Background. Treatment of urethral strictures can be challenging, but, with appropriate preoperative evaluation and surgical planning it is possible to achieve successful results. Objectives. To analyze if the stricture length affects the success with dorsal onlay buccal mucosal graft urethroplasty technique. Material and Methods. Between January 2004 and June 2010 a total of 40 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤ 7 cm, and > 7 cm), and localization of the stricture were assessed as the factors affecting success rate. Results. The clinical outcome was defined as a failure when any operative instrumentation including dilatation was needed or the urine flow rate was less than 14 mL per second at the sixth month, postoperatively. The mean follow-up period was 43.44 months. Of 40 patients, 28 (70%) were successful and 12 (30%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p = 0.26 and p = 0.41). The statistical difference was significant for the localization and length of the stricture by means of success (p = 0.002 and p = 0.025). Conclusions. Our results show that the stricture length and localization are the most important variables for desirable success. Even though surgical techniques are constantly evolving, long strictures stay as a problem for urologists. Studies with larger number of patients with long urethral strictures may support our findings, and may prove the efficiency of these surgical techniques (Adv Clin Exp Med 2015, 24, 2, 297-300).
Objective To evaluate the effectiveness and long-term results of using a self-expanding metallic urethral stent (Urolume Results During a mean (range) follow-up of 3.8 (1±9) years the strictures in 52 of the 60 patients (87%) were treated successfully. All patients initially had postvoid dribbling incontinence, but this resolved in most within one week; 19 patients remain incontinent. Conclusion The Urolume is a cost-effective alternative to other treatments for recurrent bulbar urethral strictures of whatever cause.
PurposeTo evaluate the efficacy of subureteral injection types in patients with middle- to high-grade vesicoureteral reflux (VUR).Materials and MethodsBetween June 1999 and September 2010, subureteral dextranomer was applied at our clinic to 149 patients (214 refluxing ureters) with grades II, III, and IV VUR. Group 1 consisted of 54 patients (80 ureters), and group 2 consisted of 95 patients (134 ureters). The standard subureteric transurethral injection (STING) procedure was applied to group 1, and the modified STING procedure was applied to group 2. A second and if needed a third injection was applied to unsuccessfully treated patients. The mean follow-up period was 2 years. Patients were evaluated by cystography and ultrasonography in the third month of follow-up.ResultsVUR was resolved completely after a single injection in 54/80 ureters (67.5%) in group 1 and in 94/134 ureters (70.1%) in group 2. Overall successes after a second or a third injection were 61/80 (76.2%) and 111/134 (82.8%), respectively. There was a statistically significant difference between the groups only for grade IV reflux following multiple injections (p<0.05).ConclusionsEndoscopic treatment of VUR is a recommended treatment because it is minimally invasive, efficient, and repeatable. Our study confirmed that a modified STING procedure can be an alternative treatment to the standard technique.
Hydatic cyst of seminal vesicles is very rarely seen. We report a case who complained of the inability to void, which developed progressively with dysuria, frequency, nocturia, and tenesmus, due to a giant retrovesical hydatid cyst that displaced the bladder and rectosigmoid region.
Aim: To assess the role of the dysfunctional voiding and incontinence scoring system (DVAISS) in children with voiding dysfunction. Methods: Ninety-three children were divided into three groups: those who had wetting only (group 1), recurrent urinary tract infections (UTIs) and wetting (group 2) and vesicoureteral reflux together with wetting and UTIs (group 3). Individualized multiple treatments modalities were applied. The success criteria defined by the reduction in the rate of wetting described as complete response (more than 90%), partial response (50–90%), no response (less than 50%).Also, in group 3, improvement was determined as a decrease of at least two grades in reflux. Scores of patients were determined before and after treatment. Results: Complete response rates for groups 1, 2 and 3 were 67.5, 88.8 and 85.71%, respectively. The specificity of the DVAISS in predicting the complete response was 79, 88 and 100%, respectively, and its sensitivity was 100% in all groups. In group 3, improvement rate was 71.4%. The specificity and sensitivity of the DVAISS in predicting the improvement were 83 and 100%, respectively. Conclusion: The sensitivity of the DVAISS is higher in predicting the treatment effect; however, its specificity is decreased. The DVAISS may be an auxiliary diagnostic tool in voiding dysfunction patients.
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