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Reconstructive urology

Stefan Aufderklamm, Martin Vaegler, Alexandra Kelp, Sabine Maurer, Leon Gustafsson, Jens Mundhenk, Silke Busch, Lisa Daum, Arnulf Stenzl, Bastian Amend, Karl-Dietrich Sievert
PURPOSE: Urethral strictures are a common disease of the lower urinary tract in men. At present, the use of buccal mucosa is the method of choice for long or recurrent strictures. However, autologous tissue-engineered grafts are still under investigation for reconstructive urological surgery. The aim of this pilot study was to evaluate the use of human urothelial cells (HUC) seeded on bovine collagen type I-based cell carriers (CCC) in an animal model and to evaluate short-term outcome of the surgical procedure...
October 25, 2016: World Journal of Urology
Felix Blasl, Wolfgang H Rösch, Mark Koen, Mircia-Aurel Ardelean, Anne-Karoline Ebert
OBJECTIVE AND INTRODUCTION: Cowper's syringocele is a cystic dilation of the bulbourethral gland duct, initially defined by Maizels et al. in 1983. Although obstructive and non-obstructive types of this rare anomaly are described, clinical symptoms are highly unspecific. Therefore, we report 12 cases of children and young adults diagnosed with Cowper's syringocele to further clarify clinical course, comorbidity and treatment strategies. STUDY DESIGN: We retrospectively collected clinical data of 12 children and young adults from birth to 18...
October 8, 2016: Journal of Pediatric Urology
Lee A Richter, Quinn K Lippmann, Karl Jallad, Joelle Lucas, Jennifer Yeung, Tanaka Dune, Erin Mellano, Steven Weissbart, Mihriye Mete, Ja-Hong Kim, Robert Gutman
OBJECTIVES: The objective of this study was to determine the risk factors that may contribute to the diagnosis of microscopic hematuria (MH) in women. METHODS: This multicenter case-control study reviewed cases of women presenting to Female Pelvic Medicine & Reconstructive Surgery sites with MH from 2010 to 2014. Microscopic hematuria was defined as 3 or more red blood cells per high power field in the absence of infection as indicated in the American Urologic Association guidelines...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Arvind Krishnan, Sean Chagani, Austin J Rohl
Hypospadias is a congenital anomaly of the male urethra that causes significant morbidity in the pediatric male population. The mainstay of treatment is hypospadias repair surgery. However, given the common co-occurrence of microphallus in these patients, surgery remains difficult without adequate tissue for proper reconstruction of the urethra. The use of preoperative testosterone therapy, parenterally or topically, has been a topic of study for several years in urologic literature. This literature review aims to summarize the different studies that have been conducted to address whether preoperative testosterone therapy is beneficial, inconsequential, or detrimental to the surgical and cosmetic outcomes of hypospadias repair as well as to address the differences in routes of administration...
2016: Curēus
Catherine R Harris, Jack W McAninch, Anthony R Mundy, Leonard N Zinman, Gerald H Jordan, Daniela Andrich, Alex J Vanni, Ramón Virasoro, Benjamin N Breyer
PURPOSE: Rectourethral fistula is a known complication of prostate cancer treatment. Reports in the literature on rectourethral fistula repair technique and outcomes are limited to single institution series. We examined the variations in technique and outcomes of rectourethral fistula repair in a multi-institutional setting. MATERIALS AND METHODS: We retrospectively identified patients who underwent rectourethral fistula repair after prostate cancer treatment at 1 of 4 large volume reconstructive urology centers, including University of California-San Francisco, University College London Hospitals, Lahey Clinic and Devine-Jordan Center for Reconstructive Surgery, in a 15-year period...
August 18, 2016: Journal of Urology
Kyle H Gennaro, Jennifer Gordetsky, Soroush Rais-Bahrami, John P Selph
OBJECTIVE: To identify risk factors for urologic reconstruction during surgery for endometriosis PATIENTS AND METHODS: We retrospectively identified patients in a surgical pathology database undergoing surgery for endometriosis at our institution from 2010-2015 and subsequently identified those patients with ureteral involvement. Patients were categorized as requiring minimal urologic surgery (e.g. ureterolysis only) or more extensive urologic surgery (e.g. ureteral reimplant). All patients were undergoing surgery for endometriosis, and preoperative risk factors were then identified to predict the need for intraoperative extensive urologic surgery...
August 16, 2016: Urology
Michael J Biles, Julia B Finkelstein, Mark V Silva, Sarah M Lambert, Pasquale Casale
INTRODUCTION: Robotic technology has been increasingly utilized for complicated reconstructive surgeries in pediatric urology, such as ureteroureterostomy (UU). The literature is limited regarding the performance of minimally invasive UU in children, and the existing published series utilize indwelling ureteral stents. We sought to report on our pediatric experience with robot-assisted laparoscopic (RAL)-UU using a temporary ureteral catheter in duplex systems with ureteral ectopia. METHODS: A retrospective chart review was performed of all pediatric patients who underwent RAL-UU at a single institution over a 2-year period...
October 2016: Journal of Endourology
Alexis M Tran, Peter K Sand, Miriam J Seitz, Adam Gafni-Kane, Ying Zhou, Sylvia M Botros
INTRODUCTION AND HYPOTHESIS: We compared persistence on overactive bladder (OAB) pharmacotherapy in patients treated in the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) department compared with patients treated in the Internal Medicine (IM) and General Urology (GU) departments within an integrated health-care system. We hypothesized that persistence would be higher among FPMRS patients. METHODS: This was a retrospective cohort study. Patients with at least one prescription for OAB between January 2003 and July 2014 were identified...
August 18, 2016: International Urogynecology Journal
Lindsay A Hampson, Sean P Elliott, Bradley A Erickson, Alex J Vanni, Jeremy B Myers, Christopher McClung, Benjamin N Breyer, Thomas G Smith, Judith C Hagedorn, Bryan B Voelzke
PURPOSE: Little published data exist on the impact of urethral stricture surgery on urinary urgency. We evaluated urinary urgency and urge incontinence before and after anterior urethroplasty. MATERIALS AND METHODS: Male patients who underwent 1-stage anterior urethroplasty were retrospectively identified at 8 centers. Patients with preoperative and 2-month or greater postoperative subjective urinary urgency assessments were included in study. Patients who received anticholinergic medications preoperatively were excluded...
August 10, 2016: Journal of Urology
Guilherme Lang Motta, Patric Machado Tavares, Lucas Medeiros Burttet, Milton Berger, Brasil Silva Neto, Tiago Elias Rosito
OBJECTIVE: To present a novel technique in reconstructive urology for congenital vaginal agenesis using a full-thickness mesh skin graft and to evaluate the functional capacity for maintenance of satisfactory intercourse. METHODS: From January 2009 to August 2015, seven patients diagnosed with vaginal agenesis underwent vaginoplasty using a full-thickness mesh graft from lower abdominal skin. Herein, the authors describe the technique and initial results in adult patients...
August 9, 2016: Urology
Yarkin Kamil Yakupoglu, Fazil Tuncay Aki, Yakup Kordan, Ender Ozden, Senol Tonyali, Yakup Bostanci, Hakan Vuruskan, Cenk Yucel Bilen, Saban Sarikaya
OBJECTIVE: The objective of this study is to present the experience of 3 institutions performing renal autotransplantation (RAT) and to discuss surgical techniques employed and the results in the light of the medical literature. MATERIALS AND METHODS: A total of 14 patients (11 male and 3 female) with a mean age of 47 ± 8 years (35-61 years), who underwent RAT procedure at 3 different institutions between October 2006 and November 2014, in Turkey, were evaluated retrospectively...
August 10, 2016: Urologia Internationalis
C H Thomson, M Choudry, C White, M Mecci, H Siddiqui
INTRODUCTION In our regional spinal injuries unit, complex pressure ulcer reconstruction is facilitated by a monthly multidisciplinary team clinic. This study reviews a series of the more complex of these patients who underwent surgery as a joint case between plastics and other surgical specialties, aiming to provide descriptive data as well as share the experience of treating these complex wounds. MATERIALS AND METHODS Patients operated on as a joint case from 2010 to 2014 were identified through a locally held database and hospital records were then retrospectively reviewed for perioperative variables...
August 4, 2016: Annals of the Royal College of Surgeons of England
Goran Rac, Austin Younger, James Q Clemens, Kathleen Kobashi, Aqsa Khan, Victor Nitti, Ilana Jacobs, Gary E Lemack, Elizabeth T Brown, Roger Dmochowski, Lara MacLachlan, Arthur Mourtzinos, David Ginsberg, Michelle Koski, Ross Rames, Eric S Rovner
AIMS: To investigate the possible effects of the Food and Drug Administration (FDA) Public Health Notifications in 2008 and 2011 regarding surgical trends in transvaginal mesh (TVM) placement for stress urinary incontinence (SUI) and related mesh revision surgery in Female Pelvic Medicine & Reconstructive Surgery (FPMRS) practice in tertiary care academic medical centers in the United States. METHODS: Surgical volume for procedures performed primarily by FPMRS surgeons at eight academic institutions across the US was collected using Current Procedural Terminology (CPT) codes for stress urinary incontinence repair and revision surgeries from 2007 to 2013...
July 26, 2016: Neurourology and Urodynamics
Leszek Komasara, Joanna Stefanowicz, Anna Bryks-Laszkowska, Andrzej Gołębiewski, Piotr Czauderna
OBJECTIVES: To present versatile surgical reconstructive techniques and their outcomes in pediatric patients with genitourinary rhabdomyosarcoma. METHODS: We retrospectively analyzed the oncological and urological outcomes of seven patients treated between 1992 and 2014 according to the Cooperative Weichteilsarkom Studiengruppe protocols. Intergroup Rhabdomyosarcoma Study staging: local, six patients; and IV, one patient. HISTOLOGY: embryonal, five patients; unclassified, one patient; triton tumor one patient...
August 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Puraj P Patel, Jeremy A Warren, Roozbeh Mansour, William S Cobb, Alfredo M Carbonell
Lateral abdominal wall hernias may occur after a variety of procedures, including anterior spine exposure, urologic procedures, ostomy closures, or after trauma. Anatomically, these hernias are challenging and require a complete understanding of abdominal wall, interparietal and retroperitoneal, anatomy for successful repair. Mesh placement requires extensive dissection of often unfamiliar planes, and its fixation is difficult. We report our experience with open mesh repair of lateral abdominal wall hernias...
July 2016: American Surgeon
Onur Telli, Cihat Ozcan, Nurullah Hamidi, Mehmet Ali Karagoz, Ahmet Metin Hascicek, Tarkan Soygur, Berk Burgu
OBJECTIVE: To evaluate preoperative predictive factors for postoperative complications of augmentation cystoplasty in children by using the modified Clavien classification system. METHODS: A retrospective review of medical records between 1994 and 2014 identified 117 children (64 males and 53 females) who underwent augmentation cystoplasty. Complications were evaluated according to the MCCS. Univariate and multivariate analyses were used to determine predictive factors affecting complication rates...
July 19, 2016: Urology
Sachin Malde, Marco Spilotros, Ailsa Wilson, Mahreen Pakzad, Rizwan Hamid, Jeremy Ockrim, P Julian Shah, Tamsin Greenwell
PURPOSE: To assess the indications, morbidity, efficacy and outcomes of Martius fat pad (MFP) interposition in reconstructive female urology. MATERIALS AND METHODS: Data on 159 women with MFP interposition as part of their primary procedure between 2 September 2005 and 2 July 2015 were prospectively collected. Patient demographics and the indications for MFP interposition along with the outcomes of their primary procedures and short- and long-term complications related to the MFP, along with patient reported perception of post-operative appearance, were noted...
July 7, 2016: World Journal of Urology
B Herrera-Imbroda, I M Aragón, M I Hierro, M Álvarez, M Alaminos, A Campos, A Izeta, J Machuca, M F Lara
Surgical treatment of diseases affecting long urethral areas represents a challenge in urology. Recent developments of tissue-engineered urethral substitutes represent a hope for patients. However finding an ideal tissue source for urethral reconstruction first requires proper understanding of the native human urethra physiology and a deep knowledge of the histological and molecular features of the native human urethra. Here we present a comprehensive characterization of male and female urethra by histological, histochemical and immunohistochemical methods with a panel of 15 antibodies...
June 24, 2016: Histology and Histopathology
Yu Guang Tan, Grace Tan, David Tan, Claramae S Chia, Dun Yong Ang, Melissa C C Teo
BACKGROUND: In locally advanced pelvic malignancies, there is often involvement of urological organs, necessitating resection and reconstruction, which can be associated with significant complications. METHODS: We retrospectively reviewed 20 patients undergoing urological reconstructions during pelvic oncological surgeries from January 2004 to December 2013. All patients had imaging-proven involvement of at least one urological organ preoperatively. Primary outcome was urological complication rate...
June 14, 2016: Asian Journal of Surgery
Stéphane Chabaud, Melissa Simard, Isabelle Gendreau, Roxane Pouliot, Stéphane Bolduc
Despite the emergence of serum-free media for cell culture, the use of serum to supplement the culture media is still essential in order to produce engineered urologic tissues using the self-assembly approach, not only for the stromal compartment but also for the uroepithelium. Effects of sera on thickness of these two compartments were measured and quality of the epithelial differentiation was evaluated. For bladder mucosa substitute reconstruction, the use of postnatal sera failed to produce an adequate uroepithelium whereas the fetal sera supplementation did...
2016: Scientifica
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