Uso de mucosa prepucial en la estenosis uretral e hipospadia, Hospital Nacional Guido Valadares de Timor Oriental / Uso de mucosa prepucial na estenose e hipospadia da uretra, Hospital Nacional Guido Valadares de Timor Oriental / Using preputial mucosa in urethral stricture and hypospadias, at National Hospital Guido Valadares East-Timor

Se presentó un caso intervenido en el servicio de Urología del Hospital Nacional "Guido Valadares" de Timor Oriental, con diagnóstico de retención completa de orina, insuficiencia renal aguda obstructiva posrrenal, hidronefrosis bilateral y estenosis uretral e hipospadia, con el objetivo de demostrar el uso de la mucosa prepucial para las hipospadias que concomitan con estenosis uretral. La conducta quirúrgica consistió en una uretroplastia con mucosa prepucial. Se logró la reconstrucción total de la uretra afectada, con buenos resultados finales estéticos y funcionales. El uso de la mucosa oral fue de gran utilidad en el manejo del paciente(AU)

A case was presented in the Department of Urology of Guido Valadares National Hospital in East Timor, diagnosed with complete retention of urine, post renal, obstructive and acute renal failure, bilateral hydronephrosis and urethral stricture and hypospadias, in order to demonstrate the use of prepucial mucosa for hypospadias that concomitan with urethral stricture. The surgical treatment consisted urethroplasty with preputial mucosa. Total reconstruction of the affected urethra was done with good aesthetic and functional outcomes. The use of oral mucosa was very useful in patient management(AU)

Foi apresentado um caso no Departamento de Urologia do Hospital Nacional "Guido Valadares" de Timor Oriental, com diagnóstico de retenção urinária completa, insuficiência renal aguda obstrutiva pós-renal, hidronefrose bilateral e estenose e hipospádia uretral, para demonstrar a utilização da mucosa prepucial para hipospádia que coincide com estenose uretral. O procedimento cirúrgico consistiu em uma uretroplastia com mucosa prepucial. A reconstrução total da uretra afetada foi alcançada, com bons resultados estéticos e funcionais finais. O uso da mucosa oral foi muito útil no manejo do paciente(AU)

Aspects épidémiologiques, cliniques et prise en charge de sténose urétrale chez l'adulte dans un Hôpital de District de Ngaoundéré, Cameroun

Introduction: l'objectif était de déterminer les aspects épidémiologiques, cliniques et prise en charge de la sténose de l'urètre à l'Hôpital Protestant de Ngaoundéré (HPN).Méthodes: une étude rétrospective a été conduite, basée sur la revue des dossiers des patients hospitalisés pour sténose urétrale dans l'unité urologique de l'HPN, d'une période d'un an (janvier 2013 à janvier 2014). Seuls les dossiers complets étaient inclus.Résultats: 57 patients ont été retenus sur les 69 dossiers enregistrés dont tous était de sexe masculin. L'âge moyen était 52,6 ans (19 ans à 85 ans). La tranche d'âge la plus représentée était celle de 41 à 60 ans. La sténose urétrale représentait 0,6% des consultations externes, 11,36 % des hospitalisations en chirurgie, et 6,96% des interventions chirurgicales dans cette structure sanitaire. La dysurie (70, 17%) était le principal motif de consultation. Les étiologies étaient d'origines infectieuses (52,63%), traumatiques (26,32%) et iatrogènes (21,05%). L'ECBU réalisé sur tous les patients a permis d'isoler les gonocoques (14,03%) et Escherichia coli (21,05%), le reste de culture était stérile (64,91%). L'Uretro-Cystographie Rétrograde (UCR) a été réalisée sur 28 patients (49,12%), dont 26 cas était des rétrécissements antérieurs (92,85%). L'Urétrotomie Interne Endoscopique (UTI) était le geste chirurgical le plus réalisé (58%). La sténose était le plus souvent localisée au niveau des régions bulbaires et péno-bulbaires. Le taux de guérison était de 87,73% contre 12,27% de récidives.Conclusion: la sténose urétrale est fréquente en Urologie de l'HPN mais les patients consultent souvent en stade compliqué. L'urétrotomie interne endoscopique a montré des résultats plausibles

Adult urethral stricture: practice of Turkish urologists

ABSTRACT Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.

Ventral inlay buccal mucosal graft urethroplasty: A novel surgical technique for the management of urethral stricture disease

To describe the novel technique of ventral inlay substitution urethroplasty for the management of male anterior urethral stricture disease. A 58-year-old gentleman with multifocal bulbar stricture disease measuring 7 cm in length was treated using a ventral inlay substitution urethroplasty. A dorsal urethrotomy was created, and the ventral urethral plated was incised. The edges of the urethral plate were mobilized without violation of the ventral corpus spongiosum. A buccal mucosa graft was harvested and affixed as a ventral inlay to augment the caliber of the urethra. The dorsal urethrotomy was closed over a foley catheter. No intraoperative or postoperative complications occurred. Postoperative imaging demonstrated a widely patent urethra. After three years of follow-up, the patient continues to do well with no voiding complaints and low postvoid residuals. Ventral inlay substitution urethroplasty appears to be a safe and feasible technique for the management of bulbar urethral strictures.

Traitement des sténoses de l'urètre par urétrotomie interne endoscopique: résultats anatomiques et fonctionnels d'une série de 244 cas

Evaluer les résultats d'une série homogène de sténoses urétrales traitées de façon univoque par urétrotomie interne endoscopique (UIE) et d'étudier les éléments à valeur prédictive du résultat.Patients et méthodes. Entre 1989 et 2007, 244 patients ont été hospitalisés pour sténose de l'urètre. Ils ont bénéficié d'une UIE sous contrôle de la vue. Résultats.Il y a eu 34,3% de bons résultats après la première UIE. Le recul moyen était de 3,5 ans. La mortalité était nulle et la morbidité était évaluée à 5%. Le résultat était d'autant meilleur que le geste concernait une sténose courte (inférieure à 2 cm), unique sur l'urètre proximal. La durée moyenne du cathétérisme post-opératoire a été de 2 jours; maintenir ce cathétérisme au delà n'a pas apporté d'amélioration significative. Les mauvais résultats (65,6%) ont été rapportés dans les cas de sténose étendue, siégeant sur l'urètre distal ou concernant des patients âgés. 62,5% ont été guéris après une deuxième urétrotomie, les autres cas ont nécessité des séances de dilatations urétrales d'entretien, voire un geste de plastie. Conclusion. L'UIE est une intervention simple, dépourvue de morbidité majeure et ne nécessitant qu'une hospitalisation courte. Avec un taux de succès stable de l'ordre de 75,4% à 3,5 ans, il nous paraît licite de proposer l'UIE en première intention pour toute sténose urétrale courte, unique, proximale et qu'elle survient chez un sujet jeune, sans antécédents urétraux

Male urethral cancer.

A 55 years old man presented with long standing voiding obstructive symptoms like poor stream, frequency of micturition, straining at micturition and a sense of incomplete evaluation since 2002. He was clinically diagnosed a case of stricture urethra. Later he developed a swelling in the penoscrotal region with retention of urine in March 2005 and was treated by dilatation. But on removal of the catheter he developed retention again for several times and ultimately for gross periurethral sepsis, urinary diversion was required in May 2005. In October 2005, biopsy from the scrotal abscess wall established the diagnosis of urethral carcinoma. In November 2005 extensive penoscrotectomy was done followed by chemo-radiotherapy. But the prognosis was so bad that the patient died in November 2006. Urethral carcinoma is a rare disease diagnosed in the department of urology, Mymensingh Medical College Hospital, the prognosis of which is also poor even after extensive operations.

Posterior urethral valves in childhood : experience in a center with scarce facilities

Objective: Posterior urethral valves (PUV) are the most common congenital causes of lower urinary tract obstruction in male children; but few cases have been reported from Nigeria. In this study we describe our 7-year experience of management of PUV in children in order to increase the awareness of this condition in our environment. Patients and Methods : This is a report of 41 consecutive children with PUV who were managed at the Jos University Teaching Hospitals (JUTH); Jos; Nigeria; from June 2000 to April 2006. Their age at presentation ranged from 2 days to 15 years (mean: 2.5 years). The relevant clinical; laboratory and radiological data were entered into a database and analyzed.Results: Twenty-eight patients presented with a condition highly suspicious of PUV; while 7 patients presented with other urological conditions. Six patients presented with non-urological symptoms which caused a delay in diagnosis and institution of treatment. Voiding cystourethrography was diagnostic in all cases. In the majority of patients (n=31); management consisted of transurethral balloon avulsion of the valves yielding a satisfactory outcome in over 80. Conclusion : Although this study was restricted to one hospital; there appears to be a high incidence of PUV in children in North Central Nigeria. An increased awareness of varied clinical features; a high index of suspicion and simple conservative treatment by balloon avulsion of PUV would improve the outcome.of the patients. Urethral stricture was the main complication (which responded to serial dilatation) and occurred in 3 patients. The postoperative mortality rate was 2.6

Optical internal urethrotomy in the treatment of urethral stricture disease

To evaluate the efficacy of internal urethrotomy in the treatment of urethral stricture disease as a first line of treatment. The study has been prospectively undertaken for forty five patients with urethral stricture disease who were treated with cold-knife internal urethrotomy followed by regular self calibration or hydrostatic urethral dilatation via starting micturations while applying pressure over distal urethra so leading to urethral distention. The age of the patients ranged between 22-80 years. The follow up period was from 6 months to 3 years. The success rate was 88%. The complication occurred in 6.6% of cases. Internal urethrotomy could be regarded as the first treatment of choice in patients with a single, short urethral stricture or post urethroplasty stricture

Role of sonourethrography in evaluation of anterior urethral stricture and its comparison with retrograde urethrography

The aim of this study was to compare retro grade urethrography [RUG] and sonourethrography [SUG] for assessment of urethral strictures and to evaluate whether RUG underestimates stricture length, as has been reported. Quasiexperimental study. The study was performed in the department of Radiology PNS Shifa Karachi from January 2004 till December 2004. Forty male patients diagnosed with anterior urethral stricture were assessed for presence of strictures and their length by conventional contrast urethrography and sonourethrography. Contrast urethrography was carried out by retrograde injection of Urograffin 76% under fluoroscopic guidance. Sonourethrography was done with a 7.5 MHz small parts transducer. Stricture lengths were recorded and compared. Analysis of the results showed that the estimation of stricture length measured by contrast urethrography was under-estimated as compared to sonourethrography. The difference between the two tests was significant [P < 0.001] and the correlation coefficient was poor [r = 0.493]. When the strictures were grouped into penile and bulbar anatomical locations the results remained highly significant in the bulbar region [P = 0.0001] however no significant difference was found in the estimated length for penile strictures [P = 0.25]. Sonourethrography is a good adjunct investigation before definitive surgical therapy particularly in the bulbar region where conventional contrast urethrography was shown to underestimate stricture length significantly

Experience with cold knife optical internal urethrotomy and temporary dilatation

to evaluate the out come and efficacy of cold knife optical urethrotomy and temporary dilatation. Design: a retrospective analysis of 127 cases. Place and duration of study: the study was carried out over a period of three years [March 1997 To April 2000] In The Larkana Medical Centre Private Larkana. One hundred and twenty seven male patients with urethral stricture were treated with cold knife optical urethrotomy over a period of three years. An analysis was carried out of the short-term results of optical internal urethrotomy and temporary dilatation to determine the out come and efficacy of the procedures. The age range was 15-75 years, the mean age being 36.6 years. the follow-up period of treated patients ranged from three months to three years. The results showed that early morbidity was 15% with no mortality. The recurrence rate was 8.9%. The results are consistent with other studies and confirm this as the preferred initial procedure in urethral stricture of penile,bulbar, membraneous and prostatic urethra. Optical urethrotomy is the preferred initial management of urethral stricture. Urethroplasty should be considered in failed optical urethrotomy and recurrent urethral stricture disease

Stricture of the male urethra: 29 years experience of 323 cases.

The authors reported 323 cases of male urethral stricture managed at Ramathibodi Hospital from 1969 to 1998 (29 years period). Etiology included traumatic causes 237 (73%) and post infection 54 cases (16%). The managements were urethroplasties 281 cases (87%), urethrotomy 21 cases (6%) and dilatation 21 cases (6%). The over all successful rate of urethroplasty was 89 per cent. The mean follow-up time was 2.5 years (0.5-15 years).

Desempeño de enfermería en pacientes pediátricos con estenosis del meato uretral / Nursing performance in pediatric patients with stricture of ther urinary meatus

Se realizó un estudio descriptivo y retrospectivo de 15 pacientes con estenosis del meato uretral, atendidos en el Servicio de Cardiorrenal del Hospital Infantil Sur de Santiago de Cuba, durante el primer trimestre de 1997, para lo cual se confeccionó una planilla donde fueron plasmados todos los datos de interés para la investigación. Entre los principales hallazgos sobresalieron que: los niños más afectados tenían aproximadamente 2 años, independientemente del sexo; la mayor estadía se atribuyó a las complicaciones sépticas; existió una relación manifiesta entre la estenosis y la sepsis urinaria y el desempeño del personal de enfermería fue fundamental en el cuidado de estos niños (AU)

A descriptive and retrospective study of 15 patients with stricture of the urinary meatus that received medical attention at the Cardiorenal Service of the South Pediatric Hospital, in Santiago de Cuba, during the first trimester of l997, was conducted. All the data of interest were collected in a form made to this end.The main findings were the following: the most affected children were approximately 2 years old, regardless the sex; the longest hospital stay lenght was attributed to septic complications; there was a clear relationship between stricture and urinary sepsis; and the nursing personnel played a very important role in children care(AU)

Pieloplastia Laparoscópica para tratamento de Estenose da junçäo pelve-ureteral: relato de caso / Uretero-pelvic junction Stenosis-Laparoscopic pyeloplasty: a case report

Relata-se caso de estenose da junçäo pelve-ureteral tratado por pieloplatia videolaparoscópica. Discutem-se as vantagens da via laparoscópica, assim como as demais técnicas que säo utilizadas atualmente. os autors sintetizam o quadro clínico, etiologia, diagnóstico e tratamento dessa patologia

Sonography in evaluation of male anterior urethra

Ultrasonography offers advantages over conventional urethrography in terms of abnormalities detected, convenience of the study and lack of ionizing radiation. Our study favours sonography to be the examination of choice for both follow up of postoperative patients and for the evaluation of patients with new symptoms. The urologist may require a "road map" before surgery and for this purpose contrast urethra-gram may be more helpful

Reconstruçäo uretral utilizando enxerto substitutivo para a estenose da uretra anterior / Urethral reconstruction using substitutive graft to anterior urethra stricture

Foi utilizada uma abordagem peniana-transperineal para reparar as estenoses da uretra anterior com mais de 3cm de comprimento em oito pacientes nos quais a terapêutica endoscópica foi falha. Todos os pacientes foram submetidos a substituiçao uretral com enxerto de pele total de prepúcio. A recidiva da estenose ocorreu em um paciente, sendo tratada através da uretrotomia, com índices de sucesso de 87,5 por cento. O seguimento abrange de um a três anos.

Espongiografía: utilidad en el diagnóstico integral de la estenosis de uretra masculina / Spongiosography: usefulness in the integral diagnosis of male urethral stenosis

La espongiografía es el método que permite observar el cuerpo esponjoso del pene. Se estudió un total de 20 pacientes, los cuales se dividieron en dos grupos: el grupo I formado por 15 enfermos con diagnóstico establecido de estenosis de uretra, y el grupo II o grupo control (sin patología uretral) constituido por cinco pacientes. El estudio fue a futuro con inicio en enero de 1992 y terminación en octubre del mismo año. Se realizaron un total de 20 espongiografías. En tres de los pacientes del grupo I (20 por ciento) el estudio no reveló alteraciones, pero en los 12 restantes (80 por ciento) se demostró defecto de llenado del cuerpo esponjoso, variable en profundidad y longitud. En ninguno de los pacientes ocurrieron efectos colaterales o complicaciones atribuibles al estudio. Cabe considerar que la espongiografía permite obtener información adicional con respecto a la extensión y profundidad de la fibrosis del cuerpo esponjoso -acompañante común de la estenosis de uretra-, y este parámetro ayudará a elegir mejor la modalidad de tratamiento, y con ello reducir la recidivas de la estenosis

Complicaciones urológicas en transplante renal / Urological complications in renal transplant

Se presentan las complicaciones urológicas de 55 pacientes transplantados obteniendo un 9,1 por ciento de complicaciones mayores o reintervenciones, entre ellos 4 fístulas urinarias (2 por necrosis ureteral y las otras dos por problemas anastom{oticos) y una estenosis. Las complicaciones menores fueron hematuria, infección urinaria crónica y reflujo vesicoureteral en un 16,4 por ciento. Sólo hubo una pérdida del injerto por complicaciones urológicas y ninguna muerte del receptor

Estrechez pielo ureteral: nuestra experiencia con la técnica de Anderson-Hynes / Pyelouretheral obstruction: experience with Anderson-Hynes technic

Presentamos nuestra experiencia con la pieloplastía de Anderson Hynes, en la reparación de la estrechez pielo-uretral. Se incluyeron en la investigación 55 pacientes, oteniendo éxito en 50 de ellos y escasas complicaciones. Destacamos las bondades de la técnica en adultos, y hacemos énfasis en la evaluación de la operación usando la renografía isotópica con Tc 99. Se discute la utilidad de dejar siempre tutor ureteral y nefrostomía