Perineal urethrostomy with combined buccal mucosal graft and skin flap after complete loss of anterior urethra

Background: The purpose of this study is to compare the effectiveness and safety of oral mucosa and penile skin flaps in the treatment of anterior urethral stricture.Methods: This meta-analysis was carried out according to the principle of preferred reporting items for systematic reviews and meta-analysis (PRISMA) and registered at PROSPERO (CRD42021277688). The Cochrane Library, PubMed, Embase, CKNI databases were searched and reviewed up to Sep 2021. Quality evaluation was performed with Newcastle-Ottawa Scale (NOS) system for non-randomized studies and Cochrane stools for randomized studies. Data synthesis was conducted with RevMan 5.4 software (Cochrane) and a Stata 15.0 environment (Stata Corpor, College Station, TX, USA).Results: After the research screening, eight studies (comprising 445 patients) were finally included in the quantitative analysis. In the success rate comparison, there was no significant difference between oral mucosa and penile skin flaps (oral mucosa vs. penile skin flap, Mantel-Haenszel statistic [M-H] fixed model, OR: 0.80, 95% CI: 0.47–1.34, P = 0.39). There was no significant difference in the post-operative complication comparison (oral mucosa vs. penile skin flap, Mantel-Haenszel statistic [M-H] fixed model, OR: 0.68, 95% CI: 0.40–1.16, P = 0.15). However, considering that the site of oral mucosa is far from the anterior urethra, it may have advantages in operation time through simultaneous operations (oral mucosa vs. penile skin flap, MD: −40.05, 95% CI: −79.42, −0.68, P = 0.046).Conclusion: When the oral mucosal graft was used in the anterior urethra urethroplasty, it had a similar success rate and post-operative complication rate, and oral mucosa substitution had a shorter operation time. This evidence-based medical research further supports the view that oral mucosa is the preferred substitution material for the anterior urethra urethroplasty.

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Objective Scoring Outcome Analysis of Redo Urethroplasty for Failed Hypospadias

TAJ Journal of Teachers Association ◽

10.3329/taj.v31i1.41574 ◽

2019 ◽

Vol 31 (1) ◽

pp. 38-45

Author(s):

Shah Md Ahsan Shahid ◽

Md Nawshad Ali ◽

Sayed Sirajul Islam ◽

Shantona Rani Paul

Keyword(s):

Skin Flap ◽

Outcome Analysis ◽

P Value ◽

Urethral Reconstruction ◽

Paediatric Surgery ◽

Urethrocutaneous Fistula ◽

Transposition Flap ◽

Buccal Mucosal Graft ◽

Group A ◽

Group B

Background: Failed hypospadias refers to any hypospadias repair that leads to complicationsor causes patient dissatisfaction. One of the commonest major complications of hypospadias surgery is urethrocutaneous fistula. Objectives: Present study aimed to determine a better procedure of salvage urethroplasty for failed hypospadias, caused by persistentlarge (>4mm) or multiple -small (<4mm) fistulae, by a randomized comparison. Patients and Methods. This interventional study was performed in the department of Paediatric Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, over a period of five years (from July 2011 to June, 2016). A total of 189 patients were included in present study and randomized in the three groups under study. Comparisons were made among three procedures of salvage urethroplasty of failed hypospadias caused by urethrocutaneous fistula using substitution of dorsal skin flap, Flip flap, or buccal mucosal graft in a controlled situation. Outcomes were assessed by means of objective scoring system. Results: Refistula rate, devascularization of flap and grafts and wound dehiscence rate were significantly less in Buccal mucosal graft (group A) than flip flap(group C) and dorsal transposition flap (group B ). This led to a higher success rate and better patient compliance in buccal mucosal graft. The objective scoring evaluation revealed that score gain of BM group (182) was significantly higher than that of dorsal transposition flap (112) and flip flap (89) at P value <0.05 . Conclusion: Staged redo urethroplasty for large or multiple-small fistulae using substitution of buccal mucosal graft revealed as an better option for urethral reconstruction than dorsal transposition flap and flip flap procedures (group A˃ group B ˃group C). TAJ 2018; 31(1): 38-45

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Investigating the functional link between TMEM165 and SPCA1

Biochemical Journal ◽

10.1042/bcj20190488 ◽

2019 ◽

Vol 476 (21) ◽

pp. 3281-3293 ◽

Cited By ~ 2

Author(s):

Elodie Lebredonchel ◽

Marine Houdou ◽

Hans-Heinrich Hoffmann ◽

Kateryna Kondratska ◽

Marie-Ange Krzewinski ◽

...

Keyword(s):

Subcellular Localization ◽

Complete Loss ◽

Protein Family ◽

Uncharacterized Protein ◽

Functional Link ◽

P Type

TMEM165 was highlighted in 2012 as the first member of the Uncharacterized Protein Family 0016 (UPF0016) related to human glycosylation diseases. Defects in TMEM165 are associated with strong Golgi glycosylation abnormalities. Our previous work has shown that TMEM165 rapidly degrades with supraphysiological manganese supplementation. In this paper, we establish a functional link between TMEM165 and SPCA1, the Golgi Ca2+/Mn2+ P-type ATPase pump. A nearly complete loss of TMEM165 was observed in SPCA1-deficient Hap1 cells. We demonstrate that TMEM165 was constitutively degraded in lysosomes in the absence of SPCA1. Complementation studies showed that TMEM165 abundance was directly dependent on SPCA1's function and more specifically its capacity to pump Mn2+ from the cytosol into the Golgi lumen. Among SPCA1 mutants that differentially impair Mn2+ and Ca2+ transport, only the Q747A mutant that favors Mn2+ pumping rescues the abundance and Golgi subcellular localization of TMEM165. Interestingly, the overexpression of SERCA2b also rescues the expression of TMEM165. Finally, this paper highlights that TMEM165 expression is linked to the function of SPCA1.

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