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Urology: Bladder: Urethra

Angela M Arlen, Christopher S Cooper
Vesicoureteral reflux, retrograde flow of urine from the bladder into the upper urinary tract, is one of the most common urological diagnoses in the pediatric population. Diagnosis and subsequent management of urinary reflux have become increasingly debated in the past decade, with divergent opinions over which patients should be evaluated for reflux, and when detected, which children should receive intervention. Although some argue that vesicoureteral reflux is a "phenotype" that often resolves without intervention, others contest that untreated reflux has the potential to cause irreversible renal damage over time...
February 14, 2019: International Journal of Urology: Official Journal of the Japanese Urological Association
A O Vasilyev, A V Govorov, A A Shiryaev, P I Bykov, A Kim Yu, N A Kalinina, M G Schneiderman, D Yu Pushkar
INTRODUCTION: The experience of comparative evaluation of the effectiveness of various types of urethral catheters in prevention of catheter-associated infection is described in this article. MATERIALS AND METHODS: The study included 69 patients treated at the CCH n.a. S.I. Spasokukotsky in the period from December 2017 to March 2018. The average age of patients was 67.5 years. In all patients, the bladder was drained by a two-way Foley catheter No. 16-18 Ch (100% silicone)...
December 2018: Urologii︠a︡
Kevin Shee, Kevin Koo, Xiaotian Wu, Fady M Ghali, Ryan J Halter, Elias S Hyams
Robotic surgical skill development is central to training in urology as well as other surgical disciplines. Vesicourethral anastomosis (VUA) in robotic prostatectomy is a challenging task for novices due to delicate tissue and difficult suturing angles. Commercially available, realistic training models are limited. Here, we describe the development and validation of a 3D-printed model of the VUA for ex vivo training using the da Vinci Surgical System. Models of the bladder and urethra were created using 3D-printing technology based on estimations of average in vivo anatomy...
January 28, 2019: Journal of Robotic Surgery
Jan Adamowicz, Blazej Kuffel, Marta Pokrywczynska, Shane Vontelin Van Breda, Tomasz Drewa
Reconstructive urology is a complex and demanding branch of modern urology. Complicated cases, necessity of microsurgical approach and constant exposure to urine make urinary reconstruction especially difficult. With impaired healing, excessive scarring and recurring fibrosis functional results are still not satisfying. For better, more successful outcomes a novel tissue engineering technology based solutions are being gradually investigated. The use of tissue engineering is the most promising strategy to improve results of reconstructive urology procedures due to possibility of designing organ- specific grafts...
January 18, 2019: Journal of Tissue Engineering and Regenerative Medicine
Walid Shahrour, Pankaj Joshi, Craig B Hunter, Vikram S Batra, Hazem Elmansy, Sandesh Surana, Sanjay Kulkarni
Introduction and Objective: The proper evaluation of urethral strictures is an essential part of the surgical planning in urethral reconstruction. The proper evaluation of the stricture can be challenging in certain situations, especially when the meatus is involved. We propose that the use of a small caliber ureteroscope (4.5 Fr and 6.5 Fr) can offer additional help and use for the surgical planning in urethroplasty. Methods: We prospectively collected data on 76 patients who underwent urethroplasties in Kulkarni Reconstructive Urology Center, Pune, India and Thunder Bay Regional Health Sciences Center, Thunder Bay, Canada...
2018: Advances in Urology
Paul H Chung, Alex J Vanni, Benjamin N Breyer, Bradley A Erickson, Jeremy B Myers, Nejd Alsikafi, Jill Buckley, Sean P Elliott, Lee C Zhao, Bryan B Voelzke
OBJECTIVE: To compare the utility of generic health quality of life (QOL) and condition specific indicators as patient reported outcomes measures for urethral stricture surgery. MATERIALS AND METHODS: Patient data were obtained from the Trauma and Urologic Reconstructive Network of Surgeons collaborative database. Patients who underwent any successful urethroplasty and completed both pre- and postoperative generic and condition-specific questionnaires were included...
December 20, 2018: Urology
Maria O Zayko, Rowena E Velilla, M Salah Shurbaji
BACKGROUND A condyloma acuminatum is a sexually transmitted, human papillomavirus (HPV) associated, neoplasm. In men, it is predominantly found on external genitalia and rarely progresses more proximally than the distal penile urethra. Condyloma acuminata of the prostatic urethra are rare and are usually seen as an extension of, or in association with external lesions. Therefore, it is not typically considered in the differential diagnosis of isolated papillary lesions limited to the prostatic urethra. CASE REPORT A 62-year-old male with rheumatoid arthritis treated with abatacept presented to urology due to a history of intermittent bladder self-catheterization for urinary obstruction...
December 22, 2018: American Journal of Case Reports
Jan Adamowicz, Shane Van Breda, Dominik Tyloch, Marta Pokrywczynska, Tomasz Drewa
In reconstructive urology, autologous tissues such as intestinal segments, skin, and oral mucosa are used. Due to their limitations, reconstructive urologists are waiting for a novel material, which would be suitable for urinary tract wall replacement. Human amniotic membrane (AM) is a naturally derived biomaterial with a capacity to support reepithelization and inhibit scar formation. AM has a potential to become a considerable asset for reconstructive urology, i.e., reconstruction of ureters, urinary bladder and urethrae...
December 6, 2018: Expert Opinion on Biological Therapy
Anton Grechenkov, Roman Sukhanov, Eugene Bezrukov, Denis Butnaru, Guido Barbagli, Igor Vasyutin, Alexander Tivtikyan, Leonid Rapoport, Yury Alyaev, Peter Glybochko
OBJECTIVE: To identify risk factors for urethral stricture and/or bladder neck contracture after transurethral resection of benign prostatic hyperplasia. MATERIALS AND METHODS: We performed a retrospective analysis of 402 patients, which underwent a monopolar transurethral resection of the prostate in the urology clinic of Sechenov First Moscow State Medical University for prostatic hyperplasia during the period 2011-2014. Urethral stricture and (or) bladder neck contracture in the postoperative period were diagnosed in 61 (15...
November 2018: Urologia
Qian Wan, Geng Xiong, Guihua Liu, Thomas D Shupe, Guanghui Wei, Deying Zhang, Dan Liang, Xiongbing Lu, Anthony Atala, Yuanyuan Zhang
BACKGROUND: Autologous urothelial cells are often obtained via bladder biopsy to generate the bio-engineered urethra or bladder, while urine-derived stem cells (USC) can be obtained by a non-invasive approach. The objective of this study is to develop an optimal strategy for urothelium with permeability barrier properties using human USC which could be used for tissue repair in the urinary tract system. METHODS: USC were harvested from six healthy adult individuals...
November 8, 2018: Stem Cell Research & Therapy
Elroy P Weledji, Divine Eyongeta, Eleanor Ngounou
Normal voiding needs a coordinated, sustained bladder contraction of adequate size and duration. It requires a decrease in resistance of the bladder neck and urethra and no obstruction. Voiding problems can arise from abnormal storage of urine or problems with urinary control. The aim of this article was to review the functional anatomy and physiology of urinary control and micturition and the pathophysiology of urinary control problems. The Medline (PubMed) database, Cochrane Library, and Science Citation Index were searched electronically to identify original published studies on bladder anatomy, function and urinary control...
October 10, 2018: Clinical Anatomy
Andrea Mogorovich, Cesare Selli, Alessio Tognarelli, Francesca Manassero, Maurizio De Maria
BACKGROUND: The introduction of foreign bodies in the female urethra for auto-erotic stimulation or in case of psychiatric disorders is not uncommon. The occurrence of intravesical migration of these objects makes it necessary to remove it shortly after insertion, since after long term permanence complications are likely to occurr. CASE PRESENTATION: A 47-year-old white female was referred at our Urology department for migration inside the bladder of a metallic urethral dilator used for sexual stimulation...
October 3, 2018: BMC Urology
Zafar Nazir, Muhammad Arif Mateen Khan, Javaria Qamar
BACKGROUND: Congenital Prepubic Sinus (CPS) is an uncommon urogenital anomaly characterized by a blind tract between the skin over the pubis to anterior of the urinary bladder, Urethra or umbilicus. We report four such cases to emphasize varied clinical presentation and embryological conundrum. METHODS: Following Ethical Review Committee (ERC) approval, medical records of pediatric patients (<16 years) presenting with CPS (identified through operating room records and Hospital Information Management System (HIMS) between 1994 and 2018 were reviewed for demographics, clinical presentation, investigations including histopathology, management and outcome...
July 25, 2018: Journal of Pediatric Surgery
Akihiro Kanematsu
The focus of the present review on regenerative medicine is limited; first, on a few human clinical trials carried out thus far in the urology field, and second, on more basic but important biological progress that regenerative medicine has brought us. Clinical trials for the bladder, urethra and urethral sphincter have been carried out thus far. Reconstruction with autologous cell-seeded biomaterial failed in patients in need of bladder augmentation. The strategy succeeded for urethral reconstruction in patients who might not have required this approach...
September 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Niyati Lobo, Meghana Kulkarni, Simon Hughes, Rajesh Nair, Muhammad Shamim Khan, Ramesh Thurairaja
Radiotherapy is widely used as a curative treatment for pelvic malignancies. The location of these organs leads to unavoidable exposure of the bladder, urethra, and distal ureters to radiation and may cause subsequent development of radiation cystitis, fistulae, strictures, and secondary malignancy. As cancer survival improves, an ever-increasing number of patients is living with the long-term complications of radiotherapy. Symptoms are not only debilitating for the patient but also pose a treatment challenge to the urologist...
December 2018: Urology
Blake C Gruenberg, David Mortel, Amanda Bogie
Pediatric penile pain is an uncommon complaint and is associated with a wide differential diagnosis including infectious, inflammatory, traumatic, and idiopathic conditions. Penile fractures, anatomically known as rupture of the corpus cavernosum, are almost exclusively reported in sexually mature patients and usually involve forceful manipulation during sexual activity. Rupture of the corpus cavernosum is a true urologic emergency. Failure to recognize and treat rupture of the corpus cavernosum has been associated with residual penile angulation, persistent hematoma, abscess, erectile dysfunction, and fibrosis...
June 14, 2018: Pediatric Emergency Care
Edouard Goujon, Adélaide Jarniat, Florian Bardet, Lise Bergogne, Emmanuel Delorme
INTRODUCTION: The mid-urethral sling (MUS) procedure is the gold-standard for the surgical treatment of stress urinary incontinence (SUI). Urethro-vesical sling exposure is one of the most serious complications of this procedure. We describe the treatment and follow-up of 18 patients with bladder or urethral sling exposure. PATIENTS AND METHODS: This single-center, retrospective study assessed the diagnosis and management of MUS penetrating the lower urinary tract in 18 women...
September 2018: Journal of Gynecology Obstetrics and Human Reproduction
Shoaib Safiullah, Daniel J Lama, Roshan Patel, Ralph V Clayman
INTRODUCTION: Cystoscopy is a basic urologic skill necessary for the endoscopic evaluation of the urethra and bladder. Presented is a step-by-step guide for flexible cystoscopy of the male and female patient. MATERIALS/METHODS: Routine flexible cystoscopy was performed on a male patient with a history of upper tract urothelial carcinoma and a female patient as part of a hematuria evaluation. The male patient was positioned supine, and the female patient frog-leg supine...
May 2018: Journal of Endourology
Niall F Davis, Eoghan M Cunnane, John J Mulvihill, Mark R Quinlan, Damien M Bolton, Michael T Walsh, Gregory S Jack
BACKGROUND: The urinary bladder and urethra comprise the lower urinary tracts. Pathological conditions that affect both structures necessitate reconstructive urological intervention with autologous tissue sources that cause neuromechanical and metabolic complications. Stem-cell therapies may offer an attractive alternative as they can replicate important host derived cellular functions such as mitosis, proliferation, differentiation and apoptosis. OBJECTIVE: To provide an overview on the application of stem cell therapies for regenerating the lower urinary tracts and to discuss factors that need to be addressed before stem-cells can be reliably introduced into clinical urological practice...
2018: Current Stem Cell Research & Therapy
Michael Vainrib, Kobi Stav, Ilan Gruenwald, Gabriel Gilon, Shahar Aharony, Miki Gross, Vadim Bluvshtein, Yakova Kauffman
A position paper presents the standpoint of the Israeli Urological Association on clean intermittent catheterization (CIC) for all physicians and nurses. The position paper is based on international guidelines and professional literature and is adapted to medical activities in Israel. CIC is indicated for the treatment of temporary/permanent disability in the emptying of the bladder, which is expressed by large post-voided urine/urine retention and related complications. There are a few contra-indications for CIC (low bladder volume or compliance, pressure sores/external infection of the urethra, anatomical, functional or cognitive disorder that does not allow to perform CIC, recurrent macrohematuria or urethrorrhagia, urethral pain that does not allow frequent catheterization, patient unwillingness to perform CIC by himself or by another person)...
April 2018: Harefuah
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