ABSTRACT
Objective To explore the effect of two different urethral stent flush methods for postoperative complications of hypospadias repair in children patients. Methods A total of 182 cases of children patients who underwent urethroplasty with pedicled double skin flaps from March 2014 to March 2016 were divided into intervention group (n=89) and the control group (n=93) by using random number method. The control group was treated with gentamicin irrigation urethral stent;the intervention group was treated with gentamicin irrigation urethral stent, and the patients were trained to urinate twice with the stent from the fourth day after surgery. The incidence of urinary fistula and urethral stricture within one year after surgery, and the anxiety level of patients' caregivers were assessed. Results The incidence of urinary fistula in the intervention group and the control group were 5.7％(5/87) vs. 15.2％(14/92), and the difference was statistically significant(χ2=4.227, P<0.05). In the intervention group, the cases of non anxiety, mild anxiety, moderate anxiety and severe anxiety respectively were 33(37.9％), 42(48.3％), 8 (9.2％) and 4(4.6％). However, in the control group the cases were 21(22.8％), 46(50.0％), 12(13.0％), 13 (14.1％) respectively. The anxiety degree of patients' caregivers was significantly different between intervention group and control group (Z=2.757, P<0.01). Conclusions The training of early micturition with stent after hypospadias surgery can significantly reduce the incidence of urinary fistula and the anxiety level of caregivers.
ABSTRACT
Objective To explore the feasibility of using composite scaffolds of rabbit oral epithelial cells and polycaprolactone (PCL) electrospun fibers for urethral repair. Methods The 25%PCL was prepared using a 5:1 by volume mixture of trichloromethane and anhydrous methanol, and PCL fiber tubular scaffolds were obtained by electrospinning. Rabbit oral mucosa epithelial cells (1.5 × 105) were implanted on the PCL scaffold. Subsequently, they were embedded in nude mice subcutaneous, explanted in 2 weeks. PCL fiber tubular scaffolds without rabbit oral mucosa epithelial cells were used as control. The complex urethral scaffolds were evaluated by immunofluorescence staining with cytokeratin antibody and HE staining. Results Compared with blank PCL group, the rabbit oral mucosa epithelial cell group showed a good cellularization. Rabbit oral mucosa epithelial cells formed a dense cell layer on the surface of PCL lumen, which suggested that rabbit oral mucosa epithelial cells can proliferate on the surface of PCL lumen. Conclusion Rabbit oral epithelial cells can be used as one of the seed cells for tissue engineered urethral scaffolds, and it is possible to construct tissue engineering substitute materials for urethral repair by rabbit oral epithelial cells combined with PCL.
ABSTRACT
@#ObjectiveTo observe the effect of urethral stent implantation on detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction.Methods13 patients with detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction were treated with the operation of the urethral stent implantation. Voiding function, renal function, residual urine volume and hytronephrosis were examined before and after the operation to evaluate the effect of this procedure.ResultsAfter operation, 7 patients normally emptied their bladders and 6 patients had urinary incontinence. Urethral stents were removed from 2 patients in this group due to the irritation symptoms, the second implantation was performed in a patient due to the voiding difficulty. The renal function of patients after the operation had a non-significant improvement, but the residual urine volume and hytronephrosis improved significantly.Conclusion Urethral stent implantation can decrease residual urine volume and hytronephrosis in patients with detrusor-sphincter dyssynergia caused by neurogenic lower urinary tract dysfunction.
ABSTRACT
In spinal cord injury, various options exist for the management of the neurogenic bladder. For the management of neurogenic bladder, urethral stent was placed under a cystoscopic guidance as one day procedure. Urethral stents were inserted in a T12 spinal cord injured patient who had recurrent urinary tract infections and a vesicoureteral reflux (VUR) and a T3 spinal cord injured patient who had a detrusor-sphincter dyssynergia. In the first case, recurrent urinary tract infection and VUR were resolved after the stenting. In the second case, urethral stent was removed because of the failure of continuous drainage. Because of its easily reversible nature, the urethral stent can be adopted for use in pateints as an option of neurogenic bladder management.
Subject(s)
Humans , Ataxia , Drainage , Spinal Cord Injuries , Spinal Cord , Stents , Urinary Bladder, Neurogenic , Urinary Tract Infections , Vesico-Ureteral RefluxABSTRACT
We describe the use of a new urethral stent implanted in 6 patients with prostatic outflow obstruction. All patients were in a high risk group for surgery and treated successfully, for a follow-up of 6 to 13 (mean 8.5) months. The majority of patients were satisfied with the procedure, which provided a quick, safe and effective results, compared with conventional surgical treatment. The stent, woven from nitinol in the form of a tubular mesh, was inserted into the prostatic urethra via a delivery device using endoscopic control under local anesthesia. During follow-up period, the stent remained in situ and there were no urinary incontinence or other complications. The average maximum flow rate at postoperative 6 months was 19.5 ml/sec. This stent is a useful alternative to conventional surgical treatment in the high risk and large prostate patient.
Subject(s)
Humans , Anesthesia, Local , Follow-Up Studies , Prostate , Stents , Urethra , Urinary IncontinenceABSTRACT
Endoscopic intraluminal implantation of a self-expandable permanent urethral stent ( Wallstent) has found increased use in patient with recurrent urethral strictures because of its simple implantation technique. But there has been a few reports of explantation due to complete luminal obstruction. Herein we report one with literature.
Subject(s)
Humans , Phenobarbital , Stents , Urethral StrictureABSTRACT
Self expending metallic stents are emerging as an effective alternative treatment procedure in the management of urethral obstruction. Author described the use of gold coating expandable urethral stents implicated into 13 patients with urinary obstruction due to inoperable benign prostatic hypertrophy (11 cases) and complicated urethral stricture(2 cases) respectively. The stents made of stainless steel in the form of cylindrical zigzag pattern and coated with 24 carat gold, were inserted via delivery device using fluomscopic control under local anesthesia. The treatment was successful in 9 patients. All 9 patients were able to void satisfactorily. The mean peak rate of flow measured with umflometry was 14-24 ml, sec (mean 19.5 ml/sec). In one patient, gross hematuria, frequency and dysuria were so severe that removal of the stent and insertion of an indwelling catheter was done. No sent migration was noted during follow-up. The stente reached 70-80% of their fully expanded diameter immediately on placement. By 1 week after placement 100% expansion was achieved on all cases and maintained for the duration of the study. Luminal narrowings due to overgrowing of granulation tissue were occurred 1 week and 1 month after insertion of the stent in urethral stricture patients. And the luminal narrowings were man-aged with insertion of more complexed and Wall stent. Urethroscopy has demonstrated complete covering of the stent with urothelium at 4 to 6 months. Our experience suggests that placement of Gianturco self-expanding metallic stents may be a useful method of dilating and maintaining the luminal diameter of the prostatic urethra and complicated urethral stricture.