID: 34231543 DOI: 10.1097/mou.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This review aims to highlight the pros and cons of each laser device and to consider additional possible milestones for the development of laser technologies in the surgical treatment of benign prostate hyperplasia. RECENT FINDINGS Over the last three decades, lasers' role in endourology has gone from strength to strength. Specifically, the primary techniques where laser surgery for BPO relief is concerned are vaporization and enucleation. The idea behind vaporization is that lasers are able to vaporize substantial amounts of tissue due to deep ablation depth and increased power. The most efficient devices for vaporization are those affecting hemoglobin as primary chromophore and/or using a continuous firing mode (KTP/LBO:YAG, diode lasers, Tm:YAG). As for enucleation, multiple devices have been suggested for the adequate anatomical enucleation of the prostate (EEP). As it is a skill-dependent technique, the EEP is effective irrespective of which device the surgeon uses. However, some devices have shown significant advances where enucleation is concerned. SUMMARY The choice of device should be based primarily on the technique the surgeon prefers. Although the most suitable lasers for vaporization are hemoglobin-targeting and/or continuous wave devices, the EEP may be done with any enough powered laser, yet some provides specific effects which you should be aware before the surgery.
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Spivak L, Morozov A, Shpikina A, Enikeev D, Rapoport L. Postoperative medical treatment of lower urinary tract symptoms after benign prostatic hyperplasia surgery. Are we underestimating the problem? Curr Opin Urol 2021; 31:451-455. [PMID: 34175875 DOI: 10.1097/mou.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to determine whether well timed start of medical and surgical treatment of benign prostatic obstruction (BPO) influences the treatment's effectiveness and thus the patients' overall functional outcomes and quality of life. RECENT FINDINGS Pharmacological therapy even in high-volume (>80 cm3) BPH typically begins with α-blockers sole and only subsequently are 5ARI added. Several studies showed that acute urinary retention (AUR) developed more frequently in men who suffered severe lower urinary tract symptoms (LUTS) and who did not start combination therapy immediately. Moreover, there are no strict criteria which determine the right time for performing surgery in patients with mild and moderate LUTS, especially when pharmacological therapy fails. However, sometimes, the surgery does not eliminate all the symptoms, as it deals effectively with BPO, but does not treat an overactive bladder. Also, data show that surgery should be performed as soon as possible and be more radical after the first episode of AUR. SUMMARY A combination of α-blockers and 5ARI makes for a good starting point where the treatment of high volume BPH is concerned. Ideally, surgery should be performed immediately or as soon as possible in patients with the first episode of AUR and 'anatomic' BPH tissue removal is preferable (dissection of tissue along the prostate capsule to remove its maximum volume).
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Affiliation(s)
| | | | - Anastasia Shpikina
- International School 'Medicine of the Future', Sechenov University, Moscow, Russia
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Ghandour RA, Freifeld Y, Cheaib J, Singla N, Meng X, Kenigsberg A, Bagrodia A, Woldu S, Hoffman-Censits J, Enikeev D, Rapoport L, Petros FG, Raman JD, Pierorazio PM, Matin SF, Margulis V. Predictive model for systemic recurrence following cisplatin-based neoadjuvant chemotherapy and radical nephroureterectomy for high risk upper tract urothelial carcinoma. Urol Oncol 2021; 39:788.e15-788.e21. [PMID: 34330655 DOI: 10.1016/j.urolonc.2021.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/13/2021] [Accepted: 05/30/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Neoadjuvant chemotherapy (NAC) is increasingly used prior to radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Systemic recurrence (SR) carries a dismal prognosis. We sought to determine risk factors associated with SR in this setting. METHODS We evaluated a multi-center database of patients with UTUC who received cisplatin-based NAC before RNU. Final pathology at RNU was dichotomized into ypT<2 vs ypT≥2. Univariable and multivariable analyses were performed to identify risk factors associated with SR. Three groups were defined based on the number of significant risk factors (groups 1, 2, 3 for 0-1, 2, 3 risk factors, respectively) and evaluated for recurrence-free survival (RFS) using the Kaplan-Meier method. RESULTS 106 patients were identified between 2004 and 2018. Median age was 67.0 years [IQR = 61-73.3]; 57 (54%) and 49 (46 %) patients received MVAC and GC, respectively. Final pathological stage was ypT<2 in 57 (54%); 23% (24/106) had SR. On univariable analysis, pathological variables on final specimen including ypT≥2, lymphovascular invasion (ypLVI), and nodal involvement were associated with SR. On multivariable analysis, ypLVI OR = 4.1 (95% CI 1.2-13.6; P = 0.024) and pathological nodal involvement OR = 4.5 (95% CI 1.3-15.7; P = 0.017) were predictive of recurrence. Stratifying by the number of risk factors, the 2-year RFS was 95%, 55%, and 18% for groups 1, 2, and 3 respectively (log-rank <0.001). CONCLUSION This model evaluates the risk of SR following NAC and RNU to guide counseling and decision-making after surgery. Adverse pathological variable including ypLVI and nodal involvement, in combination with ypT-stage, are strongly associated with SR.
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Affiliation(s)
- Rashed A Ghandour
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH.
| | - Yuval Freifeld
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Joseph Cheaib
- The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nirmish Singla
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Xiaosong Meng
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alexander Kenigsberg
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Aditya Bagrodia
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Solomon Woldu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jean Hoffman-Censits
- The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow
| | - Firas G Petros
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jay D Raman
- Division of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - Philip M Pierorazio
- The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Surena F Matin
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Institute for Urology and Reproductive Health, Sechenov University, Moscow
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Sirota E, Vovdenko S, Sirota A, Tsarichenko D, Rapoport L, Alyaev Y. 3D modeling in adherent perinephric fat prediction in nephron-sparing surgery planning in patients with localized renal neoplasms. Urologia 2021; 88:337-342. [PMID: 33724084 DOI: 10.1177/03915603211001695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE To develop a 3D-image based morphometry scoring system for Adherent Perinephric Fat (APF) prediction in nephron-sparing surgery in renal neoplasm patients. MATERIALS AND METHODS The retrospective study involved 391 patients who underwent a laparoscopic partial nephrectomy performed by five surgeons from January 2014 till December 2018. The surgery involved the 3D virtual operation planning with «Amira» 3D modeling software. With the multivariate logistic regression models, we developed a scoring system based on 3D-models. We tested the significance and sensitivity of new scoring system in a comparative ROC analysis with Mayo Adhesive Probability Score (MAP). RESULTS We found APF in 111 patients (28.4%). The univariate analysis revealed that significant indicators included mean age 59.88 (55-67) (p < 0.001), male sex (p < 0.001), Body Mass Index (BMI) >30 (21.47-35.08) kg/m2 (p < 0.001), arterial hypertension (p < 0.001), coronary heart disease (p = 0.019), diabetes mellitus (p = 0.005), urolithiasis (p = 0.002). The multivariate regression analysis identified three most significant indicators in 3D models evaluation: additional >5 mm shadows in perirenal space OR = 7.3 (3.6-15.3) (p < 0.001), the number of shadows >5 OR = 3.8 (2.1-6.8) (p < 0.001), the wide shadow base at the renal parenchymal level OR = 0.293 (0.146-0.588) (p = 0.001). The scoring of these indicators comprises a new prediction scale (0-5). The ROC analysis revealed AUC 0.816 (95% CI 0.772-0.861) p < 0.001 of the MAP score, and AUC = 0.803 (95% CI 0.758-0.848) p < 0.001 of the scoring system developed in the present study. CONCLUSIONS The statistical findings comparison of the scoring system that we developed with those of MAP scale suggests that the scoring system is efficient and applicable.
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Affiliation(s)
- Evgeny Sirota
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Stanislav Vovdenko
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Anastasia Sirota
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Dmitrii Tsarichenko
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Yuri Alyaev
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Kenigsberg AP, Smith W, Meng X, Ghandour R, Rapoport L, Bagrodia A, Lotan Y, Woldu SL, Margulis V. Robotic Nephroureterectomy vs Laparoscopic Nephroureterectomy: Increased Utilization, Rates of Lymphadenectomy, Decreased Morbidity Robotically. J Endourol 2020; 35:312-318. [PMID: 33081512 DOI: 10.1089/end.2020.0496] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction and Objective: Robotic radical nephroureterectomy (RRNU) may offer advantages over laparoscopic radical nephroureterectomy (LRNU). The purpose of this study is to evaluate the overall survival (OS) of patients with upper tract urothelial carcinoma (UTUC) who underwent RRNU vs LRNU and identify factors that account for differences. Methods: The National Cancer Database was queried from 2010 to 2016 for patients with American Joint Committee on Cancer 6th/7th edition Stage I/II/III UTUC. Kaplan-Meier analysis compared LRNU and RRNU OS. Univariate analysis detected differences between the groups. Cox regression determined factors associated with mortality rate. Logistic regression identified predictors of a lymph node dissection (LND) and 90-day mortality rate. Results: A total of 2631 patients met the criteria, 1129 of whom underwent RRNU and 1502 LRNU, with a follow-up of 33 and 35 months, respectively (p = 0.063). RRNU had a median OS of 71.1 vs 62.6 months (p = 0.033). LRNU patients were older (72.7 vs 71.4, p < 0.001) and had no differences in comorbidities, pathologic T stage, or grade. The LRNU cohort was less likely to undergo LND (19% vs 35%, p < 0.001) and had a lower median lymph node yield (3 vs 4, p < 0.001). LRNU patients more likely underwent conversion to an open procedure, had longer hospital stays, and higher 30- and 90-day mortality rates. LRNU was independently associated with mortality rate (p = 0.030). Age, grade, positive margins, pT/pN stage were associated with mortality rate. Younger age, RRNU, surgery at an academic center, and neoadjuvant chemotherapy predicted an LND. Conclusions: RRNU demonstrated increased rates of LND and may offer a short-term morbidity benefit to LRNU. Survival differences may be due to improved characterization of disease through LND.
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Affiliation(s)
- Alexander P Kenigsberg
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Wesley Smith
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Xiaosong Meng
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rashed Ghandour
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Aditya Bagrodia
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Yair Lotan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Solomon L Woldu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Rapoport L, Poole DN, Kazanas K, Mourtzaki M, Bump JB. Distal determinants of mental health conditions (MHC) for asylum-seeking children in Greece: A health system enhancement study. Health Policy 2020; 124:1137-1145. [PMID: 32773126 DOI: 10.1016/j.healthpol.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022]
Abstract
Mental health conditions (MHC) of asylum-seeking children in Greece are dire, but still recovering from the financial crisis, Greece cannot afford the cost of mental health treatments. We were motivated to understand the root causes of these mental health problems to explore the possibilities for prevention. We developed our inferences in four ways: (1) secondary analyses of thirty-nine semi-structured informational interviews conducted with national and international aid organizations and healthcare providers; (2) secondary analyses of nine interviews with asylum seekers; (3) direct observation during six refugee camp visits from June 1 to July 28, 2017; and (4) a literature review to develop a diagnostic tree of causal outcomes. Results revealed eight proximal causes: chronic stress, trauma, at-risk population without protection and assistance, the large number of vulnerable groups, feeling of insecurity, feeling of lacking control, a lack of autonomy, and feeling helpless and hopeless. We identified sixty-nine distal determinants of adverse MHC beneath the proximal causes. Too numerous and too diverse to treat effecvively with limited resources, these root causes of MHC were thematically grouped into: laws and regulations, capacity and resources, accountability and standards, prioritization, bias and stigma, and displacement. Using a common health systems framework, we developed strategic policy approaches to target the root causes, which could prevent ill-health while saving time and resources.
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Affiliation(s)
- L Rapoport
- Harvard T.H. Chan School of Public Health, Global Health & Population, Boston, MA, USA.
| | - D N Poole
- Harvard T.H. Chan School of Public Health, Global Health & Population, Boston, MA, USA
| | | | | | - J B Bump
- Harvard T.H. Chan School of Public Health, Global Health & Population, Boston, MA, USA
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Becker B, Enikeev D, Netsch C, Gross AJ, Laukhtina E, Glybochko P, Rapoport L, Herrmann TR, Taratkin M. Comparative Analysis of Vaporization and Coagulation Properties of a Hybrid Laser (Combination of a Thulium and Blue Diode Laser) Vs Thulium and Ho:YAG Lasers: Potential Applications in Endoscopic Enucleation of the Prostate. J Endourol 2020; 34:862-867. [DOI: 10.1089/end.2020.0009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Benedikt Becker
- Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Andreas J. Gross
- Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Enikeev D, Taratkin M, Alyaev Y, Rapoport L, Korolev D, Ali S, Klimov R, Glybochko P. Super-pulse thulium-fiber laser for lithotripsy: First clinical experience in percutaneous nephrolithotomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32789-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Enikeev D, Rapoport L, Gazimiev M, Taratkin M, Laukhtina E, Sung J, Okhunov Z, Glybochko P. Prospective randomized study of monopolar enucleation vs transurethral resection of the prostate: Two year follow up. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34280-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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13
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Korolev D, Rapoport L, Tsarichenko D, Enikeev M, Taratkin M, Enikeev D, Glybochko P. Antegrade flexible nephroscopy (second-look) in gas (CO2) medium: New technique for residual stones removal. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33854-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Enikeev D, Taratkin M, Margulis V, Sorokin N, Severgina L, Paramonova N, Kislyakov D, Kozlov V, Rapoport L, Shariat SF, Glybochko P. Safety and Short-Term Oncological Outcomes of Thulium Fiber Laser En Bloc Resection of Non-Muscle-Invasive Bladder Cancer: A Prospective Non-Randomized Phase II Trial. Bladder Cancer 2020. [DOI: 10.3233/blc-200275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Ongoing efforts aim at overcoming the challenges of conventional transurethral resection of bladder tumor (TURBT) such as the high recurrence rate, difficulty of pathologic interpretation and complications including wall injury. OBJECTIVE: To prospectively assess the safety and efficacy of Thulium fiber en bloc resection of bladder tumor (Tm-fiber ERBT) compared to TURBT. MATERIALS AND METHODS: The prospective non-randomized study included 129 patients with non-muscle-invasive bladder cancer (NMIBC) divided into two groups: 58 patients underwent conventional TURBT and 71 –Tm-fiber ERBT with FiberLase U1 (NTO IRE-Polus, Russia). Relapse-free survival (RFS), detrusor presence and complication rates were assessed. For multivariable analysis we used the Pearson chi-squared Hosmer-Lemeshow goodness of fit test; to compare survival –Cox regression analysis; for operative data comparison –chi-square test with Fisher’s correction; for survival analysis –the Kaplan–Meier method and logrank test. RESULTS: RFS rates at 3 and 6 months were 84.5% and 67.2% for conventional TURBT versus 97.2% and 91.5% for Tm-fiber ERBT (p = 0.011 and p < 0.001, respectively). Detrusor muscle was present in 58.6% of cases treated with conventional TURBT vs 91.6% for the Tm-fiber ERBT group (p < 0.001). The obturator nerve reflex and bleeding were noted in 17.2% and 10.3% of TURBT cases, respectively; and in none of cases treated with Tm-fiber ERBT. Limitations included the non–randomized nature and the small sample size. CONCLUSIONS: Tm-fiber ERBT seems to be a safe and efficacious treatment option for NMIBC. Tm-fiber ERBT had fewer adverse events, was more likely to secure detrusor muscle in the specimen and resulted in better RFS rates than conventional TURBT. Based on these promising data, we have started a prospective randomized clinical trial comparing en bloc TURBT with conventional TURBT (ClinicalTrials.gov NCT03718754).
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Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Vitaly Margulis
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nikolay Sorokin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Lubov Severgina
- Department of Pathology, Sechenov University, Moscow, Russia
| | - Nina Paramonova
- Centralized Pathology Department, Sechenov University, Moscow, Russia
| | - Dmitry Kislyakov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Vasiliy Kozlov
- Department of Public Health and Healthcare Organization, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Shahrokh F. Shariat
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Weill Medical College of Cornell University, New York, NY, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Enikeev D, Taratkin M, Klimov R, Alyaev Y, Rapoport L, Gazimiev M, Korolev D, Ali S, Akopyan G, Tsarichenko D, Markovina I, Ventimiglia E, Goryacheva E, Okhunov Z, Jefferson FA, Glybochko P, Traxer O. Thulium-fiber laser for lithotripsy: first clinical experience in percutaneous nephrolithotomy. World J Urol 2020; 38:3069-3074. [PMID: 32108256 DOI: 10.1007/s00345-020-03134-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/09/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the efficacy and safety of thulium-fiber laser (TFL) in laser lithotripsy during percutaneous nephrolithotomy (PCNL). METHODS Patients with stones < 30 mm were prospectively recruited to undergo PCNL using TFL "FiberLase" (NTO IRE-Polus, Russia). Stone size, stone density, operative time, and "laser on" time (LOT) were recorded. Study included only cases managed with fragmentation. Stone-free rate and residual fragments were determined on postoperative computer tomography. Complications were classified using the Clavien-Dindo grade. Stone retropulsion and endoscopic visibility were assessed based on surgeons' feedback using a questionnaire. RESULTS A total of 120 patients were included in the study with a mean age of 52 (± 1.8) years; of these 77 (56%) were males. Mean stone size was 12.5 (± 8.8) mm with a mean density of 1019 (± 375) HU. Mean operative time was 23.4 (± 17.9) min and mean LOT was 5.0 (± 5.7) min. Most used settings were of 0.8 J/25-30 W/31-38 Hz (fragmentation). The mean total energy for stone ablation was 3.6 (± 4.3) kJ. Overall stone-free rate was 85%. The overall complication rate was 17%. Surgeons reported stone retropulsion that interfered with surgery in 2 (1.7%) cases insignificant retropulsion was noted in 16 (10.8%) cases. Poor visualization was reported in three (2.5%) cases and minor difficulties with visibility in four (3.3%) cases. CONCLUSIONS TFL is a safe and effective modality for lithotripsy during PCNL and results in minimal retropulsion.
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Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation.
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Roman Klimov
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Yuriy Alyaev
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Magomed Gazimiev
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Dmitry Korolev
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Stanislav Ali
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Gagik Akopyan
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Dmitry Tsarichenko
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Irina Markovina
- Institute of Linguistics and Intercultural Communication, Sechenov University, Moscow, Russia
| | - Eugenio Ventimiglia
- GRC #20 Lithiase Urinaire, Hôpital Tenon, Sorbonne University, Paris, France
| | | | | | - Francis A Jefferson
- Institute of Linguistics and Intercultural Communication, Sechenov University, Moscow, Russia
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St., Moscow, 119991, Russian Federation
| | - Olivier Traxer
- GRC #20 Lithiase Urinaire, Hôpital Tenon, Sorbonne University, Paris, France
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Enikeev M, Gahan J, Yossepowitch O, Rapoport L, Grigoryan V, Abdusalamov A, Lobanov M, Chuvalov L, Taratkin M, Ali S, Gaas M, Enikeev D, Glybochko P. Extracorporeal ureter handling during laparoscopic pyeloplasty: tips and tricks for beginners. Cent European J Urol 2020; 72:413-417. [PMID: 32015913 PMCID: PMC6979559 DOI: 10.5173/ceju.2019.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/04/2019] [Accepted: 11/16/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction Laparoscopic preparation of the ureter is a challenging part of upper urinary tract reconstruction, due to limited depth perception provided by the camera and lack of wristed motion of most laparoscopic instruments needed for adequate spatulation and scar tissue removal. One solution has been to perform the more difficult portions of the surgery in an extracorporeal manner. A hybrid intracorporeal-extracorporeal approach to upper tract ureteral reconstruction facilitates ureteral preparation at the stage of mastering the technique. Material and methods This retrospective study included 100 patients with primary ureteropelvic junction obstruction, who underwent laparoscopic pyeloplasty from 2014 to 2017. The patients were stratified into 2 groups: those who underwent conventional laparoscopic surgery and those who were managed with the hybrid approach. For the hybrid approach, externalizing the ureter to skin level required additional mobilization of the upper urinary tract. Results A total of 47 patients underwent conventional laparoscopic pyeloplasty and 53 - hybrid surgery. The maximum body mass index was 32. The hybrid approach was 8.5 minutes shorter compared to the conventional approach (p <0.001). No complications higher than Clavien-Dindo IIIb (n = 2) were observed (in both groups). Complete success (the resolution of pain and/or hydronephrosis) was observed in 92.5% in the hybrid group and in 95.7% in the conventional treatment group. Conclusions Hybrid pyeloplasty may be considered safe and effective. It has the advantage of making the surgery less challenging and time-consuming while offering improved precision. The advantages of the technique are particularly apparent during training. This technique can be recommended in the learning process of the surgeon.
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Affiliation(s)
- Mikhail Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Jeffrey Gahan
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ofer Yossepowitch
- Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Vagarshak Grigoryan
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Mikhail Lobanov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Chuvalov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Stanislav Ali
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Margarita Gaas
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Snurnitsyna O, Inoyatov Z, Abdusalamov A, Malinina O, Lobanov M, Demidko Y, Rapoport L, Enikeev M. Minimally invasive surgical treatment of postcoital cystitis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30081-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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18
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Enikeev D, Taratkin M, Dymov A, Rapoport L, Alyaev Y, Glybochko P. Thulium fiber laser en-bloc resection of non-muscle-invasive bladder cancer: First results. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Enikeev D, Rapoport L, Adelman K, Taratkin M, Glybochko P. Thulium fiber laser: A universal device in urology. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Snurnitsyna O, Lobanov M, Abdusalamov A, Inoyatov Z, Rapoport L, Nikitin A, Enikeev M. Transvaginal mesh for surgical repair of anterior-apical prolapse: A multicenter study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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21
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Enikeev M, Paramonova N, Shelokova E, Chuvalov L, Rezvyh I, Fokin I, Vorobyov A, Lobanov M, Gaas M, Rapoport L. Robot-assisted fascia- and nerve-sparing prostatectomy: Early oncological and functional outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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22
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Enikeev D, Rapoport L, Gazimiev M, Allenov S, Inoyatov J, Taratkin M, Laukhtina E, Sung J, Okhunov Z, Glybochko P. Prospective randomized study of monopolar enucleation and transurethral resection of the prostate for small and medium-sized glands (<80cc). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30002-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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23
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Enikeev D, Chinenov D, Alekseeva T, Taratkin M, Perekalina A, Rapoport L, Glybochko P. Focal irreversible electroporation for management of localized prostate cancer: Initial results. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)30035-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Singla N, Elias R, Ghandour RA, Freifeld Y, Bowman IA, Rapoport L, Enikeev M, Lohrey J, Woldu SL, Gahan JC, Bagrodia A, Brugarolas J, Hammers HJ, Margulis V. Pathologic response and surgical outcomes in patients undergoing nephrectomy following receipt of immune checkpoint inhibitors for renal cell carcinoma. Urol Oncol 2019; 37:924-931. [DOI: 10.1016/j.urolonc.2019.08.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/26/2019] [Accepted: 08/19/2019] [Indexed: 01/16/2023]
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25
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Enikeev D, Netsch C, Rapoport L, Gazimiev M, Laukhtina E, Snurnitsyna O, Alekseeva T, Becker B, Taratkin M, Glybochko P. Novel thulium fiber laser for endoscopic enucleation of the prostate: A prospective comparison with conventional transurethral resection of the prostate. Int J Urol 2019; 26:1138-1143. [DOI: 10.1111/iju.14115] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/01/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | | | - Leonid Rapoport
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Magomed Gazimiev
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Olesya Snurnitsyna
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Tatyana Alekseeva
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Benedikt Becker
- Department of Urology Asklepios Hospital Barmbek Hamburg Germany
| | - Mark Taratkin
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Petr Glybochko
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
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Abstract
A common problem which we encounter on a daily basis is dispensing of yield stress fluids such as condiments, lotions, toothpaste, etc. from containers. Beyond consumer products, assuring the flow of yield stress fluids such as crude oil, mud, blood, paint, pharmaceutical products, and others, is essential for the respective industries. Elimination of wall-induced friction can lead to significant savings in the energy required for flow of yield stress fluids, as well as associated product loss and cleaning costs. Lubricant-impregnated surfaces (LIS) have been shown to change the dynamic behavior of yield stress fluids and enable them to flow without shearing. Despite the wide applicability of this technology and its general appeal, the fundamental physics governing the flow of yield stress fluids on LIS have not yet been fully explained. In this work, we study the mobility of yield stress fluids on LIS, and explain the relationship between their macroscale flow behavior and the microscale properties of LIS. We show that for yield stress fluids the thermodynamic state of an LIS can be the difference between mobility and immobility. We demonstrate that LIS can induce mobility in yield stress fluids even below their yield stress allowing them to move as a plug without shearing with an infinite slip length. We identify different mobility mechanisms and establish a regime map for drag reduction in terms of the shear stress to yield stress ratio and the microscopic properties of the LIS. We demonstrate these regimes in a practical application of pipe flow thereby providing key insights for the design of LIS to induce mobility of yield stress fluids in a broad range of practical applications.
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Affiliation(s)
- Leonid Rapoport
- Department of Mechanical Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - Brian R Solomon
- Department of Mechanical Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
| | - Kripa K Varanasi
- Department of Mechanical Engineering , Massachusetts Institute of Technology , Cambridge , Massachusetts 02139 , United States
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27
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Enikeev D, Rapoport L, Gazimiev M, Allenov S, Inoyatov J, Taratkin M, Laukhtina E, Sung JM, Okhunov Z, Glybochko P. Monopolar enucleation versus transurethral resection of the prostate for small- and medium-sized (< 80 cc) benign prostate hyperplasia: a prospective analysis. World J Urol 2019; 38:167-173. [PMID: 30963229 DOI: 10.1007/s00345-019-02757-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/02/2019] [Indexed: 12/11/2022] Open
Abstract
AIM To assess efficacy and safety of monopolar enucleation of the prostate (MEP) and to compare it with the current treatment standard for medium-sized prostates, < 80 cc, transurethral resection of the prostate (TURP). METHODS A prospective analysis patients undergoing a surgical procedure for their diagnosis of BPH (benign prostatic hyperplasia) (IPSS > 20, Qmax < 10; prostate volume < 80 cc) was performed. IPSS, Qmax were assessed preoperatively, at 6 and 12 months postoperatively. The complications were classified according to the modified Clavien-Dindo grading system. RESULTS A total of 134 patients were included in the study: 70 underwent MEP and 64 - TURP for BPH (mean prostate volumes were comparable with p = 0.163). The mean surgery time was 44 min in the TURP group and 48.2 min in the MEP group, (p = 0.026). Catheterization time for MEP was 1.7 and 3.2 days for TURP (p < 0.001). Hospital stay for MEP was 3.2 days vs. 4.8 days for TURP (p < 0.001). Both techniques shown comparable efficiency in benign prostatic obstruction relief with IPSS drop in MEP from 23.1 to 5.9 and in TURP group from 22.8 to 7.3, whereas Qmax increased from 8.2 to 20.5 after MEP and from 8.3 and 19.9 after TURP. Urinary incontinence rate after catheter removal in TURP group was 9.0% and 7.8% in MEP group, at 1 year follow-up, it was 1.4% and 3.1% in MEP and TURP, respectively (p = 0.466). CONCLUSIONS Our experience demonstrated that MEP is an effective and safe BPH treatment option combining the efficacy of endoscopic enucleation techniques and accessibility of conventional TURP.
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Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation.
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
| | - Magomed Gazimiev
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
| | - Sergey Allenov
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
| | - Jasur Inoyatov
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
| | - John M Sung
- Department of Urology, University of California, Irvine, USA
| | | | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, 2/1 Bolshaya Pirogovskaya St, Moscow, 119991, Russian Federation
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Taratkin M, Enikeev D, Glybochko P, Netsch C, Becker B, Gross A, Rapoport L. Effect of fiber tip to tissue distance on resulting damage pattern: An in vitro study of four laser systems. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)31273-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Dymov A, Rapoport L, Enikeev D, Tsarichenko D, Sorokin N, Proskura A, Akopyan G, Ali S, Klimov R, Lekarev V, Korolev D. Prospective clinical study on superpulse thulium fiber laser: Initial analysis of optimal laser settings. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/s1569-9056(19)30372-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Enikeev D, Okhunov Z, Rapoport L, Taratkin M, Enikeev M, Snurnitsyna O, Capretz T, Inoyatov J, Glybochko P. Novel Thulium Fiber Laser for Enucleation of Prostate: A Retrospective Comparison with Open Simple Prostatectomy. J Endourol 2019; 33:16-21. [DOI: 10.1089/end.2018.0791] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Dmitry Enikeev
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, California
| | - Leonid Rapoport
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mikhail Enikeev
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Olesya Snurnitsyna
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Taylor Capretz
- Department of Urology, University of California, Irvine, California
| | - Jasur Inoyatov
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Petr Glybochko
- Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Rapoport L, Yossepowitch O, Shpot E, Chinenov D, Chernov Y, Yurova M, Enikeev D. Radical prostatectomy performed via robotic, transperitoneal and extraperitoneoscopic approaches: functional and early oncological outcomes. Cent European J Urol 2018; 71:378-385. [PMID: 30680229 PMCID: PMC6338822 DOI: 10.5173/ceju.2018.1739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/24/2018] [Accepted: 10/28/2018] [Indexed: 01/02/2023] Open
Abstract
Introduction Oncological remission along with high postoperative functionality [continence and erectile function (EF)] are the main aspects of prostate cancer (PCa) treatment. The aim of this study was to compare functional and oncological treatment results achieved after a nerve-sparing radical prostatectomy (RP) via transperitoneal (TPRP), extraperitoneal (EPRP) and robot-assisted (RARP) approach. Material and methods From March 2015 to March 2016, 507 RP were performed at the Institute for Urology and Reproductive Health (Moscow, Russia). A total of 264 patients with localized (cТ1а–2с) prostate cancer [prostate-specific antigen (PSA) <20 ng/ml, Gleason score ≤7], intact prostate capsule (according to MRI), International Index of Erectile Function (IIEF-5) ≥19 and a life expectancy >10 years were included into the retrospective study. All the surgeries were performed by a single surgeon. The outcomes were evaluated after urethral catheter removal and 3–6–12 months after RP. Results Nerve preservation (NP) was performed for 153 patients without significant distinctions in time (р = 0.064) and blood loss (р = 0.073). The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) score was lower for NP: 9.23 ±6.59 and 3.86 ±5.38 after 3 and 12 months respectively compared with continence after RP without nerve preservation (NP): 14.27 ±5.1 vs. 6.15 ±4.76 (р <0.001). Continent was 52.2% vs. 83.3% vs. 81.8% in TPRP, RARP and EPRP groups; р <0.001. IIEF-5 scores were 14.67 ±9.4, 4.2 ±4.26 and 4.0 ±2.07 after RARP, TPRP and EPRP respectively (р = 0.002). After 12 months the PSA: TPRP = 0.11 ±0.19, RARP = 0.03 ±0.05 and EPRP = 0.53 ±1.87 ng/ml (р <0.001). Outcomes depend on surgical approach and was better in the RARP-group (AUC = 0.768 ±0.034 (CI 95% 0,701–0.834; р <0.001). Conclusions We suggest RARP with NP as a method of choice for treatment of prostate cancer in patients interested in preservation of EF and quality of life in general.
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Affiliation(s)
- Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Evgeniy Shpot
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Denis Chinenov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Yaroslav Chernov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Enikeev D, Glybochko P, Rapoport L, Okhunov Z, O'Leary M, Potoldykova N, Sukhanov R, Enikeev M, Laukhtina E, Taratkin M. Impact of endoscopic enucleation of the prostate with thulium fiber laser on the erectile function. BMC Urol 2018; 18:87. [PMID: 30314492 PMCID: PMC6186032 DOI: 10.1186/s12894-018-0400-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/02/2018] [Indexed: 11/16/2022] Open
Abstract
Background The impact of number of endoscopic enucleation of the prostate techniques (holmium laser enucleation - HoLEP for example) on erectile function have already been investigated. However, the thulium-fiber laser, in this setting remains unstudied. In this study, we compared sexual function outcomes in patients with benign prostatic hyperplasia (BPH) treated with transurethral resection of the prostate (TURP) or thulium-fiber laser enucleation (ThuFLEP). Methods We performed a retrospective analysis of patients who underwent transurethral resection and endoscopic enucleation of the prostate for BPH; inclusion criteria was the presence of infravesical obstruction (IPSS > 20, Qmax < 10 mL/s). Erectile function (EF) was assessed using the International Index of Erectile Function (IIEF-5) both prior to endoscopic examination, and six months after. Results A total of 469 patients with BPH were included in the study; of these, 211 underwent to ThuFLEP, and 258 TURP. Preoperative IIEF-5 in TURP and ThuFLEP groups were 11.7 (±4.5) and 11.1 (±5.0), respectively (p = 0.17). At six month the IIEF-5 score was unchanged (p = 0.26 and p = 0.08) and comparable in both groups (p = 0.49). However, mean IIEF-5 score shown significant increase of 0.72 in ThuFLEP group, comparing to decrease of 0.24 in TURP patients (p < 0.001). Conclusions Both TURP and ThuFLEP are effective modalities in the management of infravesical obstruction due to BPH. At six months follow-up after surgery, both techniques lead to comparable IIEF-5 score. However, our results demonstrated that the ThuFLEP is more likely to preserve the erectile function leading to increase of IIEF-5 at six months in contrast to TURP which lead to slight drop in IIEF-5 score.
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Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine; Orange, CA, USA
| | - Mitchel O'Leary
- Department of Urology, University of California, Irvine; Orange, CA, USA
| | - Natalya Potoldykova
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Roman Sukhanov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mikhail Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Enikeev D, Glybochko P, Rapoport L, Gahan J, Gazimiev M, Spivak L, Enikeev M, Taratkin M. A Randomized Trial Comparing The Learning Curve of 3 Endoscopic Enucleation Techniques (HoLEP, ThuFLEP, and MEP) for BPH Using Mentoring Approach-Initial Results. Urology 2018; 121:51-57. [PMID: 30053397 DOI: 10.1016/j.urology.2018.06.045] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 05/30/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess the differences in the learning curve associated with different techniques of endoscopic enucleation of the prostate. MATERIALS AND METHODS Ninety patients were randomly assigned into 3 groups (30 patients in each): HoLEP, ThuFLEP or MEP. Inclusion criteria for the study included prostate volume <80 cc, IPSS > 20, or Qmax < 10. The EEPs were performed by 3 surgeons experienced in transurethral resection of the prostate. Assignment of surgeons to surgical technique was also randomized. None of the surgeons had prior experience in EEP. RESULTS ThuFLEP was slightly superior (with no significant difference [P > .05]) to HoLEP and MEP in terms of overall enucleation rate-1.0 g/min vs 0.8 g/min and 0.7 g/min, respectively. We observed similar enucleation rates at the initial stages of training (first 20 surgeries) with insignificant increase in ThuFLEP efficiency. At next 10 surgeries ThuFLEP and HoLEP efficiency were higher than of MEP (P < .001) without significant difference between techniques of laser EEP (P = .07). CONCLUSION Endoscopic enucleation of the prostate can be adopted safely and effectively within 30 surgeries if the technique is learned with a mentoring approach. EEP is shown to be safe and effective even in the initial stages of learning. Laser EEP (HoLEP, ThuFLEP) appears to lend itself to quicker adaptation compared MEP.
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Affiliation(s)
- Dmitry Enikeev
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation.
| | - Petr Glybochko
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
| | - Leonid Rapoport
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
| | - Jeffrey Gahan
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
| | - Magomed Gazimiev
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
| | - Leonid Spivak
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
| | - Mikhail Enikeev
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
| | - Mark Taratkin
- Sechenov University, Research Institute for Uronephrology and Reproductive Health, Russian Federation
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Becker B, Netsch C, Glybochko P, Rapoport L, Taratkin M, Enikeev D. A Feasibility Study Utilizing the Thulium and Holmium Laser in Patients for the Treatment of Recurrent Benign Prostatic Hyperplasia after Previous Prostatic Surgery. Urol Int 2018; 101:212-218. [DOI: 10.1159/000489858] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 05/04/2018] [Indexed: 11/19/2022]
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Enikeev D, Glybochko P, Okhunov Z, Alyaev Y, Rapoport L, Tsarichenko D, Enikeev M, Sorokin N, Dymov A, Taratkin M. Retrospective Analysis of Short-Term Outcomes After Monopolar Versus Laser Endoscopic Enucleation of the Prostate: A Single Center Experience. J Endourol 2018; 32:417-423. [DOI: 10.1089/end.2017.0898] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dmitry Enikeev
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Petr Glybochko
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, California, USA
| | - Yuriy Alyaev
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Leonid Rapoport
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Dmitry Tsarichenko
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Mikhail Enikeev
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Nikolay Sorokin
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alim Dymov
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Mark Taratkin
- Research Institute for Uronephrology and Reproductive Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Grechenkov A, Sukhanov R, Bezrukov E, Butnaru D, Barbagli G, Vasyutin I, Tivtikyan A, Rapoport L, Alyaev Y, Glybochko P. Risk factors for urethral stricture and/or bladder neck contracture after monopolar transurethral resection of the prostate for benign prostatic hyperplasia. Urologia 2018; 85:150-157. [DOI: 10.1177/0391560318758195] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objective: To identify risk factors for urethral stricture and/or bladder neck contracture after transurethral resection of benign prostatic hyperplasia. Materials and methods: We performed a retrospective analysis of 402 patients, which underwent a monopolar transurethral resection of the prostate in the urology clinic of Sechenov First Moscow State Medical University for prostatic hyperplasia during the period 2011–2014. Urethral stricture and (or) bladder neck contracture in the postoperative period were diagnosed in 61 (15.27%) patients; 34 patients (8.6%) had urethral stricture, 20 (4.97%) bladder neck contracture, and 7 (1.7%) had a combination of urethral stricture and bladder neck contracture. In 341 of cases (84.73%), no late postoperative complications were observed. A total of 106 of the 341 patients met the inclusion criteria, hence, containing all the information necessary for analysis such as the volume of the prostate, the duration of the surgery, the size of the endoscope, data on concomitant diseases, analysis prostatic secretion, and so on. Thus, two groups were formed. Group 1 (106 patients) is the control group in which urethral strictures and/or bladder neck contractures did not occur in the long-term postoperative period and group 2 (61 patients), in which was observed the formation of these complications. To calculate the statistical significance of the differences for categorical data, Fisher criterion was used. For quantitative variables, in the case of normal data distribution, an unpaired t-test or one-way analysis of variance was used; for data having a distribution different from normal, a Mann–Whitney rank test was used. Results: Regression analysis established the significance of the influence of four factors on the development of scar-sclerotic changes of urethra and bladder neck: the tool diameter 27 Fr ( p < 0.0001), presence of prostatitis in past medical history ( p < 0.0001), prostate volume ( p = 0.003), and redraining of the bladder ( p = 0.0162). Conclusion: The relationship between the diameter of the instrument, presence of chronic prostatitis in anamnesis, increased volume of the prostate, and repeated drainage of the bladder using the urethral catheter with the risk of developing scar-sclerotic changes in the urethra and/or bladder neck are statistically reliable and confirmed as a result of regression analysis.
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Affiliation(s)
- Anton Grechenkov
- Sechenov First Moscow State Medical University, Moscow, Russia
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Roman Sukhanov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Eugene Bezrukov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Denis Butnaru
- Sechenov First Moscow State Medical University, Moscow, Russia
- Research Institute of Molecular Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Igor Vasyutin
- Research Institute of Molecular Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Leonid Rapoport
- Sechenov First Moscow State Medical University, Moscow, Russia
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Yury Alyaev
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Peter Glybochko
- Sechenov First Moscow State Medical University, Moscow, Russia
- Research Institute of Uronephrology and Human Reproductive Health, Sechenov First Moscow State Medical University, Moscow, Russia
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Enikeev D, Glybochko P, Alyaev Y, Rapoport L, Tsarichenko D, Enikeev M, Sorokin N, Sukhanov R, Dymov A, Taratkin M. MP62-10 MONOPOLAR VERSUS LASER (THUFLEP, HOLEP) ENDOSCOPIC ENUCLEATION OF THE PROSTATE: A SINGLE-CENTER EXPERIENCE. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Enikeev D, Glybochko P, Alyaev Y, Rapoport L, Enikeev M, Sorokin N, Sukhanov R, Dymov A, Taratkin M. MP62-20 STENTING IN CASES OF URETERAL ORIFICE DAMAGE DURING LASER ENUCLEATION OF THE PROSTATE FOR BPH: IS IT WORTH IT? J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Traxer O, Rapoport L, Tsarichenko D, Dymov A, Enikeev D, Sorokin N, Ali S, Akopyan G, Korolev D, Proskura A, Lekarev V, Klimov R. V03-02 FIRST CLINICAL STUDY ON SUPERPULSE THULIUM FIBER LASER FOR LITHOTRIPSY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.827] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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40
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Becker B, Netsch C, Enikeev D, Glybochko P, Rapoport L, Taratkin M, Gross AJ. PD22-04 EFFECT OF LASER FIBER DIAMETER AND PEAK POWER ON THE RESULTING TISSUE DAMAGE ZONES IN A PIG KIDNEY MODEL. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gross A, Becker B, Taratkin M, Enikeev D, Rapoport L, Netsch C. MP24-10 WAVELENGTH AND PULSE SHAPE EFFECTS ON STONE FRAGMENTATION OF LASER LITHOTRIPTERS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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42
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Dymov A, Rapoport L, Vinarov A, Enikeev D, Sorokin N, Sukhanov R, Kislyakov D, Proskura A, Damiev A, Gololobov G. MP83-06 THULIUM FIBER LASER EN BLOC RESECTION OF BLADDER CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Rapoport L, Vinarov A, Enikeev D, Sorokin N, Dymov A, Sukhanov R, Kislyakov D, Proskura A, Damiev A, Gololobov G, Lekarev V. V05-01 TECHNICAL ASPECTS OF TRANSURETHRAL THULIUM LASER EN BLOC RESECTION OF BLADDER CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Glybochko P, Alyaev Y, Rapoport L, Enikeev D, Enikeev M, Sorokin N, Sukhanov R, Dymov A, Taratkin M. PDD-guided thulium fiber laser en-bloc enucleation of bladder tumor. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1569-9056(18)32370-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Enikeev D, Glybochko P, Alyaev Y, Rapoport L, Enikeev M, Taratkin M. Thulium fiber laser enucleation of the prostate in management of giant BPH (>200 cc). ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1569-9056(18)32380-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Boiling is significantly altered by the presence of dissolved salts. In particular, salts whose solubility decreases with temperature have the tendency to crystallize and adhere to the heat transfer surface and adversely affect the thermal performance. Scaling due to the precipitation of such salts poses serious operational and safety challenges in several practical applications, including heat exchangers, pipelines, and desalination. Here, we study the effect of dissolved salts on the dynamics of pool boiling and its impact on the heat transfer coefficient and critical heat flux (CHF). We find that even undersaturated conditions can lead to crystallization and scale buildup on the boiling surface and dramatically lower heat transfer performance. For example, the CHF for a salt solution that is 75% of the saturation concentration is found to be at least 2 times lower than that for deionized water. Using simultaneous high-speed optical and infrared imaging, we determine the interdependence between crystallization-induced scale formation and bubble evolution dynamics, including bubble nucleation, growth, and departure. We find that salt crystallizes in a "coffee-ring" pattern due to evaporation at the contact line of the bubble. On the basis of the role of the microlayer and triple contact line on scale formation, we propose manipulating surface wettability as a means to avoid scale formation and the associated decrease in the heat transfer coefficient. Surfaces with hybrid wettability are demonstrated as a means to mitigate the reduction in the heat transfer coefficient and CHF in the presence of dissolved salts.
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Affiliation(s)
- Susmita Dash
- Department of Mechanical Engineering, Massachusetts Institute of Technology , Cambridge, Massachusetts 02139, United States
| | - Leonid Rapoport
- Department of Mechanical Engineering, Massachusetts Institute of Technology , Cambridge, Massachusetts 02139, United States
| | - Kripa K Varanasi
- Department of Mechanical Engineering, Massachusetts Institute of Technology , Cambridge, Massachusetts 02139, United States
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Rapoport L, Sullivan M, Harrison C. Radially Ejected Bubbles Driven by Thermocapillarity in Equilibrated Vapor-Liquid Mixtures. Langmuir 2017; 33:4435-4443. [PMID: 28418678 DOI: 10.1021/acs.langmuir.7b00628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report a novel nucleation method that exploits thermocapillary forces in binary fluids to generate a cloud of bubbles ejected radially from a thermally pulsed wire. The bubbles are nucleated within milliseconds of the extinction of the microsecond pulse and are ejected outward from the wire surface due to the thermocapillary force created by the radial temperature gradient. At low temperatures the surface tension of the vapor-liquid mixture, consisting of ethane-n-octane, increases with increasing temperature, ejecting the bubbles away from the heated wire. By proper choice of fluid composition, temperature, or pressure, the sign of the surface tension gradient can be inverted such that nucleated bubbles are attracted to the wire. As opposed to water-alcohol mixtures that have a surface tension minimum, we show that this mixture-which we refer to as an equilibrated vapor-liquid mixture-exhibits a surface tension maximum, creating a unique set of behaviors which have not yet been fully examined in the literature.
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Affiliation(s)
- Leonid Rapoport
- Schlumberger-Doll Research, 1 Hampshire Street, Cambridge, Massachusetts 02139, United States
| | - Matthew Sullivan
- Schlumberger-Doll Research, 1 Hampshire Street, Cambridge, Massachusetts 02139, United States
| | - Christopher Harrison
- Schlumberger-Doll Research, 1 Hampshire Street, Cambridge, Massachusetts 02139, United States
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Glybochko P, Alyaev Y, Rapoport L, Enikeev M, Enikeev D, Sorokin N, Sukhanov R, Dymov A, Khamraev O, Davydov D, Taratkin M. PD23-07 EFFECT OF HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP) ON THE SEXUAL FUNCTION. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Glybochko P, Altshuler G, Yaroslavsky I, Vinarov A, Rapoport L, Enikeev D, Sorokin N, Dymov A, Vinnichenko V. PD42-07 COMPARATIVE IN VITRO STUDY OF HO:YAG AND TM FIBER LASER LITHOTRIPTERS IN DUSTING MODE OF OPERATION. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Glybochko P, Altshuler G, Vinarov A, Rapoport L, Enikeev M, Grigoriev N, Enikeev D, Sorokin N, Dymov A, Sukhanov R, Taratkin M, Zamyatina V. Comparison between the possibilities of holmium and thulium laser in lithotripsy in vitro. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/s1569-9056(17)30292-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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