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https://www.readbyqxmd.com/read/27912972/fate-of-males-with-urethral-y-duplication-40-year-long-follow-up-in-8-patients
#1
Mario Lima, Francesca Destro, Neil Di Salvo, Tommaso Gargano, Giovanni Ruggeri
PURPOSE: The spectrum of male urethral duplication is heterogeneous and it includes the Y-duplication. The malformation is rare and there is only a few case series reported in the literature. The management of Y-forms remains challenging for the surgeon and the long-term follow-up is still scarcely investigated. We report our 40-year experience in the management of patients with Y-duplication. MATERIALS AND METHODS: We conducted a restrospective analysis collecting information of patients with urethral Y-duplication treated at our department from April 1975 to April 2015...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27908375/treatment-of-radiation-induced-urethral-strictures
#2
REVIEW
Matthias D Hofer, Joceline S Liu, Allen F Morey
Radiation therapy may result in urethral strictures from vascular damage. Most radiation-induced urethral strictures occur in the bulbomembranous junction, and urinary incontinence may result as a consequence of treatment. Radiation therapy may compromise reconstruction due to poor tissue healing and radionecrosis. Excision and primary anastomosis is the preferred urethroplasty technique for radiation-induced urethral stricture. Principles of posterior urethroplasty for trauma may be applied to the treatment of radiation-induced urethral strictures...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908374/effect-of-lichen-sclerosis-on-success-of-urethroplasty
#3
REVIEW
Michael A Granieri, Andrew C Peterson, Ramiro J Madden-Fuentes
Lichen sclerosis (LS) is a chronic, relapsing disease with a variable presentation. In men, genitourinary LS may affect the penile foreskin, glans, meatus, and urethra. Treatment is multifaceted, ranging from pharmacotherapy to surgery. Urethral reconstruction due to stricture disease from LS is frequently plagued by a high recurrence rate. At the authors' institution, the high recurrence rate has shifted their practice toward potent steroids and minimally invasive surgical techniques. Management of recurrence includes dilation, meatotomy/meatoplasty, 1-stage and 2-stage repairs...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908372/the-nontransecting-approach-to-bulbar-urethroplasty
#4
REVIEW
Stella Ivaz, Simon Bugeja, Anastasia Frost, Daniela Andrich, Anthony R Mundy
The standard treatment of bulbar urethral strictures of appropriate length is excision and primary anastomosis (EPA), irrespective of the cause of the stricture. This involves transection of the corpus spongiosum (CS) and disruption of the blood flow within the CS as a consequence. The success rate of EPA in curing these strictures is very high, but there is a considerable body of evidence and of opinion to suggest that there is a significant risk of sexual dysfunction and, potentially, of other adverse consequences that occur because of transection of the CS...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908371/sexual-dysfunction-after-urethroplasty
#5
REVIEW
Prem Nath Dogra, Prabhjot Singh, Rishi Nayyar, Siddharth Yadav
Posturethroplasty sexual dysfunction (SD) is multifactorial and its true incidence is unknown. Even with the current evidence suggesting that it is uncommon, de novo SD causes dissatisfaction even after a successful surgery. Posterior urethroplasty carries the highest chance of SD, mostly attributable to the pelvic fracture itself rather than the urethroplasty. With anterior urethroplasty, transecting bulbar urethroplasty leads to greater SD compared with penile or nontransecting bulbar urethroplasty. Most patients with posturethroplasty SD recover within 6 months after surgery...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908370/graft-use-in-bulbar-urethroplasty
#6
REVIEW
Mya E Levy, Sean P Elliott
The gold standard for bulbar urethroplasty has been excision and primary anastomosis. Application of this approach is generally limited to strictures that are 2 cm or less in the bulbar urethra due to penile shortening. Strictures greater than 2 cm are successfully treated with augmentation urethroplasty wherein the narrowed segment is not excised but widened with the use of a skin flap or a tissue graft. Buccal mucosa is the most prevalent tissue for bulbar urethral stricture repair for strictures greater than 2 cm...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908369/patient-selection-for-urethroplasty-technique-excision-and-primary-reanastomosis-versus-graft
#7
REVIEW
Judith C Hagedorn, Bryan B Voelzke
There are many management options for patients with urethral stricture disease. Regarding strictures of the bulbar urethra, ideal management strategies remain controversial. This article reviews important anatomic principles for surgeons to consider when repairing bulbar urethral strictures. Specific presenting features of a bulbar urethral stricture that can serve as a guide for the optimal surgical approach are described. Patient characteristics that are important and may have an impact on the outcome of repair are discussed...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908367/use-of-alternative-techniques-and-grafts-in-urethroplasty
#8
REVIEW
Brendan Michael Browne, Alex J Vanni
The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (eg, pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (eg, heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures. This article reviews the current state of alternate techniques for urethral stricture treatment besides buccal mucosa, including injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908365/cost-effective-strategies-for-the-management-and-treatment-of-urethral-stricture-disease
#9
REVIEW
E Charles Osterberg, Gregory Murphy, Catherine R Harris, Benjamin N Breyer
Following failed endoscopic intervention, the most cost-effective strategy for recurrent urethral stricture disease (USD) is urethroplasty. Inpatient hospital costs associated with urethroplasty are driven by patient comorbidities and postoperative complications. Symptom-based surveillance for USD recurrence will reduce unnecessary diagnostic procedures and cost.
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908364/management-of-urethral-strictures-after-hypospadias-repair
#10
REVIEW
Warren T Snodgrass, Nicol C Bush
Strictures of the neourethra after hypospadias surgery are more common after skin flap repairs than urethral plate or neo-plate tubularizations. The diagnosis of stricture after hypospadias repair is suspected based on symptoms of stranguria, urinary retention, and/or urinary tract infection. It is confirmed by urethroscopy during anticipated repair, without preoperative urethrography. The most common repairs for neourethra stricture after hypospadias surgery are single-stage dorsal inlay graft and 2-stage labial mucosa replacement urethroplasty...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908363/definition-of-successful-treatment-and-optimal-follow-up-after-urethral-reconstruction-for-urethral-stricture-disease
#11
REVIEW
Bradley A Erickson, George M Ghareeb
The definition of a successful urethroplasty, the lack of need for a secondary procedure, is outdated and must be amended to incorporate objective and subjective outcomes. Success is assigned if a flexible cystoscope can traverse the reconstructed urethra without force. Functional success is assigned if patient-reported outcome measures reveal improvement in voiding symptoms and urinary quality of life. Optimal follow-up strategy allows determination of anatomic and functional outcomes, protects genitourinary health, and prevents excessive invasive testing, unnecessary cost, discomfort, anxiety, and risk...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27904649/fasciocutaneous-flap-reinforcement-of-ventral-onlay-buccal-mucosa-grafts-enables-neophallus-revision-urethroplasty
#12
Stelios C Wilson, John T Stranix, Kiranpreet Khurana, Shane D Morrison, Jamie P Levine, Lee C Zhao
BACKGROUND: Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We report our experience with local fasciocutaneous flaps for support of ventrally-placed buccal mucosal grafts (BMGs) in phalloplasty. METHODS: A retrospective review of patients who underwent phalloplasty and subsequently required revision urethroplasty using BMGs between 2011 and 2015 was completed...
December 2016: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/27900223/modified-one-stage-dorsal-inlay-buccal-mucosa-graft-technique-for-ventral-penile-urethral-and-penile-skin-erosion-a-step-by-step-guide
#13
Lennert Van Putte, Gunter De Win
OBJECTIVE: To demonstrate the use of a modified single-stage technique for the repair of a ventral penile urethral erosion with involvement of the penile skin, as penile urethral erosion is a rare but potential complication of chronic indwelling catheterisation with a lack of available recommendations for reconstructive options. PATIENT AND METHODS: A 44-year-old male with paraplegia, neurogenic bladder dysfunction and chronic sacral decubitus, presented with a large mid-penile erosion of the ventral penile shaft and urethra, which was caused by chronic transurethral indwelling catheterisation while being hospitalised in an intensive care unit...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27900221/grafted-tubularised-incised-plate-urethroplasty-an-objective-assessment-of-outcome-with-lessons-learnt-from-surgical-experience-with-263-cases
#14
Vipul Gupta, Sunil Kumar Yadav, Talal Alanzi, Islam Amer, Mohmmad Salah, Mamdouh Ahmed
OBJECTIVE: Snodgrass urethroplasty remains the preferred technique in primary distal hypospadias but development of meatal stenosis often limits distal extension of the midline incision of the urethral plate (MIUP), which remains a limiting factor in reconstructing an apical neomeatus (NM). We here-in assess the cosmetic and functional outcome with distal extension of the MIUP in grafted tubularised incised-plate urethroplasty (G-TIP) repair. PATIENTS AND METHODS: This prospective study included the surgical experience of 263 cases of primary hypospadias operated upon between 2012 and 2015...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27889218/single-stage-urethroplasty-for-perineal-hypospadias-in-a-horse-a-case-report
#15
Jade Harrison, Imran Mushtaq
INTRODUCTION: Within the veterinary world, data regarding the surgical management of hypospadias is lacking. Reports within equines have documented resective phallectomy procedures rather than urethral reconstruction. This case report documents the first ever urethroplasty for an equine hypospadias, performed by a consultant paediatric surgeon. The urethroplasty was achieved by applying the same surgical principles mastered from paediatric urology to a horse. The indication for surgery was contact dermatitis of the hind-leg, which impaired the thoroughbred foal's racing potential...
November 9, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27887909/modified-tubularized-incised-plate-urethroplasty-in-distal-hypospadias-repair-stepwise-technique-with-validated-functional-and-cosmetic-outcome
#16
A-F Spinoit, A Radford, J Ashraf, M Gopal, R Subramaniam
OBJECTIVE: To describe modification of the tubularized incised plate urethroplasty (TIP) for distal hypospadias, and assess its efficacy, and functional and cosmetic outcomes. METHODS: A prospective evaluation of a consecutive series of patients operated for primary distal hypospadias was conducted at a tertiary reference center. A standardized modification of the TIP (mTIP) procedure was performed on a 10 French catheter. Clinical data were collected in a dedicated database...
October 31, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27845110/re-a-critical-evaluation-of-the-utility-of-imaging-after-urethroplasty-for-bulbar-urethral-stricture-disease
#17
Allen F Morey
No abstract text is available yet for this article.
December 2016: Journal of Urology
https://www.readbyqxmd.com/read/27844407/primary-non-transecting-bulbar-urethroplasty-long-term-success-rates-are-similar-to-transecting-urethroplasty
#18
Kirk M Anderson, Stephen A Blakely, Colin I O'Donnell, Dmitriy Nikolavsky, Brian J Flynn
OBJECTIVES: To review the long-term outcomes of transecting versus non-transecting urethroplasty to repair bulbar urethral strictures. METHODS: A retrospective review was conducted of 342 patients who underwent anterior urethroplasty performed by a single surgeon from 2003 to 2014. Patients were excluded from further analysis if there had been prior urethroplasty, stricture location outside the bulbous urethra, or age <18 years. In the transecting group, surgical techniques used included excision and primary anastomosis and augmented anastomotic urethroplasty...
November 14, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27843271/impact-of-preoperative-patient-characteristics-on-posturethroplasty-recurrence-the-significance-of-stricture-length-and-prior-treatments
#19
Jibril Oyekunle Bello
INTRODUCTION: Urethral strictures are common in urologic practice of Sub-Saharan Africa including Nigeria. We determine the rate of stricture recurrence following urethroplasty for anterior urethral strictures and evaluate preoperative variables that predict of stricture recurrence in our practice. SUBJECTS AND METHODS: Thirty-six men who had urethroplasty for proven anterior urethral stricture disease between February 2012 and January 2015 were retrospectively analyzed...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/27843181/erectile-dysfunction-in-anterior-urethral-strictures-after-urethroplasty-with-reference-to-vascular-parameters
#20
Soumya Mondal, Anindya Bandyopadhyay, Murari Mohan Mandal, Dilip Kumar Pal
BACKGROUND: Relation of erectile dysfunction (ED) with urethroplasty has long been a subject of debate. Very few studies on subcontinent population are available in this regard and still rarer are studies assessing vascular parameters of ED following urethroplasty. The objective of the study was to assess the incidence and prevalence of ED in patients of urethral stricture disease, and to find out effect of urethroplasty on ED after six months of operation including vasculogenic aetiology after operation...
October 2016: Medical Journal, Armed Forces India
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