COMPARISON OF TUBULARIZED INCISED PLATE URETHROPLASTY AND ONLAY ISLAND FLAP URETHROPLASTY TECHNIQUES IN THE REPAIR OF PRIMARILY PROXIMAL HYPOSPADIAS

WOS: 000412261200009PubMed ID: 28976350OBJECTIVES: To compare the success of the 'tubularized incised plate urethroplasty' (TIPU)' and 'Onlay island flap urethroplasty' (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS: A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated hypospadias, who were operated on in the Department of Urology Ministry of Health Ankara Education and Research Hospital, between January 1997 and December 2012. Patients who underwent hypospadias surgery with TIPU were labelled as Group 1 and the OIFU technique as Group 2. Patient age, native meatus localization, operation time, diversion type, surgical success and complication rates were all assessed. Surgical success was evaluated with direct vision of voiding and uroflowmetry at the time of catheter removal, then at 2 weeks, 6 weeks, 6 months and 1 year. RESULTS: Group 1 consisted of 43 patients and Group 2 of 25 patients. The mean age of patients was 6.4-3.1 years in Group 1 and 8.0 +/- 4.6 years in Group 2 (p=0.09). The mean operating time was significantly lower in Group 1. (Group 1- 1 04.8 +/- 16.8 min, Group 2-1 25.4 +/- 24.7min; p<0.001) The distribution of meatus localization was similar in both groups. At 1 year postoperatively, urethrocutaneous fistula was the only complication and the definitive success rates were 81.6% in Group 1 and 72% in Group 2. CONCLUSION: Despite less frequent usage since the description and popularization of TIPU for proximal hypospadias repair, OIFU remains a valuable technique as a single-stage procedure in cases where the urethral plate is insufficient. Currently, both TIPU and OIFU are used successfully in the treatment of patients with proximal hypospadias

Does the Endoscopic Treatment of Lower Ureter Stones Affect Uroflowmetric Values? A Prospective Clinical Trial

WOS: 000325832600012PubMed ID: 24052067Objectives:The aim of this study was to document if stones at the lower ureter alter the micturition capability of the patients and to investigate whether endoscopic removal of these stones restores normal urinary flow rates or not in the 3 months of follow-up. Methods: Forty patients with lower ureteral stone (group 1) and 20 control subjects with proximal ureteral stone (group 2) were enrolled into the study. All patients underwent uroflowmetry testing before and 3 months after the treatment for endoscopic stone removal. The mean average and peak flow rates with a sufficient voided volume (>= 150 ml) were evaluated before and after surgery and compared between the groups. Results: Mean values of the peak flow rates before and after surgery were 20.3 and 27.5 ml/s in group 1 and 22.5 and 23.6 ml/s in group 2, and the mean average flow rate values before and after surgery were 10.5 and 13.6 ml/s in group 1 and 11.4 and 12.1 ml/s in group 2. Statistically significant differences were determined between before and after ureteroscopy values were determined in terms of average (p < 0.05) and peak flow rates (p < 0.01) in group I; however, there no significant difference was seen in the control group. Conclusion: We document for the first time in the literature that patients with lower ureteric stones have a reduction in their urinary stream which resolves with endoscopic removal of the stones. Copyright (C) 2013 S. Karger AG, Base

Can urinary nerve growth factor and bladder wall thickness correlation in children have a potential role to predict the outcome of non-monosymptomatic nocturnal enuresis?

Introductio

Outcomes of Laparoscopic Treatment Modalities for Unilateral Non-Palpable Testes

Purpose: To date, laparoscopy has gradually become the gold standard for treatment of NPT with different success and complication rates. In this study, we aimed to evaluate outcomes of laparoscopic approaches for NPT.Materials and Methods: We reviewed data of 82 consecutive patients who underwent laparoscopic treatment for unilateral NPT at two institutions by two high volume surgeons from 2004 January to 2014 December. Laparoscopic-assisted orchidopexy(LAO) and two stage Fowler-Stephens technique(FST) was performed for 45 and 37 patients, respectively. Age(at surgery), follow-up time, laterality of testes and post-operative complications were analyzed. Modified Clavien classification system(MCCS) was used for evaluating complications.Results: The median age (at surgery) and median follow-up time were 18(range: 6-56) and 60(range: 9-130) months, respectively. Overall success rate for two laparoscopy techniques was 87.8 % during the maximal follow-up time. We observed wound infection in 2, hematoma in one, testicular atrophy in 5, testicular re-ascending in 2 patients at follow-up period. There was no statistical difference between two laparoscopic techniques for grade 1(5 vs. 2 patients, p=0.14) and grade IIIb MCCS complications(1 vs. 2 patients, p=0.44).Conclusions: Our results have shown that two laparoscopic approaches have low complication rates