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Urethral reconstruction

Felix Blasl, Wolfgang H Rösch, Mark Koen, Mircia-Aurel Ardelean, Anne-Karoline Ebert
OBJECTIVE AND INTRODUCTION: Cowper's syringocele is a cystic dilation of the bulbourethral gland duct, initially defined by Maizels et al. in 1983. Although obstructive and non-obstructive types of this rare anomaly are described, clinical symptoms are highly unspecific. Therefore, we report 12 cases of children and young adults diagnosed with Cowper's syringocele to further clarify clinical course, comorbidity and treatment strategies. STUDY DESIGN: We retrospectively collected clinical data of 12 children and young adults from birth to 18...
October 8, 2016: Journal of Pediatric Urology
K L M Pfistermüller, S Manoharan, D Desai, P M Cuckow
INTRODUCTION: Repair of severe primary and revision hypospadias is a demanding procedure. Debate continues as to whether a two-stage approach or single-stage technique is superior. The two-stage procedure with a free graft involves penile straightening followed by application of a graft for the neourethral plate at stage one; with tubularization at stage two after graft maturation. OBJECTIVE: To report the outcomes of a single surgeon's experience with the two-stage repair using a free graft for both severe primary and revision hypospadias with long-term follow-up...
September 29, 2016: Journal of Pediatric Urology
Wei Ge, Song-Song Jiang, Wang Qi, Hao Chen, Li-Ming Zheng, Gang Chen
GOAL: To share our experience of extra-levator abdominoperineal excision (ELAPE) for low rectal cancer, focusing on perineal repair with biological mesh. METHODS: We retrospectively analyzed medical records of all patients with low rectal cancer who underwent the ELAPE procedure using biological mesh for perineal repair at the Gastrointestinal Surgery of Nanjing Drum Power Hospital between January 2013 and September 2015. All patients were closely followed up to now...
October 6, 2016: Oncotarget
Anne-Francoise Spinoit, Tom Claeys, Elke Bruneel, Achilles Ploumidis, Erik Van Laecke, Piet Hoebeke
Background. Isolated male epispadias (IME) is a rare congenital penile malformation, as often part of bladder-exstrophy-epispadias complex (BEEC). In its isolated presentation, it consists in a defect of the dorsal aspect of the penis, leaving the urethral plate open. Occurrence of urinary incontinence is related to the degree of dorsal displacement of the meatus and the underlying underdevelopment of the urethral sphincter. The technique for primary IME reconstruction, based on anatomic restoration of the urethra and bladder neck, is here illustrated...
2016: BioMed Research International
Sarah J Moore, Omid Rashidipour, Ronald B Moore
This male patient presented with a scrotal abscess and urinary obstruction. The patient's history included a perineal abscess and the development of urethrocutaneous fistulae (watering-can perineum). He underwent multiple debridement procedures without resolution. During the fifth debridement for Fournier's gangrene, a biopsy revealed invasive squamous cell carcinoma. The patient was bedridden because of the large mass, a wide en bloc resection with lymphadenectomy and reconstruction was performed revealing a large (22 cm) squamous cell carcinoma originating from the urethra...
2016: Clinical Medicine Insights. Case Reports
John Heesakkers, Fawzy Farag, Ricarda M Bauer, Jaspreet Sandhu, Dirk De Ridder, Arnulf Stenzl
CONTEXT: The incidence and awareness of postprostatectomy incontinence (PPI) has increased during the past few years, probably because of an increase in prostate cancer surgery. Many theories have been postulated to explain the pathophysiology of PPI. OBJECTIVE: The current review scrutinizes various pathophysiologic mechanisms underlying the occurrence of PPI. EVIDENCE ACQUISITION: A search was conducted on PubMed and EMBASE for publications on PPI...
October 6, 2016: European Urology
Michael Bickell, Jonathan Beilan, Jared Wallen, Lucas Wiegand, Rafael Carrion
This article reviews the most up-to-date surgical treatment options for the reconstructive management of patients with penile, urethral, and scrotal cancer. Each organ system is examined individually. Techniques and discussion for penile cancer reconstruction include Mohs surgery, glans resurfacing, partial and total glansectomy, and phalloplasty. Included in the penile cancer reconstruction section is the use of penile prosthesis in phalloplasty patients after penectomy, tissue engineering in phallic regeneration, and penile transplantation...
November 2016: Urologic Clinics of North America
H Suzuki, S Matsushita, K Suzuki, G Yamada
Androgen is an essential factor involved in masculinization of external genitalia. Failure of the exposure to 5α-dihydrotestosterone (DHT) causes a hypoplastic penile size and urethral abnormality. The main pathology of hypospadias is defective urethral closure on the ventral side of the penis. Hormone-dependent genes are suggested as the causative factors. However, the detailed mechanisms of DHT functions on urethral tube formation remain unknown. Androgen is both a positive and negative regulator of cell proliferation...
October 1, 2016: Andrology
Nathan Y Hoy, Keith F Rourke
OBJECTIVES: To describe the spectrum of adult presentations with hypospadias-related complications and examine the effect of childhood surgical repair on these adult presentations. METHODS: A retrospective chart review over a 10-year period, from Aug. 2004-Dec. 2014, demonstrated 93 adult patients who presented to a reconstructive urologist with complications related to hypospadias. Patients were divided into two groups: those with no prior hypospadias surgery (Group 1, N=19) and those who underwent surgical correction as a child (Group 2, N=74)...
September 27, 2016: Urology
K M Szymanski, R C Rink, B Whittam, J D Ring, R Misseri, M Kaefer, M P Cain
INTRODUCTION: The Kropp and Salle procedures have shown good short-term outcomes for managing neuropathic urinary incontinence. However, few studies have assessed their long-term results. OBJECTIVE: This study aimed to evaluate the long-term outcomes of Kropp and Salle procedures, including: dryness, secondary interventions for incontinence or complications, upper urinary tract changes, and use of urethral catheterizations. STUDY DESIGN: Consecutive patients undergoing Kropp and Salle procedures at the present institution (1983-2012) were retrospectively reviewed...
July 26, 2016: Journal of Pediatric Urology
Cuneyd Sevinc, Muhsin Balaban, Orkunt Ozkaptan, Necmettin Kutlu, Tahir Karadeniz
The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes...
September 2016: Kaohsiung Journal of Medical Sciences
Lee A Richter, Quinn K Lippmann, Karl Jallad, Joelle Lucas, Jennifer Yeung, Tanaka Dune, Erin Mellano, Steven Weissbart, Mihriye Mete, Ja-Hong Kim, Robert Gutman
OBJECTIVES: The objective of this study was to determine the risk factors that may contribute to the diagnosis of microscopic hematuria (MH) in women. METHODS: This multicenter case-control study reviewed cases of women presenting to Female Pelvic Medicine & Reconstructive Surgery sites with MH from 2010 to 2014. Microscopic hematuria was defined as 3 or more red blood cells per high power field in the absence of infection as indicated in the American Urologic Association guidelines...
September 16, 2016: Female Pelvic Medicine & Reconstructive Surgery
Sundaramoorthy Vijayganapathy, Ashwin Mallya, Vilvapathy Senguttuvan Karthikeyan, Jayaram Sreenivas
The penile circular fasciocutaneous flap (FCF) is employed in the successful single stage reconstruction of long segment complex anterior urethral strictures especially when buccal mucosa is unavailable due to various reasons. A 65-year-old gentleman, chronic smoker and tobacco chewer, hypertensive on treatment, presented with obstructive lower urinary tract symptoms for 8 months. He had no prior urethral catheterization. On examination, he had circumcised penis, with stenosis of the external urethral meatus...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Ajit Sawant, Gaurav Vinod Kasat, Vikash Kumar, Prakash Pawar, Ashwin Tamhankar, Sumit Bansal, Lomesh Kapadnis, Abhishek Savalia
INTRODUCTION: Female urethral injury is a rare disease. Causes of urethral injuries are prolonged obstructed labour, gynaecological surgeries like vaginoplasty and post traumatic urethral injuries. The present study was conducted to evaluate outcome of female urethral reconstruction using tubularized anterior vaginal wall flap covered with fibroadipose martius flap and autologous fascia sling in patients with urethral loss. AIM: Aim of study was to evaluate outcome of reconstruction of female urethra with tubularized anterior vaginal flap...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Allen F Morey
No abstract text is available yet for this article.
October 2016: Journal of Urology
Allen F Morey
No abstract text is available yet for this article.
October 2016: Journal of Urology
Nobuyuki Mitsukawa, Yoshitaka Kubota, Shinsuke Akita, Masakazu Hasegawa, Atsuomi Saiga, Kaneshige Satoh
CASE: The patient was a 3-year-old with hypospadias. Urethroplasty was performed as a two-stage procedure, but a severe urethral stricture occurred due to a postoperative infection and the patient was virtually in urinary retention. An emergency cystostomy was performed, and thereafter urethral reconstruction was performed. A large urethral diverticulum had formed in the scrotum. The inner wall of the diverticulum was found to be completely epithelialized and well vascularized. Therefore, it was elevated as a skin flap and a neourethra was reconstructed up to the glans region using the diverticular tissue...
September 2016: Lower Urinary Tract Symptoms
Felix Moltzahn, Alan Dal Pra, Marc Furrer, George Thalmann, Martin Spahn
Urethral stricture after radiation therapy for localized prostate cancer is a delicate problem as the decreased availability of tissue healing and the close relation to the sphincter complicates any surgical approach. We here review the pathophysiology, dosimetry, and the disease specific aspects of urethral strictures after radiotherapy. Moreover we discuss different treatment option such as direct vision internal urethrotomy as well as techniques for open reconstruction with and without tissue transfer.
September 2016: Investigative and Clinical Urology
Pankaj Mishra, Simon Rajendran, Maria Asimakidou, Imran Mushtaq
INTRODUCTION: Primary epispadias is a rare congenital malformation involving the urogenital system. In patients with epispadias, bladder closure enhances bladder growth and continence. METHODS: Several steps were carried out to bring the bladder neck to the midline and allow tension-free bladder neck reconstruction and recreation of the natural angulation of urethra. The urethral plate and penile shaft were dissected and the corpora cavernosa separated, and then the bladder neck repair was performed...
August 2016: Journal of Pediatric Urology
Constantinos Nastos, Ira Sotirova, Athanasios Papatsoris, Andreas Skolarikos, Ioannis Papaconstantinou, Athanasios Dellis
BACKGROUND: Urethrorectal fistula is a rare and debilitating condition. Spontaneous closure is rarely effective, and appropriate management regarding timing of repair and surgical approach remains controversial. CASE PRESENTATION: We present a case of an 18-year-old male found to have a urethrorectal fistula after diagnostic work up for unejaculation. The patient gradually developed recurrent urinary tract infections and urine and semen leak from his rectum. He had a medical history of an anorectal reconstruction in the second postnatal day due to an anorectal malformation...
2016: J Endourol Case Rep
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