scholarly journals Substitution Buccal Mucosal Graft Urethroplasty for Long Segment Anterior Urethral Stricture : Our Experience in Dorsolateral Onlay Approach

2021 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
Shiba Prasad Nandy ◽  
- Md Asaduzzaman ◽  
Kamal Uddin Mazumder ◽  
Sakhawat Mahamud Khan ◽  
Md Monowar Ul Hoque
Keyword(s):  
Urethral Stricture ◽  
Maximum Flow ◽  
Anastomotic Site ◽  
Short Term ◽  
College Hospital ◽  
Term Outcome ◽  
Buccal Mucosal Graft ◽  
Short Term Outcome ◽  
Onlay Technique

Background: Currently the most favorable single stage procedure for management of long segment anterior urethral stricture is dorsal onlay technique of urethroplasty. This required circumferential extensive mobilization of the urethra, which might cause ischemia of urethra in addition to chordee. To evaluate the short term outcome of dorsolateral onlay BMG (Buccal Mucosal Graft) urethroplasty by unilateral urethral mobilization for treatment of long segment anterior urethral stricture Materials and methods: A prospective experimental study from January 2016 to December 2018 is carried out in Department of Urology, Chittagong Medical College Hospital (CMCH) Chattogram, Bangladesh. Total 32 patients of long segment anterior urethral stricture were treated by dorsolateral onlay BMG urethroplasty by unilateral urethral mobilization. Stricture >2cm were included; RGU, MCU and Uroflowmetry were the mainstay of assessment. Success was defined as maximum flow rate >15 ml/s, normal RGU and/ urethroscopy. Failure considered as presence of obstructive symptoms, Qmax < 15 ml/s, stricture on RGU and any post-operative urethral intervention. Results: Mean stricture length was 48.72mm (Range: 30-77mm) and mean follow up time was 22.4months (Range: 12-40 months). Three patients were found to develop stricture at proximal anastomotic site during follow up and required optical internal urethrotomy and considered as failure. 01 patients developed Surgical Site Infection (SSI) which resolved after regular dressing. Success rate was 90.7% Conclusion: Dorsolateral onlay BMG urethroplasty by unilateral mobilization is feasible, safe and easily adoptable for long segment anterior urethral stricture with good short term outcome. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 14-17

Outcome of Buccal Mucosal Graft Urethroplasty in Long Segment Anterior Urethral Stricture

2020 ◽  
Vol 19 (2) ◽  
pp. 64-68
Author(s):  
Mrinmoy Biswas ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman ◽  
Sharif Mohammad Wasimuddin
Keyword(s):  
Urethral Stricture ◽  
Flow Rate ◽  
Surgical Outcome ◽  
Simple Technique ◽  
Anterior Segment ◽  
Maximum Flow ◽  
Anastomotic Site ◽  
Buccal Mucosal Graft ◽  
Male Patients

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68

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

Outcome of Dorsolateral OnlAy OMG Urethroplasty for Anterior Urethral Stricture

2020 ◽  
Vol 16 (2) ◽  
pp. 37-42
Author(s):  
Tohid Md Saiful Hossain ◽  
Md Asaduzzaman ◽  
Md Afzalur Rahman ◽  
Md Nasir uddin ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Urethral Stricture ◽  
Donor Site ◽  
Maximum Flow ◽  
Successful Outcome ◽  
Term Outcome ◽  
Lower Lip ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft

Objective: To determine the feasibility, safety, efficacy and short term outcome of using new surgical technique for repair of anterior urethral stricture Introduction: The conventional approach for management of long segment anterior urethral stricture is a two stage Johansons repair along with the use of free grafts if required. Now a days the preferred management of urethral stricture involving long segments of anterior urethra is dorsal only oral mucosa Augmentation urethroplasty which requires circumferential mobilization of urthera that might cause ischaemia of urethra in addition of chordee. For that we adopted new technique (kulkarnis) of dorsolateral onlay buccal mucosal graft one sided anterior urethroplasty in which only unilateral urethral mobilization done through perineal approach. Materials and Methods: A total of 50 patients underwent urethroplasty for anterior urethral strictures using dorsolateral onlay BMG from April 2010 to December 2012 at NIKDU, JBFH, BSMMU and BDM Hospital. We selected 16 to 70 years old male (mean age 39 years) underwent a one-sided dorsolateral oral mucosal graft urethroplasty. The mean (range) stricture length was 6.5 (4.5-9) cm in patients with single bulbar urethral involvement and 10.5 (8.5–15.0) cm in patients with panurethral strictures. Free graft was taken from oral mucosa either lower lip or cheeks. Follow up was done by uroflowmetry at 3rd week, after removal of penile catheter and repeat at 3rd and at 6th month. In addition to uroflometry – RGU & MCU was done at 3rd month and Urethrocystoscopy was done at 6th month follow up. The results were classified into the following outcomes. Success was defined as a maximum flow rate of >10 ml/sec, normal RGU, and/or urethroscopy (with a 19 Fr. sheath). Failure was defined as the presence of obstructive urinary tract symptoms, Qmax <10 ml/sec, stricture diagnosed on retrograde urethrogram/ urethroscopy, and the need for any postoperative urethral intervention. Result: The overall follow up was 12-30 months. Of the 50 patients 45 (90%) had a successful outcome and 5(12%) had failure. 3 failure treated by OIU and 2 by meatal dilatation. No significant donor site defect was observed. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.37-42

scholarly journals Ligation of the aorta for a mycotic abdominal aortic aneurysm in an infant

2018 ◽  
Vol 6 ◽  
pp. 2050313X1876130
Author(s):  
Zahira Zouizra ◽  
Soukaina Benbakh ◽  
Gaël Biaou ◽  
Drissi Boumzebra
Keyword(s):  
Mycotic Aneurysm ◽  
Aortic Aneurysms ◽  
Infrarenal Aorta ◽  
Limited Data ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Mycotic aortic aneurysms are exceedingly uncommon in infants and they have a high risk of rupture. Their surgical management is extremely challenging. We report a case of a 22-month-old girl who presented with abdominal pain and fever revealing a ruptured mycotic aneurysm of the infrarenal aorta. The surgical treatment consisted of a ligature of the proximal and distal ends of the aneurysm. Postoperative course was significant for hypertension. A year and a half follow-up showed no other complications. Limited data are available concerning our chosen technique, but the reported cases showed a good short-term outcome.

Sex-Specific Differences in Short-Term and Long-Term Outcomes in Acute Stroke Patients from Qatar

2020 ◽  
Vol 83 (2) ◽  
pp. 154-161 ◽  
Author(s):  
Naveed Akhtar ◽  
Mahesh Kate ◽  
Saadat Kamran ◽  
Rajvir Singh ◽  
Zain Bhutta ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Major Adverse Cardiovascular Events ◽  
Stroke Patients ◽  
Long Term Outcomes ◽  
Short Term ◽  
Term Outcome ◽  
Contributory Factors ◽  
Short Term Outcome

Background: Sex differences may determine presentation, utility of treatment, rehabilitation, and occurrences of major adverse cardiovascular events (MACEs) in acute stroke (AS). Objective:The purpose of the study was to evaluate the short-term prognosis and long-term outcomes in MACEs in Qatari nationals admitted with AS. Methods: All AS patients admitted between January 2014 and February 2019 were included. We evaluated the preadmission modified Rankin scale (mRS) score, etiology and severity of symptoms, complications, and functional recovery at discharge and 90 days. MACEs were recorded for 5 years. Results: There were 891 admissions for AS (mean age 64.0 ± 14.2 years) (male, n = 519 [mean age ± SD 62.9 ± 14.1 years]; female, n = 372 [mean age ± SD 65.6 ± 14.2 years] p = 0.005). There were no differences in the preadmission mRS and severity of symptoms as measured on National Institute of Stroke Scale. At discharge, the outcome was better (mRS 0–2) in men (57.8 vs. 46.0%), p = 0.0001. This difference persisted at the 90-day follow-up (mRS 0–2, male 69.4% vs. female 53.2%, p = 0.0001). At the 90-day follow-up, more women died (total deaths 70; women 38 [10.2%] versus men 32 [6.2%], p = 0.03). MACEs occurred in 25.6% (133/519) males and 30.9% (115/372) females over the 5-year follow-up period (odds ratio 0.77, 95% confidence interval 0.57–1.0, p = 0.83). Conclusions: Female patients have a poor short-term outcome following an AS when corrected for age and comorbidities. While our study cannot explain the reasons for the discrepancies, higher poststroke depression and social isolation in women may be important contributory factors, and requires further studies are required to confirm these findings.

Natural history of longitudinally extensive transverse myelitis in 35 Hispanic patients with systemic lupus erythematosus: good short-term functional outcome and paradoxical increase in long-term mortality

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1279-1286 ◽  
Author(s):  
F D Flores-Silva ◽  
O Longoria-Lozano ◽  
D Aguirre-Villarreal ◽  
H Sentíes-Madrid ◽  
F Vega-Boada ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Functional Outcome ◽  
Lupus Erythematosus ◽  
Transverse Myelitis ◽  
Systemic Lupus ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

Background and objective Acute transverse myelitis (TM) is an infrequent neurological complication of systemic lupus erythematosus (SLE). Short-term outcome varies widely between cohorts. Little is known about the epidemiology and long-term functional outcome of TM associated to SLE. Methods Patients with SLE and acute TM were identified during hospital admission, visits to the Emergency Room or the Neurology Outpatient Clinic. We evaluated ambispectively those patients with SLE presenting with clinical myelopathy and corroborated with spinal MRI. Cases were divided as partial (non-paralyzing) or complete (paralyzing). We determined long-term functional outcome as well as mortality in those patients with follow-up periods of at least five years. Results We identified 35 patients (partial, n = 15; complete, n = 20) in which complete clinical and imaging data were available (26 with follow-up ≥ 5 years). Patients with complete TM were significantly older than those with partial forms. Positive antiphospholipid antibodies were observed in 80% of patients, suggesting a possible mechanistical role. Surprisingly, functional recovery at one year was in general good; however, we observed a five-year mortality of 31% because of sepsis (in 10 cases) or pulmonary embolism (in one case). Conclusions Short-term outcome of SLE-related TM is generally good, and recurrence rate is low. However, we observed a long-term fatality rate of 31% for reasons unrelated to TM, suggesting that TM is a manifestation of severe immune dysregulation and a predictor of severity and mortality in patients with SLE.

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

scholarly journals Dorsal Onlay Buccal Mucosal Graft Urethroplasty for Bulbar Urethral Stricture- Experience of 20 Cases

2017 ◽  
Vol 26 (1) ◽  
pp. 8-11
Author(s):  
Hafiz Al Asad ◽  
AKM Musa Bhuiyan ◽  
Md Nazmul Islam ◽  
Uttam Karmaker ◽  
Md Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Successful Outcome ◽  
Anastomotic Site ◽  
Medical College ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Onlay Technique ◽  
Retrograde Urethrogram ◽  
Dorsal Onlay ◽  
Optical Internal Urethrotomy

Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in bulbar urethral stricture.Materials and Methods: From July 2008 to June 2010, twenty patients with anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required. Patients were further followed-up at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required. Successful outcome was defined as normal voiding with no surgical intervention after catheter removal.Results: Mean stricture length was 3.5 ± 0.8 cm and mean follow up was 12 months (range 6 to 24 months). Two patients were found to develop stricture at anastomotic site, during followup and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90%.Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 8-11

Short-Term Clinical and Radiographical Outcome after Application of Anchored Intervertebral Spacers in Dogs with Disc-Associated Cervical Spondylomyelopathy

2019 ◽  
Vol 32 (02) ◽  
pp. 158-164 ◽  
Author(s):  
Deborah Rohner ◽  
Michael Kowaleski ◽  
Günter Schwarz ◽  
Franck Forterre
Keyword(s):  
Neurological Status ◽  
Screw Loosening ◽  
Short Term ◽  
Term Outcome ◽  
Neurological Signs ◽  
Fusion Device ◽  
Short Term Outcome ◽  
High Incidence ◽  
Cervical Spondylomyelopathy

Objectives The purpose of this study was to assess the short-term outcome of a new intervertebral anchored fusion device (C-LOX) for the treatment of disc associated cervical spondylomyelopathy (DA-CSM) in dogs, based on clinical and radiographical follow-up data. Materials and Methods To be included in the study, dogs had to be clinically affected by DA-CSM treated with surgical distraction/stabilization using the anchored intervertebral spacer (C-LOX). Neurological signs, as well as diagnostic imaging performed pre-, immediately postoperatively, and after 6 weeks and 3 months were assessed. If available, clinical follow-up after 3 months was documented. Results Thirty-seven cases were enrolled in the study. Outcome at 3 months was available in 25 dogs; improvement of neurological status was documented in 25/25 cases.The most common postoperative complication was screw loosening and/or breakage (n = 22), followed by subsidence (n = 15). Four dogs required revision surgery. Clinical Significance Distraction/stabilization of DA-CSM in dogs with the C-LOX device resulted in short-term clinical improvement in 33/37 treated cases. The high incidence of screw loosening was taken into consideration and modification of the implant with a new locking system and new screw dimensions was required. The C-LOX device seems to be a valuable alternative to more complicated distraction–fusion techniques.

Sign in / Sign up

Export Citation Format

Share Document