We aimed to evaluate the feasibility and long‐term functional outcomes of surgical correction of adult buried penis patients due to complications of childhood circumcision. A retrospective analysis was performed for patients who underwent treatment for buried penis between 1997 and 2019. An autologous split‐thickness skin graft (STSG) was used. Surgical management steps included circumcision, resection of the bands between the corpora and other tissues, harvesting of STSG from femoral region and graft application. Surgical and functional outcomes were the primary end points. Thirteen patients were included with a mean age of 22.4 years and median body mass index 27. Patients had similar symptoms, including sexual dysfunction, inadequate penile length, impossible penetration and decreased quality of life. No early post‐operative complication was seen. During a median of 44‐month follow‐up, post‐operative long‐term complications were seen in 4 (30%) patients: decreased graft sensation (n = 2); graft contracture five months after surgery (n = 1); and retarded ejaculation (n = 1). Patients’ post‐operative three‐month International Index of Erectile Function (IIEF) score and sexual satisfaction score (SSS) significantly increased compared with patients’ pre‐operative scores (IIEF; 22.8 vs. 14.1, p = .03, SSS; 8.7 vs. 3.2, p < .01). Buried penis is a rare but challenging condition. Patients had excellent graft acceptance with successful functional outcomes.
Background The purpose of this study was to assess the long-term clinical efficacy of temporary, Allium round posterior stent (RPS) used for treatment of recurrent bladder neck contracture (BNC). Methods Records of 42 patients with recurrent BNC who underwent Allium RPS placement after bladder neck incision, between 2009 and 2019, were analyzed. After stent removal, the success criteria for Allium RPS treatment were defined as: no evidence of stricture on urethrogram or endoscopy; more than 12 ml/sec of urinary peak flow; and no recurrent urinary tract infections. Based on clinical success, patients were divided into two groups and compared. Clinical success was evaluated with particular regard to stent indwelling time and contracture etiology. Results The mean ± standard deviation age, stricture length, and indwelling time were 66.7 ± 9 years, 2.4 ± 1.4 cm, and 7.7 ± 2.2 months, respectively. Median (range) follow-up was 59 (8–73) months. The etiologies of BNC in this cohort were 57.1% retropubic radical prostatectomy; and 42.9% transurethral resection of prostate. Overall clinical success was achieved in 64.3% and the success rates did not differ by etiology. The success rates were 54.2% and 77.8% ( P = 0.118) for retropubic radical prostatectomy and transurethral resection of prostate, respectively. Longer indwelling time (8–14 vs 3–7, months) was significantly associated with clinical success (78.3% vs 47.4%, P = 0.040). Conclusion Our data suggest that better clinical success was associated with longer indwelling time for stent in BNC treatment. In BNC management, Allium RPS treatment may be considered since its clinical efficacy is acceptable and tolerable.
<b><i>Background/Aim:</i></b> The aim of this study was to assess long-term clinical efficacy of temporary bulbar urethral stent (BUS) used for treatment of recurrent bulbar urethral stricture (US). <b><i>Materials and Methods:</i></b> A total of 168 patients with recurrent bulbar US who underwent BUS placement after internal urethrotomy between 2009 and 2019 were enrolled. An indwelling time of 12 months was planned for the stents. After stent removal, the criteria for success of BUS treatment were defined as follows: no evidence of stricture on urethrogram or endoscopy, more than 15 mL/s of urinary peak flow, and no recurrent urinary tract infections. Patients were divided into 2 groups based on clinical success and compared. <b><i>Results:</i></b> The mean age, US length, and indwelling time were 46.7 (±8.3) years, 2.32 (±0.4) cm, and 9.7 (±2.3) months, respectively. Median (range) follow-up was 71 (8–86) months. Clinical success was achieved in 77.9% patients. Longer indwelling time (8–18 [81.88%] vs. 3–7 [60%] months) and US length <2 cm (84.25% [<2 cm] vs. 58.5% [≥2 cm]) were significantly associated with clinical success (<i>p</i> < 0.05). <b><i>Conclusion:</i></b> This study is both the largest patient series and the longest follow-up for BUS in bulbar US. Our results suggest that BUS can be a safe and minimally invasive treatment alternative among bulbar US treatment options.
Objective: To evaluate the impact of Double J stent (DJS) insertion during open partial nephrectomy (OPN) on postoperative prolonged urinary leakage. Materials and methods: A retrospective study was made in consecutive cases of OPN performed between 2002 and 2020 for localized kidney tumors at our tertiary center. Urinary leakage was defined as drainage > 72 hours after surgery by biochemical analysis consistent with urine or radiographic evidence of urine leakage. The patients were divided into two groups according to intraoperative DJS placement, and compared regarding clinicopathologic characteristics, perioperative and postoperative outcomes. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with urinary leakage after the operation. Results: Review of records identified 182 patients who were included in the study. In 73 (40%) patients PN was performed without insertion of a DJS. Thus, 109 (60%) of patients had a DJS inserted. Apart from higher preoperative eGFR values among patients with DJS (96.6 vs. 94.3 mL/min/1.73 m²; p = 0.03), demographic characteristics were similar between groups. The two groups were not different regarding perioperative, postoperative and clinicopathologic outcomes. Patients with DJS had longer ischemia times (31 vs. 23 min; p = 0.02) and longer length of stay (6 vs. 5 days; p = 0.04). Urinary leakage was seen in 7.6% (n = 14) of all patients and it did not differ according to DJS placement (DJS+ 9.2 vs. DJS- 5.5%; p = 0.41). On multivariate analysis, the tumor nearness to the collecting system was the sole independently significant factor (p = 0.04) predicting postoperative urine leak. Conclusions: Routine intraoperative DJS insertion during OPN does not appear to reduce the probability of postoperative urine leak.
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