Buccal mucosal graft urethroplasty for anterior urethral stricture, experience from a low-income country

Abstract Background/purpose This study was conducted to present our experience in urethral mucosal graft urethroplasty to repair urethral stricture, as the first experience in our context. Methods This is a prospective hospital-based study that had been designed to review management outcomes of buccal mucosal graft urethroplasty for anterior urethral stricture from January 2017 to January 2019. Results The total number of involved patients was 60. The success rate was found to be 90% (n = 54), while 6 (10%) had a recurrence of stricture. Pain and pain combined bleeding from internal suture lines were the only early complication encountered in 50 (83.3%) and 2 (3.3%) patients, respectively. late complications occurred as follows 14 (23.3%) patients had UTI, 12 (20%) had wound infections, 8 (13.3%) had changes in ejaculation, and decrease in intensity of orgasm, and 6 (10%) had erectile dysfunction. One of the long-term complications was graft diverticulum in one case and was treated conservatively (in ventral on lay BMG). Conclusion Improvement of the service in limited resources countries like Sudan and was reflected in the excellent outcome of BMG urethroplasty as treatment of anterior urethral stricture (success rate 90%).

Download Full-text

Results of Buccal Mucosal Graft Urethroplasty in Management of Anterior Urethral Stricture – Experience in a Single Center

Bangladesh Journal of Urology ◽

10.3329/bju.v22i2.50098 ◽

2020 ◽

Vol 22 (2) ◽

pp. 128-131

Author(s):

Mohammad Abdul Aziz ◽

Shafiqur Rahman ◽

Mirza Mahbubul Hasan

Keyword(s):

Success Rate ◽

General Hospital ◽

Urethral Stricture ◽

Buccal Mucosa ◽

Single Center ◽

Internal Urethrotomy ◽

Exclusion Criteria ◽

Urethral Strictures ◽

Buccal Mucosal Graft ◽

Optical Internal Urethrotomy

Objective: To share our experience with buccal mucosal graft (BMG) urethroplasty for the management of anterior urethral strictures in BIRDEM General Hospital, Dhaka. Materials and methods: This study was conducted from January 2013 to January 2018. Patients selected according to inclusion and exclusion criteria. The oral mucosal characteristics were assessed in all patients during the initial workup. Single stage dorsolateral onlay graft urethroplasty done in all patients. They were followed according schedule for outcome and complications. Result:Total 59 patients were studied. Overall success rate of BMG urethroplasty was 88.1% at 12th month. Complications include development of periurethral abscess (3.4%), restructure (8.5%) development of fistula (1.7%). Total 8 patients underwent retreatment procedures like drainage of periurethral abscess, dilatation, optical internal urethrotomy (OIU) and revision urethroplasty. Conclusion:The buccal mucosa is easy to obtain and handle, therefore BMG urethroplasty is a safe and effective in managing anterior urethral stricture. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.128-131

Download Full-text

The long‐term impact of providing nursing education in a low‐income country

Public Health Nursing ◽

10.1111/phn.12681 ◽

2019 ◽

Vol 37 (1) ◽

pp. 65-72

Author(s):

Michelle R. Holm ◽

Holly L. Burkhartzmeyer ◽

Rachel Fort ◽

Raymonde Rinville ◽

Herriot Sannon

Keyword(s):

Nursing Education ◽

Low Income ◽

Income Country ◽

Low Income Country ◽

Long Term Impact

Download Full-text

Indwelling double-pigtail plastic stents for treating disconnected pancreatic duct syndrome-associated peri-pancreatic fluid collections: long-term safety and efficacy

Endoscopy ◽

10.1055/a-1319-5093 ◽

2020 ◽

Author(s):

Paraskevas Gkolfakis ◽

Arnaud Bourguignon ◽

Marianna Arvanitakis ◽

Arthur Baudewyns ◽

Pierre Eisendrath ◽

...

Keyword(s):

Success Rate ◽

Pancreatic Duct ◽

Endoscopic Treatment ◽

Late Complications ◽

Safety And Efficacy ◽

Short And Long Term ◽

Fluid Collections ◽

Duct Syndrome

Background and study aims: Long-term transmural double-pigtail stent (DPS) placement is recommended for patients with disconnected pancreatic duct syndrome (DPDS) and peripancreatic fluid collections (PFC). Long-term safety and efficacy of indwelling DPS were evaluated. Patients and methods: Medical files of patients treated with DPS for DPDS-associated PFC and a follow-up ≥48 months were reviewed. Early (<30 days) and late complications of DPS placement were evaluated and the primary endpoint –the incidence rate of late complications per 100 patients-years– was calculated. Short- and long term success rate of endoscopic treatment and PFC recurrence rate were among secondary endpoints. Results: From 2002 to 2014 we identified 116 patients [follow-up: 80.6 (34.4) months]. Among early complications (n=20), 6 occurred peri-interventionally. Late complications (n=17) were mainly pain due to DPS-induced ulcer or erosion (n=10) and 14 of these were treated conservatively or by stent removal. Two gastro-pancreatico-colo-cutaneous fistulas and one persisting bleed required surgical intervention. No DPS-related deaths were recorded. The incidence rate of late complications was 2.18 per 100 patient-years of follow-up; 95%CI [1.27, 3.49]. Short- and long-term success rate of endoscopic treatment was 97.4% [94.5, 100) and 94% [89.6, 98.3], respectively. The PFC recurrence rate was 28% [20.1, 35.9] and 92.3% of them occurred within the first two years. Stent migration, chronic pancreatitis and length of stent size (>6cm) were independently associated with higher rates of PFC recurrence. Conclusions: Long-term transmural drainage with DPS is a safe and effective treatment for DPDS-associated PFCs. However, about one fourth of PFC will recur.

Download Full-text

Post-Disaster Housing Recovery

Oxford Research Encyclopedia of Natural Hazard Science ◽

10.1093/acrefore/9780199389407.013.82 ◽

2017 ◽

Cited By ~ 1

Author(s):

Anuradha Mukherji

Keyword(s):

Low Income ◽

Limited Resources ◽

Catastrophic Event ◽

Rapid Urbanization ◽

Recovery Programs ◽

Recovery Processes ◽

Wide Range ◽

Housing Recovery ◽

Post Disaster

Rapid urbanization and growing populations have put tremendous pressures on limited global housing stocks. As the frequency of disasters has increased with devastating impacts on this limited stock of housing, the discourse on post-disaster housing recovery has evolved in several ways. Prior to the 1970s, the field was largely understudied, and there was a narrow understanding of how households and communities rebuilt their homes after a catastrophic event and on the effectiveness of housing recovery policy and programs designed to assist them. Early debates on post-disaster housing recovery centered on cultural and technological appropriateness of housing recovery programs. The focus on materials, technology, and climate missed larger socioeconomic and political complexities of housing recovery. Since then, the field has come a long way: current theoretical and policy debates focus on the effect of governance structures, funding practices, the consequences of public and private interventions, and socioeconomic and institutional arrangements that effect housing recovery outcomes. There are a number of critical issues that shape long-term post-disaster housing recovery processes and outcomes, especially in urban contexts. Some of them include the role of the government in post-disaster housing recovery, governance practices that drive recovery processes and outcomes, the challenges of paying for post-disaster housing repair and reconstruction, the disconnect between planning for rebuilding and planning for housing recovery, and the mismatch between existing policy programs and housing needs after a catastrophic event—particularly for affordable housing recovery. Moreover, as housing losses after disasters continue to increase, and as the funding available to rebuild housing stocks shrinks, it has become increasingly important to craft post-disaster housing recovery policy and programs that apply the limited resources in the most efficient and impactful ways. Creating housing recovery programs by employing a needs-based approach instead of one based solely on loss could more effectively focus limited resources on those that might need it the most. Such an approach would be broad based and proportional, as it would address the housing recovery of a wide range of groups based upon their needs, including low-income renters, long-term leaseholders, residents of informal settlements and manufactured homes, as well as those with preexisting resources such as owner-occupant housing.

Download Full-text

Inflation Forecast Targeting in a Low-Income Country

10.1093/oso/9780198785811.003.0019 ◽

2018 ◽

Author(s):

Ali Alichi ◽

Marshall Mills ◽

Douglas Laxton ◽

Hans Weisfeld

Keyword(s):

Low Income ◽

Inflation Targeting ◽

Low Income Country ◽

Long Run ◽

High Inflation ◽

The Interest Rate ◽

Optimal Approach ◽

Inflation Variability ◽

Model Features

A model in which monetary policy pursues fully fledged inflation targeting is adapted to Ghana. Model features include: endogenous policy credibility; non-linearities in the inflation process; and a policy loss function that aims to minimize the variability of output and the interest rate, as well as deviations of inflation from the long-term low-inflation target. The optimal approach from initial high inflation to the ultimate target is gradual; and transitional inflation-reduction objectives are flexible. Over time, as policy earns credibility, expectations of inflation converge towards the long-run target, the output-inflation variability trade-off improves, and optimal policy responses to shocks moderate.

Download Full-text

Dorsal onlay buccal mucosal graft or penile skin graft substitution urethroplasty in bulbar urethral stricture: compare the outcome and review

International Surgery Journal ◽

10.18203/2349-2902.isj20200535 ◽

2020 ◽

Vol 7 (3) ◽

pp. 664

Author(s):

Atul K. Khandelwal

Keyword(s):

Success Rate ◽

Urethral Stricture ◽

Skin Graft ◽

Buccal Mucosa ◽

Penile Skin ◽

Buccal Mucosa Graft ◽

Buccal Mucosal Graft ◽

Study Results ◽

Dorsal Onlay

Background: Authors describe their experience with dorsal onlay urethroplasty using Buccal mucosal graft or penile skin graft through dorsal sagittal urethrotomy for bulbar urethral stricture.Methods: From 2014 to 2017, 29 male patients with bulbar urethral stricture have been treated by one stage dorsal onlay substitution urethroplasty using buccal mucosal graft and penile skin graft. Patients with balanitis xerotica obliterans, unhealthy penile skin, oral mucosa pathology or those who had undergone more than one urethral dilation/internal urethrotomy or urethroplasty were excluded from study. Results were analyzed at 6th and 12th month follow up with clinical history and uroflowmetry. Clinical outcome was considered a failure when any postoperative instrumentation was needed, including dilation or optical internal urethrotomy.Results: A total of 16 men age between 21 to 56 years for buccal mucosa graft (BMG) urethroplasty and 13 men age between 18 to 59 years underwent dorsal onlay substitution urethroplasty using BMG and penile skin graft (PSG). Mean stricture length was 4.2 cm (3.8-6) for BMG urethroplasty and 4.1 cm (3.2-5) for PSG urethroplasty. Mean length and width of graft were 4.2 cm and 2.6 cm respectively in BMG urethroplasty while 4.6 cm and 2.5 cm in PSAG urethroplasty. Average follow up months were 13.4 months with overall success rate 87.5% in BMG urethroplasty while average follow up months were 14.6 months with overall success rate 82.3% in PSG urethroplasty.Conclusions: On short term follow up substitution urethroplasty using both penile skin and buccal mucosa graft have comparable results.

Download Full-text

37: Is Urethroplasty a Feasible Long-Term Solution for Urethral Stricture?

The Journal of Urology ◽

10.1016/s0022-5347(18)30302-1 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 13-14

Author(s):

Imran Ahmad ◽

Mustafa Hilmy ◽

Douglas R. Small ◽

Ian G. Conn

Keyword(s):

Urethral Stricture

Download Full-text

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽

10.1024/0301-1526.31.1.36 ◽

2002 ◽

Vol 31 (1) ◽

pp. 36-42 ◽

Cited By ~ 3

Author(s):

. Bucek ◽

Hudak ◽

Schnürer ◽

Ahmadi ◽

Wolfram ◽

...

Keyword(s):

Success Rate ◽

Clinical Stage ◽

Ankle Brachial Index ◽

Clinical Situation ◽

Clinical Results ◽

Transluminal Angioplasty ◽

Term Outcome ◽

Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Download Full-text