ABSTRACT
OBJECTIVE: To improve the results of corrective surgery for severe urinary incontinence in the female (sphincteric lesion) utilizing a new prosthesis that allows adjusting the degree of tension of the band or urethrocervical sling. METHODS: We have added the use of a subcutaneous hydraulic device to the classical pubovaginal sling procedure. The device can be gradually filled by percutaneous punction to adjust the urethral closure pressure. RESULTS: All patients had previously undergone different procedures and had grade III stress urinary incontinence. With the hydraulic device, the success rate (complete continence) was 95.5% (21/22 patients) and the complication rate was 9% (2 cases; one developed infection and the other chronic urinary retention). CONCLUSIONS: The hydraulic device described herein is easy to place, low-cost and carries a minimum morbidity. Its use is indicated in patients who have previously undergone surgery, with a sphincteric lesion and who require precise adjustment of the urethrocervical sling. The degree of tautness can be adjusted repeatedly according to the clinical course of a patient without requiring reoperation.
Subject(s)
Prostheses and Implants , Urinary Incontinence, Stress/surgery , Adult , Aged , Evaluation Studies as Topic , Female , Humans , Middle Aged , Polytetrafluoroethylene , Postoperative Complications , Prosthesis Design , Prosthesis ImplantationABSTRACT
OBJECTIVE: To describe a simple method of depilation of scrotal skin and the advantages of utilizing scrotal skin flaps for urethroplasty in the postpubertal male. METHODS: Depilation of the scrotal flap is achieved by electrocoagulating the dermal papillae with a needle specifically designed for scrotal hair. The frequency and the number of depilations are determined by the hair biological cycle. RESULTS: Scrotal hair is removed with no injury to tissue or changes in the characteristics of scrotal skin. This method of depilation is well-tolerated and no complication has been observed. CONCLUSION: The scrotal skin depilated provides excellent flaps for reconstructive surgery of complex urethral strictures, specially those extending beyond the penoscrotal angle up to the membranous and prostatic inframontanum portion.
Subject(s)
Electrocoagulation/methods , Hair Removal/methods , Scrotum , Surgical Flaps , Urethra/surgery , Adult , Hair/physiology , Humans , Male , Scrotum/surgeryABSTRACT
Knowing the history of Urology has allowed urologists to recover techniques which had been abandoned for different reasons, yet when modified or utilized with current technological advancements, have proved to be very useful. A brief review of the history of urinary diversion clearly shows that it has evolved in parallel with the important diseases; i.e., vesical exstrophy, urinary tuberculosis and bladder cancer. Time tests all new, and thus controversial, concepts or procedures. They become either well established or are condemned to oblivion. All the experience, both successes and failures, that make up the history of Urology undoubtedly contribute towards finding new therapeutic alternatives.
Subject(s)
Urinary Diversion/history , History, 20th Century , Humans , Intestines/surgery , Urinary Bladder/surgery , Urinary Diversion/methods , Urinary Reservoirs, Continent/history , Urinary Reservoirs, Continent/methodsSubject(s)
Hematuria/diagnosis , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Adult , Diagnosis, Differential , Humans , Male , RecurrenceABSTRACT
We make an evaluation of 66 ureteroscopies (URS) carried out in our Service over a period of 18 months. In 55 cases it was done for therapeutic purposes in ureteral lithiasis, and in 11 cases it was for diagnostic purposes. In the treatment of lithiasis resolutive effectivity at the first attempt was 68%, in 9% ureterolithotomy had to be performed due to the impossibility of approaching the calculus, and in 23% supplementary treatment was carried out by means of external litrotripsy. In the diagnostic field, effectivity was 72%. Notable complications arose in 6 cases (9%), 6 ureteral perforations, in three of which a urinoma was formed, all settled with a double J catheter. Open surgery was not resorted to in any case. No sequelae were observed and this technique therefore showed itself to be safe and effective.
Subject(s)
Endoscopy/methods , Ureteral Calculi/therapy , Ureteral Diseases/diagnosis , Adult , Aged , Aged, 80 and over , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Ureteral Calculi/diagnosisABSTRACT
We report on a 72-year-old male patient with fibrous ureteral polyp which had been diagnosed following the incidental finding of a ureteral filling defect on radiographic evaluation for prostatism and gross intermittent hematuria of several months. We underscore the low frequency of this disorder and the therapeutic implications of differential diagnosis to distinguish this condition from other causes of ureteral filling defects.
Subject(s)
Polyps/pathology , Ureteral Neoplasms/pathology , Aged , Humans , Male , Polyps/diagnostic imaging , Radiography , Ureteral Neoplasms/diagnostic imagingABSTRACT
We present a case of urinary way fistulized renal hydatid cyst, which displayed itself clinically by repeated nephritic colics caused by the expulsion of calcified daughter vesicles. We make special mention of the diagnostic process and the surgical technique used, which included cystopericystectomy and anterograde ureteroscopy for the extraction of the calcified daughter vesicles at ureteral level.
Subject(s)
Echinococcosis/diagnostic imaging , Kidney Diseases/diagnostic imaging , Kidney Pelvis , Adult , Echinococcosis/complications , Echinococcosis/surgery , Female , Fistula/diagnostic imaging , Fistula/etiology , Fistula/surgery , Humans , Kidney Diseases/complications , Kidney Diseases/surgery , RadiographyABSTRACT
A case is described of a urethral foreign body of long evolution, introduced for masturbatory purposes and which had its clinical origins as a periurethral abscess. We comment on the diagnostic steps and the therapeutic attitude followed.
