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https://www.readbyqxmd.com/read/28325472/dosimetric-comparison-between-treatment-plans-of-patients-treated-with-low-dose-rate-vs-high-dose-rate-interstitial-prostate-brachytherapy-as-monotherapy-initial-findings-of-a-randomized-clinical-trial
#1
T Major, C Polgár, K Jorgo, G Stelczer, P Ágoston
PURPOSE: The aim of this study was to compare the dosimetry of intraoperative dose plans of prostate cancer patients treated with low-dose-rate (LDR) and high-dose-rate (HDR) interstitial brachytherapy (BT). METHODS AND MATERIALS: A randomized clinical trial was initiated at our institution to compare the results and side effects of LDR and HDR BT as monotherapy in the treatment of early, organ-confined prostate cancer patients. Eighty-seven patients were randomly assigned to receive HDR afterloading BT with one fraction of 19 Gy or permanent LDR (125)I seed BT with 145 Gy...
March 15, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28322900/structural-variations-of-the-prostatic-urethra-within-the-prostate-predict-the-severities-of-obstructive-symptoms-a-prospective-multicenter-observational-study
#2
Young Hwii Ko, Tae-Hwan Kim, Phil Hyun Song, Byung Hoon Kim, Bum Soo Kim, Ki Ho Kim, Jaeho Cho
OBJECTIVE: To describe distinctive morphologic variations of the prostate associated with the prostatic urethra, and to determine whether structural changes of the urethra within the prostate resulting from gland enlargement, rather than prostrate volume itself, lead to male lower urinary tract symptom (LUTS). MATERIALS AND METHODS: After standardizing measurements, seven ultrasonography determined variables, that is, prostate volume, transitional zone volume, transitional zone to total volume ratio, presence of intraprostatic protrusion, prostatic urethral angle, prostatic urethral length (PUL), and PUL-to-volume ratio (rPUL), were obtained prospectively in 293 men that had not taken LUTS medication during the 3 months prior to initial visits...
March 17, 2017: Urology
https://www.readbyqxmd.com/read/28322899/permanent-bulbar-urethral-ligation-emerging-treatment-option-for-incontinent-men-with-end-stage-urethra
#3
Maia E VanDyke, Boyd R Viers, Travis J Pagliara, Jeremy M Scott, Nabeel Shakir, Daniel D Dugi, Billy H Cordon, Matthias D Hofer, Allen F Morey
OBJECTIVE: To report our experience with permanent urethral ligation for severe incontinence among men with end-stage urethra. METHODS: From our institutional Artificial Urethral Sphincter (AUS) database of 512 patients from 2010-2016, 10 men underwent permanent urethral ligation with concurrent suprapubic tube (SPT) diversion following recurrent AUS cuff erosion. Clinical characteristics and outcomes were evaluated. Quality of life (QOL) was assessed using the Michigan Incontinence Symptom Index (M-ISI) and the Patient Global Index of Improvement (PGI-I)...
March 16, 2017: Urology
https://www.readbyqxmd.com/read/28319023/isolated-bilateral-simplex-ureteric-ectopia-bladder-capacity-as-an-indicator-of-continence-outcome
#4
Vasilis Stavrinides, Paul Charlesworth, Dan Wood, Divyesh Desai, Abraham Cherian, Imran Mushtaq, Peter Cuckow, Naima Smeulders
INTRODUCTION: Isolated bilateral simplex ectopic ureters (BSEUs) are rare but pose a therapeutic challenge: ureteric reimplantation alone does not accomplish continence in all. Identifying the patients needing additional procedures for continence early could prevent multiple operations. OBJECTIVE: Potential preoperative indicators for postoperative continence are explored in eight BSEU girls without cloacal, anorectal, or spinal anomalies. STUDY DESIGN: With institutional approval, all patients with BSEU between 1985 and 2012 were retrospectively reviewed...
March 6, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28315496/remeex-device-external-mechanical-regulator-for-female-stress-urinary-incontinence-a-critical-review-of-a-single-operator-long-term-experience-on-implants-and-readjustments
#5
Franco Mantovani
OBJECTIVE: A single-operator, long-term (15 years) experience on a sling technique that allows a postoperative adjustment of its tension is presented to retrospectively report the objective and subjective outcomes in the treatment of female stress urinary incontinence (SUI). The readjustment option prevents the need of a reoperation in case of relapse with great compliance of the patients. MATERIALS AND METHODS: Indications for surgical tratment of SUI by ReMeEx included patients affected with not only true intrinsic sphyncteric deficency (ISD) and fixed urethra but also mild urethral hypermobility, previous incontinence surgery and relapsing conditions such as diabetes and obesity...
March 18, 2017: Urologia
https://www.readbyqxmd.com/read/28314701/genitourinary-involvement-and-management-in-children-with-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#6
J P Van Batavia, D I Chu, C J Long, M Jen, D A Canning, D A Weiss
BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are devastating hypersensitivity disorders that cause epidermal cell death and can affect all epidermal surfaces, including the urethra, vagina, labial and scrotal skin. Despite the well-described ocular and orofacial manifestations of SJS/TEN, there is a paucity of reports on the genitourinary (GU) symptoms and their management. Specifically, consulting services often ask the pediatric urology team if it is safe to place a urethral catheter, but there is no data in the literature to help guide management...
February 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#7
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
March 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306557/mri-micturating-urethrography-for-improved-urethral-delineation-in-prostate-radiotherapy-planning-a-case-study
#8
Robba Rai, Mark Sidhom, Karen Lim, Lucy Ohanessian, Gary P Liney
Stereotactic ablative body radiotherapy is used in prostate cancer to deliver a high dose of radiation to the tumour over a small number of treatments. This involves the simulation of the patient using both CT and MRI. Current practice is to insert an indwelling catheter (IDC) during CT to assist with visualisation of the urethra and subsequently minimise dose to this highly critical structure. However, this procedure is invasive and has an associated risk of infection. This is a case study, which demonstrates our initial experience of using a real-time non-invasive MRI technique to replace the use of IDC for prostate cancer patients...
March 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28299781/architectural-differences-in-the-anterior-and-middle-compartments-of-the-pelvic-floor-of-young-adult-and-postmenopausal-females
#9
Yi Wu, Noshir F Dabhoiwala, Jaco Hagoort, Li-Wen Tan, Shao-Xiang Zhang, Wouter H Lamers
The pelvic floor guards the passage of the pelvic organs to the exterior. The near-epidemic prevalence of incontinence in women continues to generate interest in the functional anatomy of the pelvic floor. However, due to its complex architecture and poor accessibility, the classical 'dissectional' approach has been unable to come up with a satisfactory description, so that many aspects of its anatomy continue to raise debate. For this reason, we opted for a 'sectional' approach, using the Chinese Visible Human project (four females, 21-35 years) and the Visible Human Project (USA; one female, 59 years) datasets to investigate age-related changes in the architecture of the anterior and middle compartments of the pelvic floor...
March 16, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28298357/how-important-is-the-%C3%AE-1-adrenoceptor-in-primate-and-rodent-proximal-urethra-sex-differences-in-the-contribution-of-%C3%AE-1-adrenoceptor-to-urethral-contractility
#10
Eduardo C Alexandre, Mariana G de Oliveira, Rafael Campos, Luiz Ricardo A Kiguti, Fabiano B Calmasini, Fábio H Silva, Andrew D Grant, Naoki Yoshimura, Edson Antunes
Urethral smooth muscle (USM) contributes to urinary continence by contracting during the urine storage phase, which is mainly mediated by activation of post-junctional α1-adrenoceptors. Males and females show differences in the functioning of the lower urinary tract and the most common urinary tract symptoms (LUTS). LUTS in men typically occur in association with bladder outlet obstruction, whereas in women urinary urge-incontinence symptoms are more common. Therefore, this study aimed to evaluate sex differences in α1-adrenoceptor subtype expression and their importance in proximal urethra contraction in mouse (C57BL6/J) and marmoset (Callithrix jacchus)...
March 15, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28295605/peri-meatal-pein-and-urethral-scc-a-case-report
#11
P R Doiron, H du P Menage, A Freeman, A Muneer, C B Bunker
A 55-year-old man presented with an asymptomatic lesion adjacent to the urethral meatus of one year's duration (Fig. 1). His medical history was significant for quiescent lung sarcoidosis (treatment never required), asthma and irritable bowel syndrome. His only medication was a budesonide/formoterol inhaler. The plaque had slowly been increasing in size, had not ulcerated or bled and had not impacted sexual or urinary function. Examination did not reveal extension into the urethra. Biopsy revealed undifferentiated penile intraepithelial neoplasia (PeIN) III/carcinoma in situ...
March 10, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28292311/sonography-of-the-distal-urethra-in-lambs
#12
Ammar AlLugami, Kerstin von Pückler, Axel Wehrend, Marlene Sickinger
Sonography is a convenient, non-invasive diagnostic modality in small ruminants, often used in reproductive management, internal medicine, and surgery. Pregnancy diagnostics and imaging anatomy and pathology of organs, such as neoplasia, are major applications. Urolithiasis is one of the most common causes of death in male sheep and goats, for which sonography is the diagnostic modality of choice. Although ultrasound-imaging techniques for kidneys, ureters, and urinary bladder in small ruminants have been described previously, this study focuses on reporting the imaging technique of the extra-pelvic portion of the urethra, as nearly all the cases of obstructive urolithiasis result from urinary stones in this part...
March 14, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28290096/the-value-and-evaluability-of-the-pca3-urine-assay-in-prostate-carcinoma-is-independent-of-the-tumor-localization
#13
Eva Neumann, Jörg Hennenlotter, Tilman Todenhöfer, Marcus Scharpf, Tim Neumann, David Schilling, Arnulf Stenzl, Jens Bedke
INTRODUCTION: The prostate cancer gene 3 (PCA3) test is based on the analysis of tumor cell mRNA in urine. As an exprimated urinary marker, its retrieval is subject to certain physical aspects like palpation pressure and detachment force during the squeezing of cells. Other potential factor of influence may be the distance the cells have to cover until they reach the urethra. Thus, it was investigated whether the localization of the tumors within the prostate with regard to the urethra and the seminal colliculus influences the PCA3 score...
March 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28289973/a-novel-laparoscopic-technique-for-anorectal-malformation-with-low-recto-bulbar-fistulae
#14
Mei Diao, Long Li, Kao-Ping Guan, Zhen Zhang, Wei Cheng
BACKGROUND: The repair of anorectal malformation (ARM) with low recto-bulbar fistula (bowel-to-skin distance: 1-1.5 cm) is contraindicated for laparoscopy due to the difficulty in exposing the fistulae. Posterior or anterior sagittal anorectoplasty is thus conventionally carried out for low recto-bulbar fistula repair. However, these procedures carry the potential risk of wound infection/dehiscence and incontinence. We have developed a single-incision laparoscopic-assisted perineal anorectoplasty (SILPARP) technique...
March 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28289208/specific-deletion-of-lkb1-stk11-in-the-m%C3%A3-llerian-duct-mesenchyme-drives-hyperplasia-of-the-periurethral-stroma-and-tumorigenesis-in-male-mice
#15
Jitu W George, Amanda L Patterson, Pradeep S Tanwar, André Kajdacsy-Balla, Gail S Prins, Jose M Teixeira
Nearly all older men will experience lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH), the etiology of which is not well understood. We have generated Stk11(CKO) mice by conditional deletion of the liver kinase B1 (LKB1) tumor suppressor gene, Stk11 (serine threonine kinase 11), in the fetal Müllerian duct mesenchyme (MDM), the caudal remnant of which is thought to be assimilated by the urogenital sinus primordial mesenchyme in males during fetal development. We show that MDM cells contribute to the postnatal stromal cells at the dorsal aspect of the prostatic urethra by lineage tracing...
March 13, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28286074/human-penile-transplantation-an-emerging-therapy-for-genitourinary-reconstruction
#16
REVIEW
Nikolai A Sopko, Sami H Tuffaha, Denver Lough, Gerald Brandacher, W P Andrew Lee, Trinity J Bivalacqua, Richard J Redett, Arthur L Burnett
PURPOSE: Reconstruction of complex functional structures is increasingly being performed with vascularized composite allo-transplantation (VCA). Penile transplantation is a novel VCA treatment option for severe penile tissue loss and disfigurement. Three allogeneic human penile transplantations have been reported. We review these cases as well as penile transplant indications, pre-clinical models, and immunosuppression therapy. MATERIALS AND METHODS: We performed a comprehensive literature review for the years 1970 to 2016 via MEDLINE, PubMed, and Google with the key words "penis transplantation", "penile rejection", "penile replantation", "penile tissue loss", and "penis vascularized composite allo-transplantation"...
March 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28285314/the-staged-urethroplasty-with-vascularised-scrotal-flap-and-buccal-mucosa-graft-after-failed-hypospadias-surgery-a-reliable-technique-with-a-novel-tool
#17
Abhishek Pandey, Anna-Maria Barta-Kelemen, Michael Borisenkov, Hansjörg Keller
Background/Aims/Objectives: To report the outcome of staged urethroplasty with buccal mucosa and vascularised scrotal flap after failed hypospadias surgery. METHODS: n = 35. INCLUSION CRITERIA: destroyed urethral plate, deficient local skin, fistula and penile deviation. Five out of 35 patients also had a secondary proximal stricture. Stage 1: excision of scarred tissue and fistulae, correction of the penile deviation through dorsal plication and the ventral placement and quilting of buccal graft...
March 11, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28284493/dosimetric-impact-of-contouring-and-needle-reconstruction-uncertainties-in-us-ct-and-mri-based-high-dose-rate-prostate-brachytherapy-treatment-planning
#18
Susanne Rylander, Simon Buus, Erik M Pedersen, Lise Bentzen, Kari Tanderup
BACKGROUND AND PURPOSE: The purpose was to evaluate the dosimetric impact of target contouring and needle reconstruction uncertainties in an US-, CT- and MRI-based HDR prostate BT treatment planning. MATERIAL AND METHODS: US, CT, and MR images were acquired post-needle insertion in 22 HDR-BT procedures for 11 consecutive patients. Dose plans were simulated for an US-, CT- and MRI-based HDR-BT treatment planning procedure. Planning uncertainties in US- and CT-based plans were evaluated using MRI-based planning as reference...
March 8, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28280687/clear-cell-adenocarcinoma-of-the-female-urethra-mimicking-cystocele
#19
Yassine Ayari, Walid Kerkeni, Nadia Znaidi, A Blel, A Bouzouita, H Ayed, Mohamed Cherif, Mohamed Riadh Ben Slama, Amine Derouiche, Soumaya Rammeh, Mohamed Chebil
Clear cell adenocarcinoma of the urethra is an extremely rare neoplasm mainly described in women. Anterior pelvic exenteration was the treatment performed in most reported cases. It seems to have poorer prognosis than urothelial carcinomas.
May 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28279224/urethral-reconstruction-with-autologous-urine-derived-stem-cells-seeded-in-three-dimensional-porous-small-intestinal-submucosa-in-a-rabbit-model
#20
Yang Liu, Wenjun Ma, Bo Liu, Yangcai Wang, Jiaqiang Chu, Geng Xiong, Lianju Shen, Chunlan Long, Tao Lin, Dawei He, Denis Butnaru, Lyundup Alexey, Yuanyuan Zhang, Deying Zhang, Guanghui Wei
BACKGROUND: Urethral reconstruction is one of the great surgical challenges for urologists. A cell-based tissue-engineered urethra may be an alternative for patients who have complicated long strictures and need urethral reconstruction. Here, we demonstrated the feasibility of using autologous urine-derived stem cells (USCs) seeded on small intestinal submucosa (SIS) to repair a urethral defect in a rabbit model. METHODS: Autologous USCs were obtained and characterized, and their capacity to differentiate into urothelial cells (UCs) and smooth muscle cells (SMCs) was tested...
March 9, 2017: Stem Cell Research & Therapy
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