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August 2010 Urology Newsletter (complete issue)

Individual Articles Below

The Evolution of the Urological Species

William See, MD Professor and Chief of Urology
The pace and breadth of change the field of urology has undergone in the last several decades is truly amazing. When I began my residency in 1982, ureterolithotomy was an accepted approach for managing stone disease. Over the six years of my training, this cornerstone of calculous management was rendered obsolete by advances in endoscopic instrumentation and the development of extracorporeal shock wave lithotripsy. Much like the dinosaurs, an approach that dominated the landscape became extinct as a consequence of environmental factors.

Applications of Laparoscopy and Minimally Invasive Techniques in Pediatric Urology

Anthony Balcom, MD, Assistant Professor of Urology
Pediatric urologic laparoscopy began in the mid-1980s, when laparoscopic evaluation of the non- palpable testis began, which facilitated accurate diagnosis and treatment of intra-abdominal testes. Shortly thereafter, many other applications of laparoscopy and minimally invasive techniques in pediatric urology occurred, the first of which was accurate placement of peritoneal dialysis catheters using laparoscopic guidance. This allowed us to place the dialysis catheters away from the omentum which would tend to plug the catheter. Laparoscopy then advanced to the point where we could accomplish complete laparoscopic orchidopexy successfully.

HIFU Clinical Trial

Holly Kelly, RN, Clinical Research Manager
The Department of Urology is participating in a high intensity focused ultrasound (HIFU) trial for the treatment of clinically localized prostate cancer. We are currently one of 12 locations in the United States and Canada and the only site in the Midwest participating in this study. Robert Donnell, MD, is the principal investigator for our site.

Laparoscopic and Robotic Surgery

For most of the past decade, Medical College of Wisconsin physicians have performed a significant volume of hand assisted laparoscopic radical nephrectomies, as well as several different conventional laparoscopic procedures. In fact, some of Wisconsin’s first laparoscopic partial nephrectomies were performed at Froedtert & The Medical College of Wisconsin in 2006. Following recent faculty changes, we have significantly changed the breadth of robotic assisted laparoscopic procedures we routinely perform.

Cryoablation for the Treatment of Small Renal Tumors

Peter Langenstroer, MD,MS, Associate Professor of Urology
The management of small renal masses is a dynamic and evolving process. Twenty years ago, the mainstay management for small renal masses was radical nephrectomy. This resulted in over-treatment of many patients. It has become evident that radical nephrectomy is a significant risk factor for the development of chronic renal disease. More recently, chronic renal insufficiency has been associated with increased risk of cardiovascular events, hospitalizations and mortality. Patients undergoing renal preservation, e.g., nephron sparing surgery, have better overall quality of life than patients undergoing radical nephrectomy.

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