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Perineal reconstruction

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https://www.readbyqxmd.com/read/27912972/fate-of-males-with-urethral-y-duplication-40-year-long-follow-up-in-8-patients
#1
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/27908374/effect-of-lichen-sclerosis-on-success-of-urethroplasty
#2
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/27898453/resolution-of-rectal-prolapse-by-vaginal-reconstruction
#3
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone...
November 28, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27894384/-reconstruction-of-anal-stenosis-induced-by-scar-contracture-after-repair-of-defect-in-perineal-region-with-paraumbilical-flap-using-random-pattern-flap
#4
Q Liu, X B You, Z Cai, K Y Tang, H Zhang
Objective: To investigate the method and timing of reconstruction of anal stenosis induced by scar contracture after repair of defect in perineal region with paraumbilical flap using random pattern flap. Methods: Ten patients who suffered anal stenosis induced by scar contracture after the first phase repair of defect of perineal region with paraumbilical flap were hospitalized from July 2009 to September 2015. Eight patients were with central type scar contracture of perineal region after healing of burn wound, and two patients were with lesion of perineal region which had been excised...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27889218/single-stage-urethroplasty-for-perineal-hypospadias-in-a-horse-a-case-report
#5
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/27887019/first-case-of-penile-metastasis-following-abdominoperineal-resection-with-vram-flap-reconstruction
#6
Andrei A Kozan, Adrian M Smith, David W Ilsley, Nicholas Rhodes
Penile metastases are rare in colorectal cancer. We report the first case of such a recurrence in a patient who had undergone an extralevator abdominoperineal resection with vertical rectus abdominis myocutaneous flap perineal reconstruction. The patient was treated with curative intent by total penectomy.
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27846665/menstrual-sexual-and-obstetrical-outcomes-after-vaginal-replacement-for-vaginal-atresia-associated-with-anorectal-malformation
#7
Clare Skerritt, Alejandra Vilanova Sánchez, Victoria Alison Lane, Richard J Wood, Geri D Hewitt, Lesley L Breech, Marc Levitt
The authors of this article became aware of significant differences in the management of two females with a rectovestibular fistula and associated vaginal agenesis. In one patient, a sigmoid colovaginoplasty was performed at the time of the posterior sagittal anorectoplasty (PSARP), and the other underwent repair of the rectovestibular fistula with a primary PSARP, but the surgeons elected to delay the timing of vaginal reconstruction. We decided to review the literature, to establish if recommendations could be made to optimize the management of these children based on current evidence...
November 15, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27833904/surgical-treatment-after-failed-primary-correction-of-urogenital-sinus-in-female-patients-with-virilizing-congenital-adrenal-hyperplasia-are-good-results-possible
#8
Maria Helena Palma Sircili, Tania Sartori Sanchez Bachega, Guiomar Madureira, Larissa Gomes, Berenice Bilharinho Mendonca, Francisco Tibor Dénes
PURPOSE: Genital reconstruction in female patients with virilizing congenital adrenal hyperplasia (CAH) is very challenging. Our aim was to evaluate the techniques employed to treat complications after failure of primary urogenital sinus (UGS) surgery, as well as the result of these reoperations. PATIENTS AND METHODS: Twenty girls with virilizing CAH who were previously submitted to genitoplasty in our service and elsewhere had recurrent UGS stenosis and vaginal introitus stenosis that required surgical treatment...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27829942/safety-and-usefulness-of-needle-guided-resection-of-levator-muscles-in-laparoscopic-abdominoperineal-resection-for-low-rectal-cancer
#9
Takehito Yamamoto, Akiyoshi Kanazawa, Hiroyuki Matsubara, Takuya Okamoto
INTRODUCTION: During laparoscopic abdominoperineal resection (APR) for low rectal cancer, it is difficult to resect the levator muscles and remove a cylindrical specimen without venturing close to the rectal wall to ensure negative circumferential resection margins (CRM). To solve this problem, we developed a needle-guided, laparoscopic, abdominoperineal resection (LAPR) technique. AIM: To present the safety and superiority of our technique, "needle-guided LAPR"...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/27769545/v-y-fasciocutaneous-flap-closure-technique-is-a-safe-and-efficacious-alternative-to-primary-closure-of-the-perineal-wound-following-abdominoperineal-resection
#10
George Kokosis, Zhifei Sun, Yash J Avashia, Mohamed A Adam, Howard Levinson, Detlev Erdmann, Christopher R Mantyh, John Migaly
BACKGROUND: The aim of this study was to compare wound complications from V-Y flap vs primary closure in the setting of abdominoperineal resection. METHODS: This was a single institution retrospective review (1999-2014). The main outcome measures were any wound complication, hospital length of stay, and unplanned readmissions. RESULTS: Among 80 patients included, 21 (26%) received reconstruction with V-Y flap. Compared with those who received primary closure, patients who underwent V-Y flap reconstruction had lower rates of overall wound complications (14...
July 21, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27760964/-a-case-of-early-anal-canal-cancer-with-pagetoid-spread-with-different-antitumor-effects-of-chemotherapy-on-different-metastatic-sites
#11
Kazuhiko Yoshimatsu, Gakuji Osawa, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Akiko Sakuma, Masaya Satake, Yasufumi Yamada, Shinichi Asaka, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Yoshihiko Naritaka
A 78-year-old man visited our hospital with a prolapsed hemorrhoid. He was referred to the dermatology unit due to the thickness and redness of the perianal skin. He was diagnosed as having extra mammary Paget's disease by skin biopsy. After a biopsy of the anal polyp was performed to investigate the primary site, he was diagnosed with early anal canal cancer with Pagetoid spread and underwent a radical operation. Abdominoperineal resection with skin(D2 prx D3 lymphadenectomy) was performed with perineal reconstruction using a gracilis muscle graft...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/27732566/extralevator-abdominoperineal-excision-for-rectal-cancer-with-biological-mesh-for-pelvic-floor-reconstruction
#12
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
https://www.readbyqxmd.com/read/27721660/primary-metastatic-squamous-cell-carcinoma-of-the-male-urethra-presenting-with-scrotal-abscess-and-subsequent-development-of-fournier-s-gangrene
#13
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
https://www.readbyqxmd.com/read/27692346/the-operative-management-of-children-with-complex-perianal-crohn-s-disease
#14
Natashia M Seemann, Sebastian K King, Abdul Elkadri, Thomas Walters, Joel Fish, Jacob C Langer
BACKGROUND/PURPOSE: Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. METHODS: A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed...
September 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27689055/three-directional-reconstruction-of-a-massive-perineal-defect-after-wide-local-excision-of-extramammary-paget-s-disease
#15
Seung Woo Cho, Hak Chang, Sung Tack Kwon
Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects...
September 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27689052/reconstruction-of-large-defects-in-the-perineal-area-using-multiple-perforator-flaps
#16
Ki Wook Sung, Won Jai Lee, In Sik Yun, Dong Won Lee
BACKGROUND: Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation. METHODS: Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >100 cm(2) in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed...
September 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27682131/treatment-of-vaginal-stenosis-with-fasciocutaneous-singapore-flap
#17
Marisa M Clifton, Raffi Gurunluoglu, Javier Pizarro-Berdichevsky, Todd Baker, Sandip P Vasavada
INTRODUCTION: Vaginal stenosis is an unfortunate complication that can occur after pelvic radiation therapy for gynecologic or colorectal malignancies. Treatment is challenging and can require significant reconstructive surgery. The objective of this video is to present a case of vaginal stenosis after radiation and describe vaginal reconstruction with a fasciocutaneous Singapore flap. METHODS: We describe the case of a 42-year-old woman with a history of stage 3 colorectal cancer who underwent partial colectomy, chemotherapy, and pelvic radiation...
September 28, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27673515/revision-vaginoplasty-a-comparison-of-surgical-outcomes-of-laparoscopic-intestinal-versus-perineal-full-thickness-skin-graft-vaginoplasty
#18
Wouter B Van der Sluis, Mark-Bram Bouman, Marlon E Buncamper, Margriet G Mullender, Wilhelmus J Meijerink
BACKGROUND: Vaginal (re)construction can greatly improve the quality of life of indicated patients. If primary vaginoplasty fails, multiple surgical approaches exist for revision. The authors compared surgical results of laparoscopic intestinal versus full-thickness skin graft revision vaginoplasty. METHODS: A retrospective chart review of patients who underwent revision vaginoplasty at the authors' institution was conducted. Patient demographics, surgical characteristics, complications, hospitalization, reoperations, and neovaginal depth for both surgical techniques were recorded and compared...
October 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27670429/phantom-rectal-sensations-following-abdominoperineal-excision-of-the-rectum-aper-and-vertical-rectus-abdominis-myocutaneous-vram-flap-perineal-reconstruction
#19
Charlotte R Gould, Graham Branagan
AIM: Phantom rectum is the sensation of an intact and/or functioning rectum, despite excision at surgery. Abdominoperineal excision of the rectum (APER) may be complemented by reconstructive operations and recently it was reported that patients undergoing APER and vertical rectus abdominis myocutaneous (VRAM) flap reconstruction are more prone to develop phantom sensations at an earlier timeframe and have more persistent symptoms than those who do not have perineal repairs. The aim of this study was to determine the prevalence of phantom rectal sensations in a cohort of these patients...
November 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27642724/is-a-curved-3d-ultrasound-reconstruction-needed-to-assess-the-warped-pelvic-floor-plane
#20
Aly Youssef, Marta Cavalera, Giuseppina Pacella, Ginevra Salsi, Giovanni Morganelli, Elisa Montaguti, Ilaria Cataneo, Gianluigi Pilu, Nicola Rizzo
OBJECTIVES: Caudal distension of female pelvic floor is common and results in perineal descent and a caudally curved hiatus (so called 'warping'). All the available ultrasound techniques to date however aim to reconstruct the pelvic floor using linear techniques (flat plane reconstruction). We aimed to evaluate the feasibility, reproducibility and potential usefulness of a new 3D technique, capable of reconstructing a curved plane of the levator hiatus. METHODS: We recruited a group of primiparous women to perform a 3D/4D transperineal ultrasound 3-6 months after delivery...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
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