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https://www.readbyqxmd.com/read/28229209/cost-effective-management-of-pelvic-fracture-urethral-injuries
#1
Niels V Johnsen, David F Penson, W Stuart Reynolds, Douglas F Milam, Roger R Dmochowski, Melissa R Kaufman
PURPOSE: To compare the cost-effectiveness of various treatment strategies in the management of pelvic fracture urethral injuries using decision analysis. METHODS: Five strategies were modeled from the time of injury to resolution of obstructed voiding or progression to urethroplasty. Management consisted of immediate suprapubic tube (SPT) placement and delayed urethroplasty; primary endoscopic realignment (PER) followed by urethroplasty in failed patients; or PER followed by 1-3 direct vision internal urethrotomies (DVIU), followed by urethroplasty...
February 22, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28210838/urinary-ngal-deficiency-in-recurrent-urinary-tract-infections
#2
Catherine S Forster, Kathryn Johnson, Viral Patel, Rebecca Wax, Nancy Rodig, Jonathan Barasch, Richard Bachur, Richard S Lee
INTRODUCTION: Children with recurrent urinary tract infections (rUTI) often show no identifiable cause of their infections. Neutrophil gelatinase-associated lipocalin (NGAL) is known to be upregulated within the uroepithelium and kidney of patients with UTI and exhibits a localized bacteriostatic effect through iron chelation. We hypothesize that some patients with rUTI without an identifiable cause of their recurrent infections have locally deficient NGAL production. We therefore explored whether a lack of NGAL production may be a factor in the pathogenesis of rUTI...
February 16, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28128904/robotic-assisted-laparoscopic-augmentation-ileocystoplasty
#3
Peter A Caputo, Daniel Ramirez, Matthew Maurice, Onder Kara, Ryan Nelson, Ercan Malkoc, Jihad Kaouk
INTRODUCTION: Augmentation ileocystoplasty is a common treatment in adults with low capacity bladders due to neurogenic bladder dysfunction. We describe here our technique for robotic assisted laparoscopic augmentation ileocystoplasty in an adult with a low capacity bladder due to neurogenic bladder dysfunction. MATERIALS AND METHODS: The patient is a 35 years-old man with neurogenic bladder due to a C6 spinal cord injury in 2004. Cystometrogram shows a maximum capacity of 96cc and Pdet at maximum capacity of 97cmH2O...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28126218/imaging-genitourinary-trauma
#4
REVIEW
Bari Dane, Alexander B Baxter, Mark P Bernstein
Contrast-enhanced multidetector computed tomography (MDCT) has become a critical tool in the evaluation of the trauma patient. MDCT can quickly and accurately assess trauma patients for renal, ureteral, and bladder injuries. Moreover, CT guides clinical management triaging patients to those requiring discharge, observation, angioembolization, and surgery. Recognition of urinary tract trauma on initial scan acquisition should prompt delayed excretory phase imaging to identify urine leaks. Urethral and testicular trauma are imaged with retrograde urethrography and sonography, respectively...
March 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28125311/functional-outcomes-following-immediate-repair-of-penile-fracture-a-tertiary-referral-centre-experience-with-76-consecutive-patients
#5
Francesco De Luca, Giulio Garaffa, Marco Falcone, Amr Raheem, Evangelos Zacharakis, Majed Shabbir, Abdelkareem Aljubran, Asif Muneer, Fiona Holden, Claire Akers, Nim Christopher, David J Ralph
OBJECTIVE: The aim of this study was to report surgical and functional outcomes in patients who underwent immediate penile fracture repair following location of the tunical tear with ultrasonography. METHODS: Patients' clinical notes from September 2005 to October 2015 were reviewed. The inclusion criteria were the documented presence of an albugineal laceration at the preoperative ultrasonography and during surgical exploration. In total, 76 patients were enrolled in the study...
January 26, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28124535/does-mri-help-in-the-pre-operative-evaluation-of-pelvic-fracture-urethral-distraction-defect-a-pilot-study
#6
Rajadoss Muthukrishna Pandian, Nirmal Thampi John, Anu Eapen, B Antonisamy, Antony Devasia, Nitin Kekre
OBJECTIVES: To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? MATERIALS AND METHODS: In this prospective study, consecutive male patients presenting with PFUDD were included from Feb 2011 till Dec 2012. Those with traumatic spinal cord injury and pre-existing ED were excluded. Patients were assessed using IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU) and MRI pelvis...
January 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28123243/to-evaluate-the-safety-and-efficacy-of-the-tvt-secur-procedure-in-the-treatment-of-stress-urinary-incontinence-in-women
#7
J S Sandhu, S C Karan, G D Maiti, Puja Dudeja
BACKGROUND: The prevalence of stress urinary incontinence (SUI) in the middle-aged Indian women is around 16%. The use of transvaginal tapes (TVTs) has revolutionised the surgical management of SUI. Patients who undergo placement of the tape via the transobturator route often complain of persistent thigh pain at the site of trocar insertion. The use of minimally invasive tapes with a single suburethral incision reduces surgical trauma by eliminating thigh incisions, while maintaining the cure achieved by conventional TVTs...
January 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28119847/ureteral-rupture-caused-by-a-suprapubic-catheter-in-a-male-patient-with-spinal-cord-injury-a-case-report
#8
Hye Jung Choi, Chang Han Lee, Heesuk Shin
Spinal cord injury (SCI) may lead to urinary system disturbances. Patients with SCI usually have neurogenic bladder, and treatment optionss for this condition include clean intermittent catheterization and a permanent indwelling urethral or suprapubic catheter. Complications of catheterization include urinary tract infection, calculi, urinary tract injury, bladder contraction, bladder spasm, renal dysfunction, bladder cancer, and so forth. To the best of our knowledge, ureteral rupture is an unusual complication of catheterization, and ureteral rupture has been rarely reported in SCI patients...
December 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28117329/outcome-comparison-of-different-approaches-to-self-intermittent-catheterization-in-neurogenic-patients-a-systematic-review
#9
REVIEW
S Shamout, X Biardeau, J Corcos, L Campeau
STUDY DESIGN: Systematic review (Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA); http://www.prisma-statement.org). OBJECTIVES: Different types of catheters and techniques have been described in the past three decades to identify the best self-intermittent catheterization method. Our aim is to review systematically the literature on the most appropriate material and technique to perform self-intermittent catheterization in the adult neurogenic population...
January 24, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28112049/kidney-disease-in-hepatitis-b-surface-antigen-positive-children-experience-from-a-centre-in-south-west-nigeria-and-a-review-of-the-nigerian-literature
#10
Adanze O Asinobi, Adebowale D Ademola, Clement A Okolo, Adedayo A Adepoju, Susan M Samuel, Wendy E Hoy
BACKGROUND: Kidney disease is an important extra-hepatic manifestation of hepatitis B virus (HBV) infection. However, there is paucity of recent literature on kidney disease in children and adolescents with HBV infection from several parts of sub-Saharan Africa including Nigeria. OBJECTIVE: To review the pattern of kidney disease in hepatitis B surface antigen (HBsAg)-positive children and adolescents seen at a tertiary hospital in south-west Nigeria. METHODS: A retrospective study was undertaken of HBsAg-seropositive children with kidney disease managed at University College Hospital, Ibadan, from January 2004 to December 2015...
January 23, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28100501/mdm2-mediates-fibroblast-activation-and-renal-tubulointerstitial-fibrosis-via-p53-independent-pathway
#11
Chen Ye, Hui Tang, Zheng Zhao, Chun-Tao Lei, Chao-Qun You, Jiao Zhang, Pan Gao, Fang-Fang He, Shan Chen, Yumei Wang, Chun Zhang, Hua Su
It is well-recognized that Murine Double Minute gene 2 (MDM2) plays a critical role in cell proliferation and inflammatory processes during tumorigenesis. Also it is reported that MDM2 is expressed in glomeruli and involved in podocyte injury. However, whether MDM2 is implicated in renal fibrosis remains unclear. Here we investigated the role of MDM2 in tubulointerstitial fibrosis (TIF). By immunohistochemical staining and western blotting we confirmed that MDM2 is up-regulated in tubulointerstitial compartment in TIF patients and Unilateral Urethral Obstruction (UUO) mice, which mainly originates from myofibroblasts...
January 18, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28092017/transanal-total-mesorectal-excision-for-a-large-leiomyosarcoma-at-the-lower-rectum-a-case-report-and-literature-review
#12
Nobuaki Hoshino, Koya Hida, Kenji Kawada, Takaki Sakurai, Yoshiharu Sakai
BACKGROUND: Rectal leiomyosarcoma (LMS) is an extremely rare disease. Previously, LMS was not properly distinguishable from gastrointestinal stromal tumor (GIST) until c-kit, a characteristic marker of GIST, was discovered in 1998. No standard therapeutic strategy for gastrointestinal LMS has been established except for surgical resection because of its rarity. Rectal LMS is often accompanied by symptoms, which can enable detection at a small size. However, when a large LMS is detected at the lower rectum, it is difficult to excise due to the narrow pelvic space...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28089342/a-simulation-based-cognitive-assessment-of-resident-decision-making-during-complex-urinary-catheterization-scenarios
#13
Jay N Nathwani, Katherine E Law, Anna K Witt, R D Ray, S M DiMarco, C M Pugh
BACKGROUND: This study explores general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios. METHODS: 40 residents were presented with two scenarios. Scenario A was a male with traumatic urethral injury and scenario B was a male with complete urinary blockage. Residents verbalized whether they would catheterize the patient and described the workup and management of suspected pathologies. Residents' decision paths were documented and analyzed...
January 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28088555/injury-in-pelvic-fracture-urethral-injury-is-membrano-bulbar-fact-or-myth
#14
Pankaj M Joshi, Devang J Desai, Darshan Shah, Devashree Joshi, Sanjay B Kulkarni
Pelvic fracture urethral injuries (PFUI) commonly result from motor vehicle collisions. The mechanism of injury conventionally thought was a shearing injury at the membranous urethra, which would destroy the striated sphincter. Continence would therefore depend on the bladder neck. Striated sphincter and site of injury has not been shown clearly on preoperative imaging. We demonstrate a our protocol of performing MRI whereby the membranous sphincter is seen intact and the injury is shown to be at the membrano-bulbar junction contrary to conventional belief...
January 11, 2017: Urology
https://www.readbyqxmd.com/read/28074462/contribution-of-mri-to-clinically-equivocal-penile-fracture-cases
#15
Rüştü Türkay, Mustafa Gürkan Yenice, Sema Aksoy, Gökhan Şeker, Selçuk Şahin, Ercan İnci, Volkan Tuğcu, Ali İhsan Taşcı
BACKGROUND: Penile fracture is a surgical emergency defined as rupture of the tunica albuginea. Although most cases can be diagnosed with clinical evaluation, it has been stated in the literature that diagnosis in as many as 15% of cases can be challenging. In uncertain cases, imaging can help determine diagnosis. METHODS: Present study included 20 cases where diagnosis could not be made with certainty and magnetic resonance imaging (MRI) was performed. MR images were examined for tunical rupture and accompanying pathologies...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28043650/epidemiology-of-blunt-lower-urinary-tract-trauma-with-and-without-pelvic-fracture
#16
Niels V Johnsen, Roger R Dmochowski, Jason B Young, Oscar D Guillamondegui
OBJECTIVE: To assess the contemporary epidemiology of blunt trauma lower urinary tract injury (LUTI) and to evaluate outcomes in patients with and without associated pelvic fracture (PF). METHODS: Patients presenting to our level I trauma center with PF and/or LUTI from blunt trauma from 2000 to 2014 were identified in our institutional trauma registry. Demographics, mechanism of injury, fracture configurations, hospital course, and outpatient disposition were analyzed...
December 30, 2016: Urology
https://www.readbyqxmd.com/read/27995942/improvement-in-detrusor-sphincter-dyssynergia-by-bladder-wall-injection-of-replication-defective-herpes-simplex-virus-vector-mediated-gene-delivery-of-kynurenine-aminotransferase-ii-in-spinal-cord-injury-rats
#17
Z Wang, L Liao
STUDY DESIGN: An experimental study. OBJECTIVES: To investigate the effect of replication-defective herpes simplex virus (HSV) vectors encoding the kynurenine aminotransferase II (HSVrd-KATII) gene on detrusor-sphincter dyssynergia (DSD) in spinal cord injury (SCI) rats. SETTING: Beijing, China. METHODS: Sprague-Dawley rats (240-265 g) were spinalized with complete transaction at the T10 level of the spinal cord. The rats were randomly divided into the following three groups: sham group (n=12, with normal saline); HSVrd group (n=12, with HSVrd) and HSVrd-KATII group (n=12, with HSVrd-KATII)...
February 2017: Spinal Cord
https://www.readbyqxmd.com/read/27980522/ultrasound-imaging-in-urogynecology-state-of-the-art-2016
#18
Michał Bogusiewicz
The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue...
November 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/27940192/3d-bioprinting-of-urethra-with-pcl-plcl-blend-and-dual-autologous-cells-in-fibrin-hydrogel-an-in-vitro-evaluation-of-biomimetic-mechanical-property-and-cell-growth-environment
#19
Kaile Zhang, Qiang Fu, James Yoo, Xiangxian Chen, Prafulla Chandra, Xiumei Mo, Lujie Song, Anthony Atala, Weixin Zhao
OBJECTIVE: Urethral stricture is a common condition seen after urethral injury. The currently available treatments are inadequate and there is a scarcity of substitute materials used for treatment of urethral stricture. The traditional tissue engineering of urethra involves scaffold design, fabrication and processing of multiple cell types. METHODS: In this study, we have used 3D bioprinting technology to fabricate cell-laden urethra in vitro with different polymer types and structural characteristics...
December 8, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27920989/dartos-fascia-interposition-flap-for-penetrating-cavernosal-and-urethral-trauma
#20
Hailiu Yang, Robert D Brown, John Chovanes, Allen D Seftel
We present an unusual case of a single gunshot to the genitalia in which the bullet trajectory injured the urethra, corpus cavernosum, and both testicles. All injuries were successfully repaired during initial exploration. Our report serves as a reminder to clinicians to have a high index of suspicion in this circumstance and consider immediate exploration of all the injured areas. We also demonstrate the use of a dartos fascia interposition flap to cover and separate the concomitant urethral and corporal sutures lines...
January 2017: Urology Case Reports
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