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https://www.readbyqxmd.com/read/28630018/the-modified-ulaanbaatar-procedure-reduced-complications-and-enhanced-cosmetic-outcome-for-the-most-severe-cases-of-hypospadias
#1
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/28579133/two-stage-flap-repair-of-severe-hypospadias-usefulness-of-the-tubularized-incised-plate-urethroplasty
#2
K H Tijani, H O Idiodi-Thomas, O A Elebute, F M Alakaloko, R W Ojewola, A O Ademuyiwa
PURPOSE: The use of flaps in the two-stage repair of posterior hypospadias associated with severe chordee has been well established. Despite the almost certain guarantee of flap take, complications such as diverticuli are still relatively high. While different applications of the tubularized incised plate have been described, experience with the application of the technique to the two-stage flap repair is very limited. A previous local review of 15 cases performed at the present institution during the period 1998-2003, using the technique as described by Rekit, revealed fistulae and diverticulum rates of 20% and 27%, respectively...
May 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28495505/penile-fracture-following-a-fall-in-a-seven-year-old-male
#3
Bhalaajee Meenakshi-Sundaram, Caitlin T Coco, James R Furr, Marshall D Shaw, Dominic C Frimberger
We report a rare case of isolated penile fracture in a prepubescent male caused by an accidental fall. The patient presented with swelling and ecchymosis on the base of the penis and along the penile shaft. A flexible cystoscopy was performed which did not reveal any concomitant urethral injury. The penis was degloved and the corporal tear was closed with absorbable suture. Due to the location of the injury, ventral mobilization of the urethra was required. The pathophysiology of penile fracture as well as the diagnosis and management of this rare injury are discussed in this report...
May 8, 2017: Urology
https://www.readbyqxmd.com/read/28462429/on-the-stiffness-of-the-mesh-and-urethral-mobility-a-finite-element-analysis
#4
Sofia Brandão, Marco Parente, Thuane Huyer Da Roza, Elisabete Silva, Isabel Maria Ramos, Teresa Mascarenhas, Renato Manuel Natal Jorge
Midurethral slings are used to correct urethral hypermobility in female stress urinary incontinence, defined as the complaint of involuntary urine leakage when the intra-abdominal pressure is increased. Structural and thermal features influence their mechanical properties, which may explain postoperative complications, e.g., erosion, urethral obstruction. We studied the effect of the mesh stiffness on urethral mobility at Valsalva maneuver, under impairment of the supporting structures (levator ani and/or ligaments), by using a numerical model...
May 2, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28429054/variables-affecting-maximum-urethral-closure-pressure-mucp-and-abdominal-leak-point-pressure-alpp-measurements
#5
Bryan J Hill, Sarah Fletcher, Jeffrey Blume, Rony Adam, Renée Ward
INTRODUCTION AND HYPOTHESIS: The relationship between pelvic floor muscles and measurements of urethral function is not well studied. It is not known whether adjusting for clinical, demographic and urodynamic parameters would improve the association between MUCP and ALPP. Our hypothesis was that pelvic floor muscle strength (PFMS) influences the relationship between MUCP and ALPP. METHODS: This was a retrospective study of women who underwent a complex urodynamic study with evaluation of MUCP and ALPP using ICD-9 codes with documentation of PFMS...
April 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28353601/urethral-hemangioma-in-a-prepubertal-female-patient-report-of-a-rare-case
#6
Chiao-Ching Li, Chiao-Zhu Li, Ching-Heng Yen, Wen-Chuan Tsai, Sheng-Tang Wu, Tai-Lung Cha, En Meng
RATIONALE: Urethral hemangiomas commonly occur in men or elderly women. We presented a rare case of urethral hemangioma in a prepubertal female patient. PATIENTS CONCERNS: An 8-year-old girl had the complaints of bloody staining of clothing, a foul perineal odor, and urethral pain. She was brought to our genitourinary outpatient department for survey and a single, 1-cm compressible reddish nodule at the 10-2 o'clock position in the distal urethra was found. DIAGNOSES: Urethral hemangioma in a prepubertal girl was diagnosed after excision of the urethral nodule...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328642/can-we-preserve-the-urethral-plate-in-proximal-hypospadias-repair
#7
Smail Acimi, Mohammed Ali Acimi
PURPOSE: To know the limits of the preservation of the urethral plate in the correction of the curvature associated with proximal hypospadias. METHODS: From January 2002 to January 2015, we treated 224 patients of proximal hypospadias. In 182 cases, we used of the lateral pictures taken during the successive saline erection tests to measure the correction obtained after each stage. RESULTS: The analysis of the lateral pictures taken at the successive saline erection tests clearly demonstrated that release of the skin and dartos fascia provides an important correction of the chordee...
July 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28322901/urethral-mobilization-as-an-alternative-procedure-for-distal-hypospadias-repair
#8
Hamed M El Darawany, Mahmoud E Al Damhogy
OBJECTIVE: To evaluate the urethral mobilization procedure as the main technique in management of glanular, coronal, subcoronal, and distal penile hypospadias. PATIENTS AND METHODS: Sixty patients with distal hypospadias were included in this prospective study between January 2013 and January 2015. All of them had urethral mobilization. All patients were followed up at 2 weeks, and at 1, 3, 6, and 12 months postoperatively. Duration of the operation, hospital stay, position of meatus and its shape before and after the operation, and the postoperative complications were recorded...
March 18, 2017: Urology
https://www.readbyqxmd.com/read/28272705/the-most-common-factors-hindering-the-independent-functioning-of-the-elderly-at-home-by-age-and-sex
#9
D Talarska, S Kropińska, M Strugała, M Szewczyczak, S Tobis, K Wieczorowska-Tobis
OBJECTIVE: Changes occurring with increased age as well progressive illnesses can negatively affect the independent functioning of older people. The goal of this study was to identify the most common problems that make independent life at home more difficult for the elderly and to try and present their relation with age and gender. PATIENTS AND METHODS: A total of 506 persons over 60 years of age took part in the study. They were residents of Poznań, Poland and surrounding areas...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28252312/-management-of-recurrent-stress-urinary-incontinence-after-anti-incontinence-surgery
#10
A Martan, J Mašata, K Švabík
OBJECTIVE: The review article describes the possibilities of procedures for failed anti-incontinence surgery - sling procedure or "bulking agent"? DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Medical Faculty, Charles University, Prague. MATERIALS AND METHODS: The correct choice of procedure type to treat persistent SUI (Stress Urinary Incontinence) which persists or soon reoccurs after anti-incontinence surgery is often problematic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28247065/the-changes-of-urethral-morphology-recognized-in-voiding-cystourethrography-after-endoscopic-transurethral-incision-for-posterior-urethral-valve-in-boys-with-intractable-daytime-urinary-incontinence-and-nocturnal-enuresis
#11
Taiju Hyuga, Shigeru Nakamura, Shina Kawai, Taro Kubo, Rieko Furukawa, Toshinori Aihara, Makiko Mieno, Hideo Nakai
PURPOSE: Endoscopic transurethral incision (TUI) of posterior urethral valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding. METHODS: Between July 2010 and December 2014, 29 boys with intractable DUI and/or NE were diagnosed as PUV and underwent endoscopic TUI...
February 28, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28197032/double-breasting-spongioplasty-in-tubularized-tubularized-incise-plate-urethroplasty-a-new-technique
#12
Amilal Bhat, Mahakshit Bhat, Rajeev Kumar, Akshita Bhat
INTRODUCTION: The main disadvantage of currently described techniques of spongioplasty is superimposition of 3 suture lines (neourethra, spongioplasty, and skin closure) which is likely to increase the chances of a fistula. We describe and evaluate the results of a double breasting spongioplasty in urethroplasty. METHODS: A prospective study of 60 primary hypospadias was undertaken by double breasting spongioplasty from August 2012 to March 2014. Mobilization of the urethral plate and the spongiosum is done by creating a plane just proximal to the meatus...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28139863/role-of-intrinsic-sphincter-deficiency-with-and-without-urethral-hypomobility-on-the-outcome-of-tape-insertion
#13
Edyta Wlaźlak, Volker Viereck, Jacek Kociszewski, Andrzej Kuszka, Oliver Rautenberg, Claudia Walser, Grzegorz Surkont, Marianne Gamper, Mathias K Fehr
AIMS: Intrinsic sphincter deficiency (ISD) is a known risk factor for therapy failure after tension-free vaginal tape (TVT) insertion. The purpose of this study was to investigate if the severity of ISD alone or other factors such as urethral mobility and tape localization influence outcomes. METHODS: One hundred and nine women with urodynamically determined ISD, a TVT insertion, and a 6-month follow-up visit were included. Urethral length, mobility, and tape localization were evaluated by pelvic floor sonography...
January 31, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28108041/strain-elastography-as-a-new-method-for-assessing-pelvic-floor-biomechanics
#14
Jana Marie Kreutzkamp, Sebastian Daniel Schäfer, Susanne Amler, Felix Strube, Ludwig Kiesel, Ralf Schmitz
Strain elastography (SE) is a new technique of parametric imaging that allows quantification of the elasticity of tissue. The aim of our study was to determine if the elasticity of para-urethral tissue correlates with urethral mobility and urinary incontinence (UI). Ninety-nine unselected women were investigated with SE. They were given a standardized interview about UI, and SE raw data for the para-urethral tissue were acquired in a sagittal standard urethra-symphysis view while being stimulated by a coughing fit...
April 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28102588/three-dimensional-translabial-ultrasound-assessment-of-urethral-supports-and-the-urethral-sphincter-complex-in-stress-urinary-incontinence
#15
Jordi Cassadó Garriga, Antoni Pessarrodona Isern, Monica Rodríguez Carballeira, Mar Pallarols Badia, Manuela Moya Del Corral, Marta Valls Esteve, Eva Huguet Galofré
AIMS: The pathophysiological mechanism of incontinence is multifactorial. We evaluated the role of 3D-4D ultrasound in the assessment of the fascial supports of the urethra and the urethral sphincter complex (USC) for diagnosing stress urinary incontinence. METHODS: Observational case-control study in women with and without stress urinary incontinence attending a urogynecology service and a general gynecology service. All women were interviewed, examined, and classified according to the Pelvic Organ Prolapse Quantification (POP-Q) and underwent a 3D-4D translabial ultrasound...
January 19, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28042169/the-problem-of-polypharmacy-in-female-patients-with-overactive-bladders-cross-sectional-study-in-a-specialist-outpatient-department
#16
C S Schneidinger, W Umek, B Böhmdorfer
Background: The consumption of certain drugs can cause urinary incontinence. The aim of this study is to determine the frequency of consumption of drugs that can favour incontinence, the incidence of polypharmacy and the incidence of potentially dangerous drug-drug interactions in female patients suffering from overactive bladder (OAB) who presented to a urogynaecological outpatient department. Methods: We undertook a retrospective case series study. The data from 100 female patients who attended the urogynaecological outpatient department of the Vienna General Hospital [VGH; Allgemeinen Krankenhauses Wien (AKH)] in the period from 20...
December 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27980522/ultrasound-imaging-in-urogynecology-state-of-the-art-2016
#17
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/27932079/urinary-continence-outcomes-following-vaginoplasty-in-patients-with-congenital-adrenal-hyperplasia
#18
John Stites, Kerlly J Bernabé, Denise Galan, Diane Felsen, Dix P Poppas
BACKGROUND: Feminizing genitoplasty techniques have diversified to encompass the spectrum of atypical genitalia in 46,XX congenital adrenal hyperplasia (CAH) patients. However, long-term outcomes evaluating postoperative continence following complex vaginoplasty remain scarce. OBJECTIVE: The aim was to review our surgical experience and assess postoperative urinary continence outcomes in CAH patients following complex, primary vaginoplasty. STUDY DESIGN: We retrospectively reviewed CAH patients who underwent complex, primary vaginoplasty at a single center by a single surgeon from 1996 to 2013...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27886590/pelvic-floor-dynamics-during-high-impact-athletic-activities-a-computational-modeling-study
#19
Nicholas Dias, Yun Peng, Rose Khavari, Nissrine A Nakib, Robert M Sweet, Gerald W Timm, Arthur G Erdman, Timothy B Boone, Yingchun Zhang
BACKGROUND: Stress urinary incontinence is a significant problem in young female athletes, but the pathophysiology remains unclear because of the limited knowledge of the pelvic floor support function and limited capability of currently available assessment tools. The aim of our study is to develop an advanced computer modeling tool to better understand the dynamics of the internal pelvic floor during highly transient athletic activities. METHODS: Apelvic model was developed based on high-resolution MRI scans of a healthy nulliparous young female...
January 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/27847256/hypospadias-repair-with-the-glanular-frenular-collar-gfc-technique
#20
Hüseyin Özbey, Şeref Etker
BACKGROUND: In the normal human penis, the glans wings merge in the midline ventrally, but are separated by the 'septum glandis' in conjunction with the frenulum. The frenulum is also included in the formation of the distal (glanular and subcoronal) urethra, which has a special part known as the 'fossa navicularis'. This has inspired a hypospadias repair technique that simulates the development of the glanular and subcoronal urethra, which can be incorporated into the repair of all cases of hypospadias...
February 2017: Journal of Pediatric Urology
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