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Peng Z, Huang Y, Chen Y, Lyu Y, Wu M, Xie H, Chen F. Urethro-urethrostomy for urethral duplication (Type IIA1) in a 3-years-old boy: Surgical approach. J Pediatr Urol 2024; 20:147-148. [PMID: 37806833 DOI: 10.1016/j.jpurol.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION To report a novel maneuver of end-to-side urethro-urethrostomy for managing Type IIA1 urethral duplication (UD). MATERIALS AND METHODS A 3-years-old boy was referred to our institute for abnormal appearance of genitalia. Physical examination revealed an epispadiac meatus on the dorsum of the penile shaft, in addition to the orthotopic meatus at the tip of glans. He can void through both urethrae with continence (grade I). Voiding cystourethrography and the cystoscopy confirmed the Type IIA1 UD with two urethrae arising independently from the bladder neck. A novel maneuver of end-to-side urethro-urethrostomy transferring the dorsal urethra through the corpus cavernosa and anastomosing it to the posterior wall of the ventral urethra was successfully performed. RESULTS The urethral catheter was removed 2 weeks postoperatively. Neither urethral stricture nor fistula was noticed. After 1 year of followed-up, the boy can void fluently with continence (grade I). The Qmax was 10.4 ml/s. CONCLUSION Our maneuver of end-to-side urethro-urethrostomy for managing Type IIA1 UD was safe and effective, especially for the continent cases with the ectopic meatus on the penile shaft.
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Affiliation(s)
- Zhiwei Peng
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yichen Huang
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yan Chen
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Yiqing Lyu
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Min Wu
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Hua Xie
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Fang Chen
- Department of Urology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Pina IM, Omar AM, Floyd MS. Letter to the editor: Comparison of perineal urethrostomy versus augmentation urethroplasty in anterior urethral stricture disease. Urologia 2024; 91:238-239. [PMID: 37747139 DOI: 10.1177/03915603231199809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Affiliation(s)
- Ines M Pina
- Department of Reconstructive Urology, St Helens & Knowsley Hospital NHS Trust, Whiston Hospital Merseyside, UK
| | - Ahmad M Omar
- Department of Reconstructive Urology, St Helens & Knowsley Hospital NHS Trust, Whiston Hospital Merseyside, UK
| | - Michael S Floyd
- Department of Reconstructive Urology, St Helens & Knowsley Hospital NHS Trust, Whiston Hospital Merseyside, UK
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Yang Y, Long J, Yang J, Zheng H, Lai Y, Chen C, Tang F, Gao Y, Chen L, He Z. METTL3-dependent m6A modification mediates bladder remodeling after partial bladder outlet obstruction through CCN2 activation. Neurourol Urodyn 2023; 42:1506-1521. [PMID: 37455557 DOI: 10.1002/nau.25233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023]
Abstract
AIMS N6-methyladenosine (m6A) modification is a critical posttranscriptional event in gene regulation. Thus, identifying methyltransferase, demethylase, or m6A binding protein-mediated m6A modifications in cancer or noncancer transcriptomes has become a promising novel strategy for disease therapy development. However, novel insights into m6A modification in partial bladder outlet obstruction (pBOO) and detailed information about the drivers of bladder remodeling remain to be elucidated. Here, we first characterized the m6A modification landscape in pBOO and investigated potential actionable pharmaceutical targets for future therapies. METHODS We generated an improved animal model of pBOO in SD rats with urethral meatus stricture induced by suturing. Urodynamic investigations and cystometry were carried out to evaluate the physiologic changes elicited by pBOO. Whole-transcriptome sequencing (RNA-seq) and m6A-modified RNA immunoprecipitation sequencing (MeRIP-seq) were subsequently performed to analyze the expression pattern associated with bladder remodeling in pBOO. RESULTS The cystometric evaluation of bladder function demonstrated obvious increases in pressure-related parameters in the pBOO group. Hematoxylin and eosin staining and Masson's trichrome staining validated the occurrence of bladder remodeling. A global elevation in m6A RNA methylation levels was observed in parallel to a increased expression of METTL3 in the pBOO group. High-throughput sequencing revealed the differences in expression patterns between the pBOO and sham-operated groups. Furthermore, potential m6A-modified genes, including CCN2, may serve as new pharmaceutical targets to reverse bladder remodeling. CONCLUSIONS Exploring the roles of m6A-modified genes identified as associated with bladder remodeling by integrating RNA-seq and MeRIP-seq data can offer new insights for developing promising treatments for pBOO patients.
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Affiliation(s)
- Yafei Yang
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jun Long
- Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
- Graduate School, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jin Yang
- Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Hanxiong Zheng
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yongchang Lai
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Chiheng Chen
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Fucai Tang
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yibo Gao
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Lin Chen
- Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Zhaohui He
- Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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Li K, Ding K, Zhu Q, Han F, He X, Tan S, Wu Z, Zheng Z, Tang Z, Liu Y. Extracellular matrix stiffness aggravates urethral stricture through Igfbp3/Smad pathway. Sci Rep 2023; 13:14315. [PMID: 37653219 PMCID: PMC10471624 DOI: 10.1038/s41598-023-41584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023] Open
Abstract
Urethral stricture refers to the narrowing of the urethral lumen. While previous studies have hinted at inflammation as the initial driver of this condition, the reasons and mechanisms behind its progression remain largely unknown. By Atomic force microscope (AFM), researchers measured the matrix stiffness of urethra to be 5.23 ± 0.37 kPa for normal tissue and 41.59 ± 2.48 kPa for stricture urethral scar. Similar results were observed in rat urethral stricture models, where the matrix stiffness of normal urethra was 4.29 ± 0.82 kPa, while 32.94 ± 7.12 kPa for urethral stricture scar. Notably, the matrix stiffness increased in rat models over time. To further investigate, polyacrylamide hydrogels were employed to mimic different levels of stiffness for normal and stricture condition. Interestingly, higher matrix stiffness led to an increased fibroblast-to-myofibroblast transition (FMT) in rat urethral fibroblasts, indicated by enhanced expression of α-SMA and Collagen I, as well as changing in the morphology of fibroblast. RNA-seq analysis suggested that Igfbp3/Smads might regulate the progressive FMT in urethral stricture. In the experiment where the expression of Igfbp3 was inhibited, increasing matrix stiffness lose the potential to stimulate FMT progression and the expression of p-Smad2/3 decreased. On the contrary, overexpression of Igfbp3 promoted the process of FMT in urethral fibroblasts. In conclusion, Igfbp3/Smad pathway appeared to be involved in the progression of urethral fibrosis. This finding suggested that Igfbp3/Smad might be an promising target for future research and treatment in this filed.
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Affiliation(s)
- Kaixuan Li
- Department of Cardiac Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Ke Ding
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Quan Zhu
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Feng Han
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Xi He
- Department of Orthopedics, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, 310003, Zhejiang, China
| | - Shuo Tan
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Department of Urology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Ziqiang Wu
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Zhihuan Zheng
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Zhengyan Tang
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Yanling Liu
- Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
- Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, 87 Xiangya Road, Changsha, 410008, Hunan, China.
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Hyuga T, Fujimoto K, Hashimoto D, Tanabe K, Kubo T, Nakamura S, Ueda Y, Fujita-Jimbo E, Muramatsu K, Suzuki K, Osaka H, Asamura S, Moriya K, Nakai H, Yamada G. Wound healing responses of urinary extravasation after urethral injury. Sci Rep 2023; 13:10628. [PMID: 37391520 PMCID: PMC10313654 DOI: 10.1038/s41598-023-37610-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/24/2023] [Indexed: 07/02/2023] Open
Abstract
The post-surgical fluid leakage from the tubular tissues is a critical symptom after gastrointestinal or urinary tract surgeries. Elucidating the mechanism for such abnormalities is vital in surgical and medical science. The exposure of the fluid such as peritonitis due to urinary or gastrointestinal perforation has been reported to induce severe inflammation to the surrounding tissue. However, there have been no reports for the tissue responses by fluid extravasation and assessment of post-surgical and injury complication processes is therefore vital. The current model mouse study aims to investigate the effect of the urinary extravasation of the urethral injuries. Analyses on the urinary extravasation affecting both urethral mesenchyme and epithelium and the resultant spongio-fibrosis/urethral stricture were performed. The urine was injected from the lumen of urethra exposing the surrounding mesenchyme after the injury. The wound healing responses with urinary extravasation were shown as severe edematous mesenchymal lesions with the narrow urethral lumen. The epithelial cell proliferation was significantly increased in the wide layers. The mesenchymal spongio-fibrosis was induced by urethral injury with subsequent extravasation. The current report thus offers a novel research tool for surgical sciences on the urinary tract.
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Affiliation(s)
- Taiju Hyuga
- Department of Developmental Genetics Institute of Advanced Medicine, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan.
- Department of Pediatric Urology, Jichi Medical University Children's Medical Center Tochigi, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan.
| | - Kota Fujimoto
- Department of Developmental Genetics Institute of Advanced Medicine, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan
- Department of Plastic and Reconstructive Surgery, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan
| | - Daiki Hashimoto
- Department of Developmental Genetics Institute of Advanced Medicine, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan
| | - Kazuya Tanabe
- Department of Pediatric Urology, Jichi Medical University Children's Medical Center Tochigi, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Taro Kubo
- Department of Pediatric Urology, Jichi Medical University Children's Medical Center Tochigi, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Shigeru Nakamura
- Department of Pediatric Urology, Jichi Medical University Children's Medical Center Tochigi, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Yuko Ueda
- Department of Urology, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan
| | - Eriko Fujita-Jimbo
- Department of Pediatrics, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Kazuhiro Muramatsu
- Department of Pediatrics, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Kentaro Suzuki
- Faculty of Life and Environmental Sciences, University of Yamanashi, Takeda 4-4-37, Kofu City, Yamanashi, 400-8510, Japan
| | - Hitoshi Osaka
- Department of Pediatrics, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Shinichi Asamura
- Department of Plastic and Reconstructive Surgery, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan
| | - Kimihiko Moriya
- Department of Pediatric Urology, Jichi Medical University Children's Medical Center Tochigi, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Hideo Nakai
- Department of Pediatric Urology, Jichi Medical University Children's Medical Center Tochigi, Yakushiji 3311-1, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Gen Yamada
- Department of Developmental Genetics Institute of Advanced Medicine, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan.
- Department of Plastic and Reconstructive Surgery, Wakayama Medical University, Kimiidera 811-1, Wakayama City, Wakayama, 641-8509, Japan.
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Satyagraha P, Alluza HHD, Indradiputra IMU, Purnomo AF, Nurhadi P, Anita KW, Yueniwati Y, Permatasari HK, Purnomo BB. TGF-β1 Effects on Total Collagen of the New Zealand Rabbit's Urethral Wall (Oryctolagus cuniculus) in Animal Models of Urethral Stricture. Med Arch 2023; 77:189-193. [PMID: 37700922 PMCID: PMC10495137 DOI: 10.5455/medarh.2023.77.189-193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/10/2023] [Indexed: 09/14/2023] Open
Abstract
Background Currently, animal models of urethral stricture are not standardized. Transforming Growth Factor Beta 1 (TGF-β1) regulates extracellular matrix deposition in homeostatic and pathological responses. Objective The aim of this study was to present the potential model to be developed as a urethral stricture. Methods True experimental laboratory research was conducted by using Male New Zealand rabbits (Oryctolagus cuniculus), which were divided into 5 groups; control, placebo, and 3 treatment groups (TGF-β1 injection of 1 µg, 2 µg, 4 µg). Urethrography, histopathological analysis, and evaluation of total collagen formation of the urethral wall were performed after 6 weeks. Results An increase in the dose of TGF-β1 decreased the mean rabbit's urethral lumen diameter (29.3% in the 2µg group and 34% in the 4µg group) compared to controls. Three rabbits decreased as much as ≤ 50% in urethral lumen diameter. Significant increases in total collagen density in the periluminal and peripheral urethral spongiosum were noted by increasing doses of TGF-β1. The percentage of urethral lumen diameter has a strong negative correlation with periluminal total collagen density (r = -0,798; p = 0,000) and very strong negative correlation with peripheral spongiosa total collagen density (r = -0,748, p = 0,000). Conclusion TGF-β1 plays a role in changing total collagen compositions of the rabbit's urethral wall, decreasing the urethral lumen diameter. Further research with increasing doses of TGF-β1 is needed to determine the effective dose of TGF-β1 in inducing urethral stricture.
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Affiliation(s)
- Paksi Satyagraha
- Doctoral Program in Medical Science, Faculty of Medicine Universitas Brawijaya, Malang, Indonesia
- Department of Urology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | - Hamid Hunaif Dhofi Alluza
- Department of Urology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | - I Made Udiyana Indradiputra
- Department of Urology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | - Athaya Febriantyo Purnomo
- Department of Urology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | - Pradana Nurhadi
- Department of Urology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | - Kenty Wantri Anita
- Department of Pathology Anatomy, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | - Yuyun Yueniwati
- Department of Radiology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
| | | | - Basuki Bambang Purnomo
- Department of Urology, Faculty of Medicine Universitas Brawijaya – Saiful Anwar General Hospital, Malang, Indonesia
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Krishna M, Chaudhary K, Sharma AP. Primary bladder neck obstruction in female: 'an enigmatic disorder'. BMJ Case Rep 2022; 15:e248851. [PMID: 35387794 PMCID: PMC8987696 DOI: 10.1136/bcr-2022-248851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 06/14/2023] Open
Abstract
A 36-year-old woman presented with problems of lower urinary tract symptoms for 2 years duration. Patient was being managed as a case of urethral stricture with routine calibration. Micturating cystourethrogram showed failure of bladder neck to open. On urodynamic study, she was found to have bladder outlet obstruction with high pressure, low flow pattern. Based on these findings, patient was diagnosed to have primary bladder neck obstruction (PBNO). She was also being evaluated for primary infertility and was to undergo in vitro fertilisation. She successfully underwent bladder neck incision after discussion about management options. Bladder neck incision is one of the accepted management options for PBNO. Post procedure patient was relieved of symptoms and also had an uneventful full-term pregnancy. Bladder neck incision in women is an effective treatment option when patient has been properly selected and procedure done with expert hands.
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Affiliation(s)
- Murali Krishna
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kapil Chaudhary
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditya Prakash Sharma
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Fenner V, Vouga L, Vaccaro F, Iselin CE. [Urology]. Rev Med Suisse 2022; 18:201-204. [PMID: 35107897 DOI: 10.53738/revmed.2022.18.767.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Over this last year, urology has progressed both in oncology and reconstructive surgery. Genomic tests have been since quite a few years foreseen as very promising prognostic factors of prostate cancer, however remaining not clearly convincing. At last, the present data available seem to favour their contribution to improve selecting patients for active surveillance. For the same cancer, but at a metastatic stage resistant to androgenic deprivation, therano stics is providing an elegant targeting of disseminated tumor cells using a PSMA radio-active ligand fatal for the latter. Finally, penile urethral strictures appear to convincingly benefit on a long-term basis from a new method to place the substitution tissue which will restore urethral caliber.
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Affiliation(s)
- Vanessa Fenner
- Service d'urologie, Département de chirurgie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Leo Vouga
- Service d'urologie, Département de chirurgie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Francesco Vaccaro
- Service d'urologie, Département de chirurgie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Christophe E Iselin
- Service d'urologie, Département de chirurgie, Hôpitaux universitaires de Genève, 1211 Genève 14
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Bakheet OE, Hassan MA, Fahal AH. Extensive perineal Actinomadura pelletieri actinomycetoma-induced urethral stricture: a rare complication. Trans R Soc Trop Med Hyg 2021; 115:415-419. [PMID: 33399848 DOI: 10.1093/trstmh/traa166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/15/2020] [Accepted: 11/26/2020] [Indexed: 11/14/2022] Open
Abstract
Mycetoma is a neglected tropical disease that causes tremendous suffering and misery to affected patients. In Sudanese rural communities, many patients hide their lesions, especially those located in the perineal, scrotal, inguinal and genital regions, and they regard them as sources of social stigma. We report the case of a 45-year-old male from northern Kordofan State, Sudan, who presented with multiple discharging sinuses in the perineal region. Clinical diagnosis was actinomycetoma and fine-needle aspiration cytology was consistent with Actinomadura pelletieri, confirmed by culture and biochemical analysis. To our knowledge, this is the first case of A. pelletieri with urethral complications and subsequent implications for management.
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10
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De Rose AF, Ambrosini F, Tomasello L, Boccardo F, Terrone C. Urethral stricture and scrotal abscess: a rare case presentation of penile cancer and review of the literature. Aging Male 2020; 23:991-994. [PMID: 31397610 DOI: 10.1080/13685538.2019.1650017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Penile cancer is a very rare malignancy and it is usually identified as a nodule or an ulceration. We report a case of locally advanced penile cancer presented as a urethral stricture and recurrent scrotal abscess. The patient had been treating for obstructive voiding symptoms and septic condition for 5 months. Because of persistent symptoms, a drainage of the abscess was performed and the histopathological examination showed infiltrating moderately differentiated squamous cell carcinoma of penis. He underwent a surgical Emasculation followed by the administration of a combination of chemotherapy (paclitaxel, ifosfamide, and cisplatin). We highlight the importance of including penile cancer in the differential diagnosis of scrotal abscess and urethral stricture. A multimodal approach is an effective strategy to manage the disease.
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Affiliation(s)
- Aldo Franco De Rose
- Department of Urology, San Martino University Hospital - IST National Cancer Research Institute, Genoa, Italy
| | - Francesca Ambrosini
- Department of Urology, San Martino University Hospital - IST National Cancer Research Institute, Genoa, Italy
| | - Laura Tomasello
- Academic Unit of Medical Oncology, San Martino University Hospital - IST National Cancer Research Institute, Genoa, Italy
| | - Francesco Boccardo
- Department of Urology, San Martino University Hospital - IST National Cancer Research Institute, Genoa, Italy
| | - Carlo Terrone
- Department of Urology, San Martino University Hospital - IST National Cancer Research Institute, Genoa, Italy
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Perez-Carral JR, Cansino R, Trelles C, Quintana LM, Mainez JA, Martínez-Piñeiro L. [Holmium laser prostate enucleation. All we should aim for.]. ARCH ESP UROL 2020; 73:699-708. [PMID: 33025915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Prostate enucleation is becoming more relevant within BPH treatment. Nowadays is probably the gold standard for enucleation. Several studies have shown holmium laser as the most frequently used safe and efficient energy source. The long learning curve remains as its major drawback. The current review aims to describe step to step technique at our institutionand describing the rational for its use. METHODS A detailed description on our step-to-step Holep technique is provided. We focused on the main differences with other techniques already described highlighting the largest experience reported. RESULTS None of the published series has shown better results in terms of functional, safety and less complications outcomes on the short and long term. No differences are shown in terms of intraoperative/postoperative blood loss, reoperations, capsular perforations or urethral strictures. Our techniques provides shorter surgical length and improved efficiency than blocking and trilobular techniques. The rates of early continence are 4% vs5-40%. Lastly, improvement in morcellator devices delivered no complications related to that part of the surgery. CONCLUSIONS Holep is the gold standard technique for prostate enucleation. It provides improved functional and safety outcomes than with other techniques. A standardized and optimized technique is mandatory.
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Affiliation(s)
| | - Ramón Cansino
- Servicio de Urologia. Hospital Universitario La Paz. Madrid. España
| | - Carlos Trelles
- Servicio de Urologia. Hospital Universitario La Paz. Madrid. España
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王 建, 满 立, 徐 啸, 刘 振, 何 峰, 黄 广, 翟 建, 周 宁, 李 玮. [Combined transperineal and transpubic urethroplasty for patients with complex male pelvic fracture urethral distraction defect]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:646-650. [PMID: 32773794 PMCID: PMC7433633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Indexed: 05/08/2024]
Abstract
OBJECTIVE To evaluate the clinical effects and characteristics of combined transperineal and transpubic urethroplasty for patients with complex pelvic fracture urethral distraction defect (PFUDD). METHODS We retrospectively reviewed the clinical data of 17 male patients with complex posterior PFUDD from January 2010 to December 2019. The complications included urethrorectal fistulas in 2 patients (11.8%), urethroperineal fistula in 1 patient (5.9%). Ten patients had undergone previous treatments: dilatation in 3 patients (17.6%), internal urethrotomy in 1 patient, failed urethroplasty in 6 patients (35.3%), of whom 2 patients had two times of failed urethroplasties. All the patients were performed with urethroplasty by combined transperineal and transpubic approach with removing the entire pubic bone followed by the anastomosis. RESULTS The mean age of the patients included in this study was 35.5 (range: 21-62) years. The mean length of stricture was 5.5 (range: 4.5-7.0) cm, the mean follow-up was 27 (range: 7-110) months, the mean time of operation was 190 (range: 150-260) min, the mean evaluated blood loss was 460 (range: 200-1 200) mL. There were 5 patients who needed blood transfusion intraoperatively or postoperatively. Wound infection was seen in 4 out of 17 patients and thrombosis of lower extremities in 1 out of 17 patients. The last follow-up showed that the mean postoperative maximum urinary flow rate was 22.7 (range: 15.5-40.7) mL/s. After removing the catheter, one patient presented with decreased urinary flow and symptoms of urinary infection. Cystoscopy showed the recurrent anastomotic stricture, which was cured by internal urethrotomy. In our series, the success rate of the combined transperineal and transpubic urethroplasty was 94.1% (16/17). CONCLUSION Combined transperineal and transpubic urtheroplasty can achieve a tension free anastomosis after removing the entire wedge of pubis in some patients with complex PFUDD. However, this procedure should be completed in a regional referral hospital due to the complexity of the operation and the high percentage of complications.
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Affiliation(s)
- 建伟 王
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 立波 满
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 啸 徐
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 振华 刘
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 峰 何
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 广林 黄
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 建坡 翟
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 宁 周
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
| | - 玮 李
- />北京积水潭医院, 北京大学第四临床医学院泌尿外科, 北京 100096Department of Urology, Beijing Jishuitan Hospital, the Fourth Medical College of Peking University, Beijing 100096, China
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Lozano JL, Ruiz S, Fernández R, Gutiérrez G, Iturregui AM, Anton M. [20 years urethroplasty experience. Retrospective review and outcomes.]. ARCH ESP UROL 2020; 73:89-95. [PMID: 32124838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
To present the evolution in the diagnosis and treatment of urethral stricture, after performing 300 surgical procedures over urethral meatus,penile and bulbar urethra along 20 years, contrasting two surgical periods: from 1997-2006 to 2007-2016. MATERIAL AND METHODS: A retrospective review of495 medical records between 1997-2016 was conducted.All the patients treated with urethroplasty were included and those who under went internal urethrotomy,stents or dilatations plus those with strictures due to prostate cancer treatment or orthotopic neobladder were excluded. RESULTS: 300 patients were selected: 100 patients within the first period (1997-2006) and 200 within the second (2007-2016). The median follow-up was 36 months (range 12-60). In relation to the surgical techniques, among the most employed, four are outstanding so their results can be compared in both periods:termino-terminal urethroplasty, penile flap urethroplasty and the buccal mucosa in penile or bulbar urethroplasty.Other techniques were incorporated during the second period. The best outcomes were provided by end' to endurethroplasty with 90 and 92% success. Over the second period, buccal mucosa indications were consolidated with an increase use from 16% to 56%. Were considered as successful those patients that did not need any endoscopic procedure and reporting excellent urinary flow without low urinary tract symptoms. CONCLUSIONS: A trend towards an increased usage of open surgery vs urethrotomy is observed. Buccal mucosa graft has been consolidated as a reconstructive technique. End-to end urethroplasty seems to provide the best functional outcomes.
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Affiliation(s)
- José Luis Lozano
- Servicio de Urología. Hospital Universitario de Cruces. Baracaldo. España
| | - Sara Ruiz
- Servicio de Urología. Hospital Universitario de Cruces. Baracaldo. España
| | - Ramón Fernández
- Servicio de Urología. Hospital Universitario de Cruces. Baracaldo. España
| | - Garazi Gutiérrez
- Servicio de Urología. Hospital Universitario de Cruces. Baracaldo. España
| | | | - Marta Anton
- Servicio de Urología. Hospital Universitario de Cruces. Baracaldo. España
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Kozyrev GV, Manasherova DT, Abdulkarimov GA, Kushnir BL, Abdullaev FK, Nikolaev VV, Gazimiev MA. [Comparative histological analysis of different materials used for urethroplasty in children with proximal forms of hypospadias: preputial skin vs buccal mucosa]. Urologiia 2019:87-91. [PMID: 32003174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM Buccal mucosa and preputial skin grafts are used for staged urethroplasty in proximal forms of hypospadias in children. Aim of our study was to carry out a comparative histological analysis of preputial skin and buccal mucosa. METHOD s and materials: Histological analysis of urethral tissue samples from 10 patients with proximal forms of hypospadias was conducted. All patients were treated with staged Brackas technique using free grafts at the Russian Childrens Clinical Hospital from 2013 to 2016. Patients were divided into two groups. In Group I (n=5), preputial skin graft was used for urethroplasty, while in Group II (n=5) buccal mucosa was taken. A histological study of both materials with comparison to a native urethra was performed. RESULTS In Group I, the histological analysis showed keratinizing multilayered squamous epithelium, large number of dilated sweat and sebaceous glands with signs of inflammation, and hair follicles. In Group II, histological analysis revealed the presence of the typical structure for mucosal tissue, including multilayered flat non-keratinizing epithelium, as well as full absence of sweat, sebaceous glands, and hair follicles. CONCLUSION comparative histological analysis of neourethra has shown the absence of sweat and sebaceous glands, hair follicles, and areas of chronic inflammation in buccal mucosa vs preputial skin, showing that buccal mucosa is more similar to native urethra. Therefore, buccal mucosa is favored as the material for urethroplasty.
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Affiliation(s)
- G V Kozyrev
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - D T Manasherova
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - G A Abdulkarimov
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - B L Kushnir
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - F K Abdullaev
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - V V Nikolaev
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - M A Gazimiev
- Department of Uroandrology of the Russian Childrens Clinical Hospital, Moscow, Russia
- Faculty of Fundamental Medicine, Moscow State University, Moscow, Russia
- Department of Pathologic Anatomy of the Russian Childrens Clinical Hospital, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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Zhivov AV, Tedeev RL, Koshmelev AA, Karpovich AV, Yudovskyi SO, Pushkar DY. [Results of treatment and risk factors for recurrence of iatrogenic urethral strictures in men]. Urologiia 2019:7-13. [PMID: 31808625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM Iatrogenic etiologies continue playing an increasing role in the formation of urethral strictures (US) in the industrially developed countries. Our aim was to study specific iatrogenic causative factors in the etiology of US, treatment efficacy and risk factors of their recurrence. MATERIALS AND METHODS A total of 230 men with iatrogenic urethral strictures operated between 2008 and 2017 were included into the study group. Median age was 58.7+/-15.3 years. Inclusion criteria were presence of iatrogenic etiologic factor, open reconstruction or visual internal urethrotomy as a treatment, absence of other etiologic factors. Patients were investigated using the standard protocol. Postoperative follow up time ranged from 14 to 102 months, median 43 months. RESULTS Average stricture length was 5,8+/-4,7 cm (1-24 cm). Primary stricture was diagnosed in 107 (46.5%) patients, while 123 (53.5%) patients with recurrent stricture were treated. Localization of urethral stricture was as following: anterior urethra (62.2%), posterior urethra (12.6%) and combined anterior/posterior strictures (25.2%). Endoscopic surgical procedures were the major cause of iatrogenic US followed by urethral catheterizations, hypospadias repair and surgical/radiation therapy of prostate cancer. The whole efficacy of surgical treatment in iatrogenic US was 84,8%. Treatment success after anastomotic urethroplasties was higher than after augmented or substitution surgical procedures. Independent risk factors for US recurrence were: 1) augmentation or substitution urethroplasty; 2) history of hypospadias repair; 3) stricture length more or equal 5,5 cm. CONCLUSION Establishment of the particular etiologic factors may help to prevent iatrogenic US. Current methods of the US surgical management are highly effective but anastomotic urethroplasties should be preferred over augmentation and substitution techniques when possible.
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Affiliation(s)
- A V Zhivov
- Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
- Municipal clinical hospital named after S.I. Spasokukotskiy, Moscow, Russia
| | - R L Tedeev
- Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
- Municipal clinical hospital named after S.I. Spasokukotskiy, Moscow, Russia
| | - A A Koshmelev
- Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
- Municipal clinical hospital named after S.I. Spasokukotskiy, Moscow, Russia
| | - A V Karpovich
- Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
- Municipal clinical hospital named after S.I. Spasokukotskiy, Moscow, Russia
| | - S O Yudovskyi
- Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
- Municipal clinical hospital named after S.I. Spasokukotskiy, Moscow, Russia
| | - D Yu Pushkar
- Department of Urology of A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
- Municipal clinical hospital named after S.I. Spasokukotskiy, Moscow, Russia
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Veliev EI, Bogdanov AB, Katibov MI, Loran OB. [Non-transecting anastomotic urethroplasty]. Urologiia 2019:135-140. [PMID: 31535820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The review analyzes the results of using non-transecting anastomotic urethroplasty in men with urethral strictures. Identified 14 original studies using this technique: 13 foreign and 1 Russian. In total, this technique was applied in 704 patients. This technique was used in 85% of cases with bulbar urethral stricture, in 15% - with posterior stricture.The average length of the urethral stricture in all studies was less than 2 cm, except for two works, where the average stricture length was 2.3 cm and 3.9 cm, respectively. This technique is equally successfully applied in all etiological variants of urethral stricture. The incidence of postoperative complications in all studies using non-transecting anastomotic urethroplastyaveraged 13.7%.Postoperative complications were mostly mild and corresponded to G1 according to Clavien-Dindo classification.According to 10 out of 14 studies that evaluated the effect of surgical treatment on the occurrence of erectile dysfunction (ED), the incidence of ED de novo was on average 13.4%. The success of treatment with the use of non-transecting anastomotic urethroplastyaveraged 95% (82-100%) with a median postoperative follow-up of 27 months (6-64 months). In 4 out of 14 studies, an additional comparison was transecting versus non-transecting techniques. Non-transecting technique was not inferior to transecting technique by any criterion, but, on the contrary, exceeded it in a number of indicators, including the dynamics of sexual function after surgery.On the basis of available studies on the use of non-transecting anastomotic urethroplasty, this technique should be recognized as a highly efficient and reasonably safe method for treating short urethral strictures and recommended for widespread clinical use.
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Affiliation(s)
- E I Veliev
- S.P. Botkin City Clinical Hospital, Moscow, Russia
- Federal State Budgetary Educational Institution of Further Professional Education Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- State budgetary institution of the Republic of Dagestan City Clinical Hospital No. 1, Makhachlala, Russia
| | - A B Bogdanov
- S.P. Botkin City Clinical Hospital, Moscow, Russia
- Federal State Budgetary Educational Institution of Further Professional Education Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- State budgetary institution of the Republic of Dagestan City Clinical Hospital No. 1, Makhachlala, Russia
| | - M I Katibov
- S.P. Botkin City Clinical Hospital, Moscow, Russia
- Federal State Budgetary Educational Institution of Further Professional Education Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- State budgetary institution of the Republic of Dagestan City Clinical Hospital No. 1, Makhachlala, Russia
| | - O B Loran
- S.P. Botkin City Clinical Hospital, Moscow, Russia
- Federal State Budgetary Educational Institution of Further Professional Education Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
- State budgetary institution of the Republic of Dagestan City Clinical Hospital No. 1, Makhachlala, Russia
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Kogan MI, Amirbekov BG, Kryuchkova MN, Mitusov VV, Krasulin VV, Sizyakin DV. [The influence of urethral stricture disease and urethroplasty on anxiety and depression in men]. Urologiia 2018:60-63. [PMID: 30575351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The relationship of surgical treatment of urethral stricture and such mental deviations as anxiety and depression is still poorly understood. Particularly, there is no reliable data on how mental status is associated to surgical treatment of the urethral stricture and its efficacy. AIM to study the indicators of anxiety and depression in patients with urethral stricture before and after surgery. MATERIALS AND METHODS The prospective study involving 30 men aged 20-74 years with urethral stricture of various etiologies and localizations was conducted. The validated questionnaires, HADS-1 and HADS-2 were used to evaluate anxiety and depression, lower urinary tract symptoms (I-PSS-QoL), erectile dysfunction (IIEF-5) before and 3 and 6 months after surgery. RESULTS Almost all patients with urethral stricture before surgery had an increased level of anxiety and depression, which in 70% cases decreased to normal values by 6 months after successful surgery. Clinically, these changes correlated with the improvement of lower urinary tract symptoms. The restoration of erectile function in patients by 6 months was less pronounced, though it had no influence on the resolution of anxiety/depression. CONCLUSION The determination of psycho-emotional status in patients with urethral stricture before and after urethroplasty should be as important for the evaluation of the efficiency of surgical treatment, as the resolution of lower urinary tract symptoms and restoration of sexual function.
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Affiliation(s)
- M I Kogan
- Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
| | - B G Amirbekov
- Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
| | - M N Kryuchkova
- Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
| | - V V Mitusov
- Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
| | - V V Krasulin
- Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
| | - D V Sizyakin
- Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
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Kogan MI, Dementieva IY, Mitusov VV, Glukhov VP, Krasulin VV, Sizyakin DV, Ilyash AV. [Histopathological evaluation of the evolution of oral mucosa grafts used for augmentation urethroplasty]. Urologiia 2018:64-68. [PMID: 30575352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The clinical efficiency of oral mucosa grafts used for augmentation urethroplasty has been proven. However, a small number of studies in literature are dedicated to the determination of pathologic changes in grafts during the engraftment in the urethra. AIM to assess the histopathologic evolution of oral mucosa graft used for augmentation urethroplasty. MATERIAL AND METHODS A total of 15 patients aged 19-67 years with penile and combined penile/bulbar urethral strictures of length 3.5-11 cm were undergone to two-staged urethroplasty by Asopa technique. In 9 cases the pathologic study of oral mucosa grafts after sampling (buccal mucosa in 5 cases and lip mucosa in 4 cases) and 6 months after their engraftment in the urethra during the second stage of urethroplasty was performed. In other 6 cases the graft tissue in patients with recurrent stricture that occurred 12-24 months after tubularization and requiring additional intervention was studied. RESULTS The general structure of mucosal graft was preserved 6 months after sampling. The dystrophic changes in epithelium, inflammatory infiltration and foci of fibrosis in subepithelial layer were observed. Buccal grafts were distinguished by a smaller epithelium thickness and the presence of keratinization foci. The grafts also retained their structure after 12-24 months. A decrease in the severity of chronic inflammatory reaction and the absence of keratinization of the squamous buccal epithelium were found. The stricture in the area of anastomosis was characterized by the presence of sclerotic and fibrous connective tissue covered with urothelium. CONCLUSION The oral mucosa grafts completely preserve their histologic structure during 1-2 years and they are not involved in recurrence of urethral stricture, which develops in the area of anastomosis between graft and native urethra.
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Affiliation(s)
- M I Kogan
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
| | - I Yu Dementieva
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
| | - V V Mitusov
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
| | - V P Glukhov
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
| | - V V Krasulin
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
| | - D V Sizyakin
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
| | - A V Ilyash
- FGBOU VO Rostov State Medical University of Minzdrav of Russia, Rostov-on-Don, Russia
- GBU RO Medical and social expertise service, Rostov-on-Don, Russia
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Kotov SV, Belomitsev SV, Guspanov RI, Iritsyan MM, Surenkov DN, Semenov MK, Ugurchiev AM. [Surgical technique and the first clinical experience of augmentation urethroplasty without dividing of corpus spongiosum (KODAMA technique)]. Urologiia 2018:39-44. [PMID: 30575348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM In case of complex and long urethral stricture a use of augmentation technique is often limited by "critically" narrowing of urethral plate. In such cases, the augmentation anastomotic urethroplasty without division of the corpus spongiosum can be the method of choice, because it allows to perform simultaneous augmentation urethroplasty with maximal sparing of antegrade blood flow in corpus spongiosum. MATERIALS AND METHODS In urologic clinic of N.I. Pirogov City Clinical Hospital No1 the analysis of 17 patients who were undergone to augmentation anastomotic urethroplasty without division of the corpus spongiosum (Kodama technique), performed by single surgeon from 2013 to 2017 yy was done. The meant stricture length was 3.75 cm (2-6). Penile, bulbar and panurethral stricture was found in 6 (35.3%), 7 (41.2%) and 4 (23.5%) cases, respectively. RESULTS Technique efficiency was 88.2% and in 2 patients (11.8%) a stricture recurrence developed. The mean maximum flow rate before and after surgery were 5.4 and 23.1 ml/s, respectively (p<0.05). The mean catheterization time was 14 (7-30) days. There were no patients with de novo urinary incontinence and erectile dysfunction. CONCLUSION The initial results of augmentation anastomotic urethroplasty without division of the corpus spongiosum showed high efficiency. To our opinion, the antegrade blood flow sparing makes it the method of choice in patients with long non-traumatic urethral stricture (without severe spongiofibrosis), good preoperative erectile function but isolated length of "critically" narrowing of the urethral lumen.
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Affiliation(s)
- S V Kotov
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
| | - S V Belomitsev
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
| | - R I Guspanov
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
| | - M M Iritsyan
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
| | - D N Surenkov
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
| | - M K Semenov
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
| | - A M Ugurchiev
- Department of Urology and Andrology in N.I. Pirogov RNRMU of Minzdrav of Russia, Moscow, Russia
- N.I. Pirogov City Clinical Hospital
- Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital 64, Moscow Health Department, Moscow, Russia, Moscow, Russia
- N.E. Bauman City Clinical Hospital 29, Moscow, Russia
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Aydemir H. "Re: Direct Vision Internal Urethrotomy for Short Anterior UrethralStrictures and Beyond:Success Rates, Predictors of Treatment Failure, and Recurrence Management". Urology 2018; 124:312-313. [PMID: 30452969 DOI: 10.1016/j.urology.2018.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 09/11/2018] [Accepted: 09/15/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Hüseyin Aydemir
- Department of Urology, Sakarya University, Education and Research Hospital, Sakarya, Turkey.
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Siegel C. Re: Urethrography for Assessment of the Adult Male Urethra: RadioGraphics Fundamentals. J Urol 2018; 200:924-925. [PMID: 30360304 DOI: 10.1016/j.juro.2018.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2018] [Indexed: 11/30/2022]
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Kotov SV, Belomyttsev SV, Guspanov RI, Semenov MK, Iritsyan MM, Ugurchiev AM. [Iatrogenic urethral structures in men]. Urologiia 2018:56-63. [PMID: 30761791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Iatrogenic urethral damage is the leading etiologic factor for urethral stricture in men in developed countries and second after traumatic injury in developing ones. This study aimed to evaluate the frequency of iatrogenic strictures of the urethra and the results of their treatment. MATERIALS AND METHODS This retrospective analysis comprised 133 patients who were treated for iatrogenic urethral stricture from 2011to 2016. Group I included 72 (54%) patients after trans(intra)urethral interventions (transurethral resection of the prostate or urinary bladder), urethral dilation, traumatic catheterization, etc. Forty-five (34%) patients with post-catheter strictures (ischemic/post-inflammatory), 7 (5%) patients after failed treatment of hypospadias, and 9 (7%) patients after open adenomectomy made up groups II, III, and IV. The diagnosis of recurrent stricture and the need for repeat surgical intervention were determined based on uroflowmetry, urethrography, and urethrocystoscopy. RESULTS In group I, the mean extent (rank) of the stricture was 2 (0.1-15) cm, the most frequent location (85%) was the bulbar urethra. In group II, the most frequent location (71%) was also the bulbar urethra with a mean stricture length of 2.4 (0.3-13) cm. There were 4 cases of panurethral strictures, lesions of the penile urethra and meatal stenosis. In group III, the strictures were on average 6 (2-12) cm long. Patients group IV had strictures of the bulbar and prostatic urethra. In general, the effectiveness of endoscopic treatment (direct vision internal urethrotomy, DVIU) was 52%, the effectiveness of urethroplasty varied from 83 to 100% depending on the method. In group I, the effectiveness of the DVIU was 52%, various types of urethroplasty - 88-100%, in group II - 50% and 82-100%, respectively. In group III, the effectiveness of the single-stage/multi-stage buccal mucosa urethroplasty was estimated at 0%/100%. In group IV, the effectiveness of DVIU/urethroplasty/perineal prostatectomy was 20%/75%/100%. CONCLUSION The proportion of iatrogenic urethral strictures in large megacities can reach 45%. Iatrogenic urethral strictures most commonly result from catheterization and transurethral interventions. Each subgroup of iatrogenic strictures is characterized by its location, extent and degree of urethral spongiofibrosis. With the correct choice of surgical modality, urethroplasty is almost twice more effective than DVIU.
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Affiliation(s)
- S V Kotov
- N.I. Pirogov RNRMU of Minzdrav of Russia, Department of Urology and Andrology, Moscow, Russia
- N.I. Pirogov City Clinical Hospital 1, Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital, Moscow Health Department, Moscow, Russia
| | - S V Belomyttsev
- N.I. Pirogov RNRMU of Minzdrav of Russia, Department of Urology and Andrology, Moscow, Russia
- N.I. Pirogov City Clinical Hospital 1, Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital, Moscow Health Department, Moscow, Russia
| | - R I Guspanov
- N.I. Pirogov RNRMU of Minzdrav of Russia, Department of Urology and Andrology, Moscow, Russia
- N.I. Pirogov City Clinical Hospital 1, Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital, Moscow Health Department, Moscow, Russia
| | - M K Semenov
- N.I. Pirogov RNRMU of Minzdrav of Russia, Department of Urology and Andrology, Moscow, Russia
- N.I. Pirogov City Clinical Hospital 1, Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital, Moscow Health Department, Moscow, Russia
| | - M M Iritsyan
- N.I. Pirogov RNRMU of Minzdrav of Russia, Department of Urology and Andrology, Moscow, Russia
- N.I. Pirogov City Clinical Hospital 1, Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital, Moscow Health Department, Moscow, Russia
| | - A M Ugurchiev
- N.I. Pirogov RNRMU of Minzdrav of Russia, Department of Urology and Andrology, Moscow, Russia
- N.I. Pirogov City Clinical Hospital 1, Moscow Health Department, Moscow, Russia
- V.V. Vinogradov City Clinical Hospital, Moscow Health Department, Moscow, Russia
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Kyzlasov PS, Martov AG, Zabelin MV, Bokov AI, Kazhera AA. [Buccal mucosa substitution urethroplasty in a patient with an extensive urethral stricture]. Urologiia 2018:127-129. [PMID: 30761802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Urethral strictures are one of the most common reasons to see a urologist and are considered a socially significant disease. Management of urethral strictures is one of the challenging issues in urology. The article presents a case of a patient with extensive iatrogenic stricture of the penile urethra. The patient underwent penile augmentation urethroplasty using buccal mucosa resulting in the restoration of the whole length of the urethral lumen and non-obstructive urination according to uroflowmetry findings.
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Affiliation(s)
- P S Kyzlasov
- IPPE of A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia, Moscow, Russia
| | - A G Martov
- IPPE of A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia, Moscow, Russia
| | - M V Zabelin
- IPPE of A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia, Moscow, Russia
| | - A I Bokov
- IPPE of A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia, Moscow, Russia
| | - A A Kazhera
- IPPE of A.I. Burnazyan Federal Medical Biophysical Center, FMBA of Russia, Moscow, Russia
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Babu R, Hariharasudhan S, Ramesh C. Posterior urethra: Anterior urethra ratio in the evaluation of success following PUV ablation. J Pediatr Urol 2016; 12:385.e1-385.e5. [PMID: 27344603 DOI: 10.1016/j.jpurol.2016.04.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/21/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There are conflicting reports on the criteria with which to determine success following posterior urethral valve (PUV) ablation. The aims of this study were to assess the value of the posterior urethra: anterior urethra ratio (PAR) in predicting successful PUV ablation. MATERIALS AND METHODS All neonates and infants with confirmed PUV on voiding cystourethrogram (VCUG) were included. Initial PAR was computed by dividing maximum posterior urethral diameter by anterior urethral diameter. Distances were measured by an on-screen distance measurement tool in the Radiology department, to avoid error. Only oblique images with good voiding phases were used for assessment. All patients underwent cystoscopy and PUV ablation using cold knife. Postoperative VCUG and cystoscopy were performed at 3 months follow-up. Success was defined as cystoscopic resolution of obstruction, in addition to biochemical and radiological improvement, and this was compared with PAR findings. An equal number of age-matched control patients who had a normal VCUG (as a part of evaluation of antenatal hydronephrosis) were also analyzed. RESULTS A total of 56 patients (median age 15 days, range 3-250 days) were analyzed between 2013 and 2016. The mean PAR was 1.5 (0.42) in controls and 3.42 (0.75) in those with PUV at diagnosis (P = 0.001). In those with successful PUV ablation (n = 51) the mean PAR was 1.8 (0.21), and in those with residual PUV/stricture (n = 5) the mean PAR was 3.16 (0.54). The difference between these two groups was statistically significant (P = 0.0001). Applying the value of mean + 2 SD of successful PUV ablation, an upper limit of PAR >2.2 was proposed to predict failure. Using this cut-off, 4/7 with PAR >2.2 had confirmed failure, while 48/49 with PAR <2.2 had successful resolution (P = 0.001) CONCLUSION: Whenever the posterior urethra is more than 2.2 times the diameter of the anterior urethra (PAR >2.2) on repeat VCUG following a PUV ablation, a cystoscopy check is essential to rule out residual PUV/stricture.
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Affiliation(s)
- R Babu
- Department of Pediatric Urology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India.
| | - S Hariharasudhan
- Department of Pediatric Urology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
| | - C Ramesh
- Department of Pediatric Urology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, India
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Morey AF. Re: Critical Analysis of the Use of Uroflowmetry for Urethral Stricture Disease Surveillance. J Urol 2016; 196:1693. [PMID: 27845112 DOI: 10.1016/j.juro.2016.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Guo Q, Xiao Y, Li JW, Zhang JD, Zhang YG. [Safety and effect of transurethral holmium laser enucleation of the prostate versus bipolar transurethral plasmakinetic prostatectomy for benign prostatic hyperplasia: A meta-analysis]. Zhonghua Nan Ke Xue 2016; 22:914-922. [PMID: 29278474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the safety and effect of transurethral holmium laser enucleation of the prostate (HoLEP) in comparison with bipolar transurethral plasmakinetic prostatectomy (TUPKP) in the treatment of benign prostatic hyperplasia (BPH). METHODS We searched the databases of PubMed, SCI, Ovid, The Cochrane Library, CNKI, CBM, VIP, and Wangfang Data for controlled clinical trials about HoLEP versus TUPKP in the treatment of BPH published up to April 2016. The studies were screened according to the inclusion and exclusion criteria, the data extracted, and their quality evaluated by 2 reviewers independently, followed by a meta-analysis using the RevMan 5.3 software. RESULTS A total of 7 studies were included, involving 2031 cases. In comparison with TUPKP, HoLEP showed significantly longer operation time (WMD = 24.61, 95% CI 11.88, 37.34, P lt; 0.001), shorter hospital stay (WMD =-1.91, 95% CI -3.74, -0.07, P = 0.04), shorter bladder irrigation time (WMD = -21.50, 95% CI -34.95, -8.06, P = 0.002), shorter catheter-indwelling time (WMD = -27.60, 95% CI -48.17, -7.03, P = 0.009), less hemoglobin loss (WMD = - 0.42, 95% CI -0.78, -0.07, P = 0.02); lower postvoid residual urine (PVR) at 3 months (WMD = -3.35, 95% CI -4.46, -2.23, P<0.001) and 6 months after surgery (WMD =-1.11, 95% CI -2.18, -0.05, P = 0.04); higher maximum urinary flow rate (Qmax) (WMD = 0.42, 95% CI 0.04, 0.80, P = 0.03) and fewer urinary tract irritation symptoms (OR =0.58, 95% CI 0.41, 0.81, P = 0.002) at 12 months after surgery. No statistically significant differences were found between the two groups in the volume of resected tissue, serum sodium reduction, urethral stricture, erectile dysfunction, retrograde ejaculation, or transient urinary incontinence (P>0.05), or in the improvement of the quality of life (QoL) at 1, 3 and 12 months, International Prostate Symptom Score (IPSS) at 1, 3, 6 and 12 months, Qmax at 1, 3 and 6 months, or International Index of Erectile Function-5 (IIEF-5) at 6 months after surgery (P>0.05). CONCLUSIONS HoLEP is preferred to TUPKP in clinical application for its advantages of higher Qmax at 12 months after surgery, lower PVR at 3 and 6 months, higher peri-operative safety, faster recovery, and fewer urinary tract irritation symptoms. However, for the quantity and quality limitations of the included publications, our findings are to be further supported by large-sample, multi-center, and high-quality prospective controlled clinical studies.
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Affiliation(s)
- Qiang Guo
- Graduate School, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yi Xiao
- Graduate School, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jian-Wen Li
- Shanxi Academy of Medical Sciences, Shanxi Dayi Hospital, Taiyuan, Shanxi 030032, China
| | - Jian-Dong Zhang
- Shanxi Academy of Medical Sciences, Shanxi Dayi Hospital, Taiyuan, Shanxi 030032, China
| | - Yan-Gang Zhang
- Shanxi Academy of Medical Sciences, Shanxi Dayi Hospital, Taiyuan, Shanxi 030032, China
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Islam MR, Alam MM, Siddique MI, Rahman MA, Sami-Al-Hasan A, Choudhury IM. Comparative study of early and conventional catheter removal following buccal mucosal graft urethroplasty. Mymensingh Med J 2015; 24:290-294. [PMID: 26007256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The duration of catheterization period following urethroplasty is a great controversy. For buccal mucosal graft urethroplasty recommended catheterization period ranges from 2-4 weeks. In recent years, early catheter removal has been advocated for several reasons. Early catheter removal improves both patient comfort, mobility and reduces catheter related complications and shortens post operative hospital stay. This prospective observational study was done from January 2007 and December 2008, 50 patients underwent dorsal onlay buccal mucosal graft urethroplasty for stricture urethra. Among them 25 cases were selected for early catheter removal on 7th postoperative day and 25 cases for conventional catheter removal at 3 weeks. Three patients (12%) of early catheter removal group and 2 patients (8%) of conventional catheter removal group exhibited periurethral leakage. One patient (4%) and three patients (12%) developed wound infection in early and conventional catheter removal group respectively. No significant difference was observed in urinary flow (p=0.089). In these two groups the mean postoperative hospital stay was significant (p<0.001). Early catheter removal on 7th postoperative day is safe and has better impact on patient comfort with minimum catheter related complications and shortens hospital stay.
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Affiliation(s)
- M R Islam
- Dr Mohammed Rafiqul Islam, Medical Officer, Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka, Bangladesh
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Ren XL, Gao ZM, Xia HB, Bao GC, Li CS, Zhang H. [Transurethral resection of the prostate combined with 2-micron continuous-wave laser vaporesection for benign prostatic hyperplasia with the prostate volume > 80 ml]. Zhonghua Nan Ke Xue 2015; 21:136-139. [PMID: 25796686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To sum up the clinical experience in the management of benign prostatic hyperplasia (BPH) with the prostate weighing over 80 ml by transurethral resection of the prostate (TURP) combined with 2 μm continuous-wave laser vaporesection (LVR). METHODS We retrospectively analyzed the clinical effects of TURP combined with 2 μm LVR in the treatment of 46 cases of BPH with the prostate volume > 80 ml. RESULTS All the operations were successfully accomplished. The operation time and intraoperative blood loss were (112.0 ± 20.0) min (range 86-176 min) and (77.9 ± 25.9) ml (range 50-200 ml), respectively. The catheters were withdrawn at 7 days after surgery. Transient urinary incontinence occurred in 6 cases and secondary hemorrhage was found in 2 postoperatively. Six-month follow-up revealed no urethral stricture or other complications. Compared with the baseline, the international prostate symptom score (IPSS) was significantly decreased at 6 months after operation (26.3 ± 1.8 vs 11.6 ± 1.7, P <0.05), and so were the quality of life (QOL) score (5.3 ± 0.7 vs 1.3 ± 1.1, P <0.05) and post-void residual urine (PVR) ([115.5 ± 55.6] ml vs [19.9 ± 11.6] ml, P <0.05). However, the maximum urinary flow rate (Qmax) was remarkably increased from (4.1 ± 2.6) ml/s to (16.2 ± 1.7) ml/s (P <0.05). CONCLUSION TURP combined with 2 μm LVR is safe and effective for the treatment of BPH with the prostate volume >80 ml.
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Li X, Xu N, Xue X, Wei Y, Zheng Q, Sun X, Cai H, Jiang T. [One-stage nonstented tubularized incised plate urethroplasty for pain and complication after hypospadias repair]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014; 28:1505-1508. [PMID: 25826896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To comparatively analyze the effect of one-stage nonstented tubularized incised plate urethroplasty (TIP) on operative pain and complication by comparing with urethral catheter and urethral stent drainages. METHODS Between March 2010 and June 2013, 214 cases of distal and mid-shaft hypospadias underwent TIP, and the clinical data were analyzed retrospectively. The patients were divided into 3 groups based on different urinary drainage techniques: indwelling urethral catheter was used in 68 cases (group A), indwelling urethral stent in 70 cases (group B), and nonstented drainage in 76 cases (group C). There was no significant difference in age, hypospadias type, and accompany malformation among 3 groups (P > 0.05). At 2 days after operation, Wong-Banker facial scale (WBS) and Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) were used for pain and praxiology assessment. The complications after operation also were observed and compared among 3 groups. RESULTS All patients were followed up 6-25 months (median, 11.8 months). At 2 days after operation, the median WBS scores were 4.0 (0-10), 3.5 (0-10), and 3.0 (0-10) in groups A, B, and C, respectively; median CHEOPS pain scores were 6.0 (1-13), 6.0 (1-13), and 4.0 (1-11), respectively. The WBS pain score and CHEOPS pain score in group C were significantly lower than those in groups A and B (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The postoperative complication occurred in 27 cases (39.7%) of group A, 29 cases (41.4%) of group B, and 13 cases (17.1%) of group C; two or more than two complications occurred in 14, 15, and 9 cases, respectively. There was significant difference in total incidence of postoperative complication among 3 groups (P < 0.05). The incidences of postoperative overactive bladder, bladder spasms, urinary tract infection, and fistula in group C were significantly lower than those in groups A and B (P < 0.05). There was no significant difference in incision infection, acute urinary retention, urinary extravasation, meatal stenosis, and urethral stricture among 3 groups (P > 0.05). CONCLUSION One-stage nonstented TIP is suitable for distal and mid-shaft hypospadias and could reduce postoperative pain and complications compared with the traditional postoperative indwelling urethral catheter and indwelling urethral stent.
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Lu MJ, Wang Z, Zhou GD, Yu B, Liu W, Cao YL. [Construction of urethra mucosa structure in vitro by tissue engineering]. Zhonghua Nan Ke Xue 2008; 14:1072-1076. [PMID: 19157225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To construct a structure of urethra mucosa in vitro by tissue engineering. METHODS Primary porcine urothelial cells (UC) were obtained from the porcine bladder by enzymatic digestion and detected by immunofluorescence and RT-PCR. Bladder acellular matrix grafts (BAMG) were prepared, used as the scaffold and then evaluated by HE staining, Masson's trichrome staining, immunohistology and scanning electron microscopy. After in vitro culture and amplification, the UCs were seeded on the luminal surface the BAMGs. RESULTS After 1 week of in vitro culture, the UCs formed a multilayer structure on the luminal surface of the BAMGs along the basement membrane. The tissue-engineered urothelium and BAMG complex was well formed and pan cytokeratins were positively expressed in the UCs on the scaffold. CONCLUSION By tissue engineering, the urethra mucosa structure can be rapidly constructed in vitro, which can be applied to the repair of such urethral defect as hypospadias and urethral stricture.
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Affiliation(s)
- Mu-Jun Lu
- Department of Urology, The 9th People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
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Wiedemann A. [Catheterization with "pick-a-back" procedure]. Aktuelle Urol 2007; 38:369. [PMID: 17953039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Andreas Wiedemann
- Urologische Abteilung, Evangelisches Krankenhaus im Diakoniewerk Ruhr, Witten an der Ruhr
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Essiet A, Irekpita EE, Ekwere PD, Nkposong EO. Management Of Urethral Strictures In The UCTH Calabar. Niger Postgrad Med J 2007; 14:50-3. [PMID: 17356591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Forty-five consecutive cases of urethral stricture seen in a single unit over a three-year period (May 2000-April 2003) were studied to determine mode of presentation, symptoms on presentation, cause of the stricture, course of the illness and the outcome of treatment. Thirty-nine patients were treated while 6 were lost to follow up before definitive therapy could be given. Most of the patients were adult males in their prime of life. Strictures were as a result of urethritis in 24 (53.3%) cases, trauma in 16 (35.6%) cases, indwelling catheter in 3 (6.6%) cases and of uncertain aetiology in 2 (4.4%) cases. Three of the post-traumatic cases were post prostatectomy. Definitive treatment was by urethroplasty in 28 (62.2%) patients, bouginage in 11 (24.4%) patients.. Results of treatment were classified as 'GOOD' or 'POOR' based on patients' judgement of improved flow, observed improvement of flow and comparison of urethrogram results, before and after treatment. Of the 28 patients treated by urethroplasty, 21 (75%) had 'GOOD' outcome while in 7 patients (25%) the outcome was 'POOR'. In the bouginage group, outcome was 'GOOD' in 63.6% (7/11) of patients, 'POOR' in 27.3% (3/11), while one patient died from septic complications. It is concluded that urethroplasty gives overall, better results in management of strictures, but dilatation remains a viable option in carefully selected cases and that urethritis is still a foremost aetiological factor for urethral strictures in Calabar.
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Affiliation(s)
- A Essiet
- Urology Unit, Dept of Surgery, University of Calabar Teaching Hospital, Calabar
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Abstract
OBJECTIVES To investigate the feasibility of replacing urinary epithelium cells with foreskin epidermal cells to reconstruct engineered anterior urethra with an acellular collagen matrix. MATERIALS AND METHODS Acellular collagen matrices were generated from allogeneic rabbit bladder submucosa. In nine rabbits, autologous foreskin epidermal cells were isolated, expanded in vitro, and labelled with 5-bromo2'-deoxy-uridine (BrdU) before seeding onto a tubular acellular collagen matrix (1.5x1 cm). In male rabbits, a urethral mucosal defect was created, and urethroplasty performed with a tubular acellular collagen matrix seeded with epidermal cells (nine rabbits) or with a matrix with no cell seeding (nine rabbits; control group). Urethrography was done at 1, 2 and 6 months after grafting. The urethral grafts were harvested and analysed grossly and histologically. RESULTS In the control group, gross views and urethrography revealed stricture of repaired defects at the different sample times. In the experimental group, a wide urethral calibre was maintained with no sign of strictures. Histology in the control group showed a single layer of epithelium cells with disorganized muscle fibre bundles in the submucosa layer at 1 month after grafting, and a transitional cell layer surrounded by disorganized muscle fibre bundles at 2 and at 6 months. Grafts seeded with epidermal cells formed a single-layer structure by 1 month, and at 2 and 6 months there were several layers of epidermal cells with abundant vessels in the submucosa. There was an evident margin between graft epidermal cells and host epithelium at 6 months. The implanted cells expressed keratin, shown by staining with anti-pancytokeratins. Immunofluorescence for BrdU confirmed the presence of implanted epidermal cells at 1 month after grafting; there were fewer positive cells at the implantation site at 2 months. At 6 months, there were several layers of epidermal cells with no signs of BrdU staining. CONCLUSIONS Urethral reconstruction was better with an acellular collagen matrix seeded with epidermal cells than with the acellular collagen matrix alone. Foreskin epidermal cells seem adequate in replacing urethral epithelium cells for urethral reconstruction.
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Affiliation(s)
- Qiang Fu
- Department of Urology, Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, China.
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Hayashi Y, Kojima Y, Mizuno K, Nakane A, Maruyama T, Kohri K. Mathieu and Barcat repair with a V incision sutured meatoplasty for secondary hypospadias surgery. Int J Urol 2006; 13:733-7. [PMID: 16834652 DOI: 10.1111/j.1442-2042.2006.01395.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Today single-stage methods are more frequently selected for hypospadias repair than multistaged methods, but complications cannot always be avoided. We employed two kinds of meatal based flip-flap urethroplasty procedures for those with an unsuccessful primary hypospadias repair. PATIENTS AND METHODS From 1997 to 2005, a meatal based flip-flap urethroplasty was performed as a secondary hypospadias surgery on 17 patients. Basically we attempted the Mathieu repair, but when the wings of the glans were not generously widened and the urethral groove was not sufficiently deep we applied the Barcat procedure. While 11 patients were repaired with the Mathieu technique, six patients underwent the Barcat repair. The V incision sutured meatoplasty was added to obtain a natural ventral slit-like meatus. RESULTS Ten of the 11 patients who underwent the Mathieu repair had a good outcome, but one patient developed a urethrocutaneous fistula. None of the six patients repaired with the Barcat procedure encountered postoperative complications. Cosmetically, a vertical slit was constructed near the normal neomeatus with the Mathieu and V incision sutured (MAVIS) meatoplasty and the Barcat and V incision sutured (BAVIS) meatoplasty. CONCLUSIONS The Mathieu or the Barcat meatal based flip-flap urethroplasty procedure is feasible as a salvage surgery for those with relatively short urethral defects and adequate mobile ventral skin if an exact procedure is selected. Excellent cosmetic results could be obtained by adding the technique of V incision sutured meatoplasty.
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Affiliation(s)
- Yutaro Hayashi
- Nagoya City University Graduate School of Medical Sciences, Department of Nephro-urology, Nagoya, Japan.
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Abstract
The efficacy of high-intensity focused ultrasound (HIFU) used for the treatment of localized prostate cancers has been demonstrated over the past decade. We present our early results after HIFU used as a single session in patients with clinically localized prostate cancer. A total of 58 patients were treated using the Ablatherm HIFU device with or without transurethral resection of the prostate (TURP). HIFU failure was defined as the presence of a cancer remnant on repeated biopsies or three consecutive increases in the prostate-specific antigen (PSA) >/=1.0 ng/ml. The mean follow-up was 14 months (range, 6-21 months). After HIFU treatment, 78% of patients had a decreased PSA level to <0.5 ng/ml within 3 months. The median value of the last PSA was 0.6 ng/ml and the median nadir PSA was 0.2 ng/ml. The success rates of HIFU were 85, 77 and 47% in low-, intermediate- and high-risk groups, respectively. The HIFU failure rate was closely associated with clinical stage, presence of cancer on TURP chips and nadir PSA on univariate analysis. However, the only significant predictor for HIFU failure was the nadir PSA value by multivariate Cox regression analysis. The operation-related complications were minimal. Although both the period and number of patients were limited to evaluate the clinical efficacy, HIFU appears to be a safe and effective treatment option in selected patients with prostate cancer.
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Affiliation(s)
- H M Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Long Y, Zhu H, Cai Z, Li A, Chen X, Long D. [Reconstruction of urethra partial defect with scrotal flap]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2006; 20:229-31. [PMID: 16579228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To introduce the application of the scrotal flap on reconstructing partial urethra defect. METHODS From March 1998 to August 2004, 31 patients with urethra defect were treated with scrotal flap. Their ages ranged from 6 to 34 years. Thirty-one patients included 8 cases of congenital deformity of urethra and 23 cases of complication of urethral fistula, urethral stenosis and phallus bend after hypospadias repair. The flap widths were 1.5-2.5 cm in child and 2.5-3.5 cm in adult. The flap length was 1.5-2.0 times as much as the width. Nine cases were classified as penile type, 10 cases as penoscrotal type, 7 cases as scrotal type (3 children in association with cleft scrotum) and 5 cases as perineal type because of pseudohermaphroditism. Urethroplasty was given by scrotal fascia vascular net flap to reconstruct urethra defect. RESULTS All the flaps survived, and the incision healed well. Twenty-four cases achieved healing by first intention and 7 cases by second intention. And fistula occurred and healed after 2 weeks in 1 case. 27 cases were followed up 1-4 years, 2 cases had slight chordee, the others were satisfactivly. CONCLUSION Urethroplasty with scrotal fascia vascular net flap is an ideal method for the partial defect urethra.
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Affiliation(s)
- Yun Long
- Reproductive Medicine Center, Peking University Shenzhen Hospital, Shenzhen Guangdong 518036, P R China.
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Wang YQ, Li YQ, Liu LQ, Xu JJ, Huo R, Li Q, Li SK. [Rabbit urethral defect repair with freeze-dried acellular bladder submucosa]. Zhonghua Zheng Xing Wai Ke Za Zhi 2005; 21:62-5. [PMID: 15844603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To evaluate the result of urethral defect repair using freeze-dried acellular bladder submucosa. METHODS The freeze-dried acellular bladder submucosa was obtained from human cadaveric bladder submucosa using freeze-thawed enzymatic treatment and the freeze-drying technique. 18 male New Zealand rabbits were used in this experiment. A defect of 1.0 cm x 0.5 cm was created in the ventral urethra of the animal. The acellular matrix was grafted to the urethral defect in 14 rabbits. The other 4 animals underwent a sham operation as the controls. From postoperative one to twenty-four weeks, the animals underwent retrograde urethrography at certain intervals. The grafts of the acellular matrix were taken and prepared for histological evaluation. RESULTS No obvious urethral stricture was observed in the 14 matrix-grafted animals. Histological examinations of the specimens showed progressive infiltration of cells and vascular vessels. Complete epithelization was obtained at 2 weeks. The orientation of collagen fibers in the matrix-grafted area tended to be regular with time. CONCLUSIONS Freeze-dried acellular bladder submucosa may be a suitable material for urethral defect repair, which induces urethral mucous cells to migrate, grow and epithelialize.
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Affiliation(s)
- Yong-qian Wang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100041, China
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Markovic B, Markovic Z, Filimonovic J, Hadzi Djokic J. New generation urethral stents in treatment bladder outlet obstruction caused by prostate cancer. Acta Chir Iugosl 2005; 52:89-92. [PMID: 16673603 DOI: 10.2298/aci0504089m] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Our clinical trial included until now, 22 patients in whom new generation urethral stent named Allium, were inserted due to bladder outlet obstruction caused in 7 patients (pt) with benign prostate hyperplasia, in 13 pt with bulbar urethral stricture of different ethiology and in 2 pt with prostate cancer. Allium prostatic stents, designed by Daniel Yachia differs in some crucial characteristics from previously used stents: they are covered for the first time in urethra stenting history, without relatively low radiation force and because of that nonirritative. The indications, contraindications and preliminary results in this study are discussed concerning the patients with cancer of the prostate.
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Affiliation(s)
- B Markovic
- Institute of Radiology, Clinical Centre of Serbia, Belgrade
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Xu Y, Qiao Y, Wu D, Sa Y, Zhang X, Chen R, Si J, Jin C. Urethral reconstruction with colonic mucosa in treatment of complex urethral stricture. Zhonghua Yu Fang Yi Xue Za Zhi 2002; 36:522-4. [PMID: 12411160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To investigate the possibility of urethral reconstruction with colonic mucosa for the treatment of complex longer urethral stricture (>/= 10 cm). METHODS From October 2000 to September 2001, 6 patients with complex longer urethral stricture were treated with colonic mucosal graft urethroplasty. They had under gone 3 previous unsuccessful urethral repairs on average. Urethral reconstruction with a free graft of colonic mucosa ranged from 10 to 15 cm (mean 12.17 cm). Follow-up included retrograde urethrography, urethroscopy, and uroflowmetry. RESULTS The patients were followed up 3 - 14 months postoperatively (mean 7.8 months). Meatal stenosis developed in one patient 3 months after operation needed reoperation. The patient voided very well with urinary peak flow 28.7 ml per second duing follow-up for 12 months postoperatively. The other patients voided well with urinary peak flow greater than 15 ml per second. At urethroscopy, colonic mucosa was macroscopically difficult to distinguish from normal original urethral mucosa in 4 patients over 6 months after the operation. CONCLUSIONS Colonic mucosa graft urethroplasty is feasible for the treatment of complex longer anterior urethral stricture. The technique is useful for urethral reconstruction when penial skin and bladder mucosa are not available.
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Affiliation(s)
- Yuemin Xu
- Department of Urology, Sixth Municipal Hospital of Shanghai, Shanghai 200233, China
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Dorfman B, Yussim A, Gillon G, Shmuely D, Shaharabani E, Bar-Nathan N, Lustig S, Sigenreich E, Shapira Z. Conservative approach to lower urinary tract abnormalities in cadaveric renal transplantation. Transplant Proc 1997; 29:143-4. [PMID: 9122934 DOI: 10.1016/s0041-1345(96)00040-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- B Dorfman
- Department of Organ Transplantation, Rabin Medical Center, Petah Tikva, Israel
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Bülow H, Wullstein HK. [Canine urethra as a model for experimental studies on urethral strictures (author's transl)]. Urologe A 1981; 20:155-8. [PMID: 7196623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Of all commonly used laboratory animals, the dog seems especially suited for transurethral experiments on the urethra when using normally available urological instruments. Because of its particular anatomy only the pelvic portion of the urethra in male dogs is available for study. In animals weighing at least 20 kg this segment is wide enough to permit insertion of instruments of up to F 24 size. Anatomically, this segment corresponds to the proximal segment of the bulbous portion of the urethra in man, i.e. there is no corpus cavernosum urethrae surrounding the urethra. Experiments in this segment require a perineal urethrostomy, the construction of which is associated with a high complication rate. The pelvic urethra of the male dog does not differ structurally from that of the female dog. Experiments on the female canine urethra can therefore be performed equally well and with less complications. Urethral strictures can be simply and effectively created by circular transurethral electrocoagulation of the urethral wall. With extensive urethral wall coagulation, temporary complete urinary retention may be observed postoperatively, which is due to extensive edema of the affected area.
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Klarskov P, Møller I, Iversen P, Hansen RI. Urethral pressure profile and retrograde urethrography in diagnosis of urethral strictures. Urol Int 1979; 34:161-6. [PMID: 473426 DOI: 10.1159/000280262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In 20 male patients with urethral strictures, urethral pressure profile was compared with retrograde urethrography. There was good accordance between the two methods with only minor discrepancies in multiple or very distal strictures. Urethral profile did not provide more exact information than did urethrography.
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Schärli AF. [Congenital anomalies of the urogenital system. 2]. Z Krankenpfl 1975; 68:230-2. [PMID: 167529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Markland C, Kelly WD, Buselmeier T, Kjellstrand C, Simmons R, Najarian J. Renal transplantation into ileac urinary conduits. Transplant Proc 1972; 4:629-31. [PMID: 4566810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Brocklehurst JC. Bladder outlet obstruction in elderly women. Nurs Mirror Midwives J 1972; 135:36-9. [PMID: 4626741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Tanagho EA. Surgically induced partial urinary obstruction in the fetal lamb. I. Technique. Invest Urol 1972; 10:19-24. [PMID: 5064515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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