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Urethroplasty

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https://www.readbyqxmd.com/read/28286073/intermediate-term-outcomes-and-complications-of-long-segment-urethroplasty-with-lingual-mucosa-grafts
#1
Yue-Min Xu, Chao Li, Hong Xie, Ying-Long Sa, Qiang Fu, Deng-Long Wu, Jiong Zhang, Chao Feng, Chong-Rui Jin, Lu-Jie Song, Hong-Bin Li, Ying Liu
PURPOSE: We evaluated the outcomes and donor site complications of male patients with complex urethral strictures (CUS) that underwent urethroplasty by using with long-strip oral mucosal grafts (OMGs). The study analyzed whether lingual mucosa graft (LMG) is a good substitute for repairing long segment urethral strictures. MATERIALS AND METHODS: This was a retrospective study of 81 male patients with CUS that underwent OMGs urethroplasty. Patients with long segment anterior urethral strictures(≥8 cm)that were considered for long-strip LMG urethroplasty were included in the study...
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
#2
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/28263822/low-testosterone-levels-result-in-decreased-periurethral-vascularity-via-an-androgen-receptor-mediated-process-pilot-study-in-urethral-stricture-tissue
#3
Matthias D Hofer, Payal Kapur, Billy H Cordon, Farrah Hamoun, David Russell, Jeremy M Scott, Claus G Roehrborn, Allen F Morey
OBJECTIVE: To compare expression of androgen receptor (AR) and angiopoietin 1 receptor TIE-2 and vessel density of urethral stricture tissue among eugonadal and hypogonadal men to identify a pathophysiological basis for our observations that low testosterone is associated with urethral atrophy. METHODS: Among 1200 men having urethroplasty at our institution, we retrospectively identified 11 patients with testosterone levels drawn within 2 years of surgery. Low testosterone was defined as <280 ng/dL and detected in 5 of 11 (45...
March 2, 2017: Urology
https://www.readbyqxmd.com/read/28248029/-large-urethral-stones-a-case-report
#4
O V Teodorovich, A V Krasnov, M N Shatokhin, G G Borisenko, M I Abdullaev
The article describes a clinical observation of a 68 y/o patient with large stones of the urethra, reaching 5 cm in length and located in the penile urethra. The patient underwent a three-stage treatment: the first stage consisted of drainage of the urinary bladder, the second stage of the urethrolithotomy and a double-barreled fistula, the third was an anastomotic urethroplasty. After removing the cystostomic drainage tube, normal urination was restored.
November 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28248017/-quality-of-life-as-an-effectiveness-criterion-of-surgical-treatment-for-anterior-urethral-strictures
#5
A N Shibaev, V V Bazaev, Yu V Pavlova
RELEVANCE: Recent trends in the contemporary medicine have shown a growing request for the personalized choice of treatment and evaluation of its results. PROM-USS questionnaire has been designed for patients undergoing surgical correction of anterior urethral strictures to measure the treatment success using patient reported outcomes in numerical terms. AIM: To test the effectiveness of different surgical modalities for anterior urethral strictures using patient reported outcomes...
November 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28229209/cost-effective-management-of-pelvic-fracture-urethral-injuries
#6
Niels V Johnsen, David F Penson, W Stuart Reynolds, Douglas F Milam, Roger R Dmochowski, Melissa R Kaufman
PURPOSE: To compare the cost-effectiveness of various treatment strategies in the management of pelvic fracture urethral injuries using decision analysis. METHODS: Five strategies were modeled from the time of injury to resolution of obstructed voiding or progression to urethroplasty. Management consisted of immediate suprapubic tube (SPT) placement and delayed urethroplasty; primary endoscopic realignment (PER) followed by urethroplasty in failed patients; or PER followed by 1-3 direct vision internal urethrotomies (DVIU), followed by urethroplasty...
February 22, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28220592/turkish-validation-of-the-urethral-stricture-surgery-specific-patient-reported-outcome-measure-uss-prom-with-supplemental-assessment-of-erectile-function-and-morbidity-due-to-oral-graft-harvesting
#7
Fikret Fatih Önol, Ahmet Bindayi, Ahmet Tahra, Ismail Basibuyuk, Sinasi Yavuz Onol
AIMS: We validated a Turkish language version of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) in men undergoing anterior urethroplasty. We also investigated changes in erectile function (EF) and quality of life (QoL) due to oral mucosa graft (OMG) harvesting. METHODS: The USS-PROM captures lower urinary tract symptoms (LUTS), health related QoL (HRQoL) with EQ-5D visual analogue scale (EQ-VAS). To evaluate EF and OMG morbidity, we used International Index of Erectile Function (IIEF-5) and a self-completed questionnaire, respectively...
February 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28216923/direct-visual-internal-urethrotomy-is-it-a-durable-treatment-option
#8
Dilip Kumar Pal, Sanjay Kumar, Bastab Ghosh
OBJECTIVE: To evaluate the long-term success rate of direct vision internal urethrotomy as a treatment for anterior urethral strictures. MATERIALS AND METHODS: We retrospectively analyzed the results for patients who underwent internal urethrotomy from January 2009 to January 2014 for anterior urethral strictures. Patients were followed till January 2016. Patients with complicated urethral strictures with a history of previous urethroplasty, hypospadias repair, or previous radiation were excluded from the study, as anticipated low success rate of direct visual internal urethrotomy (DVIU) in these patients...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28214570/routine-urethrograpy-after-buccal-graft-bulbar-urethroplasty-the-impact-of-initial-urethral-leak-on-surgical-success
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
March 2017: Journal of Urology
https://www.readbyqxmd.com/read/28130178/urethral-stricture-outcomes-after-aus-cuff-erosion-results-from-a-multicenter-retrospective-analysis
#17
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
#18
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...
March 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
#19
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. Key words were: urethroplasty, urethral reconstruction, onlay, graft, urethral stricture...
February 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28111208/outcome-of-urethroplasty-after-parenteral-testosterone-in-children-with-distal-hypospadias
#20
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
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