114: Flow Rate Pattern after Pelvic Fracture Urethral Reconstruction

2007 ◽  
Vol 177 (4S) ◽  
pp. 39-39 ◽  
Author(s):  
Daniela E. Andrich ◽  
Jodi P. Hirst ◽  
Anthony R. Mundy
Keyword(s):  
Pelvic Fracture ◽  
Flow Rate ◽  
Urethral Reconstruction

scholarly journals Evaluation of the short-term outcome of unilateral urethral mobilization for the management of bulbar urethral stricture

2021 ◽  
Vol 9 (12) ◽  
pp. 3506
Author(s):  
Kartik Chandra Ghosh ◽  
Prodyut Kumar Saha ◽  
Masud Ahmed ◽  
Farhad Mahmud ◽  
Uttam Karmaker
Keyword(s):  
Urethral Stricture ◽  
Flow Rate ◽  
Urine Volume ◽  
Postoperative Outcome ◽  
Urinary Flow Rate ◽  
Urethral Reconstruction ◽  
Urinary Flow ◽  
College Hospital ◽  
Term Outcome ◽  
The Mean

Background: In modern urology, successful male urethral reconstruction poses a continuing challenge.Methods: It was a quasi-experimental study conducted in the department of urology, Dhaka medical college hospital, Dhaka, Bangladesh between January 2010 to December 2011. 35 patients having bulbar urethral strictures admitted in the department were study participants. All the participants underwent unilateral urethral mobilization, for buccal mucosa graft urethroplasty and followed up at least six months. RGU and MCU was done when peak flow was <15 ml /sec in uroflowmetry. Urethroscopy was done at 3rd and 6th month. The statistics used to analyze the data were descriptive statistics, and the tests done were student’s t-test, chi-square test, ANOVA, and Fisher exact test.Results: The length of strictures was observed ≤3 cm among 31% (n=11) and >3 cm among 69% (n=24) patients. As the immediate postoperative outcome among the participants, we found the mean peak urinary flow rate (Qmax), 15.3±1.2 and voided urine volume (ml), 328.8±50. Finally, as the postoperative outcome after 6 months among the participants, we found the mean peak urinary flow rate (Qmax), 24.2±2.9; voided urine volume (ml), 330.8±50.1 and PVR (ml), 11.6±3.3. In this study, some potential complications were bleeding and wound infection which were found among 11.43% and 17.14% patients respectively. Conclusions: Considering the satisfactory outcomes and lower complications unilateral urethral mobilization procedure can be considered as an effective treatment method for the management of bulbar urethral stricture.  

scholarly journals Posterior Urethral Strictures

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Joel Gelman ◽  
Eric S. Wisenbaugh
Keyword(s):  
Pelvic Fracture ◽  
Primary Anastomosis ◽  
Standard Of Care ◽  
Urethral Catheter ◽  
Tube Placement ◽  
Urethral Reconstruction ◽  
Urethral Strictures ◽  
Suprapubic Tube ◽  
Controversial Topic ◽  
Urethral Injuries

Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty.

scholarly journals Delayed Anastomotic Urethroplasty in Children and Adolescence with Pelvic Fracture Urethral Injury (PFUI): Experiences in Two Centers of Reconstructive Urethral Surgery in Indonesia

2021 ◽  
Vol 1 (2) ◽  
pp. 58-65
Author(s):  
Paksi Satyagraha ◽  
Kuncoro Adi ◽  
I Made Udiyana Indradiputra ◽  
Ahmad Agil ◽  
Besut Daryanto
Keyword(s):  
Success Rate ◽  
Pelvic Fracture ◽  
Average Length ◽  
Operation Time ◽  
Urethral Injury ◽  
Urethral Reconstruction ◽  
Tension Free ◽  
Children And Adolescence ◽  
Urethral Surgery ◽  
Anastomotic Urethroplasty

Introduction: Incidence of pediatric pelvic fracture urethral injury (PFUI) is rare. This study reviews the experience of anastomotic urethroplasty surgery in children and adolescence PFUI in the last 3 years in two center of reconstructive urethral surgery in Indonesia. Method: This study retrospectively reviewed PFUI cases in Hasan Sadikin Hospital and Saiful Anwar Hospital from 2013-2016. The data cases were analysed base on aetiology of the trauma, urethral gap, and previous operations. The operation time and intra operative additional procedure to achieve tension free anastomotic was also noted. Result: A total 31 children and adolescence patients with PFUI were recorded in two institutions. Twenty patients were in Hasan Sadikin Hospital while 11 patients were in Saiful Anwar Hospital. The trauma mechanisms for PFUI were 28 (90.3%) cases due to motorcycle accidents and 3 (9.7%) cases due to high falls accidents. All patients underwent delayed urethral reconstruction in median 6 months (3-72). The median operation time was 150±101 minutes for children and 160±50.5 minutes for adolescence. The average length of the urethral gap in children cases was 2.8±1.2 cm, meanwhile 4±1.9 cm for adolescence cases. In order to achieve the tension free of anastomotic urethroplasty, 5 (16.1%) of PFUI patients underwent crural separation, 16 (51.6%) patients underwent inferior pubectomy and 3 (9.7%) patients for supracrural re-routing. Posterior pubectomy with omental wrap via transpubic approach was performed in one patient. The success rate for children cases was 83.3% and 88% for adolescence cases. Thus, the overall success rate after anastomotic urethroplasty for pediatric PFUI was 83.9%. Conclusions: In short-term follow up, delayed repair urethral reconstructive surgery by transperineal and transpubic anastomotic urethroplasty in children and adolescence with PFUI achieved a significant good result and showed promising outcome.

scholarly journals Genitourinary injuries associated with pelvic fractures

2013 ◽  
Vol 60 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Tomislav Pejcic ◽  
Zlatibor Loncar ◽  
Dragutin Rafailovic ◽  
Miodrag Acimovic ◽  
Zoran Dzamic ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Motor Vehicle ◽  
Pelvic Fractures ◽  
Motor Vehicles ◽  
Urethral Reconstruction ◽  
Tertiary Institutions ◽  
Vehicle Accidents ◽  
Clinical Center ◽  
Bladder Injuries ◽  
Urethral Injuries

Introduction: Pelvic fractures represent approximately 3% of all skeletal injuries. About 15% of patients with pelvic fractures have associated bladder or urethral injuries. The most common causes of pelvic fracture are motor vehicle accidents, motorcycle crashes, motor vehicles striking pedestrians, and falls. Material and methods: Retrospective study included the patients treated in the Emergency Center, Clinical Center of Serbia, Belgrade, between 2000 and 2009. Of 7445 patients, there were 894 injuries of the urinary tract and 376 pelvic fractures; 55 patients with pelvic fractures (14.6%) had bladder or urethral injuries. There were 31 patients with bladder injuries, 22 patients with urethral injuries, and two patients with associated injuries of the posterior urethra and the bladder neck. Results: The bladder injuries were treated by surgical exploration, cystostomy, suture of the bladder lesions and urethral catheterization. Urethral injuries were treated by primary cystostomy and urethral reconstruction and catheterization in 18 patients (82%), while cystofix-cystostomy was performed in four patients (18%). Discussion: Genitourinary injuries increase overall mortality in patients with pelvic fracture, compared with traumas without associated GU injuries. These patients require multidisciplinary approach, preferably in tertiary institutions.

scholarly journals Partial Inferior Pubectomy in the Delayed Repair of Pelvic Fracture Urethral Injury: Adopting a Bone-nibbling Technique

2021 ◽  
Vol 18 (2) ◽  
pp. 69-74
Author(s):  
Ikenna Ifeanyi Nnabugwu ◽  
Fredrick Obiefuna Ugwumba ◽  
Anthony Alex Ilukwe
Keyword(s):  
Pelvic Fracture ◽  
Urethral Injury ◽  
Pubic Bone ◽  
Resource Poor Setting ◽  
Previous Attempt ◽  
Urethral Reconstruction ◽  
Inferior Margin ◽  
Delayed Repair ◽  
Post Operation ◽  
Urethral Defect

Background: The use of wedge inferior pubectomy can be challenging to many urethral surgeons. Our objective was to introduce a bone-nibbling technique to accomplish a partial inferior pubectomy (PIP) in a resource-poor setting, and to report the medium- to longterm outcome of using the technique. Methods: Five patients were recruited (mean age: 38.8 years) who presented, over a 30-month period, with posterior urethral fibrosis from a pelvic fracture urethral injury (PFUI). One had failed a previous attempt at posterior urethral reconstruction elsewhere. The length of urethral defect was from 2 to 4 cm. We describe a bone-nibbling technique used to carry out PIP for the delayed repair of PFUI in these patients. The outcomes in the medium to long term of surgical procedures done with this technique are presented. Results: Immediate postoperative complications in all were essentially a Clavien–Dindo grade I. Peak flow rate assessed 12 weeks’ post operation was between 20 mL/s and 23 mL/s (mean: 21 mL/s). The longest duration of follow-up was 34 months, and all patients were voiding satisfactorily. Conclusions: A satisfactory and durable outcome can be obtained from nibbling at the bone from the inferior margin of the pubic bone to achieve PIP. This is of interest to lower urinary tract reconstructive surgeons who have concerns with chiseling-out wedge of the inferior pubis. Keywords: Bone nibbling, Partial inferior pubectomy, PFUI, Posterior urethra, Urethral anastomosis

A Novel Reconstitution Method for Inducing the Formation of Regular 2-Dimensional Arrays of Membrane Proteins and Lipids

1988 ◽  
Vol 46 ◽  
pp. 152-153 ◽  
Author(s):  
A. Engel ◽  
A. Holzenburg ◽  
K. Stauffer ◽  
J. Rosenbusch ◽  
U. Aebi
Keyword(s):  
Membrane Proteins ◽  
Flow Rate ◽  
Lipid Membranes ◽  
Functional Characterization ◽  
Dimensional Structure ◽  
Electron Crystallography ◽  
Peltier Element ◽  
Protein Ratio ◽  
Precise Control ◽  
3 Dimensional

Reconstitution of solubilized and purified membrane proteins in the presence of phospholipids into vesicles allows their functions to be studied by simple bulk measurements (e.g. diffusion of differently sized solutes) or by conductance measurements after transformation into planar membranes. On the other hand, reconstitution into regular protein-lipid arrays, usually forming at a specific lipid-to-protein ratio, provides the basis for determining the 3-dimensional structure of membrane proteins employing the tools of electron crystallography.To refine reconstitution conditions for reproducibly inducing formation of large and highly ordered protein-lipid membranes that are suitable for both electron crystallography and patch clamping experiments aimed at their functional characterization, we built a flow-dialysis device that allows precise control of temperature and flow-rate (Fig. 1). The flow rate is generated by a peristaltic pump and can be adjusted from 1 to 500 ml/h. The dialysis buffer is brought to a preselected temperature during its travel through a meandering path before it enters the dialysis reservoir. A Z-80 based computer controls a Peltier element allowing the temperature profile to be programmed as function of time.

Novel epoxy/anhydride alternatives for biological electron microscopy: Physical and performance characteristis of embed 812 and LX 112 in combination with NSA/NMA/DMAE

1989 ◽  
Vol 47 ◽  
pp. 1000-1001
Author(s):  
Joe A. Mascorro ◽  
Gerald S. Kirby
Keyword(s):  
Electron Microscopy ◽  
Flow Rate ◽  
Succinic Anhydride ◽  
Volume Flow Rate ◽  
Mass Density ◽  
Uranyl Acetate ◽  
Volume Flow ◽  
Base Resin ◽  
And Performance ◽  
Acid Anhydrides

Embedding media based upon an epoxy resin of choice and the acid anhydrides dodecenyl succinic anhydride (DDSA), nadic methyl anhydride (NMA), and catalyzed by the tertiary amine 2,4,6-Tri(dimethylaminomethyl) phenol (DMP-30) are widely used in biological electron microscopy. These media possess a viscosity character that can impair tissue infiltration, particularly if original Epon 812 is utilized as the base resin. Other resins that are considerably less viscous than Epon 812 now are available as replacements. Likewise, nonenyl succinic anhydride (NSA) and dimethylaminoethanol (DMAE) are more fluid than their counterparts DDSA and DMP- 30 commonly used in earlier formulations. This work utilizes novel epoxy and anhydride combinations in order to produce embedding media with desirable flow rate and viscosity parameters that, in turn, would allow the medium to optimally infiltrate tissues. Specifically, embeding media based on EmBed 812 or LX 112 with NSA (in place of DDSA) and DMAE (replacing DMP-30), with NMA remaining constant, are formulated and offered as alternatives for routine biological work.Individual epoxy resins (Table I) or complete embedding media (Tables II-III) were tested for flow rate and viscosity. The novel media were further examined for their ability to infilftrate tissues, polymerize, sectioning and staining character, as well as strength and stability to the electron beam and column vacuum. For physical comparisons, a volume (9 ml) of either resin or media was aspirated into a capillary viscocimeter oriented vertically. The material was then allowed to flow out freely under the influence of gravity and the flow time necessary for the volume to exit was recored (Col B,C; Tables). In addition, the volume flow rate (ml flowing/second; Col D, Tables) was measured. Viscosity (n) could then be determined by using the Hagen-Poiseville relation for laminar flow, n = c.p/Q, where c = a geometric constant from an instrument calibration with water, p = mass density, and Q = volume flow rate. Mass weight and density of the materials were determined as well (Col F,G; Tables). Infiltration schedules utilized were short (1/2 hr 1:1, 3 hrs full resin), intermediate (1/2 hr 1:1, 6 hrs full resin) , or long (1/2 hr 1:1, 6 hrs full resin) in total time. Polymerization schedules ranging from 15 hrs (overnight) through 24, 36, or 48 hrs were tested. Sections demonstrating gold interference colors were collected on unsupported 200- 300 mesh grids and stained sequentially with uranyl acetate and lead citrate.

Severe Drooling and Treatment With Botulinum Toxin

2012 ◽  
Vol 21 (1) ◽  
pp. 15-21
Author(s):  
Merete Bakke ◽  
Allan Bardow ◽  
Eigild Møller
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Health Risk ◽  
Flow Rate ◽  
Clinical Evidence ◽  
Acetylcholine Release ◽  
Psychosocial Problems ◽  
Rate Reduction ◽  
Local Inhibition ◽  
Surgical Treatments

Severe drooling is associated with discomfort and psychosocial problems and may constitute a health risk. A variety of different surgical and non-surgical treatments have been used to diminish drooling, some of them with little or uncertain effect and others more effective but irreversible or with side effects. Based on clinical evidence, injection with botulinum toxin (BTX) into the parotid and submandibular glands is a useful treatment option, because it is local, reversible, and with few side effects, although it has to be repeated. The mechanism of BTX is a local inhibition of acetylcholine release, which diminishes receptor-coupled secretion and results in a flow rate reduction of 25–50% for 2–7 months.

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