Browsing by Author "El Tayeb, Marawan M."

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    Calcium Tartrate Tetrahydrate, Case Report of a Novel Human Kidney Stone
    (Mary Ann Liebert, 2017-12-01) Kleinguetl, Colin; Williams, James C.; Ibrahim, Samar A.; Daudon, Michel; Bird, Erin T.; El Tayeb, Marawan M.; Anatomy and Cell Biology, School of Medicine
    Background: Calcium tartrate tetrahydrate has been reported as the main mineral in urinary stones in rats that have significant tartrate in their diet, but in humans, there has been only one mention of calcium tartrate stones in the form of bladder stone, and that case was in Africa., Case Presentation: Patient is a 34-year-old Caucasian male who presented with typical symptoms of nephrolithiasis. CT abd/pelvis (renal stone protocol) revealed a 2 cm nonobstructing stone of the right renal pelvis. Patient underwent an uncomplicated right percutaneous nephrolithotomy and was noted to be stone free after surgery. Stone analysis was difficult with regard to determining composition, but was finally identified as calcium tartrate tetrahydrate., Conclusion: This was an unusual case, as this is the first recorded case of a calcium tartrate tetrahydrate outside of Africa. This type of stone had only been mainly described in rat models with dl-bitartrate in their diet. Our patient was an otherwise healthy, relatively muscular individual with no obvious source for this stone other than a vitamin and amino acid supplement that he takes regularly that contains l-carnitine (as tartrate) and choline (as bitartrate and citrate). The prevalence of this stone type is presently unknown, as stone analysis laboratories have not had the ability to recognize it. Although a connection between the supplement and stone formation is conjecture at this time, we believe this necessitates further investigation.
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    The Circle Nephrostomy Tube: An Attractive Nephrostomy Drainage System Following Complex Percutaneous Nephrolithotomy
    (Elsevier, 2017-05) El Tayeb, Marawan M.; Borofsky, Michael S.; Lingeman, James E.; Urology, School of Medicine
    Objective To describe our experience with the circle nephrostomy tube (NT) (Cook Medical), a drainage system uniquely designed for use after multiple-access percutaneous nephrolithotomy (PNL). Methods A retrospective review of 1317 consecutive patients undergoing 1599 PNLs at IU Health Methodist Hospital was performed. All multiple access cases utilizing circle NTs were reviewed and analyzed. The method of insertion of circle NT was demonstrated. Results A total of 1843 accesses were obtained in 1599 renal units (RUs): 380 upper pole, 129 interpolar, and 1334 lower pole. Multiple accesses in this series were required in 282 RUs (17.6%). Following multiple-access PNL, circle NTs, Cope loop, and reentry Malecot NTs were inserted in 91 RUs (32.3%), 208 RUs (73.8%), and 31 RUs (11%), respectively. None of the patients who had circle NT experienced clogging, dislodgement, or obstruction of the tube. The cost of circle, Cope loop, and Malecot NTs are 121.73 USD, 95.20 USD, and 81 USD, respectively. Conclusion Circle NTs are easy to insert, secure, cost-effective compared with inserting two NTs. Circle NTs provide excellent drainage and facilitate secondary procedures.
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    Comparison of Perioperative Outcomes Between Holmium Laser Enucleation of the Prostate and Robot-Assisted Simple Prostatectomy
    (Liebert, 2017-09) Zhang, Mimi W.; El Tayeb, Marawan M.; Borofsky, Michael S.; Dauw, Casey A.; Wagner, Kristofer R.; Lowry, Patrick S.; Bird, Erin T.; Hudson, Tillman C.; Lingeman, James E.; Urology, School of Medicine
    Objectives: To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH).Methods: Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015.Results: Patients undergoing HoLEP and RSP had comparable ages (71 vs 71, p = 0.96) and baseline American Urological Association Symptom Scores (20 vs 24, p = 0.21). There was no difference in mean specimen weight (96 g vs 110 g, p = 0.15). Mean operative time was reduced in the HoLEP cohort (103 minutes vs 274 minutes, p < 0.001). Patients undergoing HoLEP had lesser decreases in hemoglobin, decreased transfusions rates, shorter hospital stays, and decreased mean duration of catheterization. There was no difference in the rate of complications Clavien grade 3 or greater (p = 0.33).Conclusions: HoLEP and RSP are both efficacious treatments for large gland BPH. In expert hands, HoLEP appears to have a favorable perioperative profile. Further studies are necessary to compare long-term efficacy, cost, and learning curve influences, especially as minimally invasive approaches become more widespread.
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    Sensitivity of Non-Contrast Computed Tomography for Small Renal Calculi with Endoscopy as the Gold Standard
    (Elsevier, 2018) Bhojani, Naeem; Paonessa, Jessica E.; El Tayeb, Marawan M.; Williams, James C.; Hameed, Tariq A.; Lingeman, James E.; Urology, School of Medicine
    Objectives To compare the sensitivity of non-contrast CT to endoscopy for detection of renal calculi. Imaging modalities for detection of nephrolithiasis have centered on abdominal x-ray (KUB), ultrasound (US), and non-contrast computed tomography (CT). Sensitivities of 58-62% (KUB), 45% (US), and 95-100% (CT) have been previously reported. However, these results have never been correlated with endoscopic findings. Methods Idiopathic calcium oxalate stone formers with symptomatic calculi requiring ureteroscopy (URS) were studied. At the time of surgery, the number and location of all calculi within the kidney were recorded followed by basket retrieval. Each calculus was measured and sent for micro CT and infrared spectrophotometry. All CT scans were reviewed by the same genitourinary radiologist who was blinded to the endoscopic findings. The radiologist reported on the number, location, and size of each calculus. Results 18 renal units were studied in 11 patients. Average time from CT scan to URS was 28.6 days. The mean number of calculi identified per kidney was 9.2±6.1 for endoscopy and 5.9±4.1 for CT (p<0.004). The mean size of total renal calculi (sum of longest stone diameters) per kidney was 22.4±17.1 mm and 18.2±13.2 mm for endoscopy and CT, respectively (p=0.06). Conclusions CT scan underreports the number of renal calculi, probably missing some small stones and unable to distinguish those lying in close proximity to one another. However, the total stone burden seen by CT is, on average, accurate when compared to that found on endoscopic examination.
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    A Survey Regarding Preference in the Management of Bilateral Stone Disease and a Comparison of Clavien Complication Rates in Bilateral vs Unilateral Percutaneous Nephrolithotomy
    (Elsevier, 2017) Rivera, Marcelino E.; Bhojani, Naeem; Heinsimer, Kevin; El Tayeb, Marawan M.; Paonessa, Jessica E.; Krambeck, Amy E.; Lingeman, James E.; Urology, School of Medicine
    Objective To discuss complications of simultaneous bilateral percutaneous nephrolithotomy (SB-PCNL) when compared with unilateral percutaneous nephrolithotomy and survey surgeon preference in bilateral stone disease management. Patients and Methods A database of all participating percutaneous nephrolithotomy (PCNL) patients who underwent treatment at Indiana University Health Methodist Hospital within a 10-year period from 2006 to 2015 by a single surgeon (JL) was utilized. Perioperative data, as well as complications, defined according to the Clavien grading system, were recorded. A survey of members of the Endourological Society was performed regarding surgical management in the setting of bilateral stone disease. Results A total of 563 patients were identified over the study period with 129 undergoing SB-PCNL. Overall, SB-PCNL patients had a longer procedure (176.9 vs 115.6 minutes, P <.0001), were more likely to undergo a secondary procedure (73% vs 44, P <.001), and had a longer hospital stay (3.2 vs 2.3 days, P <.001). Notably, there were no differences in the number or the severity of complications between the 2 groups. A total of 153 endourologists completed the survey. Of these endourologists, 58 (38%) performed bilateral PCNL under anesthesia. The top reasons for electing not to perform bilateral PCNLs included the duration of bilateral procedures (53%), bilateral renal injury (48%), and rare performance of bilateral surgery (35%). Conclusion Although the procedure length was longer in the SB-PCNL group, there were similar rates of complications and severity between unilateral PCNL and SB-PCNL. A majority of endourologists surveyed do not perform bilateral PCNL but would perform bilateral ureteroscopy with the duration of the procedure and concern for bilateral renal injury representing the most common reasons.
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    The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP-tool): a Delphi consensus project on standardised evaluation of flexible ureterorenoscopes
    (Wiley, 2023) Henderickx, Michaël M. E. L.; Hendriks, Nora; Baard, Joyce; Wiseman, Oliver J.; Scotland, Kymora B.; Somani, Bhaskar K.; Şener, Tarik E.; Emiliani, Esteban; Dragos, Laurian B.; Villa, Luca; Talso, Michele; Hamri, Saeed Bin; Proietti, Silvia; Doizi, Steeve; Traxer, Olivier; Chew, Ben H.; Eisner, Brian H.; Monga, Manoj; Hsi, Ryan S.; Stern, Karen L.; Leavitt, David A.; Rivera, Marcelino; Wollin, Daniel A.; Borofsky, Michael; Canvasser, Noah E.; Ingimarsson, Johann P.; El Tayeb, Marawan M.; Bhojani, Naeem; Gadzhiev, Nariman; Tailly, Thomas; Durutovic, Otas; Nagele, Udo; Skolarikos, Andreas; Schout, Barbara M. A.; Beerlage, Harrie P.; Pelger, Rob C. M.; Kamphuis, Guido M.; Urology, School of Medicine
    Objective: To develop a standardised tool to evaluate flexible ureterorenoscopes (fURS). Materials and methods: A three-stage consensus building approach based on the modified Delphi technique was performed under guidance of a steering group. First, scope- and user-related parameters used to evaluate fURS were identified through a systematic scoping review. Then, the main categories and subcategories were defined, and the expert panel was selected. Finally, a two-step modified Delphi consensus project was conducted to firstly obtain consensus on the relevance and exact definition of each (sub)category necessary to evaluate fURS, and secondly on the evaluation method (setting, used tools and unit of outcome) of those (sub)categories. Consensus was reached at a predefined threshold of 80% high agreement. Results: The panel consisted of 30 experts in the field of endourology. The first step of the modified Delphi consensus project consisted of two questionnaires with a response rate of 97% (n = 29) for both. Consensus was reached for the relevance and definition of six main categories and 12 subcategories. The second step consisted of three questionnaires (response rate of 90%, 97% and 100%, respectively). Consensus was reached on the method of measurement for all (sub)categories. Conclusion: This modified Delphi consensus project reached consensus on a standardised grading tool for the evaluation of fURS - The Uniform grading tooL for flexIble ureterorenoscoPes (TULIP) tool. This is a first step in creating uniformity in this field of research to facilitate future comparison of outcomes of the functionality and handling of fURS.
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    Uncovering a Novel Stone in 27 Patients: Calcium Tartrate Tetrahydrate
    (Elsevier, 2019) Kleinguetl, Colin; Williams, James C., Jr.; Lieske, John; Daudon, Michel; Rivera, Marcelino; Janneto, Paul; Bornhorst, Joshua; Rokke, Denise; Bird, Erin T.; Lingeman, James E.; El Tayeb, Marawan M.; Anatomy and Cell Biology, IU School of Medicine
    Objective To further analyze calcium tartrate tetrahydrate stones after a recent case report described this novel stone. Prior to this, there was only one previously reported occurrence of this stone in a human. This unusual stone composition is not tested for routinely. True prevalence and possible causes of this stone are unknown. Materials/Methods During the previous case report, micro-CT and Fourier-transform infrared spectroscopy were used to identify a calcium tartrate tetrahydrate stone. This information was applied to urinary stones with previously unidentified compositions in the Mayo Metals laboratory database between 2010 and March 2018. Two additional stones were identified at our institution. Three patients had medical records available for analysis. Results Between 2010 and March 2018, 35 calcium tartrate stones in 25 patients were identified in the Mayo database as well as 2 at our institution (37 stones in 27 patients). Thirty stones were pure calcium tartrate with the remainder having elements of more common stones. The average age was 46.3 (±14.7) with a slightly higher incidence in females (17 vs 10). Of the 3 medical records investigated, all 3 were males (average age 48.7), and each reported consumption of an energy supplement (Spark) routinely. Conclusion The true prevalence of this relatively unknown stone remains unclear and additional investigation is warranted. We believe all stone laboratories should have access to the IR spectra for calcium tartrate tetrahydrate. Attention should be paid to possible causes of this stone, particularly with relation to oral supplements, to aid with future prevention and treatment.