Publications by authors named "Zohar A Dotan"

Purpose: Kidney-sparing endoscopic surgery is considered the preferred approach for the treatment of low-risk upper tract urothelial cancer (UTUC), yet its impact on subsequent radical nephroureterectomy's (RNU) surgical complexity remains uncertain. This study aims to evaluate the effect of prior endoscopic procedures on peri-operative outcomes of UTUC patients undergoing RNU.

Methods: A retrospective analysis of 176 consecutive UTUC patients who underwent RNU from July 2008 to July 2023 at a single tertiary center.

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Purpose: Urine leakage (UL) is a recognized complication after partial nephrectomy (PN). This study aimed to determine the incidence of UL and identify key risk factors, including tumor size and surgical approach, to clarify the impact of robotic-assisted, laparoscopic, and open PN on postoperative outcomes.

Methods: A retrospective review of 785 consecutive clinical T1 PN cases (2012-2022) was undertaken.

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Achieving renal access during percutaneous nephrolithotomy is challenging, with a complication rate of 10-20%. This study aims to assess a novel technique for planning access to the renal collecting system using augmented reality (AR). Using Digital Imaging and Communications in Medicine software (DICOM 2-print), we generated 3-dimensional (3D) models of patients with different types of kidney stones (staghorn, lower pole, and pelvic stones) who underwent PCNL between 2018 and 2022.

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Purpose: This study aims to assess the evaluation, management, clinical outcomes and incidence of postoperative hematuria following partial nephrectomy (PNx) for renal tumors.

Methods: We retrospectively reviewed the medical charts of 936 adult patients who underwent PNx between 2008 and 2023. Patients presenting with hematuria during the first 6 months of surgery were included.

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Pelvic kidney is a congenital anomaly characterized by the kidney's failure to ascend to its normal anatomical location during early embryonic development. This anomaly complicates traditional surgical approaches for renal calculi due to the kidney's atypical positioning and associated anatomical challenges. We sought to summarize our experience with robotic-assisted pyelolithotomy (RPPK) for pelvic kidney stones.

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Article Synopsis
  • Aquablation is a new robotic-assisted procedure using ultrasound and water jets to treat benign prostatic hyperplasia (BPH), aiming to assess its efficiency and safety.
  • A retrospective analysis of 50 patients revealed successful surgeries with no intra-operative complications, a median surgery time of 51 minutes, and minimal change in hemoglobin levels.
  • The procedure led to a significant improvement in urinary symptoms and quality of life, with most patients showing stable functional outcomes and none reporting significant urinary incontinence post-surgery.
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While partial nephrectomy offers oncologic efficacy and preserves renal function for T1 renal tumors, renal artery pseudoaneurysm (RAP) remains a rare but potentially life-threatening complication. This study compared RAP incidence across robotic-assisted (RAPN), laparoscopic (LPN), and open (OPN) partial nephrectomies in a large tertiary oncological center. This retrospective study analyzed 785 patients undergoing partial nephrectomy between 2012 and 2022 (398 RAPN, 122 LPN, 265 OPN).

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Urolithiasis has a seasonal pattern, with an established increase in incidence during the summer months. This study aims to assess the impact of high ambient temperatures on emergency room (ER) visits related to renal colic (RC) in a Middle Eastern country over the past decade. Population data were extracted using the MDClone Big Data platform.

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Background: Current guidelines recommend a stringent follow-up regimen that includes interval cystoureteronephscopy, CT urography, and selective urine cytology sampling for upper tract urothelial carcinoma (UTUC) patients undergoing endoscopic treatment and management. There are no recommendations regarding FISH analysis. Our purpose was to assess the efficacy of cytology and FISH as part of the follow-up protocol and its significance to clinical decision-making in this scenario.

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Article Synopsis
  • Primary ureteroscopy with laser lithotripsy is effective for treating both proximal and distal ureteral stones, with similar surgical outcomes.
  • A study analyzed data from 241 patients and found no significant difference in complication rates or stone-free rates between the two groups.
  • The results suggest that inserting a ureteral stent before ureteroscopy for proximal stones may not be necessary, as most patients had satisfactory outcomes without it.
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We sought to quantify the additive value of systematic biopsy (SB) using in-bore magnetic resonance (MR)-guided prostate biopsy (IBMRGpB) by retrospectively reviewing the records of 189 patients who underwent IBMRGpB for suspected prostate cancer or as part of the surveillance protocol for previously diagnosed prostate cancer. The endpoints included clinically significant and non-clinically significant cancer diagnosis. SB detected clinically significant disease in 67 (35.

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Background: Malignant ureteral obstruction (MUO) is a sequela of advanced malignant disease that requires renal drainage, with tandem ureteral stents (TUSs) being a viable option. This study aimed to evaluate the TUS failure rate, associated risk factors, and the feasibility of replacing failed TUSs with a new pair of stents.

Methods: A retrospective analysis of MUO patients treated with TUS insertion from 2014 to 2022 was conducted.

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Up-to-date guidelines on the management of upper tract urothelial carcinoma (UTUC) are continuously published. We aim to assess the variability of diagnosis and treatment strategies in the endoscopic management of UTUC and adherence to European Association of Urology and National Comprehensive Cancer Network guidelines. A 15-question survey was designed to query practitioners on approaches to clinical practice and knowledge about endoscopic treatment indications and techniques.

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Initial deleterious effects of the COVID-19 pandemic on urologic oncology surgeries are well described, but the possible influence of vaccination efforts and those of pandemic conditions on surgical volumes is unclear. Our aim was to examine the association between changing vaccination status and COVID-19 burden throughout the pandemic and the volume of urologic oncology surgeries in Israel. This multi-center cross-sectional study included data collected from five tertiary centers between January 2019 and December 2021.

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Background: Laparoscopic (LP) and robot-assisted pyeloplasty (RAP) are minimally invasive techniques for correcting uretero-pelvic junction obstruction (UPJO). We retrospectively compared the clinical outcomes of all adults who underwent RAP (n = 41) to those who underwent LP (n = 24) for UPJO at our institution between 2003−2022. Methods: Age, sex, body mass index, surgical side, past abdominal/endoscopic surgeries, pre- and postoperative renal scans, pre- and postoperative serum creatinine levels, operative time (OT), presence of crossing vessels, estimated blood loss, postoperative complications, length of hospital stay, time to JJ stent removal, follow-up length, and postoperative hydronephrosis were analyzed.

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Background: Oncocytoma is one of the most common benign kidney tumors, accounting for 3-7% of all solid renal masses. Diagnosing oncocytomas using renal biopsy remains a controversy in the uro-pathologic community. With the increasing use of biopsies for assessment of renal lesions, reaching this pathologically benign diagnosis may prevent further surgical measures and have significant clinical benefit.

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Purpose: to evaluate a unique subpopulation of radical prostatectomy (RP) candidates with “negative” prostate 68Ga-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT) imaging scans and to characterize the clinical implications of misleading findings. Materials and Methods: This case-control retrospective study compared the final histological outcomes of patients with “negative” pre-RP PSMA PET/CT prostate scans (with a prostate maximal standardized uptake value [SUVmax] below the physiologic uptake) to those with an “intense” prostatic tracer uptake (with a SUVmax above the physiologic uptake). The patients underwent an RP between March 2015 and July 2019 in five academic centers.

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Background: The combination of multi-parametric MRI to locate and define suspected lesions together with their being targeted by an MRI-guided prostate biopsy has succeeded in increasing the detection rate of clinically significant disease and lowering the detection rate of non-significant prostate cancer. In this work we investigate the urologist's learning curve of in-bore MRI-guided prostate biopsy which is considered to be a superior biopsy technique.

Materials And Methods: Following Helsinki approval by The Chaim Sheba Medical Center ethics committee in accordance with The Sheba Medical Center institutional guidelines (5366-28-SMC) we retrospectively reviewed 110 IB-MRGpBs performed from 6/2016 to 1/2019 in a single tertiary center.

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Upper tract urothelial carcinoma is a relatively rare malignancy, but with an increasing prevalence. The main risk factor for the disease is smoking. The most common presentation is hematuria or flank pain.

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Focal treatment for prostate cancer has been proposed as an innovative strategy that aims to achieve oncological benefit while reducing treatment-related morbidity. This treatment is suitable for patients with low and intermediate risk, organ-confined disease. Focal therapy can be categorized as follows: unifocal index lesion ablation, multifocal ablation, hemi-gland ablation or subtotal gland ablation.

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Background: Partial nephrectomy is the gold standard treatment for renal tumors less than 7 cm.

Objectives: To describe surgical techniques and trends of treating renal tumors less than 7 cm at our department and present the clinical outcomes of our experience with Robot-Assisted Partial Nephrectomy (RAPN).

Methods: Out of an established prospective RAPN database, we retrieved demographic, clinical, surgical and pathological parameters.

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Background: Urinary Incontinence (UI) following Robot-Assisted Laparoscopic-Radical Prostatectomy (RALP) adversely affects patients' quality of life.

Objectives: To find parameters that predict full urinary continence (FUC) following RALP.

Methods: Out of an established prospective RALP database, we retrieved and analyzed parameters that potentially predict FUC: age, Body Mass Index, American Anesthesiology Association (ASA) score, previous abdominal surgeries, pre-operative IPSS (International Prostate-Symptom Score), operative time (OT), estimated blood loss (EBL), peritoneum closure and prostate weight.

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Background: Robotic-pyeloplasty (RP) for uretero-pelvic-junction-obstruction (UPJO) has been performed in our institution since 2013.

Objectives: To summarize the outcomes of RP in adults over 18 years of age.

Methods: Adult RP cases have been prospectively documented.

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Purpose: We reviewed the experience with adrenal ganglioneuroma (AGN) pathologically confirmed following adrenalectomy in medium- to high-volume medical centers.

Methods: The medical records of all adrenalectomy cases in 4 medical centers between 2006 and 2020 were retrospectively reviewed for demographics, clinical, radiological and laboratory findings, surgical treatment, pathology results, and outcomes.

Results: Twenty-five out of 875 adrenalectomy cases (2.

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