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Renal cryoablation of renal cortical neoplasms smaller than 3.0 cm is effective and safe. Our initial experience, however, demonstrates that cryoablation of larger renal masses may be associated with increased morbidity.

Periureteral botulinum toxin type A injection improves ureteral stent tolerability by significantly decreasing postoperative pain and narcotic requirements. Improvement in irritative symptoms was not observed.

,"Prospective randomized comparison of a combined ultrasonic and pneumatic lithotrite with a standard ultrasonic lithotrite for percutaneous nephrolithotomy." Journal of Endourology.22,2. 285-289. (2008 1 uric acid [UA]). In the SUL group, there were eight hard stones (5 CaOxMono and 3 CaPO 4 ), and six soft stones (4 calcium oxalate dihydrate [CaOxDi] and 2 UA) (P ‫؍‬ 0.51). Stone composition data were unavailable for five patients. Fragmentation time for the PAL was 37 minutes versus 31.5 minutes for the SUL (P ‫؍‬ 0.22). Stone retrieval and mean operative times were similar for both groups. There were a total of three (23.1%) device-related problems in the PUL group, and eight (47%) in the SUL group. There was one (7.7%) device malfunction in the PUL group due to probe fracture. There were two (11.7%) device failures in the SUL group; one failure required the device to be reset every 30 minutes, and the second was an electrical failure. Suction tubing obstruction occurred twice (15.3%) in the PUL group and 35.3% in the SU group (P ‫؍‬ 0.35). The stone-free rates for the PUL and SUL were 46% and 66.7%, respectively (P ‫؍‬ 0.26).Conclusion: Although the PUL was more costly, stone ablation and clearance rates were similar for both the combined pneumatic and ultrasonic device and the standard ultrasonic device. When stratified with respect to stone composition, the PUL was more efficient for harder stones, and the SUL was more efficient for softer stones.

OBJECTIVE To assess the risk factors for haemorrhage and renal fracture associated with renal cryoablation. MATERIALS AND METHODS In a porcine model, 120 cryoablations were administered in 26 pigs, with five groups of 24 ice‐balls each; in groups 1 and 2 asynchronous cryoprobe activation was evaluated for the 1.47‐ and 3.4‐mm cryoprobes (IceRods, Galil Medical, Plymouth Meeting, PA, USA), respectively; in group 3, three‐3.4 mm cryoprobes were used to examine synchronous probe activation; in group 4 the 1.47‐mm cryoprobe was used to examine single‐probe activation with premature cryoprobe extraction; and in group 5 we used a new ‘guillotine’ technique for upper‐pole renal cryoablation. Ice‐ball fractures and haemorrhage were characterized by the location, length and depth of each fracture, was well as the degree of bleeding. RESULTS In all, 26 domestic pigs successfully had renal cryoablation procedures. In group 1 and 4 there were no episodes of renal fracture; in group 2 renal fracture occurred in 10 (42%) trials. Group 3 had 22 (92%) renal fractures during the freeze/thaw cycle. Group 5 had 13 (54%) renal fractures during the freeze/thaw cycle, and there was an additional ice‐ball fracture during probe removal once in 24 times. CONCLUSIONS Renal fracture is most common with the application of larger 3.4‐mm cryoprobes in the synchronous and asynchronous setting. Under standard application, smaller (1.47‐mm) cryoprobes result in little renal fracture or bleeding. The use of the guillotine technique is associated with a greater risk of renal fracture.