HOW I DO IT

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How I Do It: Transcutaneous tibial nerve stimulation TENSI+ system
Cornu Jean-Nicolas, Hashim Hashim, Van Der Aa Frank, De Nunzio Cosimo, Perez Garcia Valentina, Ferreira Roseanne, Elterman S. Dean Department of Urology, Charles Nicolle University Hospital, University of Rouen, Rouen, France

Overactive bladder (OAB) is a common condition that significantly impacts the quality of life (QoL), well-being and daily functioning for both men and women. Among various treatments, peripheral tibial nerve stimulation (PTNS) emerges as an effective third-line treatment for OAB symptoms, with options for either a percutaneous approach (P-PTNS) or by transcutaneous delivery (T-PTNS). Recent studies have shown negligible differences between P-PTNS and T-PTNS efficacy in alleviating urinary urgency and frequency and QoL improvement and, overall no difference in efficacy over antimuscarinic regimens. The TENSI+ system offers a cutting-edge transcutaneous approach, allowing patients to self-administer treatment conveniently at home with electrical stimulation delivery through surface electrodes. It stands out for its ease of preparation, tolerability, and high levels of patient satisfaction. Prospective multicentric data highlights TENSI+ to be an effective and safe treatment for lower urinary tract symptoms with high treatment adherence at 3 months. This paper aims to familiarize readers with the TENSI+ system, current studies, device assembly, operation, and treatment recommendations.

Keywords: OAB, PTNS, T-PTNS, TENSI+,
Dec 2023 (Vol. 30, Issue 6 , Page 11756)
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How I do it: laparoscopic renal cryoablation (LRC)
da Silva Donalisi Rodrigo, Jaworski Paulo, Gustafson Diedra, Nogueira Leticia, Kang Francis, Molina Wilson, Kim J. Fernando, MD Division of Urology, Denver Health Medical Center, Denver, Colorado, USA

Recently, diagnoses of small renal masses and renal cell carcinoma (RCC) have increased due to the widespread use of radiographic imaging studies (computerized tomography, magnetic resonance imaging). It appears that biological factors such as obesity and tobacco use increase the risk for RCC. In general, small malignant renal masses are low stage and low grade. The management of asymptomatic renal masses is a surgical challenge since overtreatment of benign masses is not desired, especially for patients with complex medical comorbidities, elderly patients, and those with impaired renal function. Partial nephrectomy has been considered the gold standard when treating small renal masses. However, technical challenges and possible irreversible ischemia-reperfusion injury should be considered when treating these lesions. Preservation of renal function without compromising oncological control is the foundation for nephron-sparing surgery. Laparoscopic renal cryoablation (LRC) emerges as an option to treat small renal masses due to the less invasive procedure with low intraoperative complications rates, with no renal ischemia-reperfusion injury and comparable medium term follow up. It is our objective to demonstrate our technique to perform an effective small renal tumor cryoablation using the laparoscopic approach.

Keywords: renal cancer, renal cryoablation, laparoscopic cryoablation,
Dec 2014 (Vol. 21, Issue 6 , Page 7574)
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How I do it: prostate cryoablation (PCry)
da Silva Donalisio Rodrigo , Jaworski Paulo , Gustafson Diedra , Nogueira Leticia , Molina Wilson , Kim J. Fernando, MD Denver Health Medical Center/University of Colorado Cancer Center, Denver, Colorado, USA

Prostate cryoablation (PCry) is a well-established minimally invasive therapy for the treatment of prostate cancer. Unfortunately, PCry still carries the stigma of a high rate recto-urethral fistula procedure but with the advent of argon/helium gas technology, urethral warmer and high quality transrectal ultrasound imaging, complications decreased and efficacy increased. The Denver Health Medical Center's technique in prostate cryoablation is described as follows.

Keywords: technique, prostate cryoablation,
Apr 2014 (Vol. 21, Issue 2 , Page 7251)
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