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Urethral reconstruction

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https://www.readbyqxmd.com/read/29135409/double-inlay-plus-ventral-onlay-buccal-mucosa-graft-for-simultaneous-penile-and-bulbar-urethral-stricture
#1
Luciano A Favorito, Paulo P Conte, Ulisses G Sobrinho, Rodrigo G Martins, Tomas Accioly
OBJECTIVES: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture. MATERIALS AND METHODS: A 54 year-old male patient was submitted to appendectomy where a urethral catheter was used for two days in May 2015...
November 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29132797/cloaca-reconstruction-a-new-algorithm-which-considers-the-role-of-urethral-length-in-determining-surgical-planning
#2
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
BACKGROUND: Cloacal malformations represent a uniquely complex challenge for surgeons. The surgical approach to date has been based on the common channel (CC) length with two patient groups considered: less than or greater than 3cm, which we believe is an oversimplification. We reviewed 19 patients, referred after surgery done elsewhere. Eight had postoperative urinary complications, 3 had constant urinary leakage and had been left after surgery with a urethra <1cm, .5 with an original 3 to 5cm common channel, who had undergone total urogenital mobilization (TUM), experienced peri-operative urethral loss needing a vesicostomy, and later, a Mitrofanoff...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29118550/-horrendoplasty-a-case-of-total-perineal-destruction-by-agricultural-implement
#3
Pedro Simoes de Oliveira, Tiago Ribeiro de Oliveira, David Martinho, Francisco Martins
Although posterior urethral injury occurs almost always in association with pelvic fracture, it may result from severe trauma to the perineum with its associated potential lethality and severe morbidity. Early primary endoscopic realignment over a urethral catheter can be attempted, although an immediate suprapubic tube placement remains the standard of care. Definitive treatment consists of elective open posterior anastomotic urethroplasty through a perineal approach. The authors present a 53-year-old man who sustained total, massive perineal destruction resulting from work accident with an agricultural implement...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29108977/sexual-dysfunction-in-urethral-reconstruction-a-review-of-the-literature
#4
REVIEW
Cooper R Benson, Ly Hoang, Jonathan Clavell-Hernández, Run Wang
INTRODUCTION: Urethral stricture disease accounts for 5,000 hospitalizations and 1.5 million office visits per year. Urethral reconstruction has become more commonplace with the recognition of the poor long-term success of the endoscopic management of stricture disease. Sexual dysfunction related to the surgical management of urethral strictures is an under-recognized sequela. AIM: To characterize and elucidate the various factors that contribute to sexual dysfunction after urethroplasty and hypospadias reconstruction to improve surgical decision making and patient counseling...
November 3, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/29107132/staged-urethroplasty-for-penile-urethral-strictures-from-lichen-sclerosus-and-failed-hypospadias-repair
#5
Bradley D Figler, Andrew Gomella, Logan Hubbard
OBJECTIVE: To present our technique for staged urethroplasty with buccal mucosa graft. METHODS: The patient presented is a 42 year-old male with a history of congenital hypospadias repaired as a child. He developed a penile urethral stricture at age 30 and was managed with self intermittent dilation. Recently, dilation became more difficult, and he was referred for reconstruction. Work-up revealed a high-grade stricture extending from the meatus to the site of the previous anastomosis at the penoscrotal junction...
October 26, 2017: Urology
https://www.readbyqxmd.com/read/29104795/the-use-of-amplatz-renal-dilators-in-the-minimally-invasive-management-of-complex-urethral-strictures
#6
Michael Nomikos, Sarantis Papanikolaou, George Athanasopoulos, Athanasios Papatsoris
Introduction: To present the outcomes of using Amplatz renal dilators in the management of complex urethral strictures. Material and methods: From September 2011 to August 2015, 34 patients with complex urethral strictures were treated with Amplatz renal dilators assisted with internal urethrotomy. Evaluation included uroflowmetry, IPSS and post-void residual volume measurement. Under spinal anesthesia, sequential dilatations were performed with Amplatz renal dilators measuring from 8 Fr up to 24 Fr...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/29064654/an-unusual-presentation-of-urethral-duplication-presenting-with-chronic-bladder-retention-left-scrotal-transposition-and-left-renal-agenesis
#7
Antonio Macedo, Marcela Leal da Cruz, João Luiz Gomes Parizi, Gustavo Marconi Caetano Martins, Riberto Liguori, Sérgio Leite Ottoni, Bruno Leslie, Gilmar Garrone
INTRODUCTION AND OBJECTIVE: Urethral duplication is a rare congenital anomaly, with roughly 200 cases reported in the literature (1). It is more frequent in males, with few cases reported in females. The clinical presentation differs according to the anatomical variant present. The duplication most commonly occurs in the sagittal plane with one urethra located ventrally and the other dorsally (2). Usually the ventral urethra is the more functional of both. Duplications occurring in the coronal plane are quite rare and they are usually associated with bladder duplication (3)...
October 24, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29061068/three-layer-two-step-posterior-reconstruction-using-peritoneum-during-robot-assisted-radical-prostatectomy-to-improve-recovery-of-urinary-continence-prospective-comparative-study
#8
Souichiro Ogawa, Seiji Hoshi, Tomoyuki Koguchi, Junya Hata, Yuichi Sato, Hidenori Akaihata, Masao Kataoka, Nobuhiro Haga, Yoshiyuki Kojima
INTRODUCTION: We present our experience with a novel 3-layer 2-step posterior reconstruction (PR) technique using peritoneum during robot-assisted radical prostatectomy (RARP) to improve recovery of postoperative urinary continence. METHODS: Forty-eight patients with localized prostate cancer were enrolled in this study and were divided randomly into 2 groups, which were treated by the standard PR technique (standard PR group; n=24) or the 3-layer PR technique using peritoneum (3-layer PR group; n=24) during RARP...
October 23, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29031840/urethral-reconstruction-in-aging-male-patients
#9
Boyd R Viers, Travis J Pagliara, Charles A Rew, Lauren Folgosa-Cooley, Christine Y Shiang, Jeremy M Scott, Allen F Morey
OBJECTIVE: To report stricture characteristics, complications, and treatment outcomes among elderly men undergoing urethral reconstruction. MATERIALS AND METHODS: Retrospective review of urethroplasty cases and outcomes by a single surgeon from 2007-2014 was performed. Men were stratified by decade of life at time of surgery (<50, 50-59, 60-69, ≥70 years). Individuals with a history of hypospadias were excluded. RESULTS: Among 514 urethroplasty procedures, 184 (36%) were ≥60 years...
October 11, 2017: Urology
https://www.readbyqxmd.com/read/29026065/urethral-diverticulum-presenting-as-a-large-vaginal-mass-complicating-pregnancy-and-delivery
#10
Everett F Magann, Lisa S Newton, Susan A Barr
BACKGROUND A case report of urethral diverticulum complicating pregnancy is presented. The diagnosis and management are challenging because of the rare nature of this condition, the varied presentations and differential diagnoses, and the possibility of misdiagnosis. CASE REPORT A 25-year-old primigravida with scheduled induction of labor at 39 weeks gestation due to gestational diabetes mellitus presented for a routine antenatal appointment at 38 weeks and four days. On digital cervical examination, she was found to have a large semi-solid anterior vaginal mass, shown by trans-vaginal ultrasound to have a nearly solid appearance of a 5×7 cm mass with septation...
October 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29025178/-reconstructive-urethral-surgery
#11
Vahudin Zugor, Daniel Porres, Leonidas Karapanos, Axel Heidenreich, Ilgar Akbarov
Urethral strictures are independent of a patient's age and can happen in every life period. They are often iatrogenic, resulting from a transurethral surgical procedure or traumatic catheterisation. Endoscopic slotting is the surgery of choice; although this method is frequently associated with recurrence. Retrograde urethrography or cystourethrography continue to play a central role in diagnostic evaluation and treatment. There is no standardised procedure regarding the surgical technique, perioperative management, and postoperative follow-up...
October 12, 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/29022780/primary-urethral-reconstruction-results-in-penile-fracture
#12
R Barros, Mis Silva, V Antonucci, L Schulze, L Koifman, L A Favorito
Objective This study assessed primary urethral reconstruction results in patients with a penile fracture. Materials and methods Between January 2005 and April 2016, patients who underwent primary urethral reconstruction due to penile fracture were called for a follow-up. Epidemiological and clinical presentation data and operative findings were reviewed retrospectively. Partial urethral lesions were primarily treated with interrupted absorbable sutures over urethral catheter. In cases of complete urethral lesion, tension-free end-to-end anastomosis was performed...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28954448/-evaluation-of-transperineal-sonography-for-lower-urinary-tract-symptoms-after-pelvic-floor-reconstruction
#13
X L Zhong, J Song, Y L Xu, X L Lyu, X H Zhong, A P Wang, Y F Song
Objective: To evaluate transperineal sonography for lower urinary tract symptoms after pelvic floor reconstruction. Methods: Eighty-three patients with severe pelvic organ prolapse received surgeries in Fuzhou General Hospital from September 2014 to September 2015, dividing into two groups: 27 patients were selected to receive transvaginal mesh (TVM) pelvic floor reconstruction surgery with tension-free vaginal tape-Abbrevo (TVT-Abbrevo) incontinence surgery, named TVM+TVT-Abbrevo group; 56 patients were selected to receive TVM pelvic floor reconstruction surgery only, named TVM group...
September 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28913706/novel-pericatheter-retrograde-urethrogram-technique-is-a-viable-method-for-postoperative-urethroplasty-imaging
#14
Rachael D Sussman, F Cameron Hill, George E Koch, Versha Patel, Krishnan Venkatesan
PURPOSE: The purpose of this study is to describe our technique for pericatheter retrograde urethrogram (pcRUG) and to evaluate the utility of a pcRUG to detect a clinically significant leak after urethral reconstruction. METHODS: We retrospectively reviewed our prospective IRB-approved database of patients undergoing urethral reconstruction. pcRUG was performed at 3-4 weeks after surgery, in standardized fashion. Patients were placed in oblique position, and with the penis stretched, diluted contrast was instilled via an angiocatheter alongside the indwelling urethral catheter under dynamic fluoroscopy...
December 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28899606/is-tissue-engineering-of-patient-specific-oral-mucosa-grafts-the-future-of-urethral-reconstruction
#15
Hans M Larsson
No abstract text is available yet for this article.
October 2017: EBioMedicine
https://www.readbyqxmd.com/read/28893083/tissue-engineering-of-urethra-systematic-review-of-recent-literature
#16
Stanislav Žiaran, Martina Galambošová, L'uboš Danišovič
The purpose of this article was to perform a systematic review of the recent literature on urethral tissue engineering. A total of 31 articles describing the use of tissue engineering for urethra reconstruction were included. The obtained results were discussed in three groups: cells, scaffolds, and clinical results of urethral reconstructions using these components. Stem cells of different origin were used in many experimental studies, but only autologous urothelial cells, fibroblasts, and keratinocytes were applied in clinical trials...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28888708/ureteric-urethral-engraftment-as-a-new-surgical-technique-for-management-of-incontinence-in-bladder-exstrophy-complex-a-retrospective-cohort
#17
Abdol-Mohammad Kajbafzadeh, Shabnam Sabetkish, Nastaran Sabetkish
OBJECTIVES: To report the results of a novel surgical technique for achieving urinary continence in patients with bladder exstrophy complex (BEC) by ureteric-urethral engraftment (UUE) technique. PATIENTS AND METHODS: Sixteen female patients with BEC and a mean ± SD age of 3.48 ± 1.75 years were referred for primary exstrophy repair from 2009 to 2012. From these, 9 patients were operated by single-stage bladder closure (group I); while 7 patients underwent the novel technique of UUE to compare the continence achievement (group II)...
October 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28866465/three-dimensional-computerized-model-based-on-the-sonourethrogram-a-novel-technique-for-evaluating-the-anterior-urethral-stricture
#18
Lei Chen, Chao Feng, Xiang-Guo Lv, Hai-Hao Fan, Pankaj Joshi, Guido Barbagli, Yu-Min Zhao, Yue-Min Xu, Zhe Li, Bing Hu, Qiang Fu
PURPOSE: The sonourethrogram is a useful alternative to the traditional retrograde urethrogram (RUG) for evaluating anterior urethral stricture. With the development of three-dimensional (3-D) reconstructive technique, 3-D urethral image can provide more accurate and useful information to allow the surgeon make the best surgical decision. The purpose of this study is to evaluate the accuracy and efficacy of a 3-D reconstructed digital model of the urethra based on the sonourethrogram for assessing anterior urethral disease...
August 30, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28865886/posterior-hypospadias-evaluation-of-a-paradigm-shift-from-single-to-staged-repair
#19
H Badawy, S Orabi, A Hanno, H Abdelhamid
INTRODUCTION: Repair of posterior hypospadias is a current dilemma. Single versus staged repair is the main question to answer. The answer is not easily reached due to lack of comparative studies. Hence such studies are not available, the reports of a change from one approach to the other one are important to point out the results of each procedure in the same hands and in the same center. Herein, we report our results of the repair of posterior hypospadias shifting from single stage to staged repair...
August 9, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28831521/-redo-urethroplasty-with-buccal-mucosa
#20
REVIEW
C M Rosenbaum, L Ernst, O Engel, R Dahlem, M Fisch, L A Kluth
Urethral strictures can occur on the basis of trauma, infections, iatrogenic-induced or idiopathic and have a great influence on the patient's quality of life. The current prevalence rate of male urethral strictures is 0.6% in industrialized western countries. The favored form of treatment has experienced a transition from less invasive interventions, such as urethrotomy or urethral dilatation, to more complex open surgical reconstruction. Excision and primary end-to-end anastomosis and buccal mucosa graft urethroplasty are the most frequently applied interventions with success rates of more than 80%...
October 2017: Der Urologe. Ausg. A
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