Objectives To validate an experimental non-animal model for training of vasectomy reversal.Materials and Methods The model consisted of two artificial vas deferens, made with silicon tubes, covered by a white resin, measuring 10 cm (length) and internal and external diameters of 0.5 and 1.5 mm, respectively. The holder of the ducts is made by a small box developed with polylactic acid, using a 3D print. The objective of the invention is to simulate the surgical field of vasovasostomy, when the vas deferens are isolated from other cord structures. For validation, it was verified the acquisition of microsurgical skills during its use, in a capacitation course with 5 urology residents from a Hospital of the region. Along the training sessions, it was analyzed the time (speed) of microsurgical sutures, and quantification of the performance using a checklist. Collected data were analyzed using de BioEstat®5.4 software.Results Medium time for the completion of microsurgical sutures improved considerably during the course, and reached a plateau after the third day of training (p=0.0365). In relation to the checklist, it was verified that during capacitation, there was significant improvement of the scores of each participant, that reached a plateau after the fourth day of training with the model (p=0.0035).Conclusion The developed model was able to allow the students that attended the course to gain skills in microsurgery, being considered appropriate for training vasectomy reversal.

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Objective: To histologically evaluate, in an experimental study in rabbits, the integration process of the buccal mucosa fenestrated graft applied in the corpora cavernosa for Bracka fi rst stage urethroplasty. Materials and Methods: A urethral defect was surgically created in 16 male rabbits of the New Zealand breed through the excision of the penile urethra. The urethral defect was corrected by applying buccal mucosa fenestrated graft through two cruciform incisions in the distal portions of its longitudinal axis. The animals were sacrifi ced at 2, 4, 8 and 12 weeks post surgery and their genitals were subjected to clinical and histological assessment. Results: The buccal mucosa fenestrated graft showed complete uptake in all groups, with keratinization squamous metaplasia and mucosal proliferation of the fenestrated areas. The fenestrated graft area represented an increase in length of 25% in length in relation to the original standard graft. Conclusions: The fenestrated buccal mucosa graft presented total integration to the adjacent epithelia with re-epithelization of the incision areas of the graft (fenestrations) and no signifi cant infl ammatory or scarring reactions when compared to other mucosa transplanted areas; therefore its application is viable in cases of extensive urethral defect whenever the donating area might be insuffi cient.

Objetivo: O estudo idealizou o desenvolvimento e validação de um simulador confeccionado em impressora 3D para a capacitação em ureterolitotripsia flexível com laser. Métodos: O simulador foi confeccionado com ácido polilático e é constituído por duas partes, que se fecham de maneira hermética. O seu interior imita um sistema urinário, constituído de ureter proximal, pelve e cálices renais, permitindo o treinamento de navegação com endoscópio, a litotripsia com laser, bem como a remoção dos fragmentos de cálculos. Para validação, o simulador foi avaliado por 21 juízes especialistas, que tiveram acesso à tecnologia individualmente e puderam verificar suas principais características e funcionalidades. A avaliação foi documentada através do preenchimento de um questionário, contendo 22 afirmativas em escala Likert, dividias em três domínios: (1) OBJETIVOS, (2) ESTRUTURA e APRESENTAÇÃO e (3) RELEVÂNCIA. Resultados: Os 3 domínios obtiveram a aprovação de, respectivamente, 98,6%,98,3% e 99,3%. A consistência interna do questionário foi verificada através do teste Alfa de Cronbach que alcançou altos valores, tanto nos domínios (0.829, 0,87 e 0.9963), quanto na avaliação geral (0.92). Conclusão: O simulador desenvolvido permite o treinamento de cirurgia de ureterolitotripsia flexível com laser, podendo ser considerado uma ferramenta auxiliar no ensino-aprendizado em urologia.

The MRI showed a detailed scenario of the abnormality with advantages over the US evaluation in regard to excluding cloacal anomalies. MRI allowed accurate sexual differentiation and may be indicated after suspected bladder exstrophy on US evaluation.