The numerator which we used could also be inaccurate because all such injuries occurring at the other centers were not necessarily managed at our institution. This was also a retrospective study that by design would have its own inherent deficits

including inaccurate ICD and CPT coding. We are also a referral center for such injuries in our area and this may have introduced selection bias. Conclusions The majority of major iatrogenic ureteral injuries occur during ureteroscopic stone removal. This underscores the importance of proper patient selection and employment of appropriate surgical techniques. Renal salvage is attainable in the majority of these cases with reconstructive ureteral surgery. Main Points Inhibitors,research,lifescience,medical The current study demonstrates that the most common procedure associated with major iatrogenic ureteral injury is now ureteroscopic Inhibitors,research,lifescience,medical stone removal. Urologists have become more aggressive with ureteroscopic procedures in the kidney and proximal and middle ureter, which may be due to the development of new technology such as better flexible ureteroscopes, new lasers, grasping devices and baskets, and the utilization Inhibitors,research,lifescience,medical of ureteral access sheaths. The authors demonstrated that reconstructive ureteral surgery may yield

excellent renal salvage rates when treating ureteral injuries. Although open surgical techniques were used in all reconstructive procedures reviewed in this series, it is recognized that some of these patients can now be treated with either laparoscopic Inhibitors,research,lifescience,medical or robotic-assisted surgery. The majority of major iatrogenic ureteral injuries occur during ureteroscopic stone removal. This underscores the importance of proper patient selection and employment of appropriate surgical techniques. Renal salvage is attainable in the majority of these cases with reconstructive ureteral surgery.
Since the accepted use of prostate-specific antigen (PSA) Inhibitors,research,lifescience,medical as a screening tool for

prostate cancer (PCa), the incidence of PCa has greatly increased. PCa incidence in the United States has risen 26%, but is encouragingly accompanied by a 75% decrease in patients Carnitine palmitoyltransferase II presenting with metastases and a 30% decrease in mortality rates.1 The new means of screening have also caused an increase in overdetections, or cancers found that would have been clinically insignificant over the patient’s lifetime. It is estimated that annual PSA examinations could Selleck Alisertib result in an overdetection rate as high as 50%.2 Overdetection raises a new dilemma for the overtreatment of formerly undetectable cancers and the subsequent impact on the patient’s quality of life (QoL). Overdetection can affect QoL through the psychologic distress of a cancer diagnosis, and the possible loss of continence and sexual function that comes from definitive management. PCa can be definitively managed with whole-gland treatment.