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Reconstructive urology

Jérôme Gas, François-Xavier Nouhaud, Mathieu Roumiguié, Séverine Lagarde, Marie-Charlotte Delchier, Éric Huyghe, Michel Soulié, Xavier Gamé, Jean-Baptiste Beauval
PURPOSE: To evaluate the effectiveness of balloon nephrostomy (BN) for treating urinary tract fistulas. MATERIALS AND METHODS: In a single-center retrospective analysis, 56 patients were treated using BN between 2003 and 2014. All causes of urinary tract fistula were included. We assessed the effectiveness of drainage, complications, and the types of reconstruction surgery used. Success was defined as fistula closure without surgery. RESULTS: The cohort consisted of 25 males (54%) and 31 females (55%) with a median age of 63 years who underwent BN for a urinary fistula secondary to surgery, i...
March 15, 2018: International Urogynecology Journal
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Melissa R Kaufman
PURPOSE OF REVIEW: Classic bladder exstrophy (BE) remains one of the most demanding reconstructive challenges encountered in urology. In female BE patients, the long-term sequela of both primary and revision genitoplasty, as well as intrinsic pelvic floor deficits, predispose adult women to significant issues with sexual function, pelvic organ prolapse (POP), and complexities with reproductive health. RECENT FINDINGS: Contemporary data suggest 30-50% of women with BE develop prolapse at a mean age of 16 years...
February 26, 2018: Current Urology Reports
Susan A Barr, Catrina C Crisp, Amanda B White, Shazia A Malik, Kimberly Kenton
OBJECTIVE: The aims of this study are to identify screening, treatment, and referral practices of primary care physicians (PCPs) for patients with pelvic floor disorders (PFDs) and evaluate awareness of the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) subspecialty. METHODS: We conducted a cross-sectional survey of PCPs using a random sample of 1005 American College of Physicians members, stratified by demographic region. Electronic survey content included awareness of FPMRS certification, comfort diagnosing and treating PFDs, and PFD referral patterns for PCPs...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Kian Asanad, Pooja S Parameshwar, Justin Houman, Brennan M Spiegel, Timothy J Daskivich, Jennifer T Anger
OBJECTIVES: This study aimed to qualitatively analyze online reviews of Female Pelvic Medicine and Reconstructive Surgery (FPMRS) specialists to better understand patients' experiences and improve patient satisfaction. METHODS: Fifty urologists and urogynecologists were randomly sampled from the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction membership website. We evaluated patient ratings and reviews of physicians from 4 websites: Yelp, Healthgrades, Vitals, and UCompareHealthCare...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Hadley Burns, J Stephen Gunn, Saeed Chowdhry, Thomas Lee, Steven Schulz, Bradon J Wilhelmi
Objective: This paper discusses the various surgical techniques and outcomes associated with management of buried penis syndrome. Methods: Presented is the case of a 49-year-old man with morbid obesity, leading to massive panniculus and buried penis. We review our technique for reconstruction of the buried penis and treatment of the overlying large panniculus. Literature search was conducted to review current techniques in correcting buried penis syndrome. Results: The patient underwent a successful panniculectomy with removal of all excess skin and tissue...
2018: Eplasty
Mary K Wang, Yi Li, Rachel E Selekman, Thomas Gaither, Anne Arnhym, Laurence S Baskin
INTRODUCTION: Patients undergo pediatric urologic surgery as infants and young children. OBJECTIVE: The purpose of the study was to evaluate the evolution of surgical scars over several years in order to inform parents and surgeons on the true cosmetic impact of pediatric surgery and evaluate patient scar satisfaction. STUDY DESIGN: This was a cross-sectional study where patients who have undergone urologic surgery at a young age are evaluated years later for scar satisfaction via an abbreviated validated questionnaire...
January 9, 2018: Journal of Pediatric Urology
Paurush Babbar, Nitin Yerram, Andrew Sun, Sij Hemal, Prithvi Murthy, Darren Bryk, Naveen Nandanan, Yaw Nyame, Maxx Caveney, Ryan Nelson, Ryan Berglund
Robotic surgery in the treatment in certain urological diseases has become a mainstay. With the increasing use of the robotic platform, some surgeries which were historically performed open have transitioned to a minimally invasive technique. Recently, the robotic approach has become more utilized for ureteral reconstruction. In this article, the authors review the surgical techniques for a number of major ureteral reconstuctive surgeries and briefly discuss the outcomes reported in the literature.
January 2018: Urology Annals
Amir H Lebastchi, Roger K Khouri, Ian D McLaren, Gary J Faerber, Kate H Kraft, Khaled S Hafez, Casey A Dauw, Vincent G Bird, Thomas F Stringer, Ajay K Singla, Mathew D Sorensen, Hunter Wessells, Sapan N Ambani
OBJECTIVE: To better understand today's urology applicant. MATERIAL AND METHODS: All 2016 Urology Residency Match applicants to the study-participating institutions were provided a survey via email inquiring about their paths to urology, their career aspirations, how they evaluate a training program, and how they perceive residency programs evaluate them. RESULTS: Out of a possible 468 applicants registered for the match, 346 applicants completed the survey...
February 1, 2018: Urology
Jared P Schober, Kristian D Stensland, Benjamin N Breyer, Bradley A Erickson, Jeremy B Myers, Bryan B Voelzke, Sean P Elliott, Jill C Buckley, Alex J Vanni
INTRODUCTION: and Objective: Anxiety and depression (AD) in patients with urethral stricture disease (USD) and the impact of urethroplasty on mental health has never been explored. We hypothesized that patients with USD will have higher than normal AD levels and urethroplasty would improve mental health. METHODS: Patients undergoing anterior urethroplasty were retrospectively reviewed from a multi-institutional reconstructive urology database. Pre- and postoperative evaluation of AD and overall health was recorded using the validated EQ-5D-3L Questionnaire, while sexual function was evaluated with the International Index of Erectile Function (IIEF) and Men's Sexual Health Questionnaire (MSHQ)...
February 3, 2018: Journal of Urology
M Spaggiari, C Di Bella, P Di Cocco, S Furno, E Benedetti, I Tzvetanov
BACKGROUND: The external iliac vein is the standard site used for venous anastomosis in kidney transplantation. When a pre-transplantation diagnosis of iliocaval thrombosis is established, a different and suitable venous drainage for the renal outflow must be identified for successful transplant. METHODS: We report 4 cases of kidney transplantation, performed from 2004 to 2016, in recipients presenting with thrombosis of the inferior vena cava and iliac system needing, because of the lack of access for dialysis, urgent kidney transplantations...
January 2018: Transplantation Proceedings
Jonathan E Kiechle, Nathan Chertack, Christopher M Gonzalez
Penile and urethral reconstructive surgical procedures are used to treat a variety of urologic diagnoses. Urethral stricture disease can lead to progressive lower urinary tract symptoms and may require multiple surgical procedures to improve patient's symptoms. Male stress urinary incontinence is associated with intrinsic sphincter deficiency oftentimes associated with radical prostatectomy. Men suffering from urethral stricture disease and stress urinary incontinence should be referred to a urologist because multiple treatment options exist to improve their quality of life...
March 2018: Medical Clinics of North America
S Struk, Q Qassemyar, N Leymarie, J-F Honart, H Alkhashnam, K De Fremicourt, A Conversano, J-B Schaff, F Rimareix, F Kolb, B Sarfati
Robot-assisted surgery is more and more widely used in urology, general surgery and gynecological surgery. The interest of robotics in plastic and reconstructive surgery, a discipline that operates primarily on surfaces, has yet to be conclusively proved. However, the initial applications of robotic surgery in plastic and reconstructive surgery have been emerging in a number of fields including transoral reconstruction of posterior oropharyngeal defects, nipple-sparing mastectomy with immediate breast reconstruction, microsurgery, muscle harvesting for pelvic reconstruction and coverage of the scalp or the extremities...
February 2, 2018: Annales de Chirurgie Plastique et Esthétique
K O Rove, M A Brockel, A F Saltzman, M I Dönmez, K E Brodie, D J Chalmers, B T Caldwell, V M Vemulakonda, D T Wilcox
BACKGROUND: Enhanced recovery after surgery (ERAS) protocol is a set of peri-operative strategies to increase speed of recovery. ERAS is well established in adults but has not been well studied in children. OBJECTIVE: The purpose of the current study was to establish the safety and efficacy of an ERAS protocol in pediatric urology patients undergoing reconstructive operations. It was hypothesized that ERAS would reduce length of stay and decrease complications when compared with historical controls...
February 1, 2018: Journal of Pediatric Urology
Lindsey Cox, Chang He, Jack Bevins, J Quentin Clemens, John T Stoffel, Anne P Cameron
INTRODUCTION: This study aimed to determine if gentamicin bladder instillations reduce the rate of symptomatic urinary tract infection (UTI) in neurogenic bladder (NGB) patients on intermittent self-catheterization (ISC) who have recurrent UTIs. Secondary aims were to examine the effects of intravesical gentamicin on the organism resistance patterns. METHODS: We retrospectively reviewed our prospective NGB database. Inclusion criteria were NGB patients performing ISC exclusively for bladder drainage with clinical data available for six months before and six months after initiating prophylactic intravesical gentamicin instillations...
September 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Dimitrios Barbalias, Georgios Lappas, Panagiota Ravazoula, Despoina Liourdi, Iason Kyriazis, Evangelos N Liatsikos, Panagiotis Kallidonis
INTRODUCTION: Urethral strictures are a common urological problem which could require complex reconstructive procedures. Urethral dilation represents a frequent practiced invervention associated with high recurrence rates. Drug-coated balloons with cytostatic drugs have been successfully used for the prevention of vascular restenosis after balloon dilation. In an attempt to reduce the restenosis rates of urethral dilation, these balloons could be used in the urethra. Nevertheless, the urothelium is different than the endothelium and these drugs may not be distributed to the outer layers of the urethra...
January 30, 2018: Journal of Endourology
A Ch Usupbaev, R M Kurbanaliev, G S Chernetsova, I V Kolesnichenko, B M Sultanov, N M Myrzakanov, A O Zolotukhin, N A Vagner
AIM: To evaluate the results of surgical reconstruction of the upper urinary tract using an autograft of testicular tunica vaginalis in experimental animals. MATERIALS AND METHODS: The article presents the results of partial replacement of the renal pelvis and ureter with an autograft in 25 male dogs. The grafts were harvested by resection of the parietal layer of the testicular tunica vaginalis, which was transplanted into the region of the pelvi-ureteric junction and the proximal ureter...
December 2017: Urologii︠a︡
Bolesław Kuzaka, Marta M Wróblewska, Tomasz Borkowski, Dariusz Kawecki, Piotr Kuzaka, Grażyna Młynarczyk, Piotr Radziszewski
BACKGROUND Fournier's gangrene (FG) is a fulminant form of infective, polymicrobial, necrotizing fasciitis of the perineal, genital, and perianal regions. It commonly affects men, but women and children may also develop this type of tissue necrosis. MATERIAL AND METHODS This study is a retrospective analysis of the management of 13 cases of Fournier's gangrene, diagnosed from among about 45 000 patients (men, women, and children) treated in the Department of General, Oncological, and Functional Urology (Medical University of Warsaw) from 1995 to 2013...
January 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
N F Davis, E M Cunnane, M R Quinlan, J J Mulvihill, N Lawrentschuk, D M Bolton, M T Walsh
Autologous gastrointestinal tissue is the gold standard biomaterial for urinary tract reconstruction despite its long-term neuromechanical and metabolic complications. Regenerative biomaterials have been proposed as alternatives; however many are limited by a poor host derived regenerative response and deficient supportive elements for effective tissue regeneration in vivo. Urological biomaterials are sub-classified into xenogenic extracellular matrices (ECMs) or synthetic polymers. ECMs are decellularised, biocompatible, biodegradable biomaterials derived from animal organs...
January 17, 2018: Advances in Experimental Medicine and Biology
Sarah S Boyd, Elena Tunitsky-Bitton, David M OʼSullivan, Adam C Steinberg
OBJECTIVE: The aim of this study was to evaluate practice preferences in catheter management after a failed inpatient voiding trial after pelvic reconstructive surgery. METHODS: This is a cross-sectional study of postoperative catheter management after pelvic reconstructive surgery after failed voiding trial. Physicians practicing at ACGME-accredited residencies and fellowships in Obstetrics and Gynecology (Ob/Gyn), Urology, and Female Pelvic Medicine and Reconstructive Surgery (FPMRS) within the United States completed a Web-based questionnaire in March 2017...
January 3, 2018: Female Pelvic Medicine & Reconstructive Surgery
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