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Translational Andrology and Urology

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https://www.readbyqxmd.com/read/28904910/complications-acknowledging-managing-and-coping-with-human-error
#1
REVIEW
Sevann Helo, Carol-Anne E Moulton
Errors are inherent in medicine due to the imperfectness of human nature. Health care providers may have a difficult time accepting their fallibility, acknowledging mistakes, and disclosing errors. Fear of litigation, shame, blame, and concern about reputation are just some of the barriers preventing physicians from being more candid with their patients, despite the supporting body of evidence that patients cite poor communication and lack of transparency as primary drivers to file a lawsuit in the wake of a medical complication...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904909/office-based-andrology-and-male-infertility-procedures-a-cost-effective-alternative
#2
Manaf Alom, Matthew Ziegelmann, Josh Savage, Tanner Miest, Tobias S Köhler, Landon Trost
BACKGROUND: From 2014-2016, our clinical practice progressively incorporated several male infertility and andrology procedures performed under local anesthesia, including circumcision, hydrocelectomy, malleable penile prostheses, orchiectomy, penile plication, spermatocelectomy, testicular prostheses, varicocelectomy, vasectomy reversal (VR), and testicular and microepididymal sperm aspiration (TESE/MESA). Given the observed outcomes and potential financial and logistical benefits of this approach for surgeons and patients, we sought to describe our initial experience...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904908/vasectomy-reversal-decision-making-and-technical-innovations
#3
REVIEW
E Will Kirby, Mark Hockenberry, Larry I Lipshultz
Vasectomy is the method of contraception chosen by more than 500,000 American men annually, and by upwards of 8% of married couples worldwide. However, following the procedure, nearly 20% of men express the desire for children in the future, and approximately 2-6% of American men will ultimately undergo vasectomy reversal (VR). VR is a complex microsurgical procedure. Intraoperative decision-making, surgical technique, and postoperative management are each critical step in achieving high success rates. The aim of this article is to provide a detailed description of the operative and perioperative procedures employed by surgeons performing VRs...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904907/microdissection-testicular-sperm-extraction
#4
REVIEW
Ryan Flannigan, Phil V Bach, Peter N Schlegel
Microdissection testicular sperm extraction (microTESE) is considered the gold standard method for surgical sperm retrieval among patients with non-obstructive azoospermia (NOA). In this review, we will discuss the optimal evaluation of NOA patients and strategies to medically optimize NOA patients prior to microTESE. In addition, we will also discuss technical principles and pearls to maximize the chances of successful sperm retrieval, sperm retrieval rates (SRR) based upon testicular histology, predictors of successful sperm retrieval, gonadal recovery following microTESE, and potential complications...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904906/a-step-by-step-guide-to-office-based-sperm-retrieval-for-obstructive-azoospermia
#5
REVIEW
Robert M Coward, Jesse N Mills
A variety of surgical options exists for sperm retrieval in the setting of obstructive azoospermia (OA). With appropriate preparation, the majority of these techniques can safely be performed in the office with local anesthesia and with or without monitored anesthesia care (MAC). The available techniques include percutaneous options such as percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA), as well as open techniques that include testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA)...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904905/the-role-of-microsurgical-varicocelectomy-in-treating-male-infertility
#6
REVIEW
Alexander J Tatem, Robert E Brannigan
Varicoceles are the most common cause of male infertility. They afflict 15-20% of the general male population and 40% of males with primary infertility. Although multiple treatment modalities exist, including radiographic embolization and laparoscopy, open subinguinal microsurgical varicocelectomy is currently the gold standard of treatment for this condition. In this article, we discuss the role of varicocelectomy in the treatment of the modern infertile male and present a practical, safe, and reproducible technique for the microsurgical approach...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904904/scrotal-reconstruction-and-testicular-prosthetics
#7
REVIEW
Jacob W Lucas, Kyle M Lester, Andrew Chen, Jay Simhan
Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques, and pit-falls for various reconstructive scrotal surgeries as-well-as surgical tips for placement of testicular prostheses. Penoscrotal webbing (PSW) is an abnormal, often-problematic distal insertion of scrotal skin onto the ventral penile shaft. There are several effective and straightforward techniques used to revise this condition, which include simple scrotoplasty, single- or double-Z-plasty, or the VY-flap scrotoplasty...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904903/vasectomy-tips-and-tricks
#8
REVIEW
Dane Johnson, Jay I Sandlow
According to data from the National Study of Family Growth, vasectomy is utilized by 6-13% of American couples for their form of contraception. Physician surveys have shown that over 500,000 men undergo vasectomies per year, and more than 75% of vasectomies are performed by urologists. This chapter provides a brief history of vasectomy, as well as recommendations for preoperative counseling, an overview of the modified no-scalpel vasectomy technique, and a brief description of the complications of vasectomy...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904902/technique-considerations-and-complication-management-in-transurethral-resection-of-the-prostate-and-photoselective-vaporization-of-the-prostate
#9
REVIEW
Charles Welliver, Sevann Helo, Kevin T McVary
The prevalence of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) increases with age. While a variety of treatments are available for these men, endoscopic treatments are generally preferred for men with small to moderate size glands. Novel treatment options are continually introduced into this large market. However, the practicing urologist should have a well tested surgical option in regular practice that is applicable to a wide range of patients. Herein we discuss two well recognized surgical options that can be used for the majority of men with LUTS due to BPH who have failed medical management...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904901/artificial-urinary-sphincter
#10
REVIEW
William O Brant, Francisco E Martins
Although currently still the gold standard treatment for post-prostatectomy urinary incontinence, the artificial urinary sphincter (AUS) (AMS800) is an invasive procedure with associated risks factors. In this paper, we aim to outline what the scientific literature and what we personally believe are the factors that are useful and/or necessary to mitigate these risks, including both patient factors and surgeon factors. We also review special populations, including transcorporal (TC) AUS approach, AUS with inflatable penile prosthesis, AUS after male urethral sling, AUS erosion management, and AUS after orthotopic urinary diversion...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904900/advance-male-sling
#11
REVIEW
Amanda S J Chung, Oscar A Suarez, Kurt A McCammon
The AdVance sling (American Medical Systems, Minnetonka, MN, United States of America) is a synthetic transobturator sling, which is a safe and effective minimally invasive treatment for mild to moderate stress urinary incontinence (SUI) in male patients. This article provides a step-by-step description of our technique for placement of the AdVance male sling, including details and nuances gained from surgical experience, advice for avoidance of complications and discussion on management of complications and sling failures...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904899/virtue-quadratic-male-sling-for-stress-incontinence-surgical-guide-for-placement-and-delayed-revision
#12
REVIEW
Rachel S Rubin, Keith R Xavier, Eugene Rhee
The algorithm for surgical management of post prostatectomy incontinence classically includes male slings and artificial urinary sphincter (AUS) placement. The Virtue Quadratic Male Sling was designed to provide both urethral elevation and prepubic compression making it a viable option for a wider spectrum of incontinent men whose symptoms range from mild to severe. With a focus on two key steps of the surgery, (I) sling fixation (II) use of intraoperative retrograde leak point pressure (RLPP), this guide is intended to outline a safe and efficacious treatment for post-prostatectomy incontinence...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904898/avoiding-complications-surgery-for-ischemic-priapism
#13
REVIEW
Amanda B Reed-Maldonado, Janet S Kim, Tom F Lue
Ischemic, or low-flow, priapism is among the most common and challenging urologic emergencies. Management of recurrent or refractory ischemic priapism is even more challenging, with increasing levels of risk for both the patient and the urologist. The goal of this commentary is to condense a career of experience (TF Lue) in the management of ischemic priapism into a concise, practical clinical tool for the reader. We will describe our current algorithm for the treatment of ischemic priapism in addition to detailing how we arrived at these recommendations...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904897/peyronie-s-graft-surgery-tips-and-tricks-from-the-masters-in-andrologic-surgery
#14
Georgios Hatzichristodoulou, Peter Tsambarlis, Hubert Kübler, Laurence A Levine
BACKGROUND: Grafting techniques in the surgical management of Peyronie's disease (PD) are challenging, especially in inexperienced hands. In order to improve surgical outcomes the urologist should follow a standard surgical approach, preferably of an established and reliable grafting technique. The aim of this study is to provide tips and tricks for graft surgery for PD. METHODS: This report offers a step-by-step tutorial for grafting techniques in PD, especially for the Sealing technique and the partial plaque excision and grafting (PEG) procedure...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904896/peyronie-s-penile-plication
#15
REVIEW
Billy H Cordon, Daniar Osmonov, Georgios Hatzichristodoulou, Allen F Morey
Penile plication has become the preferred surgical technique for Peyronie's disease (PD) as it can be performed efficiently, safely, with a high success rate, low morbidity and a low complication rate. Here in we describe two modern plication techniques in detail: the Kiels Knot plication and the minimally invasive penoscrotal plication. Benefits of the techniques include no palpable sutures for the Kiels Knot Plication and less surgical trauma for the penoscrotal plication. Plication has a low rate of failure...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904895/the-penoscrotal-surgical-approach-for-inflatable-penile-prosthesis-placement
#16
REVIEW
Nikhil K Gupta, Josh Ring, Landon Trost, Steven K Wilson, Tobias S Köhler
Optimizing outcomes with placement of inflatable penile prostheses (IPPs) can be challenging, especially in inexperienced hands. In this article, we outline Dr. Köhler's penoscrotal penile prosthesis surgical approach. We also highlight patient selection, post-operative care and complications.
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904894/the-infrapubic-surgical-approach-for-inflatable-penile-prosthesis-placement
#17
REVIEW
Annah Vollstedt, Martin S Gross, Gabriele Antonini, Paul E Perito
In this invited article, we briefly review the history of the penile prosthesis and the various surgical approaches that have been described. With intra-operative photos and illustrations, we discuss Dr. Perito's infrapubic surgical approach. We also highlight the patient selection, post-operative care and complications.
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904893/surgical-patient-selection-and-counseling
#18
REVIEW
Matt Ziegelmann, Tobias S Köhler, George C Bailey, Tanner Miest, Manaf Alom, Landon Trost
The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in published literature (ability to complete surgery, complications, satisfaction) and fails to account for patient desires and expectations, temporal changes, natural history of underlying diseases, or independent validation. Factors associated with satisfaction and dissatisfaction are often surgery-specific, although correlation with pre-operative expectations, revisions, and complications are common with most procedures...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28904892/technique-and-complications-from-masters-in-andrological-surgery
#19
Tobias S Köhler
No abstract text is available yet for this article.
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28791238/the-underactive-bladder-diagnosis-and-surgical-treatment-options
#20
REVIEW
Johan Gani, Derek Hennessey
The underactive bladder (UAB)/detrusor underactivity (DU) is a relatively common condition. It is difficult to diagnose and can be difficult to manage. The aim of this review is to provide a review of the diagnosis and different surgical treatment options for UAB/DU. A comprehensive literature review using medical search engines was performed. The search included a combination of the following terms, UAB, DU, TURP, reduction cystoplasty, bladder diverticulectomy and sacral neuromodulation (SNM). Search results were assessed for their overall relevance to this review...
July 2017: Translational Andrology and Urology
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