Tung Shu - Academia.edu (original) (raw)
Papers by Tung Shu
Male Infertility for the Clinician, 2013
The Journal of urology, 2004
We characterized evaluation, management and outcomes in a group of patients diagnosed with renal ... more We characterized evaluation, management and outcomes in a group of patients diagnosed with renal and perirenal abscesses who had otherwise anatomically normal urinary tracts. We reviewed our experience with renal/perirenal abscesses at University of Texas Medical Branch from 1991 to 2002. Treatment was determined by physician preference in each individual. Of 70 patients with renal/perirenal abscesses 26 had otherwise anatomically normal urinary tracts, 24 (92%) had at least 1 possible contributory factor, such as diabetes mellitus, and only 38% had the correct diagnosis at initial presentation. The abscess was intranephric in 39% of cases, intranephric and perinephric in 19%, and perinephric only in 42%. Of the 26 patients 18 were treated with percutaneous drainage or aspiration of the abscess and 12 (66.7%) had positive cultures. Eight of the 12 patients (67%) with positive abscess cultures had the same organism in urine and/or blood. All 26 patients were treated with broad-spectr...
Current Treatment Options in Oncology, 2004
Urology, 2014
To report our results from series of robotic-assisted laparoscopic augmentation enterocystoplasty... more To report our results from series of robotic-assisted laparoscopic augmentation enterocystoplasty (RALAE) performed in a completely intracorporeal fashion. Patients who underwent RALAE with or without the creation of a catheterizable channel between 2006 and 2011 at the University of Texas, Houston and Northwestern Memorial Hospital were identified. Perioperative and follow-up data were analyzed. Preoperative and postoperative urodynamic data were analyzed when available. Twenty-two patients with neurogenic bladder underwent RALAE with or without the creation of a catheterizable channel. Fifteen patients underwent robotic augmentation enterocystoplasty alone, and 7 patients had creation of a catheterizable channel (4 Monti and 3 Mitrofanoff). There was 1 conversion to an open procedure in a patient undergoing concomitant creation of an appendicovesicostomy. Mean follow-up was 38.9 months (range, 6.2-72.1 months). Mean operative time was 365 minutes (range, 220-788 minutes); mean est...
Urology, 2004
We present an immunocompromised patient with a painless testicular mass. Usually, this mass is su... more We present an immunocompromised patient with a painless testicular mass. Usually, this mass is suspicious for testicular cancer; however, a fungal abscess from Pseudallescheria boydii was found. The patient eventually died from disseminating infection. This is the first such report of a testicular infection involving P. boydii. Early diagnosis and treatment are paramount because of the poor outcome with disseminated disease.
Urology, 2004
Bleeding disorders are generally considered absolute contraindications to laparoscopic surgery. W... more Bleeding disorders are generally considered absolute contraindications to laparoscopic surgery. We believe laparoscopic/retroperitoneoscopic renal surgery is an optimal choice in patients with hemophilia, because it minimizes tissue trauma. We present a case of successful retroperitoneoscopic renal surgery in a patient with factor VIII deficiency with a perinephric abscess that failed less invasive treatments. A fully equipped coagulation laboratory, experienced hematologists, and an experienced laparoscopic surgeon play a large role in the outcome in patients with bleeding disorders undergoing minimally invasive procedures. We conclude that although uncorrected bleeding disorders are absolute contraindications for surgical procedures, those that are corrected and appropriately monitored are not.
The Journal of Urology, 2004
We characterized evaluation, management and outcomes in a group of patients diagnosed with renal ... more We characterized evaluation, management and outcomes in a group of patients diagnosed with renal and perirenal abscesses who had otherwise anatomically normal urinary tracts. We reviewed our experience with renal/perirenal abscesses at University of Texas Medical Branch from 1991 to 2002. Treatment was determined by physician preference in each individual. Of 70 patients with renal/perirenal abscesses 26 had otherwise anatomically normal urinary tracts, 24 (92%) had at least 1 possible contributory factor, such as diabetes mellitus, and only 38% had the correct diagnosis at initial presentation. The abscess was intranephric in 39% of cases, intranephric and perinephric in 19%, and perinephric only in 42%. Of the 26 patients 18 were treated with percutaneous drainage or aspiration of the abscess and 12 (66.7%) had positive cultures. Eight of the 12 patients (67%) with positive abscess cultures had the same organism in urine and/or blood. All 26 patients were treated with broad-spectrum intravenous antibiotics. In most patients abscess size influenced additional treatments, such as percutaneous needle aspiration or catheter drainage. None of the patients required open surgical drainage, nephrectomy or nephrostomy tube placement. At a mean followup of 10 months all patients had complete radiographic resolution of the abscess without further complications except 1 who had pyelonephritis and another who was found to have a poorly perfused kidney. With accurate diagnosis and minimally invasive therapy patients with renal and/or perirenal abscesses and otherwise anatomically normal urinary tracts have excellent functional and anatomical outcomes.
Journal of Endourology, 2004
Postpubertal vesicoureteral reflux is a rare occurrence. In the adolescent group, its repair can ... more Postpubertal vesicoureteral reflux is a rare occurrence. In the adolescent group, its repair can be a challenging open procedure. We present our preliminary experience with laparoscopic extravesical ureteral reimplantation for postpubertal vesicoureteral reflux. Six female patients with a mean age of 18.7 years presented with recurrent urinary tract infection secondary to vesicoureteral reflux. The indications for treatment were febrile urinary tract infection, recurrent pyelonephritis, renal scarring, and breakthrough urinary tract infection. The reflux was unilateral in all patients at the time of treatment, but one patient had previously experienced bilateral reflux and had persistent left-sided reflux following subureteral injection of Durasphere. This patient underwent bilateral laparoscopic extravesical ureteral reimplantation. The mean operative times for the unilateral and bilateral procedures were 1.75 hours and 3.75 hours, respectively. The average length of stay in the hospital was 36 hours; five patients went home in <24 hours. The mean time to resumption of full activity was 8 days. All six patients had resolution of vesicoureteral reflux, as shown by radiographic studies, with a mean follow-up of 11.4 months. Laparoscopic extravesical ureteral reimplantation for postpubertal vesicoureteral reflux has excellent outcomes with minimal postoperative morbidity. Long-term radiographic follow-up is needed.
European Urology, 2001
We report a case of acute renal failure due rhabdomyolysis as a result of the exaggerated lithoto... more We report a case of acute renal failure due rhabdomyolysis as a result of the exaggerated lithotomy position during radical perineal prostatectomy. The pathogenesis, diagnosis, management, and preventive measures of acute renal failure associated with rhabdomyolysis are also reviewed.
Asian Journal of Andrology, 2008
To determine if robot-assisted varicocelectomy can be safely and effectively performed when compa... more To determine if robot-assisted varicocelectomy can be safely and effectively performed when compared to microscopic inguinal varicocelectomy. Eight patients aged 29.1+/-12.5 years underwent microscopic subinguinal varicocelectomies: seven patients with left-sided repair, and one patient with bilateral repair. Eight patients aged 22.0+/-8.0 years underwent robot-assisted varicocelectomies: seven patients with left-sided repair and one patient with bilateral repair. The average operative time for microscopic inguinal varicocelectomy was 73.9+/-12.2 min, whereas the robot-assisted technique took 71.1+/-21.1 min. There were no difficulties in identifying and isolating vessels and the vas deferens with robot-assisted subinguinal varicocelectomy. Hand tremor was eliminated using the robotic procedure. Patients who underwent either microscopic or robot-assisted varicocelectomies were able to resume daily activities on the day of surgery and full activities within 2 weeks. There were no complications or recurrences of varicocele. From our experience, compared to microscopic surgery, robot-assisted varicocelectomy can be safely and effectively performed, with the added benefit of eliminating hand tremor.
Journal of Clinical Anesthesia, 2011
Male Infertility for the Clinician, 2013
The Journal of urology, 2004
We characterized evaluation, management and outcomes in a group of patients diagnosed with renal ... more We characterized evaluation, management and outcomes in a group of patients diagnosed with renal and perirenal abscesses who had otherwise anatomically normal urinary tracts. We reviewed our experience with renal/perirenal abscesses at University of Texas Medical Branch from 1991 to 2002. Treatment was determined by physician preference in each individual. Of 70 patients with renal/perirenal abscesses 26 had otherwise anatomically normal urinary tracts, 24 (92%) had at least 1 possible contributory factor, such as diabetes mellitus, and only 38% had the correct diagnosis at initial presentation. The abscess was intranephric in 39% of cases, intranephric and perinephric in 19%, and perinephric only in 42%. Of the 26 patients 18 were treated with percutaneous drainage or aspiration of the abscess and 12 (66.7%) had positive cultures. Eight of the 12 patients (67%) with positive abscess cultures had the same organism in urine and/or blood. All 26 patients were treated with broad-spectr...
Current Treatment Options in Oncology, 2004
Urology, 2014
To report our results from series of robotic-assisted laparoscopic augmentation enterocystoplasty... more To report our results from series of robotic-assisted laparoscopic augmentation enterocystoplasty (RALAE) performed in a completely intracorporeal fashion. Patients who underwent RALAE with or without the creation of a catheterizable channel between 2006 and 2011 at the University of Texas, Houston and Northwestern Memorial Hospital were identified. Perioperative and follow-up data were analyzed. Preoperative and postoperative urodynamic data were analyzed when available. Twenty-two patients with neurogenic bladder underwent RALAE with or without the creation of a catheterizable channel. Fifteen patients underwent robotic augmentation enterocystoplasty alone, and 7 patients had creation of a catheterizable channel (4 Monti and 3 Mitrofanoff). There was 1 conversion to an open procedure in a patient undergoing concomitant creation of an appendicovesicostomy. Mean follow-up was 38.9 months (range, 6.2-72.1 months). Mean operative time was 365 minutes (range, 220-788 minutes); mean est...
Urology, 2004
We present an immunocompromised patient with a painless testicular mass. Usually, this mass is su... more We present an immunocompromised patient with a painless testicular mass. Usually, this mass is suspicious for testicular cancer; however, a fungal abscess from Pseudallescheria boydii was found. The patient eventually died from disseminating infection. This is the first such report of a testicular infection involving P. boydii. Early diagnosis and treatment are paramount because of the poor outcome with disseminated disease.
Urology, 2004
Bleeding disorders are generally considered absolute contraindications to laparoscopic surgery. W... more Bleeding disorders are generally considered absolute contraindications to laparoscopic surgery. We believe laparoscopic/retroperitoneoscopic renal surgery is an optimal choice in patients with hemophilia, because it minimizes tissue trauma. We present a case of successful retroperitoneoscopic renal surgery in a patient with factor VIII deficiency with a perinephric abscess that failed less invasive treatments. A fully equipped coagulation laboratory, experienced hematologists, and an experienced laparoscopic surgeon play a large role in the outcome in patients with bleeding disorders undergoing minimally invasive procedures. We conclude that although uncorrected bleeding disorders are absolute contraindications for surgical procedures, those that are corrected and appropriately monitored are not.
The Journal of Urology, 2004
We characterized evaluation, management and outcomes in a group of patients diagnosed with renal ... more We characterized evaluation, management and outcomes in a group of patients diagnosed with renal and perirenal abscesses who had otherwise anatomically normal urinary tracts. We reviewed our experience with renal/perirenal abscesses at University of Texas Medical Branch from 1991 to 2002. Treatment was determined by physician preference in each individual. Of 70 patients with renal/perirenal abscesses 26 had otherwise anatomically normal urinary tracts, 24 (92%) had at least 1 possible contributory factor, such as diabetes mellitus, and only 38% had the correct diagnosis at initial presentation. The abscess was intranephric in 39% of cases, intranephric and perinephric in 19%, and perinephric only in 42%. Of the 26 patients 18 were treated with percutaneous drainage or aspiration of the abscess and 12 (66.7%) had positive cultures. Eight of the 12 patients (67%) with positive abscess cultures had the same organism in urine and/or blood. All 26 patients were treated with broad-spectrum intravenous antibiotics. In most patients abscess size influenced additional treatments, such as percutaneous needle aspiration or catheter drainage. None of the patients required open surgical drainage, nephrectomy or nephrostomy tube placement. At a mean followup of 10 months all patients had complete radiographic resolution of the abscess without further complications except 1 who had pyelonephritis and another who was found to have a poorly perfused kidney. With accurate diagnosis and minimally invasive therapy patients with renal and/or perirenal abscesses and otherwise anatomically normal urinary tracts have excellent functional and anatomical outcomes.
Journal of Endourology, 2004
Postpubertal vesicoureteral reflux is a rare occurrence. In the adolescent group, its repair can ... more Postpubertal vesicoureteral reflux is a rare occurrence. In the adolescent group, its repair can be a challenging open procedure. We present our preliminary experience with laparoscopic extravesical ureteral reimplantation for postpubertal vesicoureteral reflux. Six female patients with a mean age of 18.7 years presented with recurrent urinary tract infection secondary to vesicoureteral reflux. The indications for treatment were febrile urinary tract infection, recurrent pyelonephritis, renal scarring, and breakthrough urinary tract infection. The reflux was unilateral in all patients at the time of treatment, but one patient had previously experienced bilateral reflux and had persistent left-sided reflux following subureteral injection of Durasphere. This patient underwent bilateral laparoscopic extravesical ureteral reimplantation. The mean operative times for the unilateral and bilateral procedures were 1.75 hours and 3.75 hours, respectively. The average length of stay in the hospital was 36 hours; five patients went home in <24 hours. The mean time to resumption of full activity was 8 days. All six patients had resolution of vesicoureteral reflux, as shown by radiographic studies, with a mean follow-up of 11.4 months. Laparoscopic extravesical ureteral reimplantation for postpubertal vesicoureteral reflux has excellent outcomes with minimal postoperative morbidity. Long-term radiographic follow-up is needed.
European Urology, 2001
We report a case of acute renal failure due rhabdomyolysis as a result of the exaggerated lithoto... more We report a case of acute renal failure due rhabdomyolysis as a result of the exaggerated lithotomy position during radical perineal prostatectomy. The pathogenesis, diagnosis, management, and preventive measures of acute renal failure associated with rhabdomyolysis are also reviewed.
Asian Journal of Andrology, 2008
To determine if robot-assisted varicocelectomy can be safely and effectively performed when compa... more To determine if robot-assisted varicocelectomy can be safely and effectively performed when compared to microscopic inguinal varicocelectomy. Eight patients aged 29.1+/-12.5 years underwent microscopic subinguinal varicocelectomies: seven patients with left-sided repair, and one patient with bilateral repair. Eight patients aged 22.0+/-8.0 years underwent robot-assisted varicocelectomies: seven patients with left-sided repair and one patient with bilateral repair. The average operative time for microscopic inguinal varicocelectomy was 73.9+/-12.2 min, whereas the robot-assisted technique took 71.1+/-21.1 min. There were no difficulties in identifying and isolating vessels and the vas deferens with robot-assisted subinguinal varicocelectomy. Hand tremor was eliminated using the robotic procedure. Patients who underwent either microscopic or robot-assisted varicocelectomies were able to resume daily activities on the day of surgery and full activities within 2 weeks. There were no complications or recurrences of varicocele. From our experience, compared to microscopic surgery, robot-assisted varicocelectomy can be safely and effectively performed, with the added benefit of eliminating hand tremor.
Journal of Clinical Anesthesia, 2011