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https://www.readbyqxmd.com/read/28689649/epispadias-repair-with-tunica-vaginalis-flap
#1
R S Zee, J H Makari, Fernando Ferrer, C D A Herndon
INTRODUCTION: Primary epispadias is a rare congenital malformation that afflicts about 1 in 80,000 children. The surgical repair, originally described by Cantwell over 100 years ago, is fundamentally sound and incorporates several important steps to achieve an optimal result. METHODS: A 9-month-old male with penopubic epispadias presented for surgical repair. Pre-operative imaging included a normal renal ultrasound and voiding cystourethrogram that demonstrated a moderate-sized bladder, partially competent bladder neck, and no vesicoureteral reflux...
June 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28674908/transperineal-reanastomosis-for-treatment-of-highly-recurrent-anastomotic-strictures-after-radical-retropubic-prostatectomy-extended-follow-up
#2
Victor Maximilian Schuettfort, Roland Dahlem, Luis Kluth, Daniel Pfalzgraf, Clemens Rosenbaum, Tim Ludwig, Margit Fisch, Christoph-Philip Reiss
OBJECTIVES: To re-evaluate safety and efficacy of transperineal reanastomosis (TPRA) as a viable therapeutic option in highly recurrent anastomotic strictures (AS) after radical retropubic prostatectomy (RRP). METHODS: Retrospective analysis by standardized questionnaire inquiring for recurrence of stricture, stress urinary incontinence (SUI), sexual function, satisfaction, and changes in quality of life (QoL) was performed in all patients undergoing TPRA. Validated questionnaires (ICIQ-UI, EQ-5D, and IPSS) were included...
July 3, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28673060/urethral-closure-pressure-at-stress-a-predictive-measure-for-the-diagnosis-and-severity-of-urinary-incontinence-in-women
#3
Anne-Cécile Pizzoferrato, Arnaud Fauconnier, Xavier Fritel, Georges Bader, Philippe Dompeyre
PURPOSE: Maintaining urinary continence at stress requires a competent urethral sphincter and good suburethral support. Sphincter competence is estimated by measuring the maximal urethral closure pressure at rest. We aimed to study the value of a new urodynamic measure, the urethral closure pressure at stress (s-UCP), in the diagnosis and severity of female stress urinary incontinence (SUI). METHODS: A total of 400 women without neurological disorders were included in this observational study...
June 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28670672/anterior-urethral-advancement-as-a-single-stage-technique-for-repair-of-anterior-hypospadias-our-experience
#4
Venkat A Gite, Jayant V Nikose, Sachin M Bote, Saurabh R Patil
PURPOSE: Many techniques have been described to correct anterior hypospadias with variable results. Anterior urethral advancement as one stage technique was first described by Ti Chang Shing in 1984. It was also used for the repair of strictures and urethrocutaneous fistulae involving distal urethra. We report our experience of using this technique with some modification for the repair of anterior hypospadias. MATERIALS AND METHODS: In the period between 2013-2015, 20 cases with anterior hypospadias including 2 cases of glanular, 3 cases of coronal, 12 cases of subcoronal and 3 cases of distal penile hypospadias were treated with anterior urethral advancement technique...
July 2, 2017: Urology Journal
https://www.readbyqxmd.com/read/28665528/trauma-hazards-in-children-an-update-for-the-busy-clinician
#5
REVIEW
Andrew Ja Holland, Soundappan Sv Soundappan
Trauma and injury continue to be common in children and remain an important cause of mortality and morbidity. Legislation mandating the use of helmets for all cyclists appears to have been effective in reducing the incidence and severity of head and facial injuries, with no clear evidence of a reduction in cycling usage or activity. Straddle injuries, whilst uncommon and generally minor, require careful clinical assessment as they may be associated with urethral trauma. Quad bikes remain highly dangerous with continuing reports of deaths in child riders due to their inherent lack of stability: a ban on their use by children would seem the most effective solution...
June 30, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28656661/sonographic-localization-of-a-retained-urethral-foreign-body-in-an-elderly-patient
#6
Hamid Shokoohi, Zachary Kendrick, Neal Sikka, Keith S Boniface
A retained urethral foreign body is an uncommon presentation in the Emergency Department. The diagnosis and treatment of retained urethral foreign bodies are determined by their size, location, shape, and mobility and often require specialty consultation and operative intervention. In this case of a 74-year-old man with a self-inserted, retained urethral foreign body, we present the utility of a bedside ultrasound to detect the depth, size, and distance from the meatus of the object to guide the approach to extraction of the object at the bedside in the Emergency Department...
June 27, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28647400/intraoperative-registered-ultrasound-and-fluoroscopy-iruf-for-dose-calculation-during-prostate-brachytherapy-improved-accuracy-compared-to-standard-ultrasound-based-dosimetry
#7
Junghoon Lee, Omar Y Mian, Yi Le, Hee Joon Bae, E Clif Burdette, Theodore L DeWeese, Jerry L Prince, Daniel Y Song
BACKGROUND AND PURPOSE: Intraoperative transrectal ultrasound dosimetry during low-dose-rate prostate brachytherapy is imprecise due to sonographic distortion caused by seed echoes and needle tracks that obscure seed positions or create false signals as well as traumatic edema. Here we report the results of a pilot study comparing a combined ultrasound and fluoroscopy-based seed localization method (iRUF) to standard ultrasound-based dosimetry (USD). MATERIAL AND METHODS: Eighty patients undergoing permanent Pd-103 seed implantation for prostate cancer were prospectively enrolled...
June 21, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28630018/the-modified-ulaanbaatar-procedure-reduced-complications-and-enhanced-cosmetic-outcome-for-the-most-severe-cases-of-hypospadias
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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