Comparative assessment of postoperative erectile function and quality of life in male one-stage onlay vs. inlay buccal mucosal graft urethroplasty

2017 ◽  
Vol 16 (3) ◽  
pp. e483-e484 ◽  
Author(s):  
M. Vetterlein ◽  
C. Rosenbaum ◽  
P. Gild ◽  
C. Meyer ◽  
T. Ludwig ◽  
...  
Author(s):  
Wanchart Yippaditr ◽  
Antja Watanangura ◽  
Disdanai Pencharee ◽  
Nobuo Sasaki

Abstract OBJECTIVE To evaluate the feasibility of buccal mucosal graft urethroplasty for repairing complete urethral rupture in cats. ANIMALS 15 male domestic shorthair cats with traumatic complete urethral rupture. PROCEDURES In each cat, a section of buccal mucosa was harvested, sutured, and formed into a tubule by use of an 8F indwelling catheter as support. This tubular graft was connected to both ruptured ends of the urethra to renew the urinary passage. The catheter was left in place until the absence of leakage was confirmed by positive contrast retrograde urethrography. After spontaneous urination was confirmed, cats were discharged from the hospital. Six months later, urethrography was repeated and owners were asked to score their cats’ urinary function and quality of life. RESULTS 13 cats recovered well following surgery, with no complications in the oral cavity or surgical site and no signs of difficulty or discomfort when urinating. Urethrography 2 weeks and 6 months after surgery revealed no stricture or leakage in the abdominal cavity. The 2 remaining cats developed a urethral stricture and underwent second surgery with a successful outcome. At the 6-month follow-up, 14 cats had only mild urinary signs, and 1 cat had incontinency. Owners indicated they were delighted (n = 14) or pleased (1) with their cats’ quality of life. CLINICAL RELEVANCE Buccal mucosa was found to be a good source of graft tissue for performance of urethroplasty in male cats, yielding satisfactory outcomes with few postoperative complications. The described technique may be suitable for severe and complicated cases of urethral rupture in male cats.


2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Rachel A. Mann ◽  
Ramon Virasoro ◽  
Jessica M. DeLong ◽  
Rafael E. Estrella ◽  
Merycarla Pichardo ◽  
...  

Introduction: Mechanical balloon dilation and direct visualization internal urethrotomy (DVIU) are the most widely used treatments for urethral stricture disease in the U.S., but recurrence rates are high, especially after re-treatment. This study investigates the safety and efficacy of the Optilume™ paclitaxel-coated balloon for the treatment of recurrent strictures. Methods: Men with recurrent bulbar strictures ≤2 cm with 1–4 prior endoscopic treatments were treated with the Optilume™ drug-coated balloon. Patients were evaluated within 14 days, three, six, 12, and 24 months post-treatment. The primary safety endpoint was serious urinary adverse events. The primary efficacy endpoint was ≥50% improvement in International Prostate Symptom Score (IPSS) at 24 months. Secondary outcomes included quality of life, erectile function, flow rate, and post-void residual urine volume. Results: A total of 53 subjects were enrolled and treated; 46 completed the 24-month followup. Forty-three percent of men had undergone >1 previous dilations, with a mean of 1.7 prior dilations. There were no serious adverse events related to treatment at two years. Success was achieved in 32/46 (70%), and baseline IPSS improved from a mean of 25.2 to 6.9 at 24 months (p<0.0001). Quality of life, flow rate, and post-void residual urine volumes improved significantly from baseline. There was no impact on erectile function. Conclusions: Two-year data indicates the Optilume™ paclitaxel-coated balloon is safe for the treatment of recurrent bulbar urethral strictures. Early efficacy results are encouraging and support further followup of these men through five years, as well as further investigation with a randomized trial.


2018 ◽  
Vol 37 (2) ◽  
pp. 385-389 ◽  
Author(s):  
E. Morán ◽  
M.A. Bonillo ◽  
L. Fernández-Estevan ◽  
E. Martínez-Cuenca ◽  
S. Arlandis ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Elie Nemr ◽  
Elie El Helou ◽  
Georges Mjaess ◽  
Albert Semaan ◽  
Josselin Abi Chebel

Phytotherapy for lower urinary tract symptoms (LUTSs) due to benign prostate hyperplasia (BPH) is progressively demanded by patients and trusted by physicians. The aim was to assess the efficacy of a mix of pumpkin seed extract, soy germ isoflavonoids, and cranberry (Novex®) in the management of mild to moderate LUTS in BPH patients. Male patients aged ≥40 years, who had had mild to moderate LUTS for >6 months at screening, with no previous therapy or who are still symptomatic despite current use of alpha-blockers, were recruited. Exclusion criteria were an IPSS >19 and an age >80 years. The mixed compound was administered orally, daily, for 3 months. Patients were evaluated by means of IPSS, urological quality of life (uQoL) index, and International Index of Erectile Function (IIEF-5) at 3 visits: baseline (visit 1), 30 days (visit 2), and 90 days after treatment (visit 3). Among 163 screened patients, 128 patients (61.8 ± 9.9 years) were recruited. IPSS improved from 15 (Q1 : 12–Q3 : 17) in visit 1, to 11 (Q1 : 8–Q3 : 14) in visit 2, and to 9 (Q1 : 6–Q3 : 12) in visit 3 (p<0.001). uQoL improved from 4 (3–4) in visit 1, to 3 (2–3) in visit 2, and to 2 (1–2) in visit 3 (p<0.001). The patients had an IIEF-5 score of 15 (12–18.7) in visit 1, 15 (12–18) in visit 2, and 17 (13–19) in visit 3 (p=0.99 visits 1 vs. 2, p=0.004 visits 2 vs. 3, and p=0.001 visits 1 vs. 3). Treating mild to moderate LUTS/BPH patients with Novex® might therefore relieve symptoms, improve the quality of life, and have a mild beneficial effect on erectile function.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S605-S605
Author(s):  
V Domislović ◽  
M Brinar ◽  
L Vujičić ◽  
M Novosel ◽  
D Grgić ◽  
...  

Abstract Background Inflammatory Bowel Disease (IBD) has a negative impact on quality of life (QOL), and sexuality is one of its major determinants. The impact of disease characteristics on sexuality and intimacy is one of the main concerns of IBD patients. Despite the obvious relevance of this problem, knowledge of the extent and the determinants of sexual dysfunction in persons with IBD is limited. The main goal of the study was to determine the correlation of quality of life (QOL) and it’s components in patients with IBD, and to investigate the impact of disease duration on QOL components. Methods In this cross-sectional study patients fulfilled anonymous validated questionnaire on their sexual function. In International Index of Erectile Function (IIEF) for males, five domains were evaluated through questions on erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction. In women were six domains assessed, desire, arousal, lubrication, orgasmic function, satisfaction and pain. For both scores, higher scores indicated a better function. Patients also fulfilled IBDQ-32, a validated questionnaire for assessing quality of life in IBD patients that consists of four main components (social, emotional, systemic and bowel function). Results In this study we have enrolled 202 patients who fulfilled the questionnaire (133 CD, 69 UC). Among them 122 were men and 80 women. Average age of included patients was 39.2 ± 11.02. Prevalence of SD in women was 70% (n = 60) and 18% (n = 22) in males. Female patients with sexual dysfunction had lower emotional and social QOL (p = 0.035 and p = 0.03, respectively). Total male IIEF sexual function score correlated significantly with all of the components of IBDQ; emotional (rho=0.36, p &lt; 0.001) systemic (rho=0.24, p = 0.006), social (rho=0.28, p = 0.002), bowel (rho=0.27, p = 0.002) and with total IBDQ (rho=0.36, p &lt; 0.001). Regarding erectile function score, there was also correlation with all of the components of IBDQ. Total female sexual function FSFI score correlated significantly only with systemic component of IBDQ (rho=0.25, p = 0.02). Interestingly, in male patients disease duration correlate negatively with emotional and social component of IBDQ (rho = −0.21, p = 0.02 and rho=-023, p = 0.01, respectively), which was not the case in female patients. Conclusion The results show correlation of sexual function score with components of QOL, which were more correlated in male patients. Our results suggest that longer disease duration might have positive impact on emotional and social life in male patients, which could be connected with achieving disease control and accepting the disease. It is important to provide proper psychological support, medical treatment and educational information.


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