Background : In the pathogenesis of urethral stricture, fibrosis is associated with an excessive collagen increase. After the recognition that topical application of Mitomycin-C (MMC) inhibits fibroblast proliferation and is effective in preventing scar formation, many studies have been carried out on this subject outside the scope of urology. The aim of the present study is to observe the intraurethral impact of the employment of low doses of MMC on scar formation and fibrosis in experimental rat model. Methods : Urethral injuries were made by internal urethrotomy knife. The study was carried out with 35 adult male Wistar albino rats. Five rats were allocated to the control group (group 1), 10 to a group that was administered 2 mg/L MMC (group 2) and 20 to a group that was administered 10 mg/ L MMC (group 3). Mitomycin-C was administered to the injured urethra in the form of irrigation for 5 min. The rats were sacrificed 14 days later in order to evaluate chronic inflammation and fibrosis and their penises were histopathologically examined under light microscopy with hematoxilen eosin and trichrom stains. Results : When group 2 was compared with control group, the differences in hemosiderin-laden macrophages (HLM), mononuclear cell infiltration (MCI) and fibrosis were found to be statistically significant (P < 0.01, P < 0.05, P < 0.005, respectively). When group 3 was compared with control group, the differences in HLM, MCI and fibrosis were also found to be statistically significant (P < 0.05, P < 0.05, P < 0.005, respectively). In the comparison of group 2 with group 3, no statistically significant differences were found in terms of the these parameters. Conclusions : Although MMC is toxic at high doses, the antifibrotic effect of the intraurethral low dose MMC may be useful in combination therapy for internal urethrotomy.
Thirty-two cases of penile fracture in 1983-1996 were retrospectively reviewed and the patients were recalled for assessment of current status. The time from injury to repair ranged from 8 to 31 hours. The tear in the tunica albuginea was repaired with absorbable interrupted sutures. All patients were discharged on the day after operation. Skin loss required dermal grafting one month postoperatively in one patient. Erectile function returned within 2 days and coitus was achieved on average 13 days after the repair. Two patients had slight penile curvature which did not impede coitus. At long-term follow-up all patients reported satisfactory function.
The aim of this study is to describe a new technique using laparoscopic instruments for percutaneous bladder stone management and determine the efficacy of this procedure. The technique is based on percutaneous removal of the bladder stone(s) by using laparoscopic instruments under video-cystoscopic visualization. Laparoscopic large grasper or butterfly net like sac were used to extract bladder stones in six patients who were candidates of open cystolithotomy. Satisfactory results have been obtained in patients with solitary bladder stones that have diameters up to 3 cm or multiple stones. In selected cases, operation time, urethral and mucosal damage, hospital stay, and cost can be decreased to a minimum with this simple technique. It may be an alternative method to previously reported percutaneous bladder calculi management modality, in which percutaneous nephrolithotomy devices have been utilized.
Urologic lesions accompanying pelvic fractures is a well-known entity, and reports on the correlation of pediatric pelvic fracture type with lower urinary tract injury are few in the literature. We have reviewed 27 records and x-ray films of male pediatric patients who required urologic intervention after trauma to see which type of fracture, classified according to Tile, has a higher predilection of urologic injury. Most of the fractures that were considered to be mechanically stable and mainly localized to the anterior pelvic arch had urologic lesions that were generally confined to the bulbomembranous urethra (48%).
A 70-year-old man presented with a large suprapubic mass. Ultrasonography revealed that the mass was cystic and displaced the bladder anteriorly and superiorly. Computed tomography suggested that the mass could be an echinococcal cyst. Computed tomography also showed that the patient had bilateral hydroureteronephrosis. Echinoccocal haemagglutination was positive at 1:320 dilution. The patient underwent surgical exploration during which the cyst was found to be located in the retrovesical region. The cyst was completely excised and the pathologic examination confirmed the diagnosis.
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