John Kourambas

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PURPOSE Ureteral access sheaths were initially developed to facilitate difficult ureteroscopic access. However, to our knowledge no formal evaluations have been performed to assess the routine use of ureteral access sheaths. Therefore, we prospectively analyzed intraoperative time, symptomatic outcome, major complications, stone-free rate and overall costs(More)
The Gyrus system uses bipolar electrocautery with saline irrigation to vaporize prostatic tissue and is compared to transurethral resection of the prostate (TURP) in a randomized prospective study with 1 y follow-up. Outcomes measured were fluid absorption, blood loss, period of catheterization, hospital stay, symptom scores, quality of life, flow rates,(More)
BACKGROUND AND PURPOSE A myriad of minimally invasive options exist for managing symptomatic caliceal diverticula, including shockwave lithotripsy, percutaneous surgery, retrograde ureteroscopy, and laparoscopy. Yet no direct comparisons have been made in the literature of the relative treatment efficacy of ureteroscopy (URS) and percutaneous(More)
OBJECTIVE To evaluate the natural history of a group of patients who underwent contact laser prostatectomy or transurethral resection of the prostate (TURP). PATIENTS AND METHODS Patients were followed up at 5 years after enrolling in a prospective double-blind randomized controlled trial of TURP vs contact laser prostatectomy. RESULTS Of the initial(More)
BACKGROUND AND PURPOSE Retrospective studies have suggested that routine stenting can be avoided following ureteroscopy. We prospectively analyzed the need for routine ureteral stent placement in patients undergoing ureteroscopic procedures. PATIENTS AND METHODS Fifty-five consecutive patients (60 renal units) were randomized into either a stent or a(More)
OBJECTIVES Current ureteroscopic intracorporeal lithotripsy devices and stone retrieval technology allow for the treatment of calculi located throughout the intrarenal collecting system. Difficulty accessing lower pole calculi, especially when the holmium laser fiber is used, is often encountered. We retrospectively reviewed our experience with cases in(More)
PURPOSE The acoustic and mechanical properties of various stone compositions are significantly different and thus result in varying degrees of fragility. Consequently, results to shock wave lithotripsy (SWL) are influenced accordingly. We report the results of a study of fragility of various stone compositions, and the influence on each stone's baseline(More)
BACKGROUND AND PURPOSE Comprehensive metabolic evaluation has become an important aspect of the management of recurrent nephrolithiasis, yet the role of stone analysis is often neglected or perhaps underestimated. The purpose of this study was to determine the role of stone analysis in medical decision making in patients with recurrent nephrolithiasis. (More)
BACKGROUND AND PURPOSE Introduction of the holmium laser has provided an indispensable tool for the management of urinary tract stones, strictures, and superficial urothelial tumors. While full-power holmium lasers are required for laser resection of the prostate, lower-power devices can be utilized for all cases of stone fragmentation and stricture(More)
The introduction of technological advances, such as HDTV, three-dimensional laparoscopy, and further miniaturization of high-resolution digital video cameras, will allow significantly enhanced opportunities for laparoscopic surgical proficiency and further broadening of laparoscopic applications in urology. These enhancements, coupled with the recent(More)