Surgical treatment of urethral tuberculosis in men – history and present (literature review)

The literature review provides data on tuberculosis of the urethra in men. This disease is rarely recorded, as a rule, at the stage of formation of the urethral stricture, which can develop many years after the onset of the disease. Urethral tuberculosis is usually secondary to other localizations of extrapulmonary tuberculosis, such as tuberculosis of the prostate, penis, kidney, and bladder, but there are also isolated forms of this disease. The most common symptoms of urethral tuberculosis are the presence of strictures, skin-urethral and recto-prostatic fistulas, and purulent urethritis. Almost always, with this disease, conservative specific therapy was carried out, which in some cases made it possible to completely eliminate the symptoms and ensure the patient’s clinical recovery. Tuberculous urethral strictures are operated on according to generally accepted rules, but there is no single algorithm for the surgical treatment of strictures of this etiology, often limiting itself only to urine diversion or urethral dilation. Of the urethroplasty, the most commonly used end-to-end urethral anastomosis. In our opinion, a promising direction is the use of various grafts for the surgical treatment of this disease.

Intervention mapping as a framework for planning the implementation of urine diversion toilets and Ecosan education in a community school in Kavre, Nepal

Use of human excreta as fertilizer is not a new concept. However, with the use of the modern water-flush toilet, human excreta becomes mixed with water and causes environmental pollution. To reemphasize the nutritional value of human urine in the field, a urine diversion toilet was constructed in a community school situated in Kavre, Nepal. The purpose of establishing the urine diversion toilet is to improve hygiene outcomes through promoting proper sanitation and transforming the school community’s regular practice and attitudes towards urine as a resource. To ensure effective implementation of the urine diversion toilets, intervention mapping was used as a guiding framework. The aim of this paper is to document how the urine diversion toilet was planned and implemented in the school and how the urine diversion toilet was connected with the curriculum to address concerns regarding water, sanitation, and hygiene with a focus on sustainability through intervention mapping. This study highlights the benefits of intervention mapping as a systematic and step-by-step process for the planning and implementation of the urine diversion toilet. This study also highlights the benefits of connecting urine diversion toilets with school gardening, and engaging with local government and other stakeholders about the value of the approach.

Continent cutaneous urine diversion in patients with tuberculosis of various localizations

Various diseases of the bladder lead to the loss of its function and the need for periodic catheterization of the patient or the installation of permanent urinary drainage. Reconstruction of the lower urinary tract, based on the Mitrofanov principle, improves the quality of life of patients. However, this operation has a significant number of early and late operational complications. We represent a small group of patients — 6 people who underwent continental cutaneous urine diversion in our modification, the purpose of which was to reduce incontinence. Long-term results of the operation demonstrate a good result of this technique.

Charateristics of Gynecological Abnormalities and Types of Urine Diversion at Dr Soetomo Hospital, Surabaya, Indonesia, in Three-Year Period

In the case of advanced stage gynecological disorders, most patients have a disturbance in the upper urinary tract. Most patients with uterine cervical carcinoma are already in stage 3B and require urine diversion. The purpose of this study is to find and determine the profile of gynecological disorders that require urine diversion, the type of urine diversion, and urine diverted output in patients with cervical carcinoma. This descriptive analytical retrospective study was conducted at Dr. Soetomo Hospital, Surabaya, Indonesia, between 2012 and 2015. The samples of this study were all patients with gynecological disorders who underwent retrograde DJ stent procedures, underwent ureterocutaneostomy and nephrostomy at the Integrated Central Surgery Building, Dr. Soetomo Hospital, Surabaya, for three years between 2012 and 2015. Data was collected based on the medical record number of patients with gynecological disorders who underwent urine diversion procedures and were recorded in the book on the operation schedule. We find that the most common cause of gynecological abnormalities in kidney obstruction is cervical carcinoma. There are three types of urine diversions used, namely DJ stent, percutaneous nefropyelostomy, and ureterocutaneostomy, with DJ as the most commonly performed. Urine diversion can improve creatinine without being influenced by the type of diversity.

Surgical treatment of kidney tuberculosis: a comparative analysis of open and laparoscopic approaches

Introduction. Tuberculosis remains a global problem of our time. Kidney tuberculosis, especially complicated by tuberculosis of the urinary tract, becomes a surgical disease if it diagnosed late or the therapy was not optimal.Materials and methods. 93 patients with urogenital tuberculosis (UGTB) was included in this study who were admitted to the Novosibirsk Scientific and Research Institute of Tuberculosis consecutively. All of them underwent surgical intervention on the kidney. 51 patients underwent open surgery, and 42 patients underwent laparoscopic surgery. The results of treatment and the incidence of complications in both groups were analyzed and compared.Results. The age of the patients ranged from 23 to 75 years, averaging 50.9 ± 6.7 years; there were 45 men and 48 women. Tuberculosis of the left kidney was diagnosed in 41 patients, on the right - in 52 patients. The indication for nephrectomy was polycavernous tuberculosis of the kidney with no function in 74 cases, while in 11 cases polycavernous tuberculosis was complicated by stage 4 bladder tuberculosis. In 9 patients, nephrectomy was performed with cystectomy simultaneously. In 2 patients with severe renal dysfunction, cystectomy for microcystis was not performed, preferring laparoscopic nephrectomy with heterotopic urine diversion. In the group of patients operated on with an open approach, complications developed in 14 patients (27.4%), in the group of laparoscopic operations - in 5 (11.9%). The laparoscopic approach made it possible to activate the patients much earlier: after 2.4 hours, while in the openaccess group - after 38.7 hours.Conclusion. Due to the peculiarities of the pathogenesis of UGBT, it is accompanied by the local development of gross deforming scars, which significantly complicates the implementation of the surgical procedure - both open and laparoscopic access. Nevertheless, modern technology allows to perform the entire spectrum of operations laparoscopically to UGTB, and the complication rate is 2.3 times lower than in open operations. Early activation of the patient, less need for analgesics are also positive factors of minimally invasive surgery for UGTB.

Communicating the Risks and Benefits of Human Urine-Derived Fertilizer

Ensuring long-term access to nutrients needed for food production is a growing global challenge. Human urine diversion and recycling is a viable and energy-efficient means of recovering nitrogen, phosphorus, and potassium from wastewater. Before implementation, however, it is critical to understand how communicating differently about human urine-derived fertilizer may influence its public acceptance. This study tests how different strategies of communication (video compared to texts), as well as different amounts of information, impact public acceptance. We also explored how specific characteristics, such as age and education level, may impact the usefulness of the different strategies of communication. The results indicate that short and long videos are the most useful risk communication strategies, and age fully moderates this relationship. This research may serve as a jumping off point for future studies focused on how risk communication strategies may affect consumer acceptance of other emerging food technologies.

Pre-Implementation Perceptions Among Teachers on the Use of Ecological Sanitation and Application of Human Urine as Fertilizer

Although human urine contains nutrients for plant growth, very few community schools in Nepal use a urine diversion dry toilet (UDDT) and apply the human urine as fertilizer in their school garden. Using human urine in agriculture reduces the use of chemical fertilizers, thus saving the expenditure associated with it. Application of human urine improves the soil fertility and may contribute to increased food security among school children if the school can supply the canteen with food for mid-day meals. This study adopted a Participatory Action Research (PAR) approach in order to understand stakeholder perspectives and involve them in the planning and implementation of urine diverting toilets. The data for this study were collected from five teachers’ focus group discussions. This paper presents teachers’ perceptions of the urine diversion dry toilet system and use of human urine as a fertilizer for the school garden. Only a few teachers accepted that human urine could be used as fertilizer, however, they were not willing to use it on their crops since it was considered impure. Due to a perceived bad odor and the uncomfortable sitting position on the UDDT, particularly for females, teachers disliked this toilet and they felt using urine as fertilizer was unnecessary. One of the key lessons drawn from the study is that schools, in collaboration with local governments, should employ participatory approaches to understanding and engaging local stakeholders, including teachers, to minimize negative perceptions prior to the application of human urine as fertilizer in the school garden.