scholarly journals Dorsolateral onlay urethroplasty for long segment anterior urethral stricture: outcome of a new technique

1970 ◽  
Vol 37 (3) ◽  
pp. 78-82 ◽  
Author(s):  
AKMK Habib ◽  
AKMK Alam ◽  
ATM Amanullah ◽  
H Rahman ◽  
AKMS Hossain ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Free Graft ◽  
Short Term ◽  
Chi Square ◽  
Urethral Strictures ◽  
Buccal Mucosa Graft ◽  
A New Technique ◽  
Student’S T ◽  
Level Of Significance

Conventional dorsal onlay urethroplasty requires circumferential mobilization of the urethra which might cause ischemia of the urethra. The present study was conducted to determine the feasibility and short term outcomes of applying dorsolateral free graft to treat anterior urethral stricture by unilateral urethral mobilization approach. This hospital based prospective interventional study was conducted in the Department of Urology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July, 2009 to December, 2010. Total 30 patients with long-segment anterior urethral strictures were selected and treated by a dorsolateral free buccal mucosa graft. The test statistics used to analyse the data were Chi-square (Χ2) test and Student’s t-Test. For all analytical tests, the level of significance was set at 0.05 and p <0.05 was considered significant. After 6 months follow up results were prepared. Three (10%) patients developed wound infection. One (3.3%) patient developed urethrocutaneous fistula and one (3.3%) patient had chordee. Wound infections were treated conservatively. Twenty eight (93.3%) patients out of 30 had subjective improvement of urine flow after operation. All of these patients had postoperative Qmax >10 ml/sec. Postoperative Retrograde Urethrogram (RGU) of 28(93.3%) patients was free of stricture and 2(6.7%) patients showed stricture who had postoperative Qmax <10 ml/sec. Overall success rate was 93.3% at 3 to 12 months follow up. Unilateral urethral mobilization approach for dorsolateral free graft urethroplasty is feasible for long segment anterior urethral strictures with good short term success.DOI: http://dx.doi.org/10.3329/bmrcb.v37i3.9117 BMRCB 2011; 37(3): 78-82

scholarly journals Outcome of Dorsal Onlay Urethroplasty for Long Segment Anterior Urethral Stricture: Experience of 31 Cases

2020 ◽  
Vol 19 (1) ◽  
pp. 28-31
Author(s):  
Hafiz Al Asad ◽  
Prodyut Kumar Saha ◽  
AKM Shahadat Hossain ◽  
Md Waliul Islam ◽  
Akm Musa Bhuiyan
Keyword(s):  
Urethral Stricture ◽  
Kidney Diseases ◽  
Successful Outcome ◽  
Anastomotic Site ◽  
Short Term ◽  
Term Outcome ◽  
Buccal Mucosa Graft ◽  
Retrograde Urethrogram ◽  
A Prospective Study

Objective: To determine the short-term outcome of dorsolateral onlay urethroplasty in the treatment of long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Patients were further followedup at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Successful outcome was defined as normal voiding with no surgical intervention after catheter removal. Results: Mean stricture length was 42.49±12.77 mm (range 24-70 mm) and mean follow up was 8 months (range 6 to 12 months). Three patients were found to develop stricture at anastomotic site, during follow-up and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90.32%. Conclusion: Dorsolateral onlay BMG urethroplasty is feasible for long anterior urethral stricture with good short term surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.28-31

scholarly journals Buccal One-Stage Mucosal Graft Urethroplasty for Urethral Stricture. Results of 10 Years of Experience.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Gezim Galiqi ◽  
Artan Koni ◽  
Flamur Tartari ◽  
Albert Pesha ◽  
Shpetim Ymeri ◽  
...  
Keyword(s):  
Success Rate ◽  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Dorsal Surface ◽  
Success Rates ◽  
Lower Lip ◽  
Bulbar Urethra ◽  
Urethral Strictures ◽  
Buccal Mucosa Graft

Aim: Representing our data regarding use of buccal mucosa for treatment of recurrent urethral stricture. Evaluating effectiveness of buccal graft for reconstruction of urethral segment both penile and bulbar urethra. Materials and methods: We repaired 95 urethral strictures with buccal mucosa grafts from 2004 to 2015. Mean patient age was 39 years. The etiology of stricture was unknown in 54% of cases in other cases ischemia, trauma, instrumentation was the reason. 96% had undergone previous urethrotomy or dilation. The buccal mucosa graft was harvested from lower lip mostly. Mean graft length was 3.8 cm. The graft was placed on the ventral and dorsal bulbar urethral surface in 61 and 34 cases, respectively. In pendulous urethra we routinely use the dorsal graft the Asopa inlay graft or Barbagli onlay graft. Clinical outcome was considered a success or failure at the time that any postoperative procedure was needed, including dilation. Mean follow-up was 36 months (range 16 to 62). Results: We had a success rate of 77% with dorsal inlay or onlay flap for pendulous urethra inferior than ventral graft used for bulbar urethra which was 81% success rate. Conclusions: In our experience the placement of buccal mucosa grafts into the ventral or dorsal surface of the bulbar urethra showed an acceptable success rates 81% and 77% respectively. Longer times of follow up is need to see if the results deteriorated more.

scholarly journals Dorsolateral Onlay Urethroplasty for the Long Segment Anterior Urethral Stricture: Outcome of 31 Cases

2020 ◽  
Vol 18 (1) ◽  
pp. 12-15
Author(s):  
Hafiz Al Asad ◽  
Md Sharif Shahjamal ◽  
Sarforaj Ali Khan ◽  
Md Waliul Islam ◽  
AKM Zamanul Islam Bhuiyan
Keyword(s):  
Urethral Stricture ◽  
Kidney Diseases ◽  
Successful Outcome ◽  
Anastomotic Site ◽  
Short Term ◽  
Buccal Mucosa Graft ◽  
Retrograde Urethrogram ◽  
A Prospective Study ◽  
Optical Internal Urethrotomy

Objective: This study is designed to observe the short-term outcomes of dorsolateral onlay urethroplasty to treat long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Patients were further followedup at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Successful outcome was defined as normal voiding with no surgical intervention after catheter removal. Results: Mean stricture length was 42.49±12.77 mm (range 24-70 mm) and mean follow up was 8 months (range 6 to 12 months). Three patients were found to develop stricture at anastomotic site, during follow-up and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90.32%. Conclusion: Dorsolateral onlay BMG urethroplasty is feasible for long anterior urethral stricture with good short term surgical outcome. Bangladesh Journal of Urology, Vol. 18, No. 1, Jan 2015 p.12-15

Surgery of tympanosclerosis

1997 ◽  
Vol 111 (10) ◽  
pp. 917-923 ◽  
Author(s):  
Syed Akhtar Kamal
Keyword(s):  
Middle Ear ◽  
Radical Surgery ◽  
Stapes Surgery ◽  
Hearing Improvement ◽  
Short Term ◽  
Two Stage ◽  
Chi Square ◽  
Physiological Basis

AbstractEighty-five cases with tympanosclerosis of the middle ear were treated surgically in this series from 1984 to 1995. Twelve of them were associated with cholesteatoma and had radical surgery performed. An attempt is made here to classify the tympanosclerosis on a patho-physiological basis. A planned two-stage procedure was performed in 36 cases after an interval of 18 months. The majority of patients had stapes surgery carried out by a two-stage procedure. One of the patients who did not have stapes surgery developed anacusis after 18 months post-operatively and in another patient recurrence was observed. Post-operative hearing improvement was found to be satisfactory in the short-term follow-up period of two to five years. The hearing improvement was analysed by using Chi-square value (x2) and also plotted in the Glasgow Benefit Plot.

scholarly journals Later Risk of Wheezing/Asthma and Allergy in Offspring of 2 Vitamin D (VitD) Pregnancy Cohorts: Post Hoc Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1096-1096
Author(s):  
Carol Wagner ◽  
Myla Ebeling ◽  
Judy Shary ◽  
John Baatz ◽  
Danforth Newton ◽  
...  
Keyword(s):  
Chi Square ◽  
Childhood Health ◽  
Post Hoc Analysis ◽  
Funding Sources ◽  
Long Term Effect ◽  
Adverse Pregnancy ◽  
Student’S T ◽  
Post Hoc ◽  
In Pregnancy

Abstract Objectives Maternal vitD deficiency as defined by circulating 25(OH)D concentration is linked with certain adverse pregnancy outcomes (e.g., preterm birth) and childhood outcomes (e.g., asthma), with the effect seemingly more pronounced if deficiency occurs earlier in pregnancy. OBJ: Assess the long-term effect of maternal and neonatal vitD status on later risk of childhood allergy, wheezing and/or asthma to 4 yrs. It was hypothesized that deficiency earlier in pregnancy would have a significant effect on risk that would continue during pregnancy. Methods In this follow-up post hoc analysis of women and their offspring enrolled in 1 of 2 pregnancy vitD supplementation trials (NICHD, n = 348 and Kellogg Foundation, n = 298), women were randomized to either 400, 2000 or 4000 IU vitD/day (NICHD) at 12–16 wks’ or 400 or 4400 IU/day at 10–14 wks’ (Kellogg). Baseline then monthly 25(OH)D concentration as the primary outcome in both studies and as the indicator of vitD status was measured by RIA until delivery. Neonatal vitD status was measured in cord blood. Follow-up data on the offspring were available through 4 yrs using an EMR with ICD-9 and 10 codes for eczema, wheezing and/or asthma. Student's t-test was used to analyze differences in mean 25(OH)D and eczema, wheezing, and asthma. Chi-square analyses were used to test for differences in incidence of 25(OH)D below 20, 30, and 40 and eczema, wheezing, and asthma. Results In NICHD Pregnancy, 326/348 (93.7%) offspring had EMR data available: 48 (14.7%) had eczema; 32 (9.8%) had wheezing; and 48 (14.7%) had asthma. In Kellogg Pregnancy, 205/298 (68.8%) had EMR data available; 36 (17.6%) had eczema; 14 (6.8%) had wheezing; and 10 (4.9%) had asthma. Maternal baseline 25(OH)D &lt; 30 ng/mL was associated with eczema (P = 0.024) and asthma (P = 0.035) by age 4 yrs. Neonatal 25(OH)D was inversely associated with eczema (P = 0.01) and asthma by age 4 (P = 0.0012). When dichotomized, neonates with 25(OH)D &lt; 20 ng/mL had a significantly higher risk of eczema (P = 0.02) and asthma (P = 0.004) and those below 40 ng/mL had a higher risk of eczema (P = 0.03). Conclusions In this combined cohort of pregnant women and their offspring, both maternal and neonatal vitD status were associated with later allergy, wheezing and asthma risk. Efforts to improve maternal vitD status may have later significant consequences on childhood health outcomes. Funding Sources NIH/NICHD/NCATS.

scholarly journals One-stage buccal two-flap urethroplasty using the Kulkarni technique for extended anterior urethral strictures

2020 ◽  
Vol 8 (4) ◽  
pp. 44-52
Author(s):  
M. I. Katibov ◽  
M. M. Alibekov ◽  
Z. M. Magomedov ◽  
A. M. Abdulkhalimov ◽  
V. G. Aydamirov
Keyword(s):  
Urethral Stricture ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Disease Recurrence ◽  
Urinary Flow ◽  
One Stage ◽  
Urethral Strictures ◽  
Prospective Control ◽  
Onlay Technique

Introduction. The problem of extended urethral strictures treatment remains relevant due to the complexity of the supervision of such patients and the high frequency of disease recurrence after surgical treatment.Purpose of the study. Evaluation of the effectiveness of one-stage buccal urethroplasty according to the Kulkarni technique using two flaps for extended anterior urethral strictures.Materials and methods. The study included 18 men with an extended anterior urethral stricture, who underwent buccal urethroplasty by perineal access using the Kulkarni dorsolateral onlay technique using two flaps from January 2018 to March 2020, and a postoperative follow-up period of at least 6 months. The study was prospective. Control examination was carried out 3, 6, 12, 18 and 24 months after surgery. The criteria for the recurrence of urethral stricture were the presence of complaints of deterioration in the quality of urination in combination with a decrease in the maximum urinary flow rate of less than 12 ml/sec and the presence of residual urine in an amount of more than 100 ml, as well as the need to perform any surgical intervention to restore the normal passage of urine.Results. The age of the patients ranged from 32 to 72 years (median 58 years). The length of the stricture ranged from 6 to 11 cm (median, 8 cm). The stricture was localized in the penile segment in 11 (61.1%) cases and the penile and bulbar urethra in 7 (38.9%) cases simultaneously. An iatrogenic cause of urethral stricture occurred in 11 (61.1) patients, idiopathic in 5 (27.8%) patients and inflammatory in 2 (11.1%) patients. The stricture was primary in 12 (66.7%) cases and recurrent in 6 (33.3%). Spontaneous urination was preserved in 6 (33.3%) patients, cystostomy existed in 12 (66.7%) patients. The follow-up period after surgery ranged from 3 to 24 months (median - 12 months). Recurrence of urethral stricture was noted in 3 (16.7%) cases. The use of this technique for recurrent forms of the urethral stricture (recurrence after the previous urethroplasty) is the most significant risk factor for treatment failure. 1 (5.6%) case of erectile dysfunction and stress urinary incontinence has taken place of the late postoperative complications.Conclusions. The Kulkarni operation using two buccal flaps for extended strictures of the anterior urethra allows to achieve high rates of efficacy and safety of a treatment, however, the risk of failure increases significantly when used for the treatment of recurrent types of strictures. 

scholarly journals Comparison of the accuracy of virtual and direct bonding of orthodontic accessories

2019 ◽  
Vol 24 (4) ◽  
pp. 46-53 ◽  
Author(s):  
Natalice Sousa de Oliveira ◽  
Bruno Frazão Gribel ◽  
Leniana Santos Neves ◽  
Elizabeth Maria Bastos Lages ◽  
Soraia Macari ◽  
...  
Keyword(s):  
Reference Model ◽  
Three Dimensional ◽  
Three Dimensions ◽  
Chi Square ◽  
Paired Samples ◽  
Indirect Bonding ◽  
Group I ◽  
Student’S T ◽  
Level Of Significance ◽  
The Individual

ABSTRACT Introduction: Conventional direct and indirect bonding techniques fail to obtain the ideal bracket position. Objective: To compare the accuracy of virtual and conventional direct bonding of orthodontic accessories. Methods: A single virtual configuration (dental mannequin with Class I malocclusion) served as basis for generating the reference model (treated virtually) and the intervention models (10 digital models and 10 solid models, obtained by means of prototyping). A total of 560 teeth were then equally distributed between a group of orthodontists (Group I, direct bonding; and Group II, virtual bonding), working in two different time intervals. The individual positions of the accessories were measured after three-dimensional superimposition with customized software. The Student’s-t test for paired samples, and Chi-square tests were used for statistical analysis, both at the level of significance of 5%. Results: In comparison of the errors in raw values, there were significant differences only in the vertical (p< 0.001) and horizontal dimensions (p< 0.001). Considering the groups of ranges by clinical limits of the deviations, these differences were significant in the three dimensions, vertical (p< 0.001), horizontal (p= 0.044) and angular (p= 0.044). Conclusion: Virtual bonding made it possible to obtain more precise/accurate positioning of the orthodontic accessories. The potential accuracy of this method brings new perspectives to refining the indirect bonding protocols.

scholarly journals Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
F. F. Mouafo Tambo ◽  
G. Fossi kamga ◽  
C. Kamadjou ◽  
L. Mbouche ◽  
A. S. Nwaha Makon ◽  
...  
Keyword(s):  
Surgical Management ◽  
Urethral Stricture ◽  
Pediatric Surgery ◽  
Tertiary Hospital ◽  
Internal Urethrotomy ◽  
Urethral Catheterization ◽  
Diagnosis And Management ◽  
Urethral Strictures ◽  
Surgery Department

Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon.Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy.Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n=1), urethral dilatation (n=1), vesicostomy (n=2), and urethral catheterization (n=3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free.Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered.

MP13-12 MIDTERM FOLLOW UP OF INTERNAL URETHROTOMY IN PATIENTS WITH RECURRENT URETHRAL STRICTURE AFTER BUCCAL MUCOSA GRAFT URETHROPLASTY

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Clemens Rosenbaum ◽  
Marianne Schmid ◽  
Tim Alexander Ludwig ◽  
Philip Reiss ◽  
Roland Dahlem ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Internal Urethrotomy ◽  
Buccal Mucosa Graft ◽  
Buccal Mucosa Graft Urethroplasty

scholarly journals Outcome of buccal mucosa urethroplasty in the management of urethral strictures

2017 ◽  
Vol 89 (2) ◽  
pp. 139 ◽  
Author(s):  
Basri Cakiroglu ◽  
Orhun Sinanoglu ◽  
Ersan Arda
Keyword(s):  
Success Rate ◽  
Buccal Mucosa ◽  
High Volume ◽  
Single Stage ◽  
Fistula Formation ◽  
Internal Urethrotomy ◽  
Voiding Difficulty ◽  
Urethral Strictures ◽  
Buccal Mucosa Graft

Objective: The objective of the study is to report the outcome of buccal mucosal urethroplasty. Materials and methods: The follow up data of 15 patients undergoing single stage urethroplasty from September 2010 to September 2015 were retropectively reviewed. They received buccal mucosa graft for urethroplasty. The patients were followed for complications and outcome. Results: Mean age was 53.7 ± 13.6 The stricture length ranged from 3 to 6 cm (mean 4.4 ± 0.8). The success rate for buccal mucosa urethroplasty (BMU) was 67.7% at 12th month. Three patients presenting with voiding difficulty in the 3rd month and one in the next 12 months, had urethral restenosis. One patient had fistula formation at 6th month postoperatively. Five patients underwent retreatment procedures such as internal urethrotomy, urethroplasty and/or internal urethrotomy. Conclusions: The buccal mucosa is easy to obtain and handle, therefore BMU can be safely and effectively managed outside high volume institutions.

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