Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 211
Filter
2.
Int. braz. j. urol ; 48(2): 371-372, March-Apr. 2022.
Article in English | LILACS | ID: biblio-1364945

ABSTRACT

ABSTRACT Introduction: Tissue transfer has been used in urethral reconstruction for decades, and several grafts have been described (1, 2). The ideal graft would have optimal tissue characteristics and lead to minimal morbidity at the donor site. Urethroplasty using bladder mucosa was first described by Memmelaar in 1947 (3). The main limitation in using bladder mucosal grafts has been the invasiveness of open harvesting (4). We describe an endoscopic technique using Holmium: YAG laser to harvest bladder mucosal graft for substitution urethroplasty. Methodology: A 33-year-old male with no history of urethral instrumentation, trauma, or infection presented with obstructive lower urinary tract symptoms. On retrograde urethrogram a 6cm bulbar urethral stricture was identified. Several options were discussed, and the patient opted for a one-sided onlay dorsal urethroplasty (5) using a bladder mucosal graft. Equipment used to harvest the graft included an 18.5Fr continuous flow laser endoscope with a Kuntz working element (RZ) and a 60W Holmium Laser (Quanta) with 550μm laser fiber. The procedure was started by making a perineal incision, urethral mobilization and incision of the stricture segment. The laser endoscope was then introduced via the perineum. Settings of 0.5J, 30 Hz, and long pulse were used and a 7 x 2.5cm graft was harvested from the posterior bladder wall. Hemostasis of the harvest site was performed. The bladder mucosal graft was thinned in similar fashion to a buccal mucosal graft and sutured as per previously described techniques. Conclusion: Endoscopic Holmium Laser harvesting of bladder mucosal graft is feasible and may allow this graft to become an alternative to buccal mucosa. Further studies are required to define its role in urethral reconstruction.


Subject(s)
Humans , Male , Adult , Urethral Stricture/surgery , Lasers, Solid-State/therapeutic use , Urethra/surgery , Urinary Bladder/surgery , Mouth Mucosa/transplantation
3.
Int. braz. j. urol ; 48(2): 365-366, March-Apr. 2022. graf
Article in English | LILACS | ID: biblio-1364944

ABSTRACT

ABSTRACT Introduction: A challenging situation in proximal hypospadias is the presentation of patients with successful urethroplasty but with persistent or recurrent ventral curvature (VC) after multiple hypospadias repair. Materials and Methods: We present a 13 year-old boy with 7 previous surgeries (long TIP, Duplay, meatoplasty) to treat hypospadias presenting with 60 degrees of VC, in spite of a well-accepted coronally neomeatus. We degloved the penis and artificial erection clearly appointed corporal disproportion causing curvature. We disconnected urethra from corpora. After excision of remnant fibrotic tissue, there was a residual curvature so a lenghtening corporoplasty with dermal graft from groin was performed. We have adjusted the urethral meatus position into a proximal penile shaft. We used a buccal mucosa graft placed in an inverted U-shape position planning a second stage urethroplasty (1). An indwelling silicone Foley tube was left for one week. The patient was discharged the day after surgery. Results: The aspect after corporoplasty proved satisfactory curvature correction. Patient had an excellent outcome and is scheduled for a second-stage after 6 months. Discussion: Snodgrass and Bush (2) reported that on 73 patients with an average of 2.7 operations for proximal shaft to perineal hypospadias; of which, 83% had VC at re-operation averaging 50°. We do believe that some good results with minimal dorsal plicature may recur in adolescence and therefore when these procedures may be considered, they should be performed by classic Nesbit technique (3). Otherwise, the choice for primary ventral lengthening should be taken. Conclusion: Severe curvature associated with hypospadias should undergo a major procedure at early stage to avoid decompensation after dorsal plicature in adolescence. We had a very satisfactory result, the patient awaits the second stage procedure (Figure-1). Figure 1 End aspect after complete healing of buccal mucosa. Notice that penis is straight and second stage will be performed after 6 months of interval.


Subject(s)
Humans , Male , Infant , Adolescent , Reconstructive Surgical Procedures/methods , Hypospadias/surgery , Penis/surgery , Urologic Surgical Procedures, Male/methods , Urethra/surgery , Treatment Outcome
4.
Int. braz. j. urol ; 48(1): 78-86, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356292

ABSTRACT

ABSTRACT Purpose: Posterior urethral valves (PUVs) are the most common cause of congenital bladder obstruction in boys. Our aim was to assess the impact of early diagnosis and fulguration of PUVs on bladder function and compare their functional and urodynamic outcome with children who underwent delayed intervention. Materials and Methods: We retrospectively evaluated 153 patients who underwent primary valve ablation from two tertiary hospitals between 2001 and 2018. Patients have been divided into 2 groups, group 1 included 69 patients who were detected antenatally and underwent early fulguration of PUVs while group 2 included 84 children presented postnatally and underwent delayed valve ablation. The recorded data throughout follow-up in renal function tests, urodynamics and changes in the upper urinary tracts were evaluated and compared. Results: Median age at time of valve ablation was 10 days in group 1 and 7 months in group 2. The median follow-up period was 6.5 and 7 years in group 1 and 2, respectively. Chronic kidney disease (CKD) developed in 15 (22%) boys in group 1 while in group 2 it was observed in 31 (37%), p=0.04. While Q-max, mean bladder capacity and post-void residual (PVR) volumes were comparable in both groups, percent PVR was significantly higher in group 2 (3.27 vs. 1.44, p=0.002). Detrusor overactivity was slightly different in both groups (p = 0.07). Conclusions: Compared to delayed intervention, primary ablation of PUVs during the early neonatal life possibly provides the optimum chance to have optimum renal function without impact on bladder function.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Child , Urinary Bladder/surgery , Urinary Bladder Diseases , Urethra/surgery , Urodynamics , Retrospective Studies
5.
Int. braz. j. urol ; 48(1): 198-199, Jan.-Feb. 2022.
Article in English | LILACS | ID: biblio-1356291

ABSTRACT

ABSTRACT Introduction: The transverse vaginal septum (TVS) with congenital urethra-vaginal fistula (CUVF) is a rare anomaly of the mullerian duct (1, 2). Incomplete channelling of the vaginal plate, or an abnormality in the fusion of the vaginal component of mullerian duct with the urogenital sinus results in TVS (1, 3, 4). High CUVF occurs due to the persistent communication between the urogenital sinus and utero-vaginal primordium at the tubercle sinus, whereas low CUVF is due to excessive apoptosis of the vaginal plate during channelling (5). The principles of management of CUVF with TVS include: 1) TVS resection, 2) Create a neovagina. We present a case of CUVF with TVS managed by robotic assistance. Material and methods: A 24-year-old female, married for 3 years, presented with cyclical hematuria since menarche, dyspareunia and primary infertility. Examination revealed blind ending vagina 4cm from the introitus. Magnetic resonance imaging revealed a fistulous communication between urethra and vagina, and TVS. Cystourethroscopy confirmed a proximal urethra-vaginal fistula. Urethroscopy guided puncture of the TVS was performed, tract dilated and a catheter was placed across it. Robotic assisted transvaginal approach was planned. Air docking of robot was performed. Traction on the catheter was given to identify the incised edges of the septum. Vaginal flaps were raised laterally, fistulous tract was excised. Proximal vagina mucosa was identified and vaginoplasty was performed. Result: Patient's postoperative recovery was uneventful. Urethral catheter was removed after 5 days. She had normal voiding and menstruation. Vaginoscopy performed at 1st month follow-up, revealed an adequate vaginal lumen. Vaginal moulds were advised for 6 weeks during the night, following which she resumed her sexual activity. She conceived 6 months post-surgery, and delivered a child by caesarean section. Conclusion: We successfully managed this case by resection of septum, neovagina creation and thereby achieving normal menstruation and conception. The advantages of robotic approach were magnification, precision and manoeuvrability in a limited space, avoiding a vaginal release incision.


Subject(s)
Humans , Male , Female , Vaginal Diseases , Vaginal Fistula/surgery , Robotic Surgical Procedures , Urethra/surgery , Urethra/diagnostic imaging , Vagina/surgery
7.
Int. braz. j. urol ; 47(5): 1032-1036, Sept.-Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286804

ABSTRACT

ABSTRACT The objective of this study is describing a technique with the use of a tunica vaginalis flap (TVF) to cover the suture line during anterior urethroplasty in patients with kippered urethra due to chronic indwelling catheterization (CIC). We studied 5 patients (mean age=50.2) with a neurogenic bladder that developed urethral erosion after a long period of CIC. Foley catheter was removed on the 14th postoperative day. One patient developed wound infection and utethrocutaneous fistula, which was conservatively managed and after 12 months of follow-up all the patients didn't report difficulties in intermittent self-catheterization. In conclusion, a urethroplasty with TVF technique may be a viable method for repairing penile urethral erosions, but further studies are required with a bigger sample to confirm our results.


Subject(s)
Humans , Male , Middle Aged , Fistula , Hypospadias/surgery , Urologic Surgical Procedures, Male , Surgical Flaps , Urethra/surgery
9.
Int. braz. j. urol ; 47(4): 856-860, Jul.-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1286774

ABSTRACT

ABSTRACT The management of complex urethral stenosis may involve different surgical techniques. As retraction of the graft may account for surgical failure, this risk increases in patients with more extensive stenosis requiring a graft of greater diameter. Although double grafts have already been used to maximize success in these cases, we propose a modified technique for urethroplasty with longitudinal urethral incision. The hypothesis was that this technique would increase the lumen by using only a urethral incision on the dorsal surface. Two patients presenting with recurrent urethral stenosis underwent urethroplasty using a double graft of oral mucosa that preserves the integrity of the spongy tissue and allows ventral inlay graft fixation using a midline relaxing incision in the portion of the urethra with stenosis. In both cases, the urethrocystoscopy and uroflowmetry performed after surgery showed a pervious and complacent urethra. After four and six months of follow-up, the postoperative outcomes were satisfactory for both patients. Further studies involving larger numbers of patients and long-term follow-up are required to evaluate the effectiveness of this method.


Subject(s)
Humans , Male , Female , Urethral Stricture/surgery , Urologic Surgical Procedures, Male , Urethra/surgery , Retrospective Studies , Treatment Outcome , Mouth Mucosa/surgery
10.
Int. braz. j. urol ; 47(4): 829-840, Jul.-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286765

ABSTRACT

ABSTRACT Objective: The diagnosis and treatment of female urethral stricture disease (FUSD) are practiced variably due to the scarcity of data on evaluation, variable definitions, and lack of long-term surgical outcomes. FUSD is difficult to rule out solely on the basis of a successful calibration with 14F catheter. In this study, we have tried to characterize the variable clinical presentation of FUSD, the diagnostic utility of calibration, videourodynamic study(VUDS), and urethroscopy in planning surgical management. Materials and Methods: A retrospective review of records of 16 patients who underwent surgical management of FUSD was analyzed. The clinical history, examination findings, and the results of all the investigations (including uroflowmetry, VUDS findings, urethroscopy) they underwent, the procedures they had undergone, and the follow-up data were studied. Results: A total of 16 patients underwent surgical management of FUSD. 13 out of 16 patients had successful calibration with 14F catheter on the initial presentation. These 13 patients on VUDS demonstrated significant BOO and had variable stigmata of stricture on urethroscopy. The mean IPSS, flow rate, and PVR at presentation and after urethroplasty were 23.88±4.95, 7.72±4.25mL/s, 117.06±74.46mL and 3.50±3.44, 22.34±4.80mL/s, and 12.50±8.50mL, respectively. (p <0.05). The mean flow rate after endo dilation(17F) (n=12) was 11.4±2.5mL/s while after urethroplasty improved to 20.30±4.19mL/s and was statistically significant(p <0.05). Conclusions: An adept correlation between clinical assessment, urethroscopy findings, and VUDS is key in objectively identifying FUSD and planning surgical management. A good caliber of the urethra is not sufficient enough to rule out a significant obstruction due to FUSD. Early urethroplasty provides significantly better outcomes in patients who have failed dilation as a treatment.


Subject(s)
Humans , Male , Female , Urethral Stricture/surgery , Urologic Surgical Procedures, Male , Urethra/surgery , Calibration , Retrospective Studies , Treatment Outcome
12.
Säo Paulo med. j ; 139(3): 241-250, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1252244

ABSTRACT

ABSTRACT BACKGROUND: Vesicourethral anastomotic stenosis (VUAS) following retropubic radical prostatectomy (RRP) significantly worsens quality of life. OBJECTIVES: To investigate the relationship between proliferative hypertrophic scar formation and VUAS, and predict more appropriate surgical intervention for preventing recurrent VUAS. DESIGN AND SETTING: Retrospective cross-sectional single-center study on data covering January 2009 to December 2019. METHODS: Among 573 male patients who underwent RRP due to prostate cancer, 80 with VUAS were included. They were divided into two groups according to VUAS treatment method: dilatation using Amplatz renal dilators (39 patients); or endoscopic bladder neck incision/resection (41 patients). The Vancouver scar scale (VSS) was used to evaluate the characteristics of scars that occurred for any reason before development of VUAS. RESULTS: Over a median follow-up of 72 months (range 12-105) after RRP, 17 patients (21.3%) had recurrence of VUAS. Although the treatment success rates were similar (79.5% versus 78.0%; P = 0.875), receiver operating characteristic (ROC) curve analysis indicated that dilatation using Amplatz dilators rather than endoscopic bladder neck incision/resection in patients with VSS scores 4, 5 and 6 may significantly reduce VUAS recurrence. A strong positive relationship was observed between VSS and total number of VUAS occurrences (r: 0.689; P < 0.001). VSS score (odds ratio, OR: 5.380; P < 0.001) and time until occurrence of VUAS (OR: 1.628; P = 0.008) were the most significant predictors for VUAS recurrence. CONCLUSIONS: VSS score can be used as a prediction tool for choosing more appropriate surgical intervention, for preventing recurrent VUAS.


Subject(s)
Humans , Male , Urethral Stricture/surgery , Urethral Stricture/etiology , Urethral Stricture/prevention & control , Cicatrix, Hypertrophic , Postoperative Complications/prevention & control , Prostatectomy/adverse effects , Quality of Life , Urethra/surgery , Cross-Sectional Studies , Retrospective Studies , Constriction, Pathologic , Neoplasm Recurrence, Local/prevention & control
13.
Int. braz. j. urol ; 47(2): 237-250, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154443

ABSTRACT

ABSTRACT Objective: The objective is to summarize and characterize the long-term success of anterior augmentation urethroplasty in published series. The current literature on AU consists largely of retrospective series reporting intermediate follow-up and incompletely characterize the long term outcomes of AU. Materials and Methods: A systematic literature review was performed consistent with PRISMA guidelines to characterize long-term outcomes of AU with a minimum upper limit follow-up of 100 months. Penile/preputial skin flaps and graft and oral mucosal graft urethroplasties were included. The primary outcome was stricture-free survival for one-stage AU. Secondary analysis evaluated differences in outcomes based on two failure definitions: the need for intervention versus presence of recurrent stricture on cystoscopy or urethrography. Hazard rates were induced from the reported failure rates of one-stage AU and fixed and random effect models were fitted to the data. Additional subset analysis, removing potential confounders (lichen sclerosus, hypospadias and penile skin graft), was performed. Results: Ten studies met inclusion criteria, and two studies reported separate outcomes for grafts and flaps, and thus were included separately in the analysis. The mean hazard rate across all studies was 0.0044, the corresponding survival rates at 1 year 0.948, 5 years 0.766, 10 years 0.587, and 15 years 0.45. Subset analysis of the 4 select and homogeneous studies noted 1, 5, 10, and 15 years survival rates of 0.97, 0.96, 0.74, and 0.63, respectively. Conclusions: The long-term success rates of augmentation urethroplasty are appear to be worse than previously appreciated and patients should be counseled accordingly.


Subject(s)
Humans , Male , Urethral Stricture/surgery , Urologic Surgical Procedures, Male , Urethra/surgery , Retrospective Studies , Treatment Outcome , Mouth Mucosa
14.
Int. braz. j. urol ; 46(6): 1072-1074, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1134267

ABSTRACT

ABSTRACT Introduction We present an alternative procedure for distal hypospadias consisting of urethral mobilization and partial glandar disassembly, namely GUD (glandar urethral disassembly) technique. Materials and Methods A subcoronal circumcision exposes distal dysplastic urethra. We incise the Buck´s fascia on both sides of urethra releasing it partially from the corpora. We keep a thin bridge of urethral plate to the glans and disassembly almost completely the glans from the corpora, except for the bridge. The glans is incised creating two wide wings that are extremely mobile. The urethra is mobilized, advanced and sutured to the tip of the glans. The glans wings embrace the distal urethra producing a conical glans. Discussion The concept of urethral mobilization has been reported and popularized by Koff in the literature to correct distal hypospadias. One of the limitations of this procedure is the risk of urethral retraction due to extensive proximal dissection. We got inspiration from Mitchell and Bagli' s work of penile disassembly in epispadias to develop the GUD concept. We adopt minimal urethral mobilization mainly in glandar/proximal penile shaft and complete deconstruction of the glans, detaching the corpora from the glans and rotating the wide glans wings to embrace the urethra. Therefore we avoid suture urethroplasty and refurbish the glans to a better conical shape. Conclusion We are convinced that this operation can be regarded as a genuine alternative to distal hypospadias (coronal and subcoronal) but should not be addressed to midshaft forms.


Subject(s)
Humans , Male , Infant , Reconstructive Surgical Procedures , Hypospadias/surgery , Penis/surgery , Urologic Surgical Procedures, Male , Urethra/surgery
15.
Int. braz. j. urol ; 46(6): 1029-1041, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134266

ABSTRACT

ABSTRACT Introduction To assess the feasibility of vacuum physiotherapy meant to decrease graft contraction and recurrent penile curvature (PC), hence successful tubularization and a straight penis in patients underwent two-stage buccal mucosa graft (BMG) urethroplasty, in proximal hypospadias repair. Material and methods Between January 2014 and July 2018, 59 two-stage BMG urethroplasties performed at our referral center, were included in the study. The parents were counseled to use the vacuum device between the two stages. An internal, self-administered, semiquantitative, non-validated questionnaire was designed to record parent and patient adherence to the vacuum physiotherapy and parent satisfaction. Success rate of graft tubularization, curvature correction rates, and status of early (4 months) postoperative urinary stream were evaluated. Results Of 45/59 (76.3%) who returned the questionnaire, 77.8% followed the recommended physiotherapy protocol using the vacuum device. 93.3% of parents replied that the use of the vacuum was easy or moderately easy. None of the parents interrupted the physiotherapy because of perceived difficulty or intolerability. 100% of parents would have repeated the physiotherapy, if they had to. Overall, success rate of tubularization was 98.3% (58/59), complete curvature correction was achieved in 88.2% (52/59) of patients, and 79.7% (47/59) of patients showed a straight and powerful early post-operative urinary stream. Conclusions Physiotherapy with the vacuum device is safe, easy and practically feasible. Our vacuum physiotherapy protocol had high compliance rate. Vacuum physiotherapy should be considered for further assessment in patients undergoing two stage hypospadias repair using buccal mucosa.


Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Hypospadias/surgery , Urologic Surgical Procedures, Male , Urethra/surgery , Vacuum , Physical Therapy Modalities , Mouth Mucosa
16.
Int. braz. j. urol ; 46(6): 962-970, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134260

ABSTRACT

ABSTRACT Objective To examine the impact of obesity on perioperative outcomes and urethral stricture recurrence after anterior urethroplasty. Material and Methods We reviewed our prospectively maintained single-surgeon database to identify men with anterior urethral strictures who had undergone anastomotic or augmentation urethroplasty between October 2012 and March 2018. In all, 210 patients were included for primary analysis of perioperative outcomes, while 193 patients with at least 12 months follow-up were included for secondary analysis of stricture recurrence. Patients grouped by BMI were compared using univariate and multivariate analyses for perioperative outcomes and log rank testing for recurrence-free survival. Results Overall, 41% (n=86) of patients were obese and 58.6% (n=123) had bulbar urethral strictures. Obese patients had significantly longer urethral strictures (mean=6.7cm±4.7) than nonobese patients (p <0.001). Though urethroplasty in obese patients was associated with increased estimated blood loss (EBL) relative to normal BMI patients on both univariate (p=0.003) and multivariate (p <0.001) analyses, there was no difference in operative time, length of stay, or complication rate between BMI groups. At a mean follow-up interval of 36.7 months, 15% (n=29) of patients had stricture recurrence, yet recurrence-free survival was not significantly different between groups (log rank p=0.299). Dorsal augmentation urethroplasty resulted in significantly fewer recurrences in obese patients compared to nonobese patients (p=0.036). Conclusion Despite the association with increased urethral stricture length and EBL, obesity is not predictive of adverse perioperative outcomes or stricture recurrence. Obese patients should be offered urethral reconstruction, but patient selection and preoperative counseling remain imperative.


Subject(s)
Humans , Male , Adult , Aged , Urologic Surgical Procedures, Male , Urethral Stricture/surgery , Recurrence , Urethra/surgery , Retrospective Studies , Treatment Outcome , Middle Aged , Neoplasm Recurrence, Local , Obesity/complications
17.
Int. braz. j. urol ; 46(5): 772-777, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134224

ABSTRACT

ABSTRACT Introduction: Transverse preputial island flap urethroplasty (TPIFU) is one of the most frequently performed technique for single-stage repair in proximal hypospadias. It was reported that the subepithelial urethroplasty would obviously decrease urethrocutaneous fistula (UF) complication after proximal TIP. But in the process of TPIFU, it had not been reported yet. Objective: We reviewed our experience to evaluate and compare the effect of continuous eversion suture (CES) versus continuous inversion subepithelial suture (CIS) on complication rates in the TPIFU. Material and methods: A retrospective review of all patients operated with CES and CIS in our institution between January 2017 and Jun 2017 was performed. Results: A total of 161 patients were enrolled in the research. Patients were followed up for 12~17 months. Total success rate was 73.9% (119/161). No statistically difference was found between the two groups with regard to age of patients (P=0.097), catheter size (P=0.52), time of catheterization (P=0.47), length of neourethra (P=0.20), non-urethral comorbidity (P=0.44) and post-operative infection (P=1.0). The overall postoperative complications had no statistically difference between the two groups (P=0.067). There were no statistically significant differences in the incidence of urethra-cutaneous fistula (UF) (OR=0.07, 95% CI: -0.24~0.037, P=0.22), urethral diverticulum (UD) (OR=0.026, 95% CI: -0.16~-0.056, P=0.323), urethral stricture (US) (OR=0.081, 95% CI: -0.15~0.15, P=1.0) and breakdown of urethral repair (BU) (OR=0.02, 95% CI: -0.118~-0.044, P=1.0). Discussion: The comparison of two group's postoperative complications was feasible because there were no statistically differences among perioperative variables. It seemed as if continuous inversion subepithelial suture would promote healing. However, it indicated that the overall success rate and the incidences of UF, UD, US and BU complications had no statistically difference between groups. It might be accounted for the subtle differences of techniques changing the process of establishing prime and side branches vascularization. Conclusions: The CIS technique had no significantly different effect on the four complications rates when compared with CES in TPIFU. Thus, CES and CIS could be randomly adopted in TPIFU as personal preference.


Subject(s)
Humans , Male , Infant , Hypospadias/surgery , Postoperative Complications , Urologic Surgical Procedures, Male/adverse effects , Surgical Flaps , Sutures , Urethra/surgery , Retrospective Studies
18.
Int. braz. j. urol ; 46(2): 152-157, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090594

ABSTRACT

ABSTRACT Objective To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury. Materials and Methods We searched the Pubmed database between 1998 and 2019 using the following key words: "penile fracture", "fracture of penis", "trauma to penis", "rupture of corpora cavernosa", "urethral injury", "urethral rupture" and "urethral reconstruction". Results The incidence of urethral lesion in patients with PF varies by geographic region and etiology. Blood in the meatus, hematuria and voiding symptoms are highly indicative of urethral rupture. The diagnosis of PF is eminently clinical and complementary exams are not necessary. The treatment consists of urethral reconstruction and the most common complications found are urethral stenosis and urethrocutaneous fistula. Conclusion PF is an uncommon urological emergency, particularly in cases with urethral involvement. Urethral injury should be suspected in the presence of suggestive clinical signs, and diagnosis is usually clinical. Urgent urethral reconstruction is mandatory and produces satisfactory results with low levels of complications.


Subject(s)
Humans , Male , Penile Diseases/surgery , Penile Diseases/diagnosis , Penile Diseases/etiology , Penis/injuries , Urethra/injuries , Urethral Diseases/etiology , Penis/surgery , Rupture/surgery , Rupture/diagnosis , Rupture/etiology , Urethra/surgery , Urethral Diseases/surgery
19.
Arch. argent. pediatr ; 118(1): e26-e29, 2020-02-00. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1095686

ABSTRACT

El prolapso uretral es una enfermedad poco frecuente que afecta a la uretra distal. Ocurre, con mayor frecuencia, en niñas negras prepúberes y en mujeres posmenopáusicas. El motivo de consulta suele ser sangrado genital y/o disuria. El tratamiento incluye desde terapia conservadora hasta operaciones quirúrgicas.Se presenta el caso de una niña blanca de 11 años que acudió a Urgencias por flujo vaginal desde hacía 6 días y sangrado genital desde hacía 3 días, que se acompañaba de dolor punzante en la región genital, con disuria ocasional. Se observó una eversión circular de la mucosa uretral con un área granulomatosa y necrótica, por lo que se intervino quirúrgicamente y se realizó una resección del prolapso, con resolución de la clínica


Urethral prolapse is an uncommon condition that involves the distal urethra. It occurs most often in prepuberal black girls and in postmenopausal women. The reason for consultation is usually genital bleeding and/or dysuria. The treatment includes from conservative therapy to surgical interventions.We present the case of an 11-year-old white girl who came to the Emergency Room due to vaginal discharge for 6 days and genital bleeding for 3 days that was accompanied by stabbing pain in genital region, with occasional dysuria. A circular eversion of the urethral mucosa was observed, so the patient was surgically intervened, performing a prolapse resection with clinical resolution


Subject(s)
Humans , Female , Child , Prolapse , Urethra/surgery , Female Urogenital Diseases , Hemorrhage
SELECTION OF CITATIONS
SEARCH DETAIL