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Dean G Assimos

All articles from this author are listed below.

Volume 13, Number 2 Review Articles

Impact of Stone Removal on Renal Function: A Review

Treatment Review

Patrick W Mufarrij Tristan Keys Dean G Assimos Kyle Wood

Stone removal can improve renal function by eradicating obstruction and, in certain cases, an underlying infection. Stone-removing procedures, however, may negatively impact functional integrity. Many things may impact the latter, including the procedures used, the methods of assessing function, the time when these assessments are made, the occurrence of complications, the baseline condition of the kidney, and patient-related factors. In the majority of cases, little significant functional impairment occurs. However, there are gaps in our knowledge of this subject, including the cumulative effects of multiple procedures violating the renal parenchyma and long-term functional outcomes. [Rev Urol. 2011;13(2):73-89 doi: 10.3909/riu0515] © 2011 MedReviews®, LLC

Ureteroscopy Kidney stones Shock wave lithotripsy Renal function Percutaneousnephrolithotomy

Volume 14, Number 3 Case Review

Multibacterial Growth From a Surgical Renal Stone Culture: A Case Report and Literature Review

Jessica N Lange Patrick W Mufarrij Majid Mirzazadeh Dean G Assimos Ross P Holmes

Urinary calculi may harbor bacteria, and this may lead to deleterious events during stone fragmentation and removal. The isolation of such bacteria from surgically extracted calculi allows for the specific tailoring of antimicrobial therapy. Here, we describe a case involving percutaneous stone removal from which the stone culture demonstrated growth of five different microorganisms. The results of this culture prompted a change in the antibiotic coverage, resulting in a more targeted treatment and improved patient care. [Rev Urol. 2012;14(3/4):108-114 doi: 10.3909/riu0561] © 2013 MedReviews®, LLC

Urinary tract infection Nephrolithiasis Stone culture

Volume 15, Number 2 Review Articles

Optimizing Shock Wave Lithotripsy: A Comprehensive Review

Treatment Update

Paul D McClain Jessica N Lange Dean G Assimos

Shock wave lithotripsy is a commonly used procedure for eradicating upper urinary tract stones in patients who require treatment. A number of methods have been proposed to improve the results of this procedure, including proper patient selection, modifications in technique, adjunctive therapy to facilitate elimination of fragments, and changes in lithotripter design. This article assesses the utility of these measures through an analysis of contemporary literature. [Rev Urol. 2013;15(2):49-60 doi: 10.3909/riu0568] © 2013 MedReviews®, LLC

Upper urinary tract stones Shock wave lithotripsy Comminution

Volume 17, Number 3 Review Articles

Optimizing Stone-free Rates With Ureteroscopy

Treatment Update

Thanmaya G Reddy Dean G Assimos

Ureteroscopy is being increasingly utilized in the treatment and management of patients with renal and ureteral stones. Improving stone-free rates with ureteroscopy decreases the need for ancillary procedures and improves patient outcomes and satisfaction. This article reviews contemporary literature regarding the efficacy of a wide range of currently available techniques for improving stone-free rates with this procedure. [Rev Urol. 2015;17(3):160-164 doi: 10.3909/riu0665] © 2015 MedReviews®, LLC

Ureteroscopy Upper urinary tract stones Stone-free rate

Volume 18, Number 3 Meeting Reviews

Highlights From the 2016 American Urological Association Annual Meeting

Michael K Brawer J Curtis Nickel Michael A Gorin Ellen Shapiro Benjamin M Brucker Dean G Assimos Alan W Partin Michael B Chancellor Stacy Loeb

More than 2000 posters, abstracts, and videos were presented at the 2016 American Urological Association (AUA) Annual Meeting, held in San Diego, CA, from May 6 to 10, 2016. The editors of Reviews in Urology have culled an enormous volume of information from this premier source and present the findings that are most relevant to the practicing urologist. [Rev Urol. 2016;18(3):159-173 doi:10.3909/riu0717] © 2016 MedReviews®, LLC

Prostate cancer Active surveillance Disorders of sexual development Nephrolithiasis Overactive bladder Microbiome OnabotulinumtoxinA Hemorrhagic cystitis Inflammation Four kallikrein assay Genomic prostate score

Volume 18, Number 1 Review Articles

The Role of Antibiotic Prophylaxis in Percutaneous Nephrolithotomy

Prophylactic Management Update

Win Shun Lai Dean G Assimos

Postoperative sepsis is the most common cause of mortality after percutaneous nephrolithotomy (PCNL) procedures. Studies investigating the use of antibiotics in PCNL patients have shown that prophylactic antibiotic regimens can reduce the rate of postoperative infectious complications. In addition, several studies have identified risk factors for sepsis development that can help guide antibiotic treatment and perioperative care overall. This has led the American Urological Association to recommend antibiotic prophylaxis for PCNL as a best practice policy statement. However, despite prophylaxis, postoperative sepsis has continued to remain the leading cause of mortality in PCNL patients. In addition, multiple antibiotic protocols exist within the guideline realms. This review assesses the development and role of antibiotic prophylaxis for PCNL procedures. [Rev Urol. 2016;18(1):10-14 doi: 10.3909/riu0699A] © 2016 MedReviews®, LLC

Percutaneous nephrolithotomy Antibiotic prophylaxis Urosepsis

Volume 19, Number 1 Review Articles

Urinary Tract Stone Development in Patients With Myelodysplasia Subjected to Augmentation Cystoplasty

Management Update

Courtney L Shephard Guaqiao Wang Betsy D Hopson Erika B Bunt Dean G Assimos

Patients with myelodysplasia who have undergone augmentation cystoplasty are at risk for urinary tract stones. We sought to determine the incidence and risk factors for stone development in this population. The charts of 40 patients with myelodysplasia who have undergone augmentation cystoplasty were reviewed. None had a prior history of urinary tract stones. All patients were seen on an annual basis with plain abdominal imaging, renal ultrasonography, and laboratory testing. Statistical analysis included a multivariable bootstrap resampling method and Student’s t-test. Fifteen (37.5%) patients developed stones, 14 with bladder stones and 1 with a solitary renal stone, at a mean of 26.9 months after augmentation. Five (33.3%) developed recurrent bladder stones. The patient with a renal stone never developed a bladder stone. The mean follow-up for the stone formers was 117.2 months and for non–stone formers was 89.9 months. The stone incidence per year was 6.8%. Risk factors included a decline in serum chloride after augmentation (P = .02), female sex, younger age at time of augmentation, longer time period since augmentation, and bowel continence. A significant proportion of patients with myelodysplasia subjected to augmentation cystoplasty develop urinary tract stones, predominantly in the bladder. Dehydration may play a role in development of lower urinary tract stones as the decline in serum chloride suggests contraction alkalosis, which could lead to constipation and improved bowel continence. Therefore, improved hydration should be a goal in this cohort. [Rev Urol. 2017;19(1):11-15 doi: 10.3909/riu0741] © 2017 MedReviews®, LLC

Nephrolithiasis Spina bifida Neurogenic bladder augmentation cystoplasty