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Urethral reconstruction

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https://www.readbyqxmd.com/read/27932079/urinary-continence-outcomes-following-vaginoplasty-in-patients-with-congenital-adrenal-hyperplasia
#1
John Stites, Kerlly J Bernabé, Denise Galan, Diane Felsen, Dix P Poppas
BACKGROUND: Feminizing genitoplasty techniques have diversified to encompass the spectrum of atypical genitalia in 46,XX congenital adrenal hyperplasia (CAH) patients. However, long-term outcomes evaluating postoperative continence following complex vaginoplasty remain scarce. OBJECTIVE: The aim was to review our surgical experience and assess postoperative urinary continence outcomes in CAH patients following complex, primary vaginoplasty. STUDY DESIGN: We retrospectively reviewed CAH patients who underwent complex, primary vaginoplasty at a single center by a single surgeon from 1996 to 2013...
November 22, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27912972/fate-of-males-with-urethral-y-duplication-40-year-long-follow-up-in-8-patients
#2
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
#3
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
#4
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/27908368/endoscopic-treatment-of-urethral-stenosis
#5
REVIEW
Brittney H Cotta, Jill C Buckley
Urethral stricture disease continues to be a common problem for patients and urologists alike. Endoscopic treatment offers a simple, potentially effective treatment of primary, short, urethral strictures. For patients who recur after endoscopic management, urethral or bladder neck reconstruction should be offered with an experienced urologic reconstructionist familiar with the complexity of the situation and subtleties of the surgery. With the advent of adjunctive antifibrotic agents the durability of endoscopic repair seems to improve, but their use requires continued research and longer follow-up to determine their efficacy...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908367/use-of-alternative-techniques-and-grafts-in-urethroplasty
#6
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/27908363/definition-of-successful-treatment-and-optimal-follow-up-after-urethral-reconstruction-for-urethral-stricture-disease
#7
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
#8
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
#9
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
#10
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
#11
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/27847256/hypospadias-repair-with-the-glanular-frenular-collar-gfc-technique
#12
Hüseyin Özbey, Şeref Etker
BACKGROUND: In the normal human penis, the glans wings merge in the midline ventrally, but are separated by the 'septum glandis' in conjunction with the frenulum. The frenulum is also included in the formation of the distal (glanular and subcoronal) urethra, which has a special part known as the 'fossa navicularis'. This has inspired a hypospadias repair technique that simulates the development of the glanular and subcoronal urethra, which can be incorporated into the repair of all cases of hypospadias...
November 3, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27844235/robot-assisted-laparoscopic-colpectomy-in-female-to-male-transgender-patients-technique-and-outcomes-of-a-prospective-cohort-study
#13
Freek Groenman, Charlotte Nikkels, Judith Huirne, Mick van Trotsenburg, Hans Trum
BACKGROUND: Gender-affirming surgeries in female-to-male (FtM) transgender patients include mostly hysterectomy, bilateral salpingo-oophorectomy and mastectomy. Sometimes further surgery is performed, such as phalloplasty. Colpectomy may be performed to overcome gender dysphoria and disturbing vaginal discharge; furthermore, it may be important in reducing the risk of fistulas due to the phalloplasty procedure with urethral elongation. Colpectomy prior to the reconstruction of the neourethra seems to reduce fistula rates on the very first anastomosis...
November 14, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27822441/congenital-urethral-diverticulum-with-infertility-in-an-adult-man-and-review-of-the-literature
#14
Chen Shuzhu, Wu Min, Ye Weijing, Liu Yidong
INTRODUCTION: Congenital anterior urethral diverticula in adult males are infrequent urological diseases, which they were mainly found in women. The etiology of female diverticula is that (Mohan et al. in J Urol 123(4):592-594, 1980) women have anatomically poorly supported urethral. Clinical presentation frequently involves urinary urgency, polyuria, postmicturition dribble, and hematuria. CASE DESCRIPTION: A 37 year-old male was presented to us complaining of infertility about 6 years after marriage...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27818773/transurethral-biopsy-of-the-prostatic-urethra-is-associated-with-final-apical-margin-status-at-radical-cystoprostatectomy
#15
Friedrich-Carl von Rundstedt, Douglas A Mata, Steven Shen, Yi Li, Guilherme Godoy, Seth P Lerner
PURPOSE: Biopsy of the prostatic urethra is an integral part of clinical staging in patients prior to radical cystoprostatectomy (RC) and urinary diversion. We examined whether preoperative transurethral resection (TUR) biopsy was associated with final apical urethral margin status and hypothesized that a negative biopsy could replace intraoperative frozen section for decision making regarding the feasibility of orthotopic neobladder reconstruction. METHODS: TUR biopsy, frozen section, urethrectomy, and final apical urethral margin pathologic data were extracted from the charts of men who had undergone RC at the Houston Methodist Hospital between 1987 and 2013...
November 2016: Journal of Clinical Urology
https://www.readbyqxmd.com/read/27803968/preoperative-3d-and-4d-ct-imaging-using-640-multislice-ct-640-msct-in-diagnosis-of-female-urethral-diverticulum
#16
Yong-Xian Zhao, Jia-Ping Wang, Jiong-Ming Li, Tao Chen, Cong-Wen Mao, Jian-He Liu, Yun-Shan Su, Ke-Wei Fang
OBJECTIVE: To determine the sensitivity and specificity of 640-Multislice CT (640-MSCT) in diagnosing the female UD. MATERIALS AND METHODS: We investigated 16 patients with symptomatic UDs preoperatively in our hospital from August 2010 to March 2016. The patients' average age was 38.8 years. All patients were performed 640-MSCT of pelvis; then, 3D and 4D images were reconstructed preoperatively. RESULTS: In 3D and 4D-CT images, out of 16 patients, thirteen patients had one ostium, two had 2 ostia and one had 3 ostia...
November 1, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27790300/an-unusual-case-of-polyembolokoilamania-urethral-avulsion-from-foreign-object-use-during-sexual-gratification
#17
Garson Chan, Adiel Mamut, Stephanie Tatzel, Blayne Welk
Polyembolokoilamania is the insertion of foreign objects into body orifices for sexual gratification. While the retrieval of these objects from the urethra and bladder is a well-known task among urologists, we present a rare case of an usual and serious injury from this practice: complete avulsion of the urethra at the penoscrotal junction. A single-stage urethroplasty was used to reconstruct the urethra with good result. The patient motivation, as well as concomitant medical or psychological conditions, should be explored in order to prevent further occurences...
May 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/27783146/collagen-cell-carriers-seeded-with-human-urothelial-cells-for-urethral-reconstructive-surgery-first-results-in-a-xenograft-minipig-model
#18
Stefan Aufderklamm, Martin Vaegler, Alexandra Kelp, Sabine Maurer, Leon Gustafsson, Jens Mundhenk, Silke Busch, Lisa Daum, Arnulf Stenzl, Bastian Amend, Karl-Dietrich Sievert
PURPOSE: Urethral strictures are a common disease of the lower urinary tract in men. At present, the use of buccal mucosa is the method of choice for long or recurrent strictures. However, autologous tissue-engineered grafts are still under investigation for reconstructive urological surgery. The aim of this pilot study was to evaluate the use of human urothelial cells (HUC) seeded on bovine collagen type I-based cell carriers (CCC) in an animal model and to evaluate short-term outcome of the surgical procedure...
October 25, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27781020/stem-cells-in-functional-bladder-engineering
#19
REVIEW
Jakub Smolar, Souzan Salemi, Maya Horst, Tullio Sulser, Daniel Eberli
Conditions impairing bladder function in children and adults, such as myelomeningocele, posterior urethral valves, bladder exstrophy or spinal cord injury, often need urinary diversion or augmentation cystoplasty as when untreated they may cause severe bladder dysfunction and kidney failure. Currently, the gold standard therapy of end-stage bladder disease refractory to conservative management is enterocystoplasty, a surgical enlargement of the bladder with intestinal tissue. Despite providing functional improvement, enterocystoplasty is associated with significant long-term complications, such as recurrent urinary tract infections, metabolic abnormalities, stone formation, and malignancies...
September 2016: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/27780347/indications-and-complications-associated-with-the-removal-of-506-pieces-of-vaginal-mesh-used-in-pelvic-floor-reconstruction-a-multicenter-study
#20
John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
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