Ureteral Stricture after Laparoscopic Tubal Ligation due to Suturing of the Serosa

Strictures secondary to traumas of the ureter are some of the complications of urogynecologic surgery. We present a 43-year-old female who had a history of laparoscopic tubal ligation a year ago and was admitted to our department with recurrent flank and inguinal pain. It was soon understood that a suture has pulled the ureter from the lateral serosa of the upper part to the lateral serosa of the lower part causing dilatation of the proximal and midureter because of the previous surgery while there was no damage on the ureteral lumen. Consequently successful reconstruction was performed with open ureteroureterostomy

Tubularized incised plate urethroplasty results in patients with proximal hypospadias

Amaç: Proksimal hipospadyaslı primer vakalarda uygulanan “tubularized incised plate” üretroplasti (TIPU) tekniğinin klinik sonuçlarının değerlendirilmesini amaçladık. Yöntemler: Kliniğimizde 2003–2011 tarihleri arasında, eksternal üretral meatusu proksimal penil veya penoskrotal seviyede olan ve TIPU tekniğiyle onarım yapılan 33 primer hipospadyaslı vaka geriye dönük olarak değerlendirildi. Ameliyat sonrası fistülsüz işeme başarı olarak değerlendirildi. Bulgular: Hastaların ortalama yaşı 6,82±3,07 (1–13) idi. Hastaların 15’inde (%45,4) penoskrotal, 18’inde (%54,6) proksimal penil seviyede izlenen üretral meatus bulunmaktaydı. Hastalar üretral kateter çekildikten hemen sonra, taburcu edildikten 2 hafta ve 6 ay sonra idrar yaparken gözlemlenerek değerlendirildiler. İlk operasyon sonrası penoskrotal seviyede 5/15, proksimal penil seviyede 10/18 oranlarında fistülsüz işeme sağlandı; ilk operasyonlar sonrası genel başarı %45,5‘ti. Fistüllü işeyen hastalara yapılan ikinci operasyon ile bu oranlar penoskrotal seviyede 9/15, proksimal penil seviyede ise 16/18’e yükselmiş; total başarı oranı ise %75,8 bulunmuştur. Sonuç: Günümüzde ileri derecede kordisi olmayan proksimal hipospadyas olgularında üretral plate gelişiminde önemli bir bozukluk yoksa TIPU tekniği, deneyimli merkezlerde güvenle tercih edilebilecek bir yöntemdir.Objective: To evaluate the results of the patients with primary proximal hypospadias repaired by “tubularized incised plate” urethroplasty (TIPU). Methods: Thirty-three patients who were operated with TIPU technique in our clinic between 2003-2011 for primary hypospadias with proximal penile and penoscrotal meatus were retrospectively evaluated. Evaluation of the success in this study was, “voiding without fistula”. Results: Mean age was 6.82±3.07 (1-13). Fifteen patients (45.4%) had penoscrotal and 18 patients (54.6%) had proximal penil meatus. Postoperative success was evaluated with direct vision of voiding at the time of uncatheterization, 2 weeks and 6 months after un-catheterization. Success rates were 5/15 and 10/18 after the first repair in the level penoscrotal and proximal penil, respectively. Overall success rate was 45.5% after the first repair. Patients with urethral fistula after first repair were undergone second repair, success rates were increased to 9/15 and 16/18 in the levels of penoscrotal and proximal penil, respectively. Overall success rate after second repair was 75.8%. Conclusion: TIPU may be confidently applied for the patients with proximal hypopadias in experienced clinics, if there is not an uretral cordi or/and abnormality in the development of urethral plate