Petrisor A. Geavlete

• MD, PhD
• CEO at Saint John Emergency Clinical Department

Background Flexible and navigable suction ureteral access sheath (FANS) has been proven to improve stone-free rate (SFR) and many studies report high intraoperative 100% stone-free status (IO-SFS) and postoperative 100% stone-free status (PO-SFS). The reliability of IO-SFS vis-à-vis image-proven PO-SFS needs to be evaluated as it has implications o...

Urolithiasis, or kidney stones, is a painful condition that is becoming increasingly common worldwide. For many, the solution lies in a minimally invasive procedure called flexible ureteroscopy (fURS). This technique involves inserting a tiny, flexible scope into the urinary tract to break up and remove stones. Reusable fURS scopes have traditional...

Background: Renal lithiasis continues to represent a great challenge for modern urology in terms of minimally invasive management of lithotripsy procedures. The recent revolution of endoscopes with the miniaturization of instruments and the development of improved disposable ureteroscopes combined with recent suction methods such as suction access...

Background and Objectives: This study aimed to evaluate the recurrence rates at three years for upper tract urothelial carcinoma (UTUC) cases managed conservatively, using Narrow Band Imaging (NBI)-assisted flexible ureteroscopy and Holmium laser vaporization. Materials and Methods: The study group included 61 patients who were diagnosed with NBI-a...

Purpose To evaluate the efficacy and safety of teverelix in treatment naïve patients aged over 50 years with symptomatic benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS), and to explore teverelix’ potential in preventing AUR secondary to BPH with the aim to inform a planned Phase 2 trial. Methods This Phase 2, multicenter...

Introduction: During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the management of patients with lower urinary tract symptoms (LUTS) underwent dynamic adjustments in response to an evolving understanding of the virus's impact on different patient populations. Healthcare practitioners reevaluated therapeutic approaches...

Introduction. The emergence of new scientific and clinical evidence on the use of retrograde intrarenal surgery (RIRS) for the management of kidney stones has prompted periodic systematisation, analysis, and evaluation of outcomes to standardise its application and determine future directions for research and development. Objective. To present the R...

New suction endoscopes, ureteral access sheaths (UAS) and catheters aim to improve the efficacy of flexible ureteroscopy and optimize its safety. Suction UAS with non-flexible tips have shown promising results, especially in maintaining low intrarenal pressure, but also in removing small debris and reducing the “snow globe” effect. In addition, suc...

Lynch syndrome, characterized by DNA mismatch repair deficiency, represents a significant paradigm among cancer predisposition syndromes and is notably associated with heightened susceptibility to various cancers, particularly colorectal and endometrial malignancies. The primary aim of this research paper is to scrutinize specific associations and...

Ureteroscopy is recognized as a minimally invasive and readily accessible method with low morbidity, favorable outcomes, and rapid post-interventional recovery. Recent advancements in rigid and flexible ureteroscopes have enhanced their efficiency, durability, and capability to accommodate accessory instruments. In this retrospective analysis, we e...

Introduction:Renal stones are a common pathology in daily practice with a continuously increasing incidence. Using flexible ureteroscopy (fURS), urologists can treat difficult renal stones through the natural orifice and maintain a satisfactory stone-free rate. Even though advancing technologies offer the opportunity for minimally invasive surgery,...

Urinary tract obstruction is a serious condition that can cause significant morbidity in patients with acute obstructive uropathy. Prompt urinary diversion is necessary to prevent further damage to the kidneys. Retrograde ureteral stenting (RUS) and percutaneous nephrostomy (PCN) are the two main treatment options for this condition in many hospita...

Flexible ureteroscopy (fURS) is a well-established procedure for treating multiple upper-urinary tract pathologies, particularly renoureteral lithiasis. Endoscopes have undergone significant advancements, including miniaturization, improved optics, and increased maneuverability. In addition, advancements in accessory instruments, such as the perfor...

Introduction: The aim of our study was to retrospectively evaluate the stone-free rate after the second intervention for every performed procedure (semirigid ureteroscopy, flexible ureteroscopy, semirigid plus flexible ureteroscopy and percutaneous nephrolithotomy). Materials and methods: A total of 149 patients, who came to the emergency room of "...

Background: Single-use flexible ureteroscopes for urinary retention have been developed in recent years as an alternative to reusable ureteroscopes in order to eliminate the risk of cross-infections and to solve the primary limitations of traditional reusable flexible ureteroscopes for urinary retention. Methods: In this study, we evaluated and...

Background and objectives: Renal stones are widespread, with a lifetime prevalence of 10% in adults. Flexible ureteroscopy enables urologists to treat lower calyx stones or even complex renal stones through the natural orifice and achieve an acceptable stone-free rate. Hence, we analyzed the effectiveness and safety of FURS versus PCNL in treating...

The purpose of single-use flexible ureteroscopes (su-fURS) was to overcome the limitations of conventional reusable ureteroscopes in terms of maneuverability and maintenance. We aimed to perform a systematic literature review on available su-fURS performance versus conventional reusable fURS focusing on clinical data. A systematic research using Pu...

Introduction: The COVID-19 pandemic definitely changed the management of patients with benign prostatic hyperplasia (BPH). This study followed the modalities of treatments in patients with BPH associated with SARS-CoV-2 attending the Urology Clinic of "Sf. Ioan" Emergency Clinical Hospital, Bucharest, Romania. Material and methods:The present study...

Early detection of bladder cancer has a positive impact on prognosis. A variety of biomarkers have been developed to detect bladder tumors in urine early and reduce the need for cystoscopy. To detect bladder cancer, several methods are available, but their accuracy varies according to the sensitivity and specificity of each method. This review aims...

Retrograde intrarenal surgery (RIRS) is nowadays more and more indicated in pyelocaliceal stones. Holmium and Thulium lasers are the main lasers used. Fragmenting (basketing) or dusting, despite the new technology, still have residual stones (even having 250 microns). This study evaluates second-look flexible ureteroscopy for residual fragments. We...

Urolithiasis is a major health problem which is on the rise worldwide. New procedures and technological tools have arisen, providing the urologist with a vast arsenal of options for stone disease management. The goal of this narrative review is to summarize the most recent advancements and demonstrate their efficacy in reducing complications and in...

The introduction of single-use flexible ureteroscopes (suFURSs) in daily practice tends to overcome the main limitations of reusable ureteroscopes (reFURSs), in terms of high acquisition costs, maintenance, breakages and repairing costs, reprocessing and sterilization, as retrograde intrarenal surgery (RIRS) is promoted as first-line treatment of r...

Objectives To set out the second in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis that concerns retrograde intrarenal surgery (RIRS), with the aim of providing a clinical framework for urologists performing RIRS. Materials and Methods After a comprehensive search of RIRS‐related literature pu...

Benign prostatic hyperplasia and prostate cancer are tumoral pathologies characterized by the overexpression of inflammatory processes. The exploration of tumor microenvironment and understanding the sequential events that take place in the stromal area of the prostate could help for an early management of these pathologies. This way, it is feasibl...

A staged ureteroscopic procedure is generally preferred to treat bilateral renal stones. In this study, we evaluated the feasibility of bilateral same-session flexible ureteroscopy (BS-fURS) in renal stones. A total of 81 patients underwent bilateral BS-fURS between March 2014 and March 2021 for bilateral renal stones. The mean stone burden per pat...

Introduction: Horseshoe kidney (HSK) is one of the most frequent renal malformations which appears to present an increased risk of stone formation caused by abnormal urine drainage. This study aims to compare the results of single-use flexible ureteroscopy (SUfURS) vs reusable devices (RfURS) with holmium laser in treating stones in HSK cases. Mate...

Objectifs Le laser Holmium :YAG est considéré comme « gold standard » de la lithotripsie laser. Les générateurs à haute fréquence avec la technologie Moses ont démontré une fragmentation plus rapide. La lithotripsie laser de la nouvelle génération est arrivée récemment : le laser à fibre de Thulium (TFL). Nous avons analysé la nouvelle TFL Soltive...

Objectifs Les urétéroscopes souple à usage unique semblent aujourd’hui être de plus en plus performants. Dans la majorité des cas, la taille des urétéroscopes est comprise entre 8 et 9 Fr. Notre objectif a été d’analyser l’efficacité et la sécurité du nouvel urétéroscope souple à usage unique Uscope Pusen, PU 3033A 7,5 Fr. (SU-fURS7.5). Méthodes N...

Background Retrograde intrarenal surgery (RIRS) has become the preferred treatment modality for nephrolithiasis. However, because of ongoing uncertainties regarding the optimal perioperative management, operative technique, and postoperative follow-up, as well as a lack of standardization for outcome reporting, consensus is needed to achieve more u...

Double J stent is an essential tool in urology, being a basic part of many urological procedures. However, some issues related to their use still occur. Our study aimed to evaluate an important number of procedures, the complications of ureteral stents, and their prevention and treatment retrospectively. We evaluate 50,000 procedures performed betw...

Large meta-analyses demonstrated that ureteral access sheaths (UAS) have specific complications during and after flexible ureteroscopy (fURS). The present study focused on the technical aspects, advantages, drawbacks, and limitations of the latest “no-touch” technique (NTT) in the flexible ureteroscopic therapeutic approach of renal stones. A total...

We analyzed the results of single-use flexible ureteroscopy (su-fURS) with the holmium laser in treating renal stones associated with ectopic pelvic kidney (EPK). The study retrospectively analyzed data of 11 patients diagnosed with EPK and stone disease who underwent su-fURS between May 2017 and November 2019. The analyzed surgical data included t...

Introduction: Single-use flexible ureteroscopes (SU-fURS) seems to overcome the main limitations of conventional reusable ureteroscopes in terms of acquisition and maintenance costs and breakages. Our aim was to analyz the efficiency and safety of the thinnest single use flexible scope from Pusen: Uscope Pusen, PU 3033A (Tip = 7.5 Fr.). Material an...

In this paper, we aimed to verify the efficiency and functionality of the new Soltive Thulium Fiber Laser (TFL) in the treatment of urinary stones. The Soltive Laser System was used in 17 urolithiasis cases: 10 renal, 5 ureteral, and 2 bladder stone patients. The average stone size was 13.1 mm (ranging between 11-29 mm) for the kidney, 8 mm (rangin...

Objectives: With an increasing number of patients undergoing ureteroscopic surgery worldwide for stone disease, and the concomitant pressures on health care resources, we aimed to review global patterns for ureteric stenting following ureteroscopy. With a centralized electronic database, a longitudinal cohort study was designed to help define the i...

Resumen Introducción y objetivos Evaluar la capacidad del endourólogo para evaluar la composición del cálculo mediante la observación de imágenes endoscópicas. Materiales y métodos Una serie de 20 videoclips de tratamientos endoscópicos de cálculos urinarios que también estaba disponible el resultado de la espectroscopia infrarroja se cargó en un...

Objectifs Une étude prospective, randomisée, à long terme, a évalué l’efficacité et la sécurité de la vaporisation bipolaire au plasma en mode continue (C-VBPP), par rapport à la vaporisation standard (S-VBPP) et à la résection transurétrale monopolaire de la prostate (RTUP) dans les cas d’hyperplasie bénigne de la prostate (HBP) de volume moyen. D...

Objectifs L’étude a été désignée à évaluer la résection bipolaire en-block au plasma (REBP), guidée par l’imagerie à bande étroite (narrow band imaging [NBI]) et de la comparer à la résection transurétrale de la vessie (RTUV) monopolaire standard. Les deux alternatives ont été appliquées dans des cas sélectionnés par le critère de la dimension des...

The purpose of this study is to collect information on the bacterial resistance to antibiotics of bacteria isolated from urine cultures of patients treated for upper urinary tract calculi. Data of patients with urinary tract infection and urolithiasis were retrospectively reviewed to collect information on age, gender, stone size, location, hydrone...

Resumen Introducción y objetivos Evaluar la capacidad del endourólogo para evaluar la composición del cálculo mediante la observación de imágenes endoscópicas. Materiales y métodos Una serie de 20 videoclips de tratamientos endoscópicos de cálculos urinarios que también estaba disponible el resultado de la espectroscopia infrarroja se cargó en un...

Transurethral resection of the prostate (TURP) is still considered the gold standard for male lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), but new methods like bipolar TURP became a real treatment alternative. Bipolar resection presents many option for the effective resection of the prostate: the most similar...

Introduction and Objectives. Renal hydatid cysts are very rare (2% of all locations) and kidney, as its` primary site without the liver or the lungs being involved, is even more uncommon. Materials and Methods. We present the case of a 24-years-old asymptomatic female, who addressed to the gynecologist for infertility. Physical examination was norm...

Objectifs L’étude a évalué les taux de récidives spécifiques de la cystoscopie en imagerie à bande étroite (NBI) et la vaporisation bipolaire au plasma (VBP) par rapport à la cystoscopie standard (CS) et la résection transurétrale monopolaire (RTUV), dans les cas de grandes tumeurs vésicale non invasives de la musculaire (TVNIM). Méthodes Au total...

Purpose: Traditionally, transurethral resection of bladder tumors (TURB) is performed using monopolar technique. Bipolar resection has been postulated to reduce complications. In this study we compare safety and efficacy between monopolar TURB (mTURB) and bipolar TURB (bTURB) for patients with primary non-muscle invasive bladder cancer (NMIBC). M...

Objectifs L’étude a été désignée à évaluer une nouvelle technique d’ablation tumorale (résection bipolaire en-block au plasma [REBP], complétée par biopsie de la base d’implantation) et de la comparer à la résection transurétrale de la vessie (RTUV) monopolaire standard. Les deux méthodes ont été appliquées de manière randomisée, dans des cas sélec...

Objectifs Pendant une étude à longue terme, distribuée en paires, index-témoin, un abord combiné diagnostique (cystoscopie standard [CS] et narrow band imaging [NBI]) et thérapeutique (vaporisation bipolaire au plasma [VBP]) a été comparé au protocole conventionnel (CS et résection transurétrale monopolaire de la vessie [RTUV]) dans des cas de gran...

Objective: To investigate some epidemiological aspects of kidney stones in the South- Eastern European area. Materials and methods: From September 2015 to December 2015, 538 consecutive patients were treated and evaluated for reno-ureteral stones in eight departments in Bulgaria, Greece, Italy, FYR Macedonia, Romania, Serbia and Turkey. Results...

PurposeThe aim of this review was to provide current best evidence for evaluation, dietary, and medical management of patients with urolithiasis. Methods Literature addressing evaluation, dietary, and medical management of urolithiasis was searched. Papers were analyzed and rated according to level of evidence (LOE), whereupon a synthesis of the ev...

Ureteroscopy in children, in pregnancy, and in patients with reno-ureteral malformations present certain particular aspects regarding the diagnostic algorithm, operative technique, and postoperative follow-up. The difficulties regarding retrograde endoscopic treatment in these cases derive from the particular anatomic aspects, as well as the charac...

The advances achieved in the ureteroscopic techniques, the design of the ureteroscopes, and working instruments have made the endoscopic management of ureteral strictures a reasonable alternative to open surgery. The formation of ureteral strictures is considered to be one of the postoperative complications of lithiasic disease. The development of...

Caliceal (or pyelocaliceal) diverticula are intrarenal cavities lined by urothelium, without secretion that are passively filled with urine from the intrarenal tracts. The incidence of this malformation is relatively low, being discovered in 2.1–6 out of 1000 intravenous urographies in the adult population. There are numerous theories regarding the...

The upper urinary tract, composed of the pyelocaliceal system and the ureter, ensures the function of vector of the urine from the kidney to the urinary bladder through peristaltic contractions. Knowing the internal configuration of the upper urinary tract, as well as the topography and the relations of its composing segments, is essential for the...

Initially developed as an extension of cystoscopy, ureteroscopy has become a major technique for the diagnosis and treatment of upper urinary tract disorders. At the end of the 1970s, the method was limited to the management of only a small number of lesions of the distal ureter (Lyon et al., 1979; Perez-Castro Ellendt and Martinez-Pineiro, 1980);...

Infundibular stenosis is a rare pathological entity that can be congenital or acquired. The condition is the result of the obstruction of the caliceal infundibulum associated with hydrocalycosis, and requires a differential diagnosis with other pathological entities causing segmental dilations of the upper urinary tract: caliceal diverticulum and m...

Iatrogenic ureteral lesions can occur as a complication of abdominal surgical procedures, but in most cases they are due to pelvic or retroperitoneal interventions. The widespread use of ureteroscopic and laparoscopic interventions has led to an increase in the incidence of secondary ureteral injuries.

Although it was initially introduced as an extension of cystoscopy, ureteroscopy has become an important technique in treating upper urinary tract disorders. Its progress was based on the development of rigid and flexible ureteroscopes, as well as of appropriate accessory instruments.

Ureteral calculi were first mentioned by Ambroise Pare in 1564. He also described impaction of stones in both ureters as a cause of death (Murphy, 1972). Although ureteral calculi were subsequently mentioned by many authors, a successful intervention for extracting them was performed only after 200 years. In 1788, Desault designed an instrument use...

In selected cases in which clinical, laboratory, and/or imagistic data are equivocal, establishing a correct diagnosis may require the endoscopic exploration of the upper urinary tract. Due to the complexity of the spatial distribution of the renal pelvis and the calyces, rigid or semirigid ureteroscopy does not allow for the exploration of the ent...

The instruments used for the ureteroscopic approach of upper urinary tract conditions are in a continuous evolution. The first ureteroscopes were too large in diameter, their use being restricted to a small number of patients. Moreover, the methods for stone fragmentation or extraction, as well as for tissue resection/fulguration, were limited. Sub...

Ureteropelvic junction (UPJ) stenosis is defined as the deficiency in urine transportation from the pyelocaliceal system toward the proximal ureter. Its presence leads to the dilation of the pyelocaliceal system with potentially severe consequences for the kidney. The etiology of these stenoses is not completely known, being congenital or secondary...