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Id: biblio-1252244
Autor: Selvi, Ismail; Arik, Ali Ihsan; Basay, Mehmet Sinan; Basar, Halil.
Título: The effect of proliferative hypertrophic scars on determining treatment options for preventing recurrence of vesicourethral anastomotic stenosis after radical prostatectomy: a single-center cross-sectional study
Fonte: Säo Paulo med. j;139(3):241-250, May-June 2021. tab, graf.
Idioma: en.
Resumo: ABSTRACT BACKGROUND: Vesicourethral anastomotic stenosis (VUAS) following retropubic radical prostatectomy (RRP) significantly worsens quality of life. OBJECTIVES: To investigate the relationship between proliferative hypertrophic scar formation and VUAS, and predict more appropriate surgical intervention for preventing recurrent VUAS. DESIGN AND SETTING: Retrospective cross-sectional single-center study on data covering January 2009 to December 2019. METHODS: Among 573 male patients who underwent RRP due to prostate cancer, 80 with VUAS were included. They were divided into two groups according to VUAS treatment method: dilatation using Amplatz renal dilators (39 patients); or endoscopic bladder neck incision/resection (41 patients). The Vancouver scar scale (VSS) was used to evaluate the characteristics of scars that occurred for any reason before development of VUAS. RESULTS: Over a median follow-up of 72 months (range 12-105) after RRP, 17 patients (21.3%) had recurrence of VUAS. Although the treatment success rates were similar (79.5% versus 78.0%; P = 0.875), receiver operating characteristic (ROC) curve analysis indicated that dilatation using Amplatz dilators rather than endoscopic bladder neck incision/resection in patients with VSS scores 4, 5 and 6 may significantly reduce VUAS recurrence. A strong positive relationship was observed between VSS and total number of VUAS occurrences (r: 0.689; P < 0.001). VSS score (odds ratio, OR: 5.380; P < 0.001) and time until occurrence of VUAS (OR: 1.628; P = 0.008) were the most significant predictors for VUAS recurrence. CONCLUSIONS: VSS score can be used as a prediction tool for choosing more appropriate surgical intervention, for preventing recurrent VUAS.
Descritores: Estreitamento Uretral/cirurgia
Estreitamento Uretral/etiologia
Estreitamento Uretral/prevenção & controle
Cicatriz Hipertrófica
-Complicações Pós-Operatórias/prevenção & controle
Prostatectomia/efeitos adversos
Qualidade de Vida
Uretra/cirurgia
Estudos Transversais
Estudos Retrospectivos
Constrição Patológica
Recidiva Local de Neoplasia/prevenção & controle
Limites: Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-763044
Autor: Zequi, Stênio de Cássio.
Título: Editorial in This Issue
Fonte: Int. braz. j. urol;41(4):611-612, July-Aug. 2015.
Idioma: en.
Descritores: Procedimentos Cirúrgicos Urológicos/métodos
-Prostatectomia/métodos
Estreitamento Uretral/cirurgia
Litotripsia/métodos
Prolapso Uterino/cirurgia
Resultado do Tratamento
Procedimentos Cirúrgicos Robóticos
Contraindicações
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Editorial
Responsável: BR1.1 - BIREME


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Id: lil-742871
Autor: Lopez, Juan Carlos Regueiro; Gomez, Enrique Gomez; Carrillo, Alberto Alonso; Castiñeira, Roque Cano; Tapia, Maria Jose Requena.
Título: Perineostomy: the last oportunity
Fonte: Int. braz. j. urol;41(1):91-100, jan-feb/2015. tab, graf.
Idioma: en.
Resumo: Objective To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure. Material and methods We studied 17 patients who underwent perineal urethrostomy between 2009-2013 in a single hospital. Success was defined as no need for additional surgical treatment or urethral dilatation. We reviewed the clinical data related to age, weight, previous urethral surgery, diabetes, hypertension, ischemic cardiopathy, lichen sclerosus and other causes and studied their association with the procedure failure (univariate analysis). We completed the analysis with a multivariate test based on binary regression. Results The average follow-up was 39.41 months. From all the causes, we found Lichen Sclerosus in 35%, idiopathic etiology in 29% and prior hypospadia repair in 18%. Postoperative failure occurred in 3 patients, with a final success of 82.4%. The binary regression model showed as independent risk factors ischemic cardiopathy (OR: 2.34), and the presence of Lichen Sclerosis (OR: 3.21). Conclusions The success rate with the perineal urethrostomy technique shows it to be a valid option above all when we preserve the urethral blood supply and plate. Lichen sclerosus and ischemic vascular problems are risk factors to re-stenosis. .
Descritores: Períneo/cirurgia
Uretra/cirurgia
Estreitamento Uretral/cirurgia
Estomia/métodos
-Procedimentos Cirúrgicos Urológicos/métodos
Uretra/diagnóstico por imagem
Radiografia
Análise de Regressão
Reprodutibilidade dos Testes
Estudos Retrospectivos
Fatores de Risco
Análise de Variância
Seguimentos
Falha de Tratamento
Líquen Escleroso e Atrófico/complicações
Balanite Xerótica Obliterante/complicações
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Idoso
Idoso de 80 Anos ou mais
Responsável: BR1.1 - BIREME


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Id: lil-796888
Autor: Siegel, Jordan A; Morey, Allen F.
Título: The case for excision and primary anastomotic urethroplasty for bulbar urethral stricture
Fonte: Int. braz. j. urol;42(5):868-871, Sept.-Oct. 2016.
Idioma: en.
Descritores: Procedimentos Cirúrgicos Urológicos Masculinos/métodos
Uretra/cirurgia
Estreitamento Uretral/cirurgia
-Complicações Pós-Operatórias
Anastomose Cirúrgica/métodos
Resultado do Tratamento
Procedimentos Cirúrgicos Reconstrutivos/métodos
Limites: Animais
Masculino
Tipo de Publ: Editorial
Responsável: BR1.1 - BIREME


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Id: lil-785720
Autor: Prabha, Vikram; Devaraju, Shishir; Vernekar, Ritesh; Hiremath, Murigendra.
Título: Single stage: dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures using perineal route
Fonte: Int. braz. j. urol;42(3):564-570tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective To assess the outcome of single stage dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures (>4cm long) using a perineal incision. Materials and Methods From August 2010 to August 2013, 20 patients underwent BMG urethroplasty. The cause of stricture was Lichen sclerosis in 12 cases (60%), Instrumentation in 5 cases (25%), and unknown in 3 cases (15%). Strictures were approached through a perineal skin incision and penis was invaginated into it to access the entire urethra. All the grafts were placed dorsolaterally, preserving the bulbospongiosus muscle, central tendon of perineum and one-sided attachement of corpus spongiosum. Procedure was considered to be failure if the patient required instrumentation postoperatively. Results Mean stricture length was 8.5cm (range 4 to 12cm). Mean follow-up was 22.7 months (range 12 to 36 months). Overall success rate was 85%. There were 3 failures (meatal stenosis in 1, proximal stricture in 1 and whole length recurrent stricture in 1). Other complications included wound infection, urethrocutaneous fistula, brownish discharge per urethra and scrotal oedema. Conclusion Dorsolateral buccal mucosal urethroplasty for long anterior urethral strictures using a single perineal incision is simple, safe and easily reproducible by urologists with a good outcome.
Descritores: Períneo/cirurgia
Procedimentos Cirúrgicos Urológicos Masculinos/métodos
Estreitamento Uretral/cirurgia
Mucosa Bucal/transplante
-Complicações Pós-Operatórias
Uretra/cirurgia
Reprodutibilidade dos Testes
Resultado do Tratamento
Duração da Cirurgia
Tempo de Internação
Ilustração Médica
Pessoa de Meia-Idade
Limites: Humanos
Adolescente
Adulto
Adulto Jovem
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Id: lil-785744
Autor: Favorito, Luciano A.
Título: Bucal mucosa graft in long anterior urethral stenosis - dorsal or ventral?
Fonte: Int. braz. j. urol;42(3):407-408
Idioma: en.
Descritores: Uretra/cirurgia
Estreitamento Uretral/cirurgia
Mucosa Bucal/transplante
-Procedimentos Cirúrgicos Urológicos Masculinos/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Limites: Humanos
Masculino
Tipo de Publ: Editorial
Responsável: BR1.1 - BIREME


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Id: lil-782849
Autor: Akyuz, Mehmet; Sertkaya, Zulfu; Koca, Orhan; Caliskann, Selahattin; Kutluhan, Musab Ali; Karaman, Muhammet Ihsan.
Título: Adult urethral stricture: practice of Turkish urologists
Fonte: Int. braz. j. urol;42(2):339-345, Mar.-Apr. 2016. tab.
Idioma: en.
Resumo: ABSTRACT Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.
Descritores: Estreitamento Uretral/cirurgia
Estreitamento Uretral/diagnóstico
Urologistas/estatística & dados numéricos
-Turquia
Uretra/cirurgia
Urologia
Padrões de Prática Médica/estatística & dados numéricos
Inquéritos e Questionários
Estatísticas não Paramétricas
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Id: lil-782853
Autor: Akkoc, Ali; Aydin, Cemil; Kartalmis, Mahir; Topaktas, Ramazan; Altin, Selcuk; Yilmaz, Yakup.
Título: Use and outcomes of amplatz renal dilator for treatment of urethral strictures
Fonte: Int. braz. j. urol;42(2):356-364, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Introduction Urethral stricture disease is still a major problem in men. Many procedures are available for the treatment of urethral strictures; urethral dilatation is one of the oldest. The blind dilatation of urethral strictures may be a difficult and potentially dangerous procedure. The purpose of this study was to describe safe urethral dilatation using amplatz renal dilator and to report outcomes. Materials and Methods From 2010 to 2014, a total of 26 men with primary urethral strictures were managed by urethral dilatation using amplatz renal dilators. The parameters analyzed included presentation of patients, retrograde urethrography (RGU) findings, pre-and postoperative maximum flow rate (Qmax) on uroflowmetry (UF) and post-void residual urine (PVR). Patients were followed-up at 1.6 and 12 months. The technique described in this paper enables such strictures to be safely dilated after endoscopic placement of a suitable guidewire and stylet over which amplatz renal dilators are introduced. Results The mean age of the patients was 57.6 (35–72) years. The median stricture length was 0.82 (0.6–1.5)cm. Pre-operative uroflowmetry showed Qmax of 7.00 (4–12) mL/sec and ultrasonography showed PVR of 75.00 (45–195)mL. Postoperatively, Qmax improved to 18.00 (15–22)mL/sec (p<0.001) at 1 month, 17.00 (13–21)mL/sec (p<0.001) at 6 months and 15.00 (12–17)mL/sec (p<0.001) at 12 months. The post-operative PVR values were 22.50 (10–60)mL (p<0.001), 30.00 (10–70)mL (p<0.001) and 30.00 (10–70) mL (p<0.001) at 1.6 12 months, respectively. The median procedure time was 15.00 (12–22) minutes. None of the patients had a recurrence during a 12-month period of follow-up. Conclusion Urethral dilatation with amplatz renal dilators avoids the risks associated with blind dilatation techniques. This tecnique is a safe, easy, well-tolerated and cost-effective alternative for treatment of urethral strictures.
Descritores: Uretra
Estreitamento Uretral/terapia
Dilatação/instrumentação
-Período Pós-Operatório
Recidiva
Fatores de Tempo
Cateterismo Urinário/instrumentação
Cateterismo Urinário/métodos
Estudos Prospectivos
Reprodutibilidade dos Testes
Fatores de Risco
Seguimentos
Resultado do Tratamento
Estatísticas não Paramétricas
Dilatação/métodos
Desenho de Equipamento
Duração da Cirurgia
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Adulto
Idoso
Responsável: BR1.1 - BIREME


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Id: lil-782843
Autor: Tao, Huang; Jiang, Yu Yong; Jun, Qi; Ding, Xu; Jian, Duan Liu; Jie, Ding; Ping, Zhu Yu.
Título: Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate
Fonte: Int. braz. j. urol;42(2):302-311, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Projeto: Prospective research about the efficacy of individualized treatment in LUTS/BPH patients; . Research of SNPs in predicting the efficacy and progression of BPH patients receiving medication.
Resumo: ABSTRACT Purpose: To determine risk factors of postoperative urethral stricture (US) and vesical neck contracture (BNC) after transurethral resection of prostate (TURP) from perioperative parameters. Materials and Methods: 373 patients underwent TURP in a Chinese center for lower urinary tract symptoms suggestive of benign prostatic obstruction (LUTS/BPO), with their perioperative and follow-up clinical data being collected. Univariate analyses were used to determine variables which had correlation with the incidence of US and BNC before logistic regression being applied to find out independent risk factors. Results: The median follow-up was 29.3 months with the incidence of US and BNC being 7.8% and 5.4% respectively. Resection speed, reduction in hemoglobin (ΔHb) and hematocrit (ΔHCT) levels, incidence of urethral mucosa rupture, re-catheterization and continuous infection had significant correlation with US, while PSA level, storage score, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), resection time and resected gland weight had significant correlation with BNC. Lower resection speed (OR=0.48), urethral mucosa rupture (OR=2.44) and continuous infection (OR=1.49) as well as higher storage score (OR=2.51) and lower TPV (OR=0.15) were found to be the independent risk factors of US and BNC respectively. Conclusions: Lower resection speed, intraoperative urethral mucosa rupture and postoperative continuous infection were associated with a higher risk of US while severer storage phase symptom and smaller prostate size were associated with a higher risk of BNC after TURP.
Descritores: Complicações Pós-Operatórias/etiologia
Hiperplasia Prostática/cirurgia
Estreitamento Uretral/etiologia
Obstrução do Colo da Bexiga Urinária/etiologia
Contratura/etiologia
Ressecção Transuretral da Próstata/efeitos adversos
-Fatores de Tempo
Modelos Logísticos
Estudos Prospectivos
Fatores de Risco
Curva ROC
Resultado do Tratamento
Medição de Risco/métodos
Sintomas do Trato Urinário Inferior/cirurgia
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-782872
Autor: Temeltas, Gokhan; Ucer, Oktay; Yuksel, Mehmet Bilgehan; Gumus, Bilal; Tatli, Volkan; Muezzinoglu, Talha.
Título: The long-term results of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture disease
Fonte: Int. braz. j. urol;42(2):351-355, Mar.-Apr. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Aim: To evaluate the long term outcomes of temporary urethral stent placement for the treatment of recurrent bulbar urethral stricture. Materials and Methods: Twenty-eight patients who underwent temporary polymer coated urethral stent placement due to recurrent bulbar urethral stricture between 2010 and 2014 were enrolled in the study. The long term outcomes of the patients were analyzed. Results: The mean age of the patients was 62.3±6.4 (44–81). The overall clinical success was achieved in 18 (64.2%) of the 28 patients at a median (range) follow-up of 29 (7–46) months. No patient reported discomfort at the stent site. Stone formation was observed at the urethral stent implantation area only in one patient. Stenosis occurred in the distal end of the stents in two patients and took place in bulbar urethra in seven patients after removed the stents. The mean maximum urine flow rates were 6.24±2.81mL/sec and 19.12±4.31mL/sec before and at 3 months after the procedure, respectively. Conclusion: In this study, the success rate of temporary urethral stent placement has remained at 64.2% at a median follow-up of 29 months. Therefore, our outcomes have not achieved desired success rate for the standard treatment of recurrent bulbar urethral stricture.
Descritores: Uretra/cirurgia
Estreitamento Uretral/cirurgia
Stents
Implantação de Prótese/métodos
-Recidiva
Fatores de Tempo
Uretra/diagnóstico por imagem
Estreitamento Uretral/diagnóstico por imagem
Seguimentos
Resultado do Tratamento
Remoção de Dispositivo
Dilatação/métodos
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Idoso
Idoso de 80 Anos ou mais
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME



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