Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function (EF) and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.
Conventional repair of aortic pathology such as thoracic aortic aneurysms (TAA), aortic dissections, and intramural hematomas (IMH) involves major cardiothoracic surgery. Complication rates can be as high as 30%, therefore percutaneous endograft placement has become the new gold standard. However, not every patient is a suitable candidate for endovascular repair of a thoracic aneurysm, especially, patients with a very short proximal landing zone neck or a difficult type II or type III configuration of the aortic arch. Emerging techniques have been described in the literature, but until now none have been able to confidently conquer this problem. Stacked stents in a “turtlehead” fashion offer a solution to this obstacle. The turtlehead technique utilizes commercially available stents deployed in an on-label fashion to create a rigid yet conformable endograft that can precisely treat difficult proximal landing zone necks.
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