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urethral surgery

Christina H Son, Stanley L Liauw, Yasmin Hasan, Abhishek A Solanki
BACKGROUND: Urethral cancer is rare, with limited data guiding treatment. A national hospital-based registry was used to evaluate the role of local therapy in these patients. METHODS: We performed a retrospective cohort study of patients with T0-4N0-2 M0 urethral cancer (2004-2013). Local therapy was: radiation (RT), surgery (S), or surgery and radiation (S+RT). The Cox proportional hazards model was used to assess the impact of therapy type on overall survival (primary endpoint)...
June 14, 2018: International Journal of Radiation Oncology, Biology, Physics
Lawrence J Gottlieb
The radial forearm free flap phalloplasty provides a thin, potentially sensate, minimally hair-bearing cutaneous flap. Since its initial description, several modifications of the technique have emerged. The earliest dimensions described needed to be increased because of the increase amount of subcutaneous fat in the Western population. Incorporating a centrally placed neo-urethra with a distal extension that gets folded over to create a semblance of a neoglans eliminates the distal/meatal stenosis. Performing a urethral extension at a preliminary surgery and extending the neourethra proximally has improved the position of the neophallus and minimized proximal urethral strictures and fistulas in transgender men...
July 2018: Clinics in Plastic Surgery
Karel E Y Claes, Piet Pattyn, Salvatore D'Arpa, Cedric Robbens, Stan J Monstrey
The major steps in vaginoplasty are orchiectomy, penile amputation, creation of the neovaginal cavity with lining, and reconstruction of urethral meatus, labia, and clitoris. During pedicled intestinal transfer, an intestinal segment is transferred in a dissected cavity between the bladder and rectum. The bowel harvest is performed by a total laparoscopic technique. It is imperative to create the labia majora and minora, the clitoris, and a clitoral hood to achieve the physiologic and aesthetic equivalent of female external genitalia...
July 2018: Clinics in Plastic Surgery
C M White, M K Hanna
OBJECTIVE: The glans penis may show a deep groove (surgically favorable), or may appear flat with an absent sulcus (unfavorable). Glans dehiscence following hypospadias repair, especially after multiple surgeries, frequently results in a scarred, obliterated, or absent urethral plate. The glans penis appears to be flat and grooveless. This study reported on the outcome of a two-stage salvage repair for glans dehiscence in 49 consecutive patients. MATERIALS AND METHODS: Retrospective chart review was performed for all patients who underwent repair for glans dehiscence following hypospadias repair...
May 30, 2018: Journal of Pediatric Urology
D A Weiss, C J Long, J R Frazier, A R Shukla, A K Srinivasan, T F Kolon, H DiCarlo, J P Gearhart, D A Canning
INTRODUCTION: Re-operative penile reconstruction is challenging and requires tension-free skin closure. The repair popularized by Cecil and Culp in the 1940s, using the scrotum to provide a temporary vascularized bed for complex hypospadias repairs, fell out of favor due to temporal trends towards single-stage repairs and concern for utilizing hair-bearing skin on the penile shaft. OBJECTIVE: It was hypothesized that a modified Cecil-Culp (CC) concept of penile scrotalization, leaving the penis attached to the scrotum for 1 year rather than 6 weeks as originally described, improves outcomes with this reconstruction for ventral skin deficiency or poor vascular support...
May 30, 2018: Journal of Pediatric Urology
Joseph J Pariser, Omar E Soto-Aviles, Brandi Miller, Maha Husainat, Richard A Santucci
OBJECTIVES: To propose a simple classification system for buried penis repairs and present an analysis of perioperative data based on category. METHODS: Patients undergoing buried penis repair at a single institution were examined. Classification was as follows: Category I - Penile Unburying with Local Flap; II - Skin Graft; III - Scrotal Surgery; IV - Escutcheonectomy; V - Abdominal Panniculectomy. Complex repairs were Category III or above. Success was defined as an unburied penis without additional unburying surgery...
June 10, 2018: Urology
Angela Clarke
Recent press coverage on vaginal mesh surgery has resulted in a change in how patients are counselled, managed and treated in the UK. For stress urinary incontinence surgical procedures such as insertion of tension-free vaginal tape are commonplace and generally performed as a day-case procedure. Effective and successful management of female urinary incontinence is difficult, even when using diagnostic testing where all conservative managements have failed, and this indicates a need to investigate further. Specialist texts in the fields of urology and urogynaecology argue that urodynamics can help inform the success of surgical intervention for stress urinary incontinence...
June 14, 2018: British Journal of Nursing: BJN
Abdalla M Etabbal, Fathi F Hussain, Mohamed O Benkhadoura, Abdalla M Banni
Objective: To report on our initial experience in the management of war-related penile injuries; proper diagnosis and immediate treatment of penile injuries is essential to gain satisfactory results. Besides treating primary wounds and restoring penile function, the cosmetic result is also an important issue for the surgeon. Patients and methods: The study was conducted in the Department of Urology at Benghazi Medical Center and comprised all patients who presented with a shotgun, gunshot or explosive penile injury between February 2011 and August 2017...
June 2018: Arab Journal of Urology
Amr Hodhod, John-Paul Capolicchio, Roman Jednak, Eid El-Sherif, Abd El-Alim El-Doray, Mohamed El-Sherbiny
Objective: To evaluate the utility of hydroureter (HU) to identify high-grade vesico-ureteric reflux (VUR) in patients with high-grade postnatal hydronephrosis (PH). Patients and methods: We retrospectively reviewed patients' charts that had antenatal hydronephrosis from 2008 to 2014. Patients were excluded if they presented with febrile urinary tract infection (fUTI), neurogenic bladder, posterior urethral valve, multi-cystic dysplastic kidney, and multiple congenital malformations...
June 2018: Arab Journal of Urology
Caifang Chen, Mingqiang Zeng, Ruizhi Xue, Guilin Wang, Zhiyong Gao, Wuxiong Yuan, Zhengyan Tang
To explore the etiology of male urethral stricture, analyze the therapeutic strategies of urethral stricture, and summarize the complicated cases.
 Methods: The data of 183 patients with urethral stricture were retrospectively analyzed, including etiology, obstruction site, stricture length, therapeutic strategy, and related complications.
 Results: The mean age was 49.7 years, the average course was 64.7 months, and the constituent ratio of 51 to 65 years old patients was 38.8% (71/183). The traumatic injury of patients accounted for 52...
May 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Sung Jin Kim, Jaeyoon Jung, Chanwoo Lee, Sejun Park, Sang Hoon Song, Hye-Sung Won, Kun Suk Kim
We investigated long-term functional changes in the kidney and bladder of patients with posterior urethral valve (PUV) who underwent fetal intervention or postnatal surgery.We retrospectively reviewed the medical records of 28 consecutive patients treated for PUV at our institution. Detailed data on medical and surgical histories, particularly on pre- and postnatal treatment modality, including fetal vesicoamniotic shunt, endoscopic valve ablation, and vesicostomy, were collected and analyzed. Long-term renal function was evaluated based on serum levels of creatinine (sCr), estimated glomerular filtration rate (eGFR), and renal scans...
June 2018: Medicine (Baltimore)
Samer Shamout, Yu Qing Huang, Hani Kabbara, Jacques Corcos, Lysanne Campeau
OBJECTIVE: The Argus perineal sling is a minimally invasive surgical option to treat post-prostatectomy stress urinary incontinence (PPSUI). This study retrospectively evaluated the short-term clinical outcomes with the Argus sling for PPSUI management and determined the effects of potential preoperative parameters on intraoperative retrograde leak point pressure (RLPP). METHODS: In this retrospective review of 16 men with various degrees of stress incontinence after prostatic surgery who underwent Argus sling, PPSUI was evaluated by pad usage, urodynamics, 24-hour pad weight, and validated questionnaires...
June 4, 2018: Lower Urinary Tract Symptoms
Susumu Kageyama, Tetsuya Yoshida, Masayuki Nagasawa, Shigehisa Kubota, Keiji Tomita, Kenichi Kobayashi, Ryosuke Murai, Teruhiko Tsuru, Eiki Hanada, Kazuyoshi Johnin, Mitsuhiro Narita, Akihiro Kawauchi
BACKGROUND: This study was conducted to determine whether the location of the bladder neck in postoperative cystography predicts recovery of continence after radical prostatectomy. METHODS: Between 2008 and 2015, 203 patients who underwent laparoscopic radical prostatectomy (LRP, n = 99) and robot assisted radical prostatectomy (RARP, n = 104) were analyzed. The location of the bladder neck was visualized by postoperative routine cystography, and quantitative evaluation of the bladder neck position was performed according to the bladder neck to pubic symphysis (BNPS) ratio proposed by Olgin et al...
May 30, 2018: BMC Urology
Jin K Kim, Michael E Chua, Jessica M Ming, Luis H Braga, Grahame H H Smith, Christopher Driver, Martin A Koyle
INTRODUCTION AND BACKGROUND: Although there is abundance in literature focusing on the use of prophylactic antibiotics for adult urological procedures, the evidence for using antibiotics following common pediatric urological procedures is limited with no specific guidelines for use. Consequently, current practices on antibiotic usage for common interventions may be variable among practicing pediatric urologists, lacking evidence-based support. OBJECTIVE: The aim was to evaluate the current practice pattern on antibiotic usage for common interventions amongst pediatric urologists (PU) practicing in four English-speaking sectors of the world...
May 19, 2018: Journal of Pediatric Urology
S K Maiti, P D S Raghuvanshi, M Divya, P Sangeetha, G Deepesh, K Naveen
A 40 kg crossbred calf of one month age was presented to the Institute Referral Polyclinic, with a history of dysuria, stranguria along with a fluctuant swelling in the mid-perineal region. On physical examination, a diverticulum was observed which on aspiration revealed urine. It was reported that urine outflow was from a tiny orifice at the proposed natural site of the vulva. Dissection of the skin over the diverticulum revealed hypoplastic penis with adhesion of the preputeal sheath along with penile hypospadia...
2018: Iranian Journal of Veterinary Research
Haruhiko Kanasaki, Aki Oride, Tomomi Hara, Satoru Kyo
Aim: We compared the short-term effectiveness of tension-free vaginal mesh (TVM) surgery using the Capio SLIM suture capturing device and conventional TVM surgery for treatment of pelvic organ prolapse. Methods: We retrospectively compared postoperative pain, urinary function, and length of hospital stay between 7 patients who underwent TVM surgery using the Capio device and 9 patients who underwent conventional TVM surgery. Results: There was no significant between-group difference in mean age between the Capio TVM group and the conventional TVM group (76...
2018: Obstetrics and Gynecology International
Nadir I Osman, Christopher J Hillary, Altaf Mangera, Reem Aldamanhoori, Richard D Inman, Christopher R Chapple
BACKGROUND: Surgery for stress urinary incontinence (SUI) has been dominated recently by synthetic midurethral tapes. Increasing recognition of serious complications associated with nonabsorbable polypropylene mesh has led to resurgence in interest in alternative approaches, such as the autologous fascial sling (AFS). Despite being an efficacious and durable option in women with recurrent and complex SUI, there has been a reluctance to consider AFS in women with primary SUI due to a perception that it is only appropriate for treating patients with intrinsic sphincter deficiency (ISD) and is associated with high rates of urinary retention and de novo storage symptoms...
May 23, 2018: European Urology
Malte Rieken, Tiago Antunes-Lopes, Bogdan Geavlete, Tom Marcelissen
Transurethral resection of the prostate as well as laser prostatectomy (by either holmium laser enucleation of the prostate or Greenlight laser vaporization) is associated with risks of sexual dysfunction such as antegrade ejaculation and occasionally erectile dysfunction. While ejaculation-sparing variations of these techniques show promising results, larger multicenter studies are needed to confirm promising data. Prostatic urethral lift maintains erectile and ejaculatory function at 5-yr follow-up. The same is true for the 3-yr data on the Rezum system...
May 23, 2018: European Urology Focus
Rabea G Omar, Mostafa M Khalil, Hammouda Sherif, Hesham Elezaby
OBJECTIVE: To use the prepuce for double functions one as a second layer for the neourethra to decrease the incidence of urethrocutaneous fistula and the second as a skin covering for the ventral aspect of the penis. MATERIAL AND METHODS: From January 2013 to December 2016, 37 cases of hypospadias with mild to moderate chordee were included in this study. The cases with ventral penile skin defect were managed by tubularized incised plate urethroplasty (TIPU) using pedicled preputial flap...
March 16, 2018: Turkish Journal of Urology
Michael A Maccini, David J Chalmers, Vijaya M Vemulakonda, Jeffrey B Campbell
PURPOSE: Urinary tract infections are relatively common in pediatric patients. Unrecognized bacteriuria at the time of urologic surgery puts patients at increased risk for perioperative complications. Many pediatric urologists obtain preoperative or intraoperative urine cultures prior to surgery, but data are lacking regarding rates and risk factors for positive intraoperative urine cultures. We conducted a retrospective cohort study of patients undergoing pediatric urologic surgery to examine factors associated with positive intraoperative urine cultures...
May 21, 2018: International Urology and Nephrology
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