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Urethral reconstruction

Kyle Scarberry, José Bonomo, Reynaldo G Gómez
OBJECTIVES: To compare outcomes with early versus delayed reconstruction following pelvic fracture urethral injury (PFUI) to determine if a traditional 3-month delay is necessary. This delay has been advocated to allow resolution of traumatic inflammation and hematoma but has never been validated. We proceed to reconstruction at 3-6 weeks if the associated injuries are stable, the perineum is soft on rectal palpation, and the fracture is stable for lithotomy positioning. METHODS: PFUI patients treated with a suprapubic tube and delayed urethroplasty from October 1991 to August 2016 were included...
March 12, 2018: Urology
Richard J Wood, Carlos A Reck-Burneo, Daniel Dajusta, Christina Ching, Rama Jayanthi, D Gregory Bates, Molly E Fuchs, Katherine McCracken, Geri Hewitt, Marc A Levitt
No abstract text is available yet for this article.
March 2018: Journal of Pediatric Surgery
Stephanie J Sexton, Michael A Granieri, Aaron C Lentz
BACKGROUND: Intraoperative urethral injury is an uncommon event during the placement of a penile prosthesis, and alternative management strategies have been proposed with continuation of implantation after urethral injury. AIM: To evaluate surgeon practices in the management of intraoperative urethral injury. METHODS: An online survey was sent to the society listservs of the Genitourinary Reconstructive Surgeons (GURS) and the Sexual Medicine Society of North America (SMSNA)...
March 6, 2018: Journal of Sexual Medicine
Rakesh S Joshi, Dhirendra Shrivastava, Richard Grady, Anjana Kundu, Jaishri Ramji, Pramod P Reddy, Joao Luiz Pippi-Salle, Jennifer R Frazier, Douglas A Canning, Aseem R Shukla
Importance: International collaboration to alleviate the massive burden of surgical disease is recognized by World Health Organization as an urgent need, yet the surgical mission model to treat reconstructive surgical challenges is often constrained in ensuring adequate patient follow-up, optimal outcomes, and sustainability. Objective: To determine whether a collaboration predicated on long-term commitment by surgeons returning to the same institution annually combined with an experienced host surgical team and infrastructure to ensure sustained patient follow-up could provide surgical care with acceptable outcomes to treat bladder exstrophy-epispadias complex (BE) and penopubic epispadias (PE)...
March 7, 2018: JAMA Surgery
Ameeta L Nayak, Ilias Cagiannos, Luke T Lavallée, Chris Morash, Duane Hickling, Ranjeeta Mallick, Rodney H Breau
INTRODUCTION: An orthotopic neobladder urinary diversion aims to minimize the physical and psychological effects of radical cystectomy through avoidance of a stoma and maintenance of urethral voiding. Neobladder function reported in the literature ranges widely due to differences in patient selection and method of assessment. The objective of the study was to characterize functional outcomes of consecutive patients treated at a tertiary care hospital. METHODS: A historical cohort of patients who underwent radical cystectomy with a neobladder diversion performed at The Ottawa Hospital between January 2006 and December 2014 were reviewed...
February 23, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Alison C Levy, Alex J Vanni
PURPOSE OF REVIEW: Urethral strictures that are refractory to initial management present unique challenges to the reconstructive surgeon. Treatment trends have shifted as new tissue resources are becoming available. There is renewed interest in old methods as skill and technique have improved. We describe the scope of the surgical armamentarium available to develop creative approaches and successful outcomes. RECENT FINDINGS: We discuss techniques to maximize the availability of oral mucosa, harvest and use of rectal mucosa, and developments in tissue engineering...
February 26, 2018: Current Urology Reports
Yongwei Li, Zhengfei Shan, Bin Yang, Diandong Yang, Changping Men, Yuanshan Cui, Jitao Wu
AIMS: Adipose-derived stem cells (ADSCs), a source of mesenchymal stem cells, are able to differentiate into numerous cell lineages, including epithelial and smooth muscle cells. The use of ADSCs in tissue engineering technology has become the most promising therapeutic approach for urethral reconstruction. This study aimed to explore the effect of lncRNA highly upregulated in liver cancer (HULC) on the induction of ADSCs to differentiate into epithelial and smooth-muscle-like cells. METHODS: ADSCs were isolated from a male dog, and the expression of HULC in ADSCs was overexpressed by transfection with HULC expressing vector lentivirus...
January 2, 2018: Die Pharmazie
Rajat Piplani, Satish K Aggarwal, Simmi K Ratan
Aims: To study the role of uroflowmetry in the preoperative and early postoperative period in children undergoing hypospadias repair. Materials and Methods: Twenty-six cases undergoing hypospadias repair over 1 year (tubularized incised plate [TIP] Snodgrass [17 patients], TIP with Snodgraft [5 patients], Duckett's onlay flap [2 patients], and Duckett's tube [2 patients] urethroplasty) were prospectively evaluated with preoperative ultrasound and uroflowmetry and postoperative uroflowmetry at 3 months after the surgery and at 6 and 9 months interval if these dates fell within the study period on follow-up...
January 2018: Urology Annals
Hamed Mohamed El Darawany
Introduction: The optimal management strategy for urethral injuries remains controversial. Suprapubic cystostomy followed by delayed urethral reconstruction or immediate primary urethral injury repair is associated with high complication rate. Early endoscopic realignment for urethral injuries provides early definitive procedure with low complications and avoids the need for further urethral reconstruction. Materials and Methods: Between April 2007 and March 2016, 27 patients with traumatic posterior urethral disruptions were reviewed...
January 2018: Urology Annals
Jared P Schober, Kristian D Stensland, Benjamin N Breyer, Bradley A Erickson, Jeremy B Myers, Bryan B Voelzke, Sean P Elliott, Jill C Buckley, Alex J Vanni
INTRODUCTION: and Objective: Anxiety and depression (AD) in patients with urethral stricture disease (USD) and the impact of urethroplasty on mental health has never been explored. We hypothesized that patients with USD will have higher than normal AD levels and urethroplasty would improve mental health. METHODS: Patients undergoing anterior urethroplasty were retrospectively reviewed from a multi-institutional reconstructive urology database. Pre- and postoperative evaluation of AD and overall health was recorded using the validated EQ-5D-3L Questionnaire, while sexual function was evaluated with the International Index of Erectile Function (IIEF) and Men's Sexual Health Questionnaire (MSHQ)...
February 3, 2018: Journal of Urology
Jonathan E Kiechle, Nathan Chertack, Christopher M Gonzalez
Penile and urethral reconstructive surgical procedures are used to treat a variety of urologic diagnoses. Urethral stricture disease can lead to progressive lower urinary tract symptoms and may require multiple surgical procedures to improve patient's symptoms. Male stress urinary incontinence is associated with intrinsic sphincter deficiency oftentimes associated with radical prostatectomy. Men suffering from urethral stricture disease and stress urinary incontinence should be referred to a urologist because multiple treatment options exist to improve their quality of life...
March 2018: Medical Clinics of North America
A Simsek, A J Bullock, S Roman, C R Chapple, S Macneil
INTRODUCTION: We aimed to compare alternative synthetic scaffolds suitable for future implantation and to examine the use of an inhibitor of lysyl oxidase (beta-amino- propionitrile [β-APN]) to reduce contraction in these implants. METHODS: Three synthetic scaffolds were compared to natural dermis as substrates for the production of tissue-engineered skin. For natural dermis, Euroskin was used to provide a cell-free cadaveric dermis. Synthetic scaffolds consisted of microfibrous PLA, nanofibrous PHBV, and a micro-/nanofibrous trilayer of PLA-PHBV-PLA...
February 6, 2018: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Hisashi Nagahara, Shigetomi Nakao, Tatsunari Fukuoka, Masatsune Shibutani, Kiyoshi Maeda, Shinji Matsutani, Yosuke Doi, Hiroshi Ohtani, Takeshi Yamazaki, Ryosuke Amano, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Kosei Hirakawa, Masaichi Ohira
A-58-year-old man was admitted to other hospital with complaints of anal pain and bloody stools, diagnosed as rectal cancer with invasion to prostate, and performed sigmoid colostomy. After taking 6 courses of mFOLFOX6 as preoperative chemotherapy, he introduced our hospital for the purpose of operation. Preoperative evaluation of chemotherapy was PR, but infiltration of the prostate remained. Therefore, laparoscopic abdomino-perineal resection of rectum, prostatectomy and urethral reconstruction by urethral-bladder anastomosis were performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Vahudin Zugor, Ilgar Akbarov, Leonidas Karapanos, Axel Heidenreich
Stress urinary incontinence in women is a common problem in Germany, with approx. 5 million women suffering from incontinence symptoms. These numbers are increasing, due to demographic changes; the suspected numbers are even higher. Prior to treatment, an extended diagnostic approach - including urodynamics and cystoscopy when necessary - is essential for optimal treatment selection.Primary treatment should be conservative, with pelvic floor training as an essential part of a multi-modal treatment concept. If conservative treatment fails, surgery is necessary and an increasing number of women are being treated with sub-urethral slings...
February 2018: Aktuelle Urologie
Dimitrios Barbalias, Georgios Lappas, Panagiota Ravazoula, Despoina Liourdi, Iason Kyriazis, Evangelos N Liatsikos, Panagiotis Kallidonis
INTRODUCTION: Urethral strictures are a common urological problem which could require complex reconstructive procedures. Urethral dilation represents a frequent practiced invervention associated with high recurrence rates. Drug-coated balloons with cytostatic drugs have been successfully used for the prevention of vascular restenosis after balloon dilation. In an attempt to reduce the restenosis rates of urethral dilation, these balloons could be used in the urethra. Nevertheless, the urothelium is different than the endothelium and these drugs may not be distributed to the outer layers of the urethra...
January 30, 2018: Journal of Endourology
Casey G Kowalik, Joshua A Cohn, Andrea Kakos, Patrick Lang, W Stuart Reynolds, Melissa R Kaufman, Mickey M Karram, Roger R Dmochowski
INTRODUCTION AND HYPOTHESIS: Urethral injury resulting from transvaginal mesh slings is a rare complication with an estimated incidence of <1%. Our objective was to review the surgical management and functional outcomes of women presenting with urethral mesh perforation following midurethral sling (MUS) placement. METHODS: This was a retrospective multicenter review of women who from January 2011 to March 2016 at two institutions underwent mesh sling excision for urethral perforation with Female Pelvic Medicine and Reconstructive Surgery fellowship-trained surgeons...
January 29, 2018: International Urogynecology Journal
Li-Feng Zhai, Li-Feng Shen, Gou-Ping Ma, Qiao-Feng Guo, Chun Zhang
OBJECTIVE: To discuss the treatment of life-threatening refractory pressure ulcers around hips in patients with spinal cord injuries(SCI)and evaluate its clinical outcomes. METHODS: From March 2012 to June 2015, eight paraplegic patients with life-threatening refractory pressure ulcers around hips were treated with total thigh musculocutaneous flaps following amputation of proximal femurs or hips, including 7 males and 1 female with an average age of (52.0±2.6) years old ranging from 35 to 68...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Coen Holzhauer, Anita W T M Roelofs, Arjen C Kums, Philip C Weijerman, Michael R van Balken
PURPOSE: The knife is the most common used instrument for endoscopic urethrotomy. Unfortunately, there are high recurrence rates; it is thought that a laser reduces those rates. We compared the two techniques in this retrospective study. MATERIALS AND METHODS: Between 2010 and 2014, 127 patients were operated on with the knife (KG) and for 65 patients, the laser (LG) was used. We scored the complexity of the stricture using the UREThRAL stricture score (USS) and we scored if a treatment was successful...
January 13, 2018: World Journal of Urology
Fan Zhang, Limin Liao
BACKGROUND: We review our outcomes and experience of artificial urinary sphincter implantation for patients with refractory urinary incontinence from different causes. METHODS: Between April 2002 and May 2017, a total of 32 patients (median age, 40.8 years) with urinary incontinence had undergone artificial urinary sphincter placement during urinary tract reconstruction. Eighteen patients (56.3%) were urethral injuries associated urinary incontinence, 9 (28.1%) had neurogenic urinary incontinence and 5 (15...
January 8, 2018: BMC Urology
Khushabu Kasabwala, Neal A Patel, Jim C Hu
PURPOSE OF REVIEW: Robotic-assisted radical prostatectomy has been rapidly adopted and is now the standard of care in the surgical management of prostate cancer. Since the initial description in 2001, the technique has evolved to optimize oncological functional outcomes. Herein, we review key techniques for the robotic-assisted radical prostatectomy. RECENT FINDINGS: With the current influx of new technology such as focal therapy, stereotactic body radiation therapy and prostate-sparing treatments, there is greater emphasis on maximizing outcomes of robotic-assisted radical prostatectomy...
March 2018: Current Opinion in Urology
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