This video poster section contained 25 abstracts with highlighted topics such as the percutaneous management of uretropelvic junction obstruction (UPJO), ureteroscopic management of upper tract transitional cell carcinoma (UTTCC) and stone disease, These video posters were as eclectic as they were outstanding.

In the era of laparoscopic pyeloplasty there is certainly still a role for percutaneous endopyelotomy. This is especially true in treating secondary UPJO. Dr. Mantu Gupta from Columbia University Medical Center reported on his experience with performing 120 Endopyelotomies over 8 years. Of interest were the 24 of 120 patients with secondary UPJO that were treated. The Success rate for endopyelotomy to address secondary UPJO was an impressive 91.7% (22/24). Interestingly, both failures were pediatric patients. This study supports the important role for endopyelotomy in the treatment of secondary UPJO.

Dr. BI Chung and colleagues from the Cleveland Clinic examined their data to determine the ideal endoscopic treatment (ureteroscopic vs percutaneous) for medium size (1-2 cm) renal calculi. It was found that both PCNL and ureteroscopy were equally effective treatment options for renal calculi between 1-2 cm with no statistically significant differences (i.e stone free rates, complications, operative times, etc.) between both modalities. It was concluded that the choice of treatment ultimately depends upon the individual surgeon’s preference and level of comfort.

Dr. RH Thompson et al from the Mayo Clinic in Rochester, MN presented data on their 20 year experience with the endoscopic management of upper tract transitional cell carcinoma (UTTCC). This experience might very well represent the largest series to date of patients with UTTCC treated by endoscopic means. In specific, 83 patients, the large majority (94%) with Ta disease, were followed-up of for a median of 4.6 years.

Significant findings included: 55% (46/83) developed UTTCC recurrences, 45% (37/83) developed bladder recurrences, 31% (26/83) progressed to nephroureterectomy, and 11% (9/83) died from urothelial cancer (Grade 3 tumors and CIS/T1 at highest risk). These findings underscore the importance of surveillance in the minimally invasive treatment (MIT) of UTTCC.

Dr. Hegarty’s paper from the Cleveland Clinic entitled, “Non-enhancement of renal radiolesion on follow-up MRI is not necessarily synonymous with “successful” radiofrequency ablation (RFA)” was voted the best video poster of the session. Follow-up percutaneous renal biopsy in 30 patients treated with RFA at 6 months revealed that cancer cells were present in 6; of these patients no enhancement on MRI was noted in 5. These finding suggest that RFA may not yet be an appropriate widespread treatment in the MIT treatment of small renal cancers.

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