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https://www.readbyqxmd.com/read/28718163/incidence-and-management-of-lower-urinary-tract-symptoms-after-urethral-stricture-repair
#1
REVIEW
Amanda S J Chung, Kurt A McCammon
Lower urinary tract symptoms (LUTS) after urethral stricture repair are not uncommon. Urgency has been reported in 40% of men and urge incontinence in 12% of men after anterior urethroplasty. De novo urgency and urge incontinence is seen in 9 and 5% of men, respectively, after urethroplasty. Once a complication of urethroplasty (such as recurrent urethral stricture or diverticulum) has been excluded as a cause, evaluation of LUTS in such patients should focus on differentiating bladder dysfunction (overactive bladder, underactive bladder), from other outlet obstruction (such as benign prostatic obstruction), dysfunctional voiding, or medical causes (such as nocturnal polyuria)...
September 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28709851/waves-of-change-national-trends-in-surgical-management-of-male-stress-incontinence
#2
Susan MacDonald, Marc Colaco, Ryan Terlecki
OBJECTIVE: To determine the national trend in surgical management of male stress urinary incontinence (SUI) in the context of the rate of radical prostatectomy (RP) as reported by a national database. Traditionally the artificial urinary sphincter (AUS) has been the gold standard of surgical management, but the male sling represents a newer and popular alternative. Refinements in prostate surgery may reduce the incidence and degree of subsequent SUI. MATERIALS AND METHODS: A retrospective cross sectional analysis was performed using the National Inpatient Survey (NIS) database, which captures discharge data from inpatient and overnight admissions...
July 11, 2017: Urology
https://www.readbyqxmd.com/read/28695343/posterior-colporrhaphy-does-not-affect-the-urethral-closure-mechanism
#3
Yasmine Khayyami, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Studies have suggested that a posterior vaginal wall prolapse might compress the urethra and mask stress urinary incontinence (SUI), much like an anterior vaginal wall prolapse. A recent study with urethral pressure reflectometry (UPR) has shown that the urethral closure mechanism deteriorates after anterior colporrhaphy; this could explain the occurrence of postoperative de novo SUI. We hypothesized that urethral pressure would also decrease after posterior colporrhaphy...
July 10, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28694573/two-stages-repair-of-proximal-hypospadias-review-of-700-cases
#4
Arvind Kumar Shukla, Aditya Pratap Singh, Pramila Sharma, Jyotsna Shukla
OBJECTIVE: Surgical repair of hypospadias is challenging and problematic even for the most experienced specialists, and this is especially true when severe and complicated case is confronted. Many operations had been described for the management of this deformity. MATERIALS AND METHODS: During the period from May 2004 to December 2015, we performed 700 cases with proximal hypospadias, at our institute in the Department of Pediatric Surgery by a single surgeon. Data were collected retrospectively and included patient's age at operation, degree of the hypospadias, degree of associated chordee, complications, and cosmetic outcome...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28685197/-urethral-stricture-from-diagnostics-to-appropriate-treatment
#5
F Strittmatter, V Beck, C G Stief, S Tritschler
Before making a treatment decision for patients presenting with a urethral stricture, following anamnesis and general examinations, appropriate diagnostics are necessary. This includes at least uroflowmetry and cystourethrography and the use of ultrasound and cystoscopy may be of additional help. The curative treatment of a urethral stricture is always an operation. Besides endourological procedures, open surgery for urethral reconstruction is also performed. This article aims to give an overview about the necessary diagnostic measures and the pros and cons of the different operative therapies...
July 6, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28679188/alprostadil-plus-vacuum-vitarum-in-severe-erectile-dysfunction-ed
#6
Franco Mantovani
OBJECTIVES: Severe erectile dysfunction (ED) is not uncommon, as can be seen from the epidemiological literature, and there are several possible causes, which are not always known, or leastways evident. Having ascertained the ineffectiveness, intolerance to or rejection of pharmacological aids, the option of prosthetic surgery remains, but before this, it may be wise when feasible to use Alprostadil cream in association with Vacuum device. MATERIAL AND METHODS: 12 patients, aged between 55 and 65 years, with severe erectile dysfunction without palpable cavernous fibrosis, were instructed to self-insert into the urethral meatus, 3 mg of Alprostadil cream, sufficient to make it easy to place the Vacuum device over the penis...
June 30, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28673795/use-of-3d-reconstruction-cloacagrams-and-3d-printing-in-cloacal-malformations
#7
Jennifer J Ahn, Margarett Shnorhavorian, Anne-Marie E Amies Oelschlager, Beth Ripley, Giridhar M Shivaram, Jeffrey R Avansino, Paul A Merguerian
INTRODUCTION: Cloacal anomalies are complex to manage, and the anatomy affects prognosis and management. Assessment historically includes examination under anesthesia, and genitography is often performed, but these do not consistently capture three-dimensional (3D) detail or spatial relationships of the anatomic structures. Three-dimensional reconstruction cloacagrams can provide a high level of detail including channel measurements and the level of the cloaca (<3 cm vs. >3 cm), which typically determines the approach for surgical reconstruction and can impact long-term prognosis...
June 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28673431/urethral-perforation-during-penile-implant-surgery-what-to-do
#8
Suks Minhas
No abstract text is available yet for this article.
July 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28673072/tubularized-proximally-incised-plate-in-distal-midshaft-hypospadias-repair
#9
Antonio Marte, Lucia Pintozzi
The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate...
June 23, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/28673063/a-study-of-clinical-predictors-associated-with-intrinsic-sphincter-deficiency-in-women-with-stress-urinary-incontinence
#10
Kyung Kgi Park, Sung Dae Kim, Jung-Sik Huh, Young-Joo Kim
PURPOSE: Recently, intrinsic sphincter deficiency (ISD) has been identified as one important factor in the outcome of stress urinary incontinence (SUI) related surgery. Clinical factors that can predict ISD are uncommon. The aim of this study was to determine predictive clinical factors for ISD in female patients with SUI. METHODS: The patients were classified into 3 groups according to the value of Valsalva leak point pressure (VLPP)>90 cm H2O (anatomical incontinence, AI), between 61 and 90 cm H2O (equivocal, EV), and <60 cm H2O (ISD)...
June 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28668549/design-and-implementation-of-a-robotic-surgery-training-experience-logging-system
#11
Kristin G Baldea, Ryan Thorwarth, Petar Bajic, Marcus L Quek, Gopal N Gupta
PURPOSE: Residents currently log robotic cases in the ACGME system as a "surgeon" if they performed any critical step of the procedure on the surgeon console. There is no standardization as to which steps or how much of the procedure should be performed by the resident. It was our objective to establish a tool for logging the true operative experience in robotic surgery to aid in assessing surgical competency as well as curriculum development. MATERIALS AND METHODS: We propose a tool to log surgical skill progression, experience, and feedback for robotic cases...
June 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28665458/a-robotic-needle-driver-to-facilitate-vescico-urethral-anastomosis-during-laparoscopic-radical-prostatectomy
#12
Virginia Varca, Andrea Benelli, Francesco Pietrantuono, Nazareno Suardi, Andrea Gregori, Franco Gaboardi
PURPOSE: The completion of the vescico-urethral anastomosis (VUA) represents the most critical step of laparoscopic radical prostatectomy (LRP), and it can often discourage the use of minimally invasive surgery in less experienced laparoscopic surgeons. The aim of this paper is to evaluate the usefulness of a new robotic needle driver named Dextérité in performing the VUA after LRP. MATERIALS AND METHODS: This prospective randomized clinical study enrolled 40 consecutive patients eligible for LRP, which were randomized into four groups: group A, patients undergoing LRP done by an expert surgeon; group B, patients undergoing robotic-assisted radical prostatectomy (RARP) performed by the same expert surgeon; group C, patients undergoing LRP performed by a young surgeon at the beginning of the learning curve; group D, patients undergoing LRP performed by another young surgeon at the beginning of the learning curve with the aid of Dextérité needle driver for completion of the VUA...
June 19, 2017: Urologia
https://www.readbyqxmd.com/read/28665139/intraoperative-retrograde-perfusion-sphinterometry-to-evaluate-efficacy-of-autologous-6-branch-suburethral-sling-to-properly-restore-sphincteric-apparatus-during-robotic-assisted-radical-prostatectomy
#13
Andrea Cestari, Davide Soranna, Giuseppe Zanni, Antonella Zambon, Matteo Zanoni, Mattia Sangalli, Massimo Ghezzi, Fabio Fabbri, Francesco Sozzi, Vincenzo Dell'Acqua, Patrizio Rigatti
OBJECTIVES: To describe urodynamically the effect of the use of 6-branch autologous suburethral sling, made with absorbable sutures and vas deferens, to support bladder neck and urethra during Robotic Assisted Radical Prostatectomy (RALP), to improve early urinary continence recovery. Materials &Methods: Retrograde leak point pressure (RLPP) was intraoperatively evaluated, by means of retrograde perfusion sphinterometry (RPS), in 77 patients (mean age ± SD: 65.64±7.23 years, mean BMI ± SD 26...
June 30, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28660723/outcomes-of-treatment-of-stress-urinary-incontinence-associated-with-female-urethral-diverticula-a-selective-approach
#14
Alyssa Greiman, Lauren Rittenberg, Drew Freilich, Ross Rames, Ahmed El-Zawahry, Michelle Koski, Eric Rovner
AIMS: To assess surgical outcomes of concomitant treatment of SUI at time of transvaginal urethral diverticulectomy (TVUD) based on a selective approach. METHODS: Following Institutional Review Board (IRB) approval, we identified patients with a UD and SUI who underwent TVUD between July 2004 and January 2016. SUI was documented before and after surgery using subjective and objective parameters. Autologous pubovaginal slings (APVS) were used selectively based on surgeon and patient preference...
June 29, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28657139/complications-following-the-insertion-of-two-synthetic-mid-urethral-slings-and-subsequent-removal
#15
Dominic Lee, Chasta Bacsu, Benjamin Dillon, Philippe E Zimmern
OBJECTIVE: To determine outcomes after removal of two synthetic mid-urethral slings (MUS) at a tertiary care center. METHODS: Following IRB approval, a retrospective chart review of non-neurogenic, symptomatic women requiring re-operation after ≥2 MUS was performed. Data reviewed by a third party included: demographics, prior anti-incontinence surgery, complications, pelvic/urinary symptoms, subsequent investigations, surgical repair and outcomes (including UDI-6/IIQ-7 questionnaires) at a minimum 6 months follow-up...
June 28, 2017: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/28653306/the-gross-anatomy-of-the-male-reproductive-system-of-the-european-hedgehog-erinaceus-europaeus
#16
G Akbari, M Babaei, D Kianifard, D Mohebi
Hedgehogs are small spiny-coated insectivores. Due to their low body weight, calm character, and easy maintenance, they are kept as pets. It is therefore worthwhile to care about hedgehogs' health problems and to provide pet owners with information about their reproduction. Moreover, it is necessary to be familiar with their anatomy so as to satisfy the need to improve nutrition and medical care, even surgery. This study was carried out on five adult male European hedgehogs euthanized in a chloroform chamber...
June 27, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28646238/-bladder-neck-sclerosis-following-prostate-surgery-which-therapy-when
#17
REVIEW
J J Rassweiler, H Weiss, A Heinze, M Elmussareh, M Fiedler, A S Goezen
Secondary bladder neck sclerosis represents one of the more frequent complications following endoscopic, open, and other forms of minimally invasive prostate surgery. Therapeutic decisions depend on the type of previous intervention (e.g., radical prostatectomy, TURP, HoLEP, radiotherapy, HIFU) and on associated complications (e.g., incontinence, fistula). Primary treatment in most cases represents an endoscopic bilateral incision. No specific advantages of any type of the applied energy (i.e., mono-/bipolar HF current, cold incision, holmium/thulium YAG laser) could be documented...
June 23, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28631912/-results-of-urethral-reconstruction-in-adults-after-multiple-hypospadias-repairs
#18
S I Gamidov, M G Shneiderman, D Yu Pushkar, A O Vasil'ev, A V Govorov, R I Ovchinnikov, A Yu Popova, R D Dusmukhamedov
AIM: To improve treatment results in patients after multiple hypospadias repairs by optimizing the postoperative management. MATERIALS AND METHODS: Eighty-two patients (mean age 48.1+/-15.3 years) with urethral strictures secondary to failed hypospadias repairs underwent staged graft urethroplasty using oral mucosa (cheek, lip, tongue) as a grafting material. In 62 patients, at the end of surgery the bladder was drained with a standard Foley catheter. In twenty patients the bladder was drained with a modified silicone urethral catheter, which had an additional channel for delivering drugs and removing the urethral wound effluent, and a second additional channel for inflating a balloon fixed to the catheter tube at different parts of the catheter...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28630018/the-modified-ulaanbaatar-procedure-reduced-complications-and-enhanced-cosmetic-outcome-for-the-most-severe-cases-of-hypospadias
#19
V R Jayanthi, C B Ching, D G DaJusta, D J McLeod, S A Alpert
INTRODUCTION/OBJECTIVE: Proximal hypospadias is one of the most challenging conditions that pediatric urologists have to deal with. Many procedures have been devised over the years, but nothing has been proven to be the best option. Although there have been some attempts at correcting severe hypospadias in one procedure, most have advocated a staged approach. The classic approach - laying penile skin or a graft within a split glans followed by glanuloplasty at the second stage - by definition requires two operations on the glans...
May 18, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28625744/the-anterior-sagittal-transrectal-approach-astra-for-cases-associated-with-rectal-implantation-of-the-urethra-a-retrospective-review-of-six-cases
#20
A Macedo, M I S Silva, J A Pompermaier, S L Ottoni, R de Castro, M Leal da Cruz
INTRODUCTION: Severe genital abnormalities such as urogenital sinus and urethral duplication with ectopic urethra in the rectum represent a major challenge in reconstructive urology. OBJECTIVE: We aimed to review our cases presenting with functional ectopic urethra implanted in the rectum that were treated through an ASTRA approach. METHODS: We reviewed the medical records of all patients who had undergone an ASTRA approach from 2005-2016...
May 17, 2017: Journal of Pediatric Urology
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