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Urethral reconstruction

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https://www.readbyqxmd.com/read/28314702/short-term-outcomes-of-the-multi-institutional-bladder-exstrophy-consortium-successes-and-complications-in-the-first-two-years-of-collaboration
#1
J G Borer, E Vasquez, D A Canning, J V Kryger, A Bellows, D Weiss, T Groth, A Shukla, M P Kurtz, M E Mitchell
INTRODUCTION/BACKGROUND: Bladder exstrophy is a rare diagnosis that presents major reconstructive challenges. To increase experience and proficiency in the care of bladder exstrophy (BE), the Multi-Institutional BE Consortium (MIBEC) was formed, with a focus on refining technical aspects of complete primary repair of bladder exstrophy (CPRE) and subsequent care. OBJECTIVE: Outcome measures included successful CPRE (absence of dehiscence), complications, and integrated points of technique and care over the short-term...
February 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28286073/intermediate-term-outcomes-and-complications-of-long-segment-urethroplasty-with-lingual-mucosa-grafts
#2
Yue-Min Xu, Chao Li, Hong Xie, Ying-Long Sa, Qiang Fu, Deng-Long Wu, Jiong Zhang, Chao Feng, Chong-Rui Jin, Lu-Jie Song, Hong-Bin Li, Ying Liu
PURPOSE: We evaluated the outcomes and donor site complications of male patients with complex urethral strictures (CUS) that underwent urethroplasty by using with long-strip oral mucosal grafts (OMGs). The study analyzed whether lingual mucosa graft (LMG) is a good substitute for repairing long segment urethral strictures. MATERIALS AND METHODS: This was a retrospective study of 81 male patients with CUS that underwent OMGs urethroplasty. Patients with long segment anterior urethral strictures(≥8 cm)that were considered for long-strip LMG urethroplasty were included in the study...
March 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28279224/urethral-reconstruction-with-autologous-urine-derived-stem-cells-seeded-in-three-dimensional-porous-small-intestinal-submucosa-in-a-rabbit-model
#3
Yang Liu, Wenjun Ma, Bo Liu, Yangcai Wang, Jiaqiang Chu, Geng Xiong, Lianju Shen, Chunlan Long, Tao Lin, Dawei He, Denis Butnaru, Lyundup Alexey, Yuanyuan Zhang, Deying Zhang, Guanghui Wei
BACKGROUND: Urethral reconstruction is one of the great surgical challenges for urologists. A cell-based tissue-engineered urethra may be an alternative for patients who have complicated long strictures and need urethral reconstruction. Here, we demonstrated the feasibility of using autologous urine-derived stem cells (USCs) seeded on small intestinal submucosa (SIS) to repair a urethral defect in a rabbit model. METHODS: Autologous USCs were obtained and characterized, and their capacity to differentiate into urothelial cells (UCs) and smooth muscle cells (SMCs) was tested...
March 9, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28278526/-acute-kidney-failure-due-to-urachal-cyst
#4
I Klaassen, M Wolf, M J Kemper, S Riechardt, M Boettcher, J Herrmann, D Singer
A 34-year-old para V woman was referred to our centre at 35+1 weeks of gestation for an assumed fetal malformation with prenatal renal impairment and anhydramnios. Prenatal ultrasound demonstrated unilateral renal agenesis; the bladder was not detectable. The baby was born by caesarian section at 36+2 weeks of gestation because of placental insufficiency. Postnatal adaptation was uneventful, but the newborn presented external stigmas of trisomy 21 and progressive renal impairment with anuria. Nevertheless, the postnatal ultrasound showed two enlarged kidneys in loco typico with impaired perfusion but without signs of malformations...
March 9, 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28266818/update-on-complications-of-synthetic-suburethral-slings
#5
Cristiano Mendes Gomes, Fabrício Leite Carvalho, Carlos Henrique Suzuki Bellucci, Thiago Souto Hemerly, Fábio Baracat, Jose de Bessa, Miguel Srougi, Homero Bruschini
Synthetic suburethral slings have become the most widely used technique for the surgical treatment of stress urinary incontinence. Despite its high success rates, significant complications have been reported including bleeding, urethral or bladder injury, urethral or bladder mesh erosion, intestinal perforation, vaginal extrusion of mesh, urinary tract infection, pain, urinary urgency and bladder outlet obstruction. Recent warnings from important regulatory agencies worldwide concerning safety issues of the use of mesh for urogynecological reconstruction have had a strong impact on patients as well as surgeons and manufacturers...
March 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28262534/use-of-a-fibrovascular-tube-in-creation-of-neo-urethra-during-penile-reconstruction
#6
Abdul Kerim Yapici, Sami Uguz, Yalcin Bayram, Sebahattin Sari, Yildirim Karslioglu, Ahmet Guven, Serdar Ozturk
INTRODUCTION: There are several techniques employed in the surgical treatment of total or partial penile reconstruction, hypospadias surgery, and urethral stricture. Urethral reconstruction is performed in different ways applying these techniques. OBJECTIVE: We evaluated use of a fibrovascular sheath to create a neo-urethra formed around a silicon tube. MATERIAL AND METHODS: We used nine male New Zealand rabbits for this study. In the first step, we placed a silicone tube under the skin in the lower abdomen of the rabbits and waited for the formation of a fibrovascular sheath to totally surround the tube...
February 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28252312/-management-of-recurrent-stress-urinary-incontinence-after-anti-incontinence-surgery
#7
A Martan, J Mašata, K Švabík
OBJECTIVE: The review article describes the possibilities of procedures for failed anti-incontinence surgery - sling procedure or "bulking agent"? DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Medical Faculty, Charles University, Prague. MATERIALS AND METHODS: The correct choice of procedure type to treat persistent SUI (Stress Urinary Incontinence) which persists or soon reoccurs after anti-incontinence surgery is often problematic...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28247326/reconstructive-management-options-of-delayed-complications-following-bladder-outlet-surgery
#8
REVIEW
Nora Baker, Carmen Tong, Jay Simhan
PURPOSE OF REVIEW: Technological advancements in urologic endoscopy within the last decades have improved outcomes following bladder outlet reduction surgery while minimizing risks of short- and intermediate-term complications. This review aims to examine late complications of endoscopic reduction of the prostate and the various treatment options available. RECENT FINDINGS: Urinary incontinence, ejaculatory dysfunction, urethral strictures, bladder neck contractures, and fistula formations are the most common delayed complications following bladder outlet reduction surgery...
April 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28220592/turkish-validation-of-the-urethral-stricture-surgery-specific-patient-reported-outcome-measure-uss-prom-with-supplemental-assessment-of-erectile-function-and-morbidity-due-to-oral-graft-harvesting
#9
Fikret Fatih Önol, Ahmet Bindayi, Ahmet Tahra, Ismail Basibuyuk, Sinasi Yavuz Onol
AIMS: We validated a Turkish language version of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) in men undergoing anterior urethroplasty. We also investigated changes in erectile function (EF) and quality of life (QoL) due to oral mucosa graft (OMG) harvesting. METHODS: The USS-PROM captures lower urinary tract symptoms (LUTS), health related QoL (HRQoL) with EQ-5D visual analogue scale (EQ-VAS). To evaluate EF and OMG morbidity, we used International Index of Erectile Function (IIEF-5) and a self-completed questionnaire, respectively...
February 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28191788/full-thickness-skin-mesh-graft-vaginoplasty-a-skin-sparing-technique
#10
Guilherme Lang Motta, Patric Machado Tavares, Gabriel Veber Moisés Silva, Milton Berger, Brasil Silva Neto, Tiago Elias Rosito
INTRODUCTION: The ideal vaginoplasty method should promote good cosmetic and functional results with low morbidity. We describe a new technique for congenital vaginal agenesis using a full-thickness perforated skin graft. MATERIALS AND METHODS: We report an 18 year old patient with vaginal agenesis (Morris syndrome) that undergone a modified version of McIndoe vaginoplasty. Patient is set in a low lithotomy position and lateral traction sutures are placed in labia and a 16Fr urethral catheter inserted...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28188755/defining-the-prevalence-of-asymptomatic-microscopic-hematuria-among-women-with-symptomatic-pelvic-organ-prolapse-implications-for-recommending-subsequent-diagnostic-evaluation
#11
Brian J Linder, Stephen A Boorjian, Emanuel C Trabuco, John B Gebhart, John A Occhino
OBJECTIVE: To evaluate the prevalence of asymptomatic microscopic hematuria (AMH) in women presenting with POP, as well as the relationship of POP stage with AMH. MATERIALS AND METHODS: Charts of women evaluated in a Female Pelvic Medicine and Reconstructive Surgery clinic between January 2015 and July 2016 were retrospectively reviewed. The prevalence of AMH (≥3 red blood cells per high-powered field on 1 urinalysis) was compared for women with symptomatic POP and those with urinary incontinence (UI) without symptomatic POP...
February 7, 2017: Urology
https://www.readbyqxmd.com/read/28161406/glans-duplication-in-depth-review-and-proposal-of-a-new-classification
#12
REVIEW
Lisieux E Jesus, Samuel Dekermacher, Erica Lopes, Andreia P Bacon
BACKGROUND: Diphallia is a very uncommon malformation, and glans duplication (GD) is its rarest form. In this last group, patients normally present with esthetic/sexual complaints or obstructed voiding late in life after pubertal genital development. Associated malformations are uncommon and relatively mild in those cases. METHODS: After a case presented, we present herein an extensive review of GD, as the disease is rare, and there is very little about its treatment and there are diverse approaches to address the condition...
January 18, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28161405/neo-yoke-repair-for-severe-hypospadias-a-simple-modification-for-better-outcome
#13
Hamed M Seleim, Hani Morsi, Mohamed M Elbarbary
BACKGROUND: Although staged repair for reconstructing severe hypospadias is more popular, various one-stage repairs have been attempted. Koyanagi repair (parameatal-based and fully extended circumferential foreskin flap urethroplasty) has enabled correction of severe hypospadias in one stage. However, its un-acceptably high incidence of complications has initiated a series of technical modifications, including the "yoke" repair. OBJECTIVES: To retrospectively analyze the outcome of a proposed modification of the originally described yoke repair, for patients with severe hypospadias...
January 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28159591/repair-of-urethrovaginal-fistula-secondary-to-pelvic-fracture-with-a-labia-minora-skin-flap-in-young-girls
#14
Dapeng Jiang, Zhoutong Chen, Lei He, Houwei Lin, Longhu Jin, Maosheng Xu, Guofeng Xu, Xiaoliang Fang, Hongquan Geng
The study aims to evaluate the efficacy of transpubic access using a pedicle flap from the labia minora for urethral reconstruction in young girls with urethrovaginal fistula secondary to pelvic fracture. Between January 2011 and January 2016, 4 cases of traumatic urethrovaginal fistula in young girls were treated using a pedicle flap from the labia minora. The mean follow-up was 27 months. All patients voided well and achieved normal urinary control. One patient had recurrent urethrovaginal fistula. The remaining 3 patients required no additional treatment...
January 31, 2017: Urology
https://www.readbyqxmd.com/read/28117233/-analysis-of-success-rates-of-uretroplasty-for-adult-male-bulbar-urethral-stricture-a-systematic-review
#15
E Robine, J Rigaud, F Luyckx, Q-C Le Clerc, F-X Madec, O Bouchot, J Branchereau
Male urethral stricture disease is prevalent and has an important impact on quality of life. Direct visual urethrotomy and dilatations have high rates of recurrence. OBJECTIVES: The aim of this review of literature was to evaluate the success rates of different techniques of urethroplasty for strictures of the bulbar urethra. METHODS: We performed a systematic review of the MEDLINE literature from 2004 to 2015 following the PRISMA's statement recommendations. Key words were: urethroplasty, urethral reconstruction, onlay, graft, urethral stricture...
February 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28108798/augmented-perineal-urethrostomy-using-a-dorsal-buccal-mucosal-graft-bi-institutional-study
#16
Jessica DeLong, Kurt McCammon, Leandro Capiel, Augustín Rovegno, Jeremy B Tonkin, Gerald Jordan, Ramón Virasoro
PURPOSE: To present our technique and outcomes for perineal urethrostomy augmented with a dorsal onlay buccal mucosa graft (BMG). Results from initial series and collaboration from an international center are included. METHODS: A retrospective chart review of all adult patients who underwent urethral reconstruction with perineal urethrostomy utilizing a buccal mucosal graft between January 1, 2002 and January 1, 2013 was performed. All surgeries were performed by three surgeons using the same technique (GHJ, KAM, and RV)...
January 20, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28101735/urethral-carcinoma-in-situ-recognition-and-management
#17
Ricardo H Berjeaut, Maliza D I Persaud, Nikolai Sopko, Arthur L Burnett
PURPOSE: Urethral carcinoma in situ (CIS) is an uncommon malignancy that is poorly described in the published literature and is often under-recognized in the clinical setting. This short case series reports some challenges associated with the recognition and management of this disease. METHODS: A retrospective chart review was done over a 12-year period of patients presenting with urethral cancer to the Johns Hopkins Hospital. Four patients were identified with CIS of the anterior urethra, and their demographic and clinical data were recorded...
April 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28091712/two-cases-of-female-urethral-reconstruction-with-acellular-porcine-urinary-bladder-matrix
#18
Sana Ansari, Mickey Karram
INTRODUCTION AND HYPOTHESIS: Female urethral reconstruction via the traditional routes can be limiting for various reasons. Current literature on the use of acellular biologic grafts derived from viscera for female urethral reconstruction is limited. We present two cases of women with complete loss of their posterior urethra presenting for urethral reconstruction. METHODS: Two cases of urethral reconstruction using acellular porcine urinary bladder matrix (UBM), along with labial fat pad transposition and biologic pubovaginal sling are presented...
January 13, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28089291/repair-of-stenosed-neourethra-using-the-proximal-neourethral-diverticulum-a-technique-in-redo-hypospadias-surgery
#19
Cenita J Sam, Sudipta Sen, Pavai A Arunachalam
Neourethral diverticulum secondary to distal neourethral stenosis is not uncommon after proximal hypospadias repair. We describe a technique using the neo urethral diverticular roof and overlying skin as a composite flap to reconstruct the urethral stenosis distal to the diverticulum. The composite flap is advanced distally for reconstruction of the stenosed urethra either as a tube or as an onlay. Urethra at the diverticular bed is tubularized to reduce its caliber. This technique has yielded excellent results in three children...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28088555/injury-in-pelvic-fracture-urethral-injury-is-membranobulbar-fact-or-myth
#20
Pankaj M Joshi, Devang J Desai, Darshan Shah, Devashree Joshi, Sanjay B Kulkarni
Pelvic fracture urethral injuries commonly result from motor vehicle collisions, and the mechanism of injury conventionally thought was a shearing injury at the membranous urethra, which would destroy the striated sphincter. Continence would therefore depend on the bladder neck. Striated sphincter and the site of injury have not been shown clearly on preoperative imaging. We demonstrate our protocol of performing magnetic resonance imaging whereby the membranous sphincter is seen intact and the injury is shown to be at the membranobulbar junction contrary to conventional belief...
January 11, 2017: Urology
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