Objective To propose ex vivo ureteroscopy (ExURS) and technical modification to render the donated kidney stone-free at live donor renal transplantation.Methods A suitable kidney donor with small unilateral nonobstructive calculi in the lower calyx of left kidney underwent laparoscopic live donor nephrectomy. After cold perfusion, ExURS was performed immediately in an iced saline solution. A F8.0/9.8 semirigid ureteroscope was accessed to collecting system via the ureteral stump. A 'Pull-up'skill was applied in order to facilitate the atraumatic access to the pelvis. The harvested kidney was rotated so as to facilitate the semirigid ureteroscope access to the lower calyx. The calculi was then completely endoscopic fragmented with holmium and removed. Results The warm ischemia time was 3 min and the cold ischemia time was 2.5 h. The procedure time was 18 min. There were no intra-operative or postoperative ureteral complications. The urine volume of recipient was 6260 ml in the postoperative day. the serum creatinine of 1 to 4 postoperative days were 402 μmol/L, 186 μmol/L, 136 μmol/L, 112 μmol/L, respectively, which was normal 4 days after operation. The serum creatinine maintain at 100 μmol/L approximately, in 6 months follow up.Conclusions ExURS is a technically feasible means of rendering a stone bearing donor kidney stone-free safely and efficiency.

Objective To explore the application effect of problem-based health education mode in patients with upper urinary tract calculi .Methods Effect of two different health education modes for urolithiasis patients in Peking University Third Hospital were researched .The patients were divided into observation group with 104 cases and control group with 103 cases, according to their order of admission of odd and even numbers . Patients in the observation group were assessed by a self-designed questionnaire concerning urolithiasis knowledge (with full score 20 points).Health education was conducted according to the patients′scores on key parts of the disease .Health education of the patients was recorded , according to which problem-based health education was conducted .Routine comprehensive health education mode was conducted to patients in the control group.When leaving hospital , routine discharge education and continuing nursing care were conducted to both groups.4 weeks after the operation , satisfaction of patients were evaluated , and disease-related knowledge of the patients was evaluated again .Results Patients′knowledge and attitude to health education were not statistically different (P>0.05).The patients′scores of knowledge 4 weeks after the operation were (15.49 ±2.85) in the observation group, higher than those in the control group (10.22 ±3.41) (t =12.09, P <0.001).The patients′scores of satisfaction were (9.97 ±0.17) in the observation group, higher than those in the control group (9.89 ±0.31) (t=2.249, P=0.026).Conclusions Assessment of the patients′health knowledge by questionnaires when admitted to the hospital helps to determine their need of knowledge concerning the disease . Establishment of health education record helps to give prominence to the key points in the education .Consistent in content, fine in effect, health education has won high satisfaction among patients .