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Joceline S Liu, Matthew I Bury, Natalie J Fuller, Renea M Sturm, Nida Ahmad, Arun K Sharma
Substitution urethroplasty for the treatment of male stricture disease is often accompanied by subsequent tissue fibrosis and secondary stricture formation. Patients with pre-existing morbidities are often at increased risk of urethral stricture recurrence brought upon in-part by delayed vascularization accompanied by overactive inflammatory responses following surgery. Within the context of this study, we demonstrate the functional utility of a cell/scaffold composite graft comprised of human bone marrow-derived mesenchymal stem cells (MSC) combined with CD34+ hematopoietic stem/progenitor cells (HSPC) to modulate inflammation and wound healing in a rodent model of substitution urethroplasty...
October 20, 2016: Scientific Reports
Ricardo Sol Melgar, Daniela Gorduza, Delphine Demède, Pierre Mouriquand
OBJECTIVE: The aim was to describe the clinical presentation and the surgical management of penile epispadias associated with a buried penis in five children. PATIENTS AND METHODS: This is a 5-year retrospective review of patients presenting with a buried penis, a congenital defect of the penile skin shaft associated with an unretractable foreskin for whom a penile epispadias was found at the time of surgery. All had undergone surgery combining a Cantwell-Ransley procedure and refashioning of the penile skin following the authors' technique...
September 18, 2016: Journal of Pediatric Urology
Depinder Kaur, Saurabh Anand
BACKGROUND: Efficacy of caudal bupivacaine plus ketamine on postoperative pain in children. AIMS: The aim of this study was to compare the analgesic efficacy and safety of caudal block with mixture of bupivacaine and ketamine to bupivacaine alone for postoperative analgesia in pediatric patients undergoing infraumbilical surgery. SETTINGS AND DESIGN: A prospective randomized study was conducted in a tertiary care teaching hospital. STATISTICAL ANALYSIS: Data were collected; mean value and standard deviation were computed for age, weight, duration of surgery, and duration of analgesia...
September 2016: Anesthesia, Essays and Researches
K L M Pfistermüller, S Manoharan, D Desai, P M Cuckow
INTRODUCTION: Repair of severe primary and revision hypospadias is a demanding procedure. Debate continues as to whether a two-stage approach or single-stage technique is superior. The two-stage procedure with a free graft involves penile straightening followed by application of a graft for the neourethral plate at stage one; with tubularization at stage two after graft maturation. OBJECTIVE: To report the outcomes of a single surgeon's experience with the two-stage repair using a free graft for both severe primary and revision hypospadias with long-term follow-up...
September 29, 2016: Journal of Pediatric Urology
Kamala Retnam Mayilvaganan, M Naren Satya Srinivas, Vikram N Reddy, Ranjeet Kumar Singh
BACKGROUND: A 'watering can penis' secondary to penile tuberculosis is an extremely rare clinical entity. Retrograde Urethrography - Voiding Cystourethrography evaluation of the urethra and the urinary bladder plays a very important role in the diagnostics as well as further management of the urethral abnormalities. To the best of our knowledge, this is only the second case in literature where a 'watering can penis' was noted secondary to penile TB. This is also the first documented case of 'watering can penis' as a consequence of venereal transmission of TB...
2016: Polish Journal of Radiology
Chen Shuzhu, Wu Min, Liu Yidong, Ye Weijing
BACKGROUND: Over the past two decades, Snodgrass tubularized incised plate (TIP) urethroplasty has become one of the dominant surgical techniques with wide applications and excellent cosmetic results. However, TIP has many limitations. We performed a retrospective study at our department and assessed the outcome of the inlay internal preputial graft for extending the applications of TIP. METHODS: Between January 2009 and December 2013, we performed a retrospective study consisting of approximately 508 primary distal and moderate cases...
2016: SpringerPlus
Jordan A Siegel, Allen F Morey
No abstract text is available yet for this article.
September 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
M Spilotros, S Malde, E Solomon, M Grewal, B M Mukhtar, M Pakzad, R Hamid, J L Ockrim, T J Greenwell
PURPOSE: To report the etiology, presenting symptoms and outcomes of the different treatments performed in female patients with recurrent urethral stricture. MATERIALS AND METHODS: Twenty-six patients with refractory LUTS were diagnosed with a urethral stricture. The symptoms, the treatment performed and the outcomes were prospectively recorded. Sixteen patients were treated with a urethroplasty using a buccal mucosal graft (BMG) in 14 cases (54 %) and a vaginal flap in 2 (8 %)...
October 4, 2016: World Journal of Urology
Kirtikumar Rathod, Jaskiren Loyal, Bharat More, Ashok Rajimwale
BACKGROUND: To describe a modification of PATIO repair for urethrocutaneous fistula repair and evaluate its outcome. METHODS: We studied 15 boys who underwent modified PATIO repair from Jan 2010 to Sept 2015. Parameters studied included age, type of hypospadias, age at first urethroplasty, hypospadias repair technique, number of urethroplasties required, location of fistula, time gap between urethroplasty and fistula repair, method of fistula repair, and outcome of fistula repair...
October 1, 2016: Pediatric Surgery International
Jesús Romero-Maroto, Lidia Verdú-Verdú, Luis Gómez-Pérez, Carla Pérez-Tomás, Juan-José Pacheco-Bru, Ana López-López
BACKGROUND: Female urethral stricture is a rare condition. Different types of urethroplasty have been described. However, high quality studies are sparse. The most common technique used-the Blandy's technique-has resulted in our cases in a retrusive meatus and an inward urinary stream. OBJECTIVE: To show the efficacy and safety of an alternative vaginal wall flap urethroplasty. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional observational study was undertaken in a single University Hospital...
September 27, 2016: European Urology
Ariel Fredrick, Bradley A Erickson, Kristian Stensland, Alex J Vanni
INTRODUCTION AND OBJECTIVES: Bulbar urethroplasty outcomes studies have shown low, but significant, rates of post- void dribbling (PVD) and ejaculatory dysfunction. The bulbospongiosus muscle is involved with expulsion of seminal fluid and urine from the bulbar urethra, and thus we hypothesized that performing urethroplasty utilizing a technique that does not split the muscle may result in better post-operative patient reported ejaculatory function (EF) and less PVD. METHODS: We performed a multi-institutional matched, case-control analysis comparing men who underwent a bulbospongiosus sparing (BS) technique to men that had undergone the traditional non-bulbospongiosus sparing (non-BS) technique...
September 26, 2016: Journal of Urology
Ryo Sueyoshi, Shogo Seo, Takanori Ochi, Hiroshi Murakami, Yuta Yazaki, Masahiro Takeda, Hiroki Nakamura, Geoffrey J Lane, Atsuyuki Yamataka
PURPOSE: CHARGE is our technique for reinforcing the ventral penile shaft with pedicled pericordal/scrotal fat, pedicled perimeatal connective tissue, or a combination of these at the time of initial hypospadias surgery. Such pedicled grafts "charge" poorly developed urethral plates and thin ventral foreskin prior to urethroplasty to improve compromised vascular perfusion that could prevent post-urethroplasty complications (post-UPC). METHODS: We reviewed post-UPC in 179 staged hypospadias repair patients (1997-2015)...
September 16, 2016: Journal of Pediatric Surgery
Ricardo Marcondes de Mattos, Sérgio R R de Araújo, Juliany Gomes Quitzan, Bruno Leslie, Herick Bacelar, João Luiz Gomes Parizi, Gustavo Marconi Caetano Martins, Marcela Leal da Cruz, Antonio Macedo
PURPOSE: To develop a rabbit experimental study to test the hypothesis that surgical repair of hypospadias with severe ventral curvatures might be completed in one stage, if a graft, such as buccal mucosa, could be placed over the tunica vaginalis flap used in corporoplasty for ventral lengthening, with the addition of an onlay preputial island. flap to complete the urethroplasty. MATERIALS AND METHODS: The experimental procedure with rabbits included a tunica vaginalis flap for reconstruction of the corpora after corporotomy, simulating a ventral lengthening operation...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Cuneyd Sevinc, Muhsin Balaban, Orkunt Ozkaptan, Necmettin Kutlu, Tahir Karadeniz
The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes...
September 2016: Kaohsiung Journal of Medical Sciences
Sundaramoorthy Vijayganapathy, Ashwin Mallya, Vilvapathy Senguttuvan Karthikeyan, Jayaram Sreenivas
The penile circular fasciocutaneous flap (FCF) is employed in the successful single stage reconstruction of long segment complex anterior urethral strictures especially when buccal mucosa is unavailable due to various reasons. A 65-year-old gentleman, chronic smoker and tobacco chewer, hypertensive on treatment, presented with obstructive lower urinary tract symptoms for 8 months. He had no prior urethral catheterization. On examination, he had circumcised penis, with stenosis of the external urethral meatus...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Nobuyuki Mitsukawa, Yoshitaka Kubota, Shinsuke Akita, Masakazu Hasegawa, Atsuomi Saiga, Kaneshige Satoh
CASE: The patient was a 3-year-old with hypospadias. Urethroplasty was performed as a two-stage procedure, but a severe urethral stricture occurred due to a postoperative infection and the patient was virtually in urinary retention. An emergency cystostomy was performed, and thereafter urethral reconstruction was performed. A large urethral diverticulum had formed in the scrotum. The inner wall of the diverticulum was found to be completely epithelialized and well vascularized. Therefore, it was elevated as a skin flap and a neourethra was reconstructed up to the glans region using the diverticular tissue...
September 2016: Lower Urinary Tract Symptoms
L Cogorno Wasylkowski, E Ríos González, L Martínez-Piñeiro Lorenzo
This article presents a review of the different tests used for the evaluation and follow-up of urethral strictures. Because there is no consensus on how to assess urethral pathology, we reviewed each of the next follow-up tests: questionnaires, uroflowmetry, ultrasound, urethroscopy, urethrogram, CT scan and MRI, outlining their benefits and limitations in the diagnosis and follow-up of urethral stricture. Urethrogram and urethroscopy are the most commonly used tests, as they are those that give us more information on the evaluation of stenosis and for surgery planning...
September 2016: Archivos Españoles de Urología
Farzaneh Sharifiaghdas, Azar Daneshpajooh, Samira Sohbati, Mahboubeh Mirzaei
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare anomaly in women and is characterized by congenital aplasia of the uterus and vagina, with normal development of secondary sexual characteristics and a normal karyotype. We report a case of a 38-year-old women with MRKH syndrome that had experienced urethral sex for many years. She presented with urinary incontinence and dyspareunia. The patient's secondary sexual characteristics were normal, and examination revealed a widely open incompetent megalourethra and an absent vagina...
September 2016: Investigative and Clinical Urology
Mang L Chen, Andres F Correa, Richard A Santucci
The number of patients with prostate cancer and benign prostatic hyperplasia is on the rise. As a result, the volume of prostate treatment and treatment-related complications is also increasing. Urethral strictures and stenoses are relatively common complications that require individualized management based on the length and location of the obstruction, and the patient's overall health, and goals of care. In general, less invasive options such as dilation and urethrotomy are preferred as first-line therapy, followed by more invasive substitution, flap, and anastomotic urethroplasty...
2016: Reviews in Urology
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