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Urology case reports. 2021:34.DOI: 10.1016/j.eucr.2020.101453

100% N4-acetyl-sulfamethoxazole stone induced by Trimethoprim-Sulfamethoxazole in an HIV patient being treated for toxoplasmosis [Case Report]

DeMasi, Matthew S; Bernstein, Ari P; Schulster, Michael; Silva, Mark V
Trimethoprim-Sulfamethoxazole is a common antibiotic used to treat urinary tract infections, as well as a prophylactic agent in HIV patients with low CD4 counts. Exceedingly rare are stones consisting purely of its metabolite, N4-acetyl-sulfamethoxazole, and management strategies are not well documented in the literature. We present a case of a patient with HIV who was found to have obstructing ureteral calculi composed of 100% N4-acetyl-sulfamethoxazole. Our report contributes a unique case of a Bactrim-induced stone in an immunocompromised patient. Similar patients can be prophylactically treated with diuresis and urinary alkalinization, as well as consideration for alternative medication use.
PMCID:7607417
PMID: 33163365
ISSN: 2214-4420
CID: 4716492
Journal of endourology case reports. 2020:6(3):103-106.DOI: 10.1089/cren.2019.0142

Bilateral Open Ureteroceles with Concomitant Bladder Calculi in an Adult Male [Case Report]

Bernstein, Ari P; Schulster, Michael; Chao, Brian; Silva, Mark V
PMCID:7580613
PMID: 33102700
ISSN: 2379-9889
CID: 4645682
Urology. 2019:133:46-49.DOI: 10.1016/j.urology.2019.08.026

Endoscopic Combined Intrarenal Surgery Can Accurately Predict High Stone Clearance Rates on Postoperative CT

Schulster, Michael; Small, Alexander C; Silva, Mark V; Abbott, Joel E; Davalos, Julio G
OBJECTIVE:To determine stone clearance rates using endoscopic combined intrarenal surgery (ECIRS) and assess the accuracy of intraoperative prediction of stone-free (SF) status compared to postoperative CT scan. METHODS:on CT. RESULTS:One hundred and ten procedures were reviewed. Average age was 58.9 ± 12.6 years (range 26-87) and 69 (63%) were male. The mean stone size was 33.3 ± 23.5 mm (range 4-140 mm). Ninty-three patients (84.5%) were endoscopically estimated to be SF, of which 84 (90% of predicted SF cohort, 76% of total cohort) were confirmed SF via CT scan. The sensitivity for estimating SF status with ECIRS was 65.4% (95%CI 44.3%-82.8%), specificity was 100% (95%CI 95.7%-100.0%) and accuracy was 91.8% (95%CI 85.0%-96.2%). SF patients had significantly smaller stones than those with residual fragments (28.5 ± 2.1 vs 48.4 ± 5.7mm, P <.0001). On logistic regression, the factors associated with residual stones were preoperative stone burden (OR 1.03 per mm, 95%CI 1.01-1.05, P = .0004) and fluoroscopy time (OR 1.01 per minute, 95%CI 1.0-1.02, P = .0081). CONCLUSION/CONCLUSIONS:ECIRS accurately predicts clinical SF status and may obviate the need for additional CT scans. Consistent with prior studies, the primary determinant of residual stone after percutaneous nephrolithotomy is initial stone size.
PMID: 31472203
ISSN: 1527-9995
CID: 4337402
Clinical transplantation. 2019.DOI: 10.1111/ctr.13715

Therapeutic Living Donor Nephrectomy

Dale, Leigh-Anne; Silva, Mark V; Sandoval, P Rodrigo; DeCastro, G Joel; Campenot, Eric S; Ratner, Lloyd E
Therapeutic living donor nephrectomy is defined as a nephrectomy that is performed as therapy for an underlying medical condition. The patient directly benefits from having their kidney removed, but the kidney is deemed transplantable. The kidney is subsequently used as an allograft for an individual with advanced renal disease. Therapeutic donor nephrectomy can be successfully utilized for a heterogenous cohort of disease processes as both treatment for the donor and to increase the number of suitable organs available for transplantation. We describe four cases of therapeutic donor nephrectomy that were performed at our institution. Of the four cases, two patients elected to undergo therapeutic donor nephrectomy as treatment for loin pain hematuria syndrome; one after blunt abdominal trauma that resulted in complete proximal ureteral avulsion; and the fourth after being diagnosed with a small renal mass. Based on our data presented to the United Network for Organ Sharing Board of Directors (UNOS) in December 2015, living donor evaluation has been made simpler for patients electing to undergo therapeutic donor nephrectomy. UNOS eliminated the requirement for a psychosocial evaluation for these patients. As the organ shortage continues to limit transplantation, therapeutic donor nephrectomy should be considered when appropriate.
PMID: 31541580
ISSN: 1399-0012
CID: 4098222

Acess to the ureter - flexible ureteroscopy

Chapter by: Shah, Ojas; Silva, Mark
in: Smith's textbook of endourology by Smith, Arthur D; Badlani, Gopal H; Preminger, Glenn M; Kavoussi, Louis R; Rastinehad, Ardeshir R (Eds)
Hoboken, NJ : Wiley-Blackwell, 2019
pp. ?-?
ISBN: 1119241359
CID: 3212002
Cell. 2018:173(2):515-528.e17.DOI: 10.1016/j.cell.2018.03.017

Tumor Evolution and Drug Response in Patient-Derived Organoid Models of Bladder Cancer

Lee, Suk Hyung; Hu, Wenhuo; Matulay, Justin T; Silva, Mark V; Owczarek, Tomasz B; Kim, Kwanghee; Chua, Chee Wai; Barlow, LaMont J; Kandoth, Cyriac; Williams, Alanna B; Bergren, Sarah K; Pietzak, Eugene J; Anderson, Christopher B; Benson, Mitchell C; Coleman, Jonathan A; Taylor, Barry S; Abate-Shen, Cory; McKiernan, James M; Al-Ahmadie, Hikmat; Solit, David B; Shen, Michael M
Bladder cancer is the fifth most prevalent cancer in the U.S., yet is understudied, and few laboratory models exist that reflect the biology of the human disease. Here, we describe a biobank of patient-derived organoid lines that recapitulates the histopathological and molecular diversity of human bladder cancer. Organoid lines can be established efficiently from patient biopsies acquired before and after disease recurrence and are interconvertible with orthotopic xenografts. Notably, organoid lines often retain parental tumor heterogeneity and exhibit a spectrum of genomic changes that are consistent with tumor evolution in culture. Analyses of drug response using bladder tumor organoids show partial correlations with mutational profiles, as well as changes associated with treatment resistance, and specific responses can be validated using xenografts in vivo. Our studies indicate that patient-derived bladder tumor organoids represent a faithful model system for studying tumor evolution and treatment response in the context of precision cancer medicine.
PMCID:5890941
PMID: 29625057
ISSN: 1097-4172
CID: 3196272
Journal of urology. 2018:199:E922-E922.DOI:

ARE TWO VIEWS BETTER THAN ONE? MULTI-SCOPE PERCUTANEOUS NEPHROLITHOTOMY HAS HIGH STONE CLEARANCE RATES ON POSTOPERATIVE CT [Meeting Abstract]

Silva, Mark V.; Small, Alexander C.; Abbott, Joel E.; Davalos, Julio G.
ISI:000429166602599
ISSN: 0022-5347
CID: 3212042
Journal of urology. 2018:199:E716-E717.DOI:

BLUE LIGHT IN COMBINATION WITH HEAMINOLEVULINATE (CYSVIEW (R)) LEADS TO BLADDER CANCER CELL DEATH IN AN IN VITRO MODEL [Meeting Abstract]

Matulay, Justin T.; Williams, Alanna B.; Silva, Mark V.; McKiernan, James M.; Shen, Michael M.
ISI:000429166602124
ISSN: 0022-5347
CID: 3212112
Journal of urology. 2018:199:E1206-E1206.DOI:

AMBULATORY PERCUTANEOUS NEPHROLITHOTOMY PERFORMED IN A FREE-STANDING SURGERY CENTER: OUTCOMES OF THE FIRST 219 CASES [Meeting Abstract]

Abbott, Joel E.; Silva, Mark V.; Davalos, Julio G.
ISI:000429166603482
ISSN: 0022-5347
CID: 3212052
Journal of endourology. 2016:30(10):1041-1048.DOI: 10.1089/end.2015.0645

Innovation in Robotics and Pediatric Urology: Robotic Ureteroureterostomy for Duplex Systems with Ureteral Ectopia

Biles, Michael J; Finkelstein, Julia B; Silva, Mark V; Lambert, Sarah M; Casale, Pasquale
INTRODUCTION:Robotic technology has been increasingly utilized for complicated reconstructive surgeries in pediatric urology, such as ureteroureterostomy (UU). The literature is limited regarding the performance of minimally invasive UU in children, and the existing published series utilize indwelling ureteral stents. We sought to report on our pediatric experience with robot-assisted laparoscopic (RAL)-UU using a temporary ureteral catheter in duplex systems with ureteral ectopia. METHODS:A retrospective chart review was performed of all pediatric patients who underwent RAL-UU at a single institution over a 2-year period. An externalized ureteral catheter was kept overnight and removed with the indwelling catheter on postoperative day 1. Intraoperative as well as postoperative complications, length of stay (LOS), and analgesia were recorded. Follow-up renal ultrasound (US) and evaluation for symptom resolution were completed 3 months postoperatively. RESULTS:Twelve patients (four male, eight female) underwent RAL-UU at a mean age of 19.4 months (range 9-48 months) during the study period. The majority of patients (83.3%) presented with hydronephrosis, and all were found to have duplicated systems with ureteral ectopia. No child had ipsilateral vesicoureteral reflux. Two children had bilateral duplicated systems, one of which required bilateral surgery. Median operative time was 138 minutes (IQR 119-180 minutes), and mean estimated blood loss was 1.5 mL. There were no intraoperative complications, and no case required open conversion. Median hospital LOS was 31 hours (IQR 30-39 hours). Median follow-up time was 11 months (range 3-22 months). One patient developed a postoperative febrile upper respiratory infection. All patients had improved hydroureteronephrosis on US at 3 months postoperatively. One patient with preoperative urinary incontinence was dry postoperatively. Therefore, the overall success rate was 100%. CONCLUSION:Our institutional results demonstrate that RAL-UU utilizing a temporary ureteral catheter is a safe and effective technique for managing duplicated, ectopic ureters in children and infants.
PMID: 27542552
ISSN: 1557-900x
CID: 3211972