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https://www.readbyqxmd.com/read/28214570/routine-urethrograpy-after-buccal-graft-bulbar-urethroplasty-the-impact-of-initial-urethral-leak-on-surgical-success
#1
Erik T Grossgold, Jairam R Eswara, Cary L Siegel, Joel Vetter, Steven B Brandes
OBJECTIVE: To determine the long-term impact of extravasation at initial post-urethroplasty urethrogram, we present a novel classification system and report the association of leak severity with outcome. MATERIALS AND METHODS: 91 patients underwent buccal graft urethroplasties of the bulbar urethra from 2007-2015. Median time to urethrogram was 23d. All leaks were characterized by length and width. Cutoffs for length and width were calculated using ROC curves. Each urethrogram was graded 0-3 (0=no leak) with one point given for any leak, length ≥1...
February 15, 2017: Urology
https://www.readbyqxmd.com/read/28213855/correction-of-residual-ventral-penile-curvature-after-division-of-the-urethral-plate-in-the-first-stage-of-a-2-stage-proximal-hypospadias-repair
#2
REVIEW
Bruce J Schlomer
PURPOSE OF REVIEW: The first stage of a 2-stage proximal hypospadias repair involves division of the urethral plate and correction of any residual ventral penile curvature (VPC). Options to correct residual VPC include dorsal corporal shortening or ventral corporal lengthening techniques. This review discusses these options and suggests an approach to management. RECENT FINDINGS: Recent reports of 2-stage proximal hypospadias repairs indicate low rates of recurrent VPC with either dorsal corporal shortening or ventral corporal lengthening...
February 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28208217/total-proximal-ureter-substitution-using-buccal-mucosa
#3
Omar Fahmy, Tina Schubert, Mohd Ghani Khairul-Asri, Arnulf Stenzl, Georgios Gakis
The surgical treatment of a long proximal ureteral stricture is a challenging situation for reconstructive surgeons. Despite the underlying morbidities, ileal interposition and autotransplantation are the options available to treat complex cases of long segment ureteral stricture. Buccal mucosa has shown excellent results in urethroplasty. However, its use in ureteral reconstruction is infrequent. We report on a 64-year-old female patient with multiple comorbidities and prior abdominal surgeries for Crohn's disease who underwent a successful total substitution of a long segment of the proximal ureter using buccal mucosa...
February 16, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28203286/direct-visual-internal-urethrotomy-for-isolated-post-urethroplasty-strictures-a-retrospective-analysis
#4
Elizabeth Timbrook Brown, Stephen Mock, Roger Dmochowski, W Stuart Reynolds, Douglas Milam, Melissa R Kaufman
BACKGROUND: Urethroplasty is often successful for the treatment of male urethral stricture disease, but limited data exists on recurrence management. Our goal was to evaluate direct visual internal urethrotomy (DVIU) as a treatment option for isolated, recurrent strictures after urethroplasty. METHODS: We retrospectively identified male patients who underwent urethroplasty from 1999 to 2013 and developed an isolated, recurrent stricture at the urethroplasty site treated with DVIU...
February 2017: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/28197032/double-breasting-spongioplasty-in-tubularized-tubularized-incise-plate-urethroplasty-a-new-technique
#5
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/28161405/neo-yoke-repair-for-severe-hypospadias-a-simple-modification-for-better-outcome
#6
Hamed M Seleim, Hani Morsi, Mohamed M Elbarbary
BACKGROUND: Although staged repair for reconstructing severe hypospadias is more popular, various one-stage repairs have been attempted. Koyanagi repair (parameatal-based and fully extended circumferential foreskin flap urethroplasty) has enabled correction of severe hypospadias in one stage. However, its un-acceptably high incidence of complications has initiated a series of technical modifications, including the "yoke" repair. OBJECTIVES: To retrospectively analyze the outcome of a proposed modification of the originally described yoke repair, for patients with severe hypospadias...
January 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28161353/experience-with-32-pelvic-fracture-urethral-defects-associated-with-urethrorectal-fistulas-transperineal-urethroplasty-with-gracilis-muscle-interposition
#7
Hailin Guo, Yinglong Sa, Qiang Fu, Chongrui Jin, Lin Wang
PURPOSE: Pelvic fracture urethral defects associated with urethrorectal fistulas are rare and difficult to repair. The aim of this study was to evaluate the efficacy of transperineal urethroplasty with gracilis muscle interposition for the repair of pelvic fracture urethral defects associated with urethrorectal fistulas. MATERIALS AND METHODS: Thirty-two patients who underwent transperineal urethroplasty with gracilis muscle interposition for the repair of pelvic fracture urethral defects associated with urethrorectal fistulas were identified...
February 1, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28131500/resurfacing-the-penis-of-complex-hypospadias-repair-hypospadias-cripples
#8
Mina M Fam, Moneer K Hanna
PURPOSE: After the creation of a neourethra in a "hypospadias cripple," resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred and unusable. We reviewed our experience with various strategies to resurface the penis of hypospadias cripples. MATERIALS AND METHODS: We retrospectively reviewed the records of 215 patients referred after multiple unsuccessful hypospadias repairs from 1981 to 2014. In 130 of 215 patients we performed resurfacing using local penile flaps using various techniques, including Byars flaps, Z-plasty or double Z-plasty, or a dorsal relaxing incision...
January 25, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28130178/urethral-stricture-outcomes-after-aus-cuff-erosion-results-from-a-multicenter-retrospective-analysis
#9
Martin S Gross, Joshua A Broghammer, Melissa R Kaufman, Douglas F Milam, William O Brant, Mario A Cleves, Travis W Dum, Christopher McClung, LeRoy A Jones, Jeffrey D Brady, Michael B Pryor, Gerard D Henry
OBJECTIVE: To evaluate the influence of both repair type and degree of cuff erosion on post-operative urethral stricture rate. Sparse literature exists regarding patient outcomes after artificial urinary sphincter (AUS) cuff erosion. Surgeons from six high-volume male continence centers compiled a comprehensive database of post-erosion patients to examine outcomes. MATERIALS AND METHODS: This retrospective multi-institution study included 80 patients treated for AUS cuff erosions...
January 24, 2017: Urology
https://www.readbyqxmd.com/read/28128915/assessment-of-satisfaction-and-quality-of-life-using-self-reported-questionnaires-after-urethroplasty-a-prospective-analysis
#10
Eduardo Terra Lucas, Walter José Koff, Tiago Elias Rosito, Milton Berger, Tiago Bortolini, Brasil Silva Neto
OBJECTIVES: To assess patient satisfaction and quality of life after urethroplasty using two different self-reported outcome measures and to compare it with objective clinical data. MATERIALS AND METHODS: We prospectively collected data from 35 consecutive patients who underwent urethroplasty from January 2013 to September 2014. Patient demographics, International Prostate Symptom Score (IPSS), quality of life score, urethral stricture surgery patient-reported outcome measure (USS-PROM), maximum flow rate (Qmax) and post-void residual urine were collected before, two and eight months after surgery...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28117233/-analysis-of-success-rates-of-uretroplasty-for-adult-male-bulbar-urethral-stricture-a-systematic-review
#11
E Robine, J Rigaud, F Luyckx, Q-C Le Clerc, F-X Madec, O Bouchot, J Branchereau
: Male urethral stricture disease is prevalent and has an important impact on quality of life. Direct visual urethrotomy and dilatations have high rates of recurrence. OBJECTIVES: The aim of this review of literature was to evaluate the success rates of different techniques of urethroplasty for strictures of the bulbar urethra. METHODS: We performed a systematic review of the MEDLINE literature from 2004 to 2015 following the PRISMA's statement recommendations...
February 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28111208/outcome-of-urethroplasty-after-parenteral-testosterone-in-children-with-distal-hypospadias
#12
P Menon, K L N Rao, A Handu, L Balan, N Kakkar
INTRODUCTION: Pre-operative testosterone use in hypospadias surgery is known to increase penile dimensions and vascularity, which should facilitate tension-less formation of the urethral tube and tissue healing. However, androgens can have a negative effect on wound healing. There are very few randomized studies on postoperative results after androgen use, and this study attempted to understand the utility of pre-operative testosterone in distal hypospadias. OBJECTIVE: To study the effect of parenteral testosterone in children undergoing single stage urethroplasty for distal hypospadias, especially the occurrence of urethrocutaneous fistula and wound dehiscence...
January 11, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28102436/-urethral-stricture-rate-after-prostate-cancer-radiotherapy-five-year-data-of-a-certified-prostate-cancer-center
#13
J Kranz, G Maurer, U Maurer, O Deserno, S Schulte, J Steffens
BACKGROUND: A urethral stricture is a scar of the urethral epithelium which can cause obstructive voiding dysfunction with consequential damage of the upper urinary tract. Almost 45% of all strictures are iatrogenic; they develop in 2-9% of patients after radical prostatectomy, but can also occur after prostate cancer radiotherapy. This study provides 5‑year data of a certified prostate cancer center (PKZ) in terms of urethral strictures. MATERIALS AND METHODS: Between 01/2008 and 12/2012 a total of 519 men were irradiated for prostate cancer (LDR and HDR brachytherapy as well as external beam radiation)...
January 19, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28096926/congenital-anterior-urethral-diverticulum-presenting-as-a-scrotal-mass-in-a-two-year-old-child
#14
Ali Gürağaç, Hasan Cem Irkilata, Nahit Yunusov, Zafer Demirer
Here, we describe a case of congenital anterior urethral diverticulum (CAUD) in a two-year-old boy, who presented with right inguinoscrotal swelling that mimicked a spermatic cord cyst or hydrocele. Accurate diagnosis was made intraoperatively by retrograde urethrography. Open diverticulectomy and primary urethroplasty were performed for its management. The clinical presentation, diagnosis, and the management of this rare condition is discussed.
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28089110/recurrence-after-management-of-meatal-balanitis-xerotica-obliterans
#15
Warren Snodgrass, Juan Soto Blanquel, Nicol Corbin Bush
INTRODUCTION: We review outcomes after management of meatal balanitis xerotica obliterans (BXO). The primary outcome was recurrent meatal BXO. METHODS: A database comprising mostly hypospadias patients was queried for meatal BXO. The disease was confirmed histologically in all cases. Management included topical steroids and/or immunosuppressants, and/or surgical excision of BXO with two-stage oral mucosa graft circumferential replacement urethroplasty. RESULTS: A total of 12 patients had meatal BXO (8 boys and 4 adults)...
November 23, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28073192/the-use-of-autologous-platelet-rich-plasma-gel-in-bulbar-and-penile-buccal-mucosa-urethroplasty-preliminary-report-of-our-first-series
#16
Marcello Scarcia, Francesco Paolo Maselli, Giuseppe Cardo, Giuseppe Mario Ludovico
OBJECTIVE: The Buccal Mucosa (BM) UrethroPlasty (UP) is one of the preferred treatments for long or compli-cated urethral strictures. We propose the use of autologous Platelet Rich Plasma gel (aPRPg) in order to enhance to vascularization of BM graft and reduce the fibrous spongy. We report the outcome of our ten cases of bulbar and penile UP and the safety of this technique. Materials and metods: Ten patients underwent to BM UP with use of aPRP gel. Median age was 46. Stricture etiology was idiopathic, failed hypospadias and flogistic...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28065809/chordee-and-penile-shortening-rather-than-voiding-function-are-associated-with-patient-dissatisfaction-after-urethroplasty
#17
Conrad C Maciejewski, Trevor Haines, Keith F Rourke
OBJECTIVE: To identify factors that predict patient satisfaction after urethroplasty by prospectively examining patient-reported quality of life scores using three validated instruments. METHODS: A three-part prospective survey consisting of IPSS, IIEF, and a urethroplasty Quality of Life survey was completed by patients undergoing urethroplasty preoperatively and at 6 months postoperatively. The quality of life score included questions on genitourinary pain, urinary tract infection, post-void dribbling, chordee, shortening, overall satisfaction, and overall health...
January 5, 2017: Urology
https://www.readbyqxmd.com/read/28058001/primary-tuberculosis-of-urethra-presenting-as-stricture-urethra-and-watering-can-perineum-a-rarity
#18
Gaurav Prakash, Vishwajeet Singh, Rahul Janak Sinha, Suresh Babu, Ankur Jhanwar, C N Mehrotra
A young man presented with irritative lower urinary tract symptoms and multiple fistulae (watering can) in the perineum since 6 months. Micturating cystourethrogram and retrograde urethrogram was performed after 12 weeks following suprapubic cystostomy which showed bulbar urethral stricture with multiple urethrocutaneous fistulae. He underwent anastomotic urethroplasty and excision of the urethrocutaneous fistulae. Histopathology of the excised fistulous tract showed granulomatous pathology suggestive of tuberculosis...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28057997/male-urethral-diverticulum-uncommon-entity-our-experience
#19
Naveen Thakur, Vilas Pandurang Sabale, Deepak Mane, Abhirudra Mullay
Out pouching of the urethral wall could be congenital or acquired. Male urethral diverticulum (UD) is a rare entity. We present 2 cases of acquired and 1 case of congenital male UD. Case 1A: 40 year male presented with SPC and dribbling urine. Clinically he had hard perineal swelling. RGU revealed large diverticulum in proximal bulbar, irregular narrow distal urethra and stricture just beyond diverticulum. Managed with perineal exploration, stone removal, diverticulum repair and urethroplasty using excess diverticular wall...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28051050/our-experience-of-proximal-hypospadias-repair-using-the-cloutier-bracka-technique-at-the-gynaeco-obstetric-and-paediatric-hospital-yaounde-cameroon
#20
Mouafo Tambo Faustin Felicien, A S Nwaha Makon, C Kamadjou, G Fossi, C Le Coultre, O G Andze, M A Sosso, P Y Mure
BACKGROUND: In parts of Africa, routine circumcision is practised and sometimes even on children with hypospadias. The lack of preputial foreskin renders urethroplasty more difficult and often requires to use of a mucosal graft as described by Bracka. OBJECTIVE: The authors describe their experience of hypospadias repair using Bracka's technique. MATERIALS AND METHODS: Over a period of 5 years, 100 cases of proximal hypospadias were operated in our institution...
October 2016: African Journal of Paediatric Surgery: AJPS
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