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[PMID]: 29215339 [Au] Autor: Uçar M; Karagözlü Akgül A; Kiliç N; Balkan E [Ad] Endereço: Department of Pediatric Surgery, Division of Pediatric Urology, Uludag University School of Medicine, Bursa, Turkey. [Ti] Título: The Association of Congenital Urethral Duplication and Double Megalourethra. [So] Source: Balkan Med J;34(6):572-575, 2017 12 01. [Is] ISSN: 2146-3131 [Cp] País de publicação: Turkey [La] Idioma: eng [Ab] Resumo: BACKGROUND: Urethral duplication and megalourethra are rare urethral anomalies. However, the concomitance of urethral duplication and double megalourethra has not been reported previously. CASE REPORT: A newborn was presented with penile swelling during voiding. Physical examination revealed a retractable foreskin and two external meatus of a double urethra. Retrograde urethrography demonstrated two complete megalourethras. Urethro-urethrostomy and urethroplasty were performed when the patient was 10 months old. The patient was followed up for one year without any urinary problems and has good cosmetics and urinary continence. CONCLUSION: The concomitance of these two rare anomalies and more importantly its surgical treatment makes this case report unique and valuable. [Mh] Termos MeSH primário: Uretra/anormalidades Uretra/cirurgia Doenças Uretrais/cirurgia Transtornos Urinários/cirurgia Procedimentos Cirúrgicos Urológicos [Mh] Termos MeSH secundário: Anormalidades Múltiplas/diagnóstico por imagem Anormalidades Múltiplas/fisiopatologia Anormalidades Múltiplas/cirurgia Seguimentos Seres Humanos Recém-Nascido Masculino Doenças Raras Resultado do Tratamento Uretra/diagnóstico por imagem Uretra/fisiopatologia Doenças Uretrais/diagnóstico por imagem Doenças Uretrais/fisiopatologia Transtornos Urinários/diagnóstico por imagem Transtornos Urinários/fisiopatologia Urografia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171208 [St] Status: MEDLINE [do] DOI: 10.4274/balkanmedj.2017.0471

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[PMID]: 28749039 [Au] Autor: Mukhtar BMB; Spilotros M; Malde S; Greenwell TJ [Ad] Endereço: Department of Urology, University College London Hospital at Westmoreland Street, London, UK. [Ti] Título: Ventral-onlay buccal mucosa graft substitution urethroplasty for urethral stricture in women. [So] Source: BJU Int;120(5):710-716, 2017 11. [Is] ISSN: 1464-410X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To present our outcomes of ventral-onlay buccal mucosa graft (BMG) substitution urethroplasty in treating female urethral stricture (FUS). PATIENTS AND METHODS: We conducted a review of a prospectively collected database of 22 consecutive women (median [range] age 50 [34-72] years) with urethral stricture who underwent ventral onlay BMG substitution urethroplasty after June 2012 and who had a minimum follow-up of 6 months (median 21.5, range 6-51 months). Data were analysed for stricture recurrence, change in median maximum urinary flow rate (Q ) and median post-void residual urine volume (PVR). Statistical analysis was performed using the Wilcoxon signed rank test, Student's t-test and the Mann-Whitney U-test. RESULTS: Freedom from stricture recurrence was achieved in 21/22 (95.5%) women. The median (range) Q significantly improved, increasing from 7 (3.5-11) to 18 (5-37) mL/s (P <0.05). The median (range) PVR was significantly reduced from 100 (0-300) to 15 (0-150) mL (P < 0.05). Short- and longer-term complication rates were low. One woman developed mild de novo stress urinary incontinence, which settled with conservative management by 6 months. CONCLUSIONS: Early and medium-term results indicate that ventral onlay BMG substitution urethroplasty is an excellent treatment for FUS that can avoid the need for the repeat procedures regularly required after traditional endoscopic management. [Mh] Termos MeSH primário: Mucosa Bucal/cirurgia Transplantes/cirurgia Transplantes/transplante Uretra/cirurgia Estreitamento Uretral/cirurgia Procedimentos Cirúrgicos Urológicos/métodos [Mh] Termos MeSH secundário: Adulto Idoso Feminino Seres Humanos Meia-Idade Complicações Pós-Operatórias Estudos Prospectivos Procedimentos Cirúrgicos Urológicos/efeitos adversos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170728 [St] Status: MEDLINE [do] DOI: 10.1111/bju.13970

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[PMID]: 29308838 [Au] Autor: Vasyutin IA; Lyundup AV; Viranov AZ; Butnaru DV; Kuznetsov SL [Ti] Título: Urethra Reconstruction with Tissue-Engineering Technology. [So] Source: Vestn Ross Akad Med Nauk;72(1):17-25, 2017. [Is] ISSN: 0869-6047 [Cp] País de publicação: Russia (Federation) [La] Idioma: eng [Ab] Resumo: Urethral stricture is a disease characterized by a pathological narrowing of the urethra. Treatment for this condition often requires surgery using autologous grafts (urethroplasty). It is common practice to use patient's own tissue like genital and extragenital skin, tunica vaginalis, buccal mucosa as a source of the graft. Alternative and safer approach is to use tissue-engineered graft created in a laboratory using patient's autologous cells and biocompatible matrix (scaffold). The article presents the up-to-date achievements in lab-created tissue-engineered graft, describes all components needed to build a tissue-engineered structure of the graft for urethroplasty, and summarizes authors' thoughts on advantages and disadvantages of various approaches to choose both cellular component and the matrix of future construction. The article reviews clinical studies conducted in the field of tissue engineering of the graft material for urethraplasty. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos Reconstrutivos Engenharia Tecidual/métodos Uretra/cirurgia Estreitamento Uretral/cirurgia Procedimentos Cirúrgicos Urológicos [Mh] Termos MeSH secundário: Seres Humanos Procedimentos Cirúrgicos Reconstrutivos/instrumentação Procedimentos Cirúrgicos Reconstrutivos/métodos Tecidos Suporte Transplantes/classificação Procedimentos Cirúrgicos Urológicos/instrumentação Procedimentos Cirúrgicos Urológicos/métodos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180220 [Lr] Data última revisão: 180220 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180109 [St] Status: MEDLINE [do] DOI: 10.15690/vramn771

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[PMID]: 29250970 [Au] Autor: Kliton J; Polgár C; Tenke P; Kovács G; Major T; Stelczer G; Ágoston P [Ad] Endereço: Sugárterápiás Központ, Országos Onkológiai Intézet Budapest, Ráth Gy. u. 7-9., 1122. [Ti] Título: [Image-guided radiotherapy for muscle invasive bladder cancer with intravesical lipiodol injection. A new option for bladder sparing treatment]. [Ti] Título: Izominvazív hólyagrák képvezérelt sugárkezelése intravesicalisan befecskendezett lipiodolos jelöléssel. A hólyagmegtartó kezelés új lehetosége.. [So] Source: Orv Hetil;158(51):2041-2047, 2017 Dec. [Is] ISSN: 0030-6002 [Cp] País de publicação: Hungary [La] Idioma: hun [Ab] Resumo: INTRODUCTION AND AIM: To implement lipiodol as a fiducial marker of the tumor bed for image-guided radiotherapy with simultaneous integrated boost technique as part of radiochemotherapy for muscle invasive bladder tumors. METHOD: Since April 2016, radiochemotherapy was performed in 3 male patients with muscle invasive, transitional cell bladder carcinoma. Prior to radiochemotherapy, tumor bed resection was performed for each patient, at the same time 10 ml of lipiodol solution was injected submucosally into the resection site, thus marking the tumor bed for escalated dose irradiation. During radiochemotherapy 51 Gy (1.7 Gy/die) to the pelvis, 57 Gy (1.9 Gy/die) to the whole bladder, and 63 Gy (2.1 Gy/die) to the lipiodol-labeled tumor bed was delivered with simultaneous integrated boost technique. The accuracy of the irradiation was controlled by daily kilovoltage CT. Early radiogenic urogenital and gastrointestinal side effects were recorded according to Radiation Therapy Oncology Group side-effects grading recommendation. RESULTS: Substantial perioperative side effect or toxicity were not observed during and after the injection of lipiodol. The prescribed dose was successfully delivered in all patients. Radiotherapy duration was 6 weeks. The lipiodol-labeled tumor bed was clearly visible on daily kilovoltage cone beam CT. In one patient grade II cystitis and proctitis was observed, another patient experienced only grade I cystitis. These complaints improved with symptomatic medication. In the third patient no significant side effect occurred. CONCLUSIONS: The injection of lipiodol into the bladder wall is a safe technique, without any perioperative toxicity or complication. The tumor bed demarcated by lipiodol was visible both on treatment planning and kilovoltage CTs. The total treatment time was shortened by 4 days. The treatment was well tolerated, early side effects were moderate, or slight. Orv Hetil. 2017; 158(51): 2041-2047. [Mh] Termos MeSH primário: Meios de Contraste/administração & dosagem Óleo Etiodado/administração & dosagem Radioterapia Guiada por Imagem/métodos Radioterapia de Intensidade Modulada/métodos Neoplasias da Bexiga Urinária/radioterapia [Mh] Termos MeSH secundário: Administração Intravesical Quimiorradioterapia Seres Humanos Masculino Procedimentos Cirúrgicos Urológicos/métodos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Contrast Media); 8008-53-5 (Ethiodized Oil) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180215 [Lr] Data última revisão: 180215 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171219 [St] Status: MEDLINE [do] DOI: 10.1556/650.2017.30904

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[PMID]: 29240331 [Au] Autor: Bretschneider CE; Nieto ML; Geller EJ; Palmer MH; Wu JM [Ti] Título: The Association of the Braden Scale Score and Postoperative Morbidity Following Urogynecologic Surgery. [So] Source: Urol Nurs;36(4):191-7, 2016 Jul-Aug. [Is] ISSN: 1053-816X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The Braden scale is a widely used tool to assess pressure ulcer risk. Preoperative Braden scores were significantly associated with postoperative morbidity among women undergoing urogynecologic surgery for stress incontinence and pelvic organ prolapse. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos em Ginecologia Prolapso de Órgão Pélvico/cirurgia Complicações Pós-Operatórias/epidemiologia Incontinência Urinária por Estresse/cirurgia Procedimentos Cirúrgicos Urológicos [Mh] Termos MeSH secundário: Fatores Etários Índice de Massa Corporal Comorbidade Feminino Fragilidade/epidemiologia Seres Humanos Modelos Logísticos Duração da Cirurgia Lesão por Pressão/epidemiologia Estudos Retrospectivos Medição de Risco Índice de Gravidade de Doença Fumar/epidemiologia Fumar Tabaco [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180123 [Lr] Data última revisão: 180123 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 171215 [St] Status: MEDLINE

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[PMID]: 29215517 [Au] Autor: Trabuco EC; Linder BJ; Klingele CJ; Blandon RE; Occhino JA; Weaver AL; McGree ME; Gebhart JB [Ad] Endereço: Divisions of Gynecologic Surgery and Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota; and the Department of Obstetrics and Gynecology, University of Missouri, Kansas City, Missouri. [Ti] Título: Two-Year Results of Burch Compared With Midurethral Sling With Sacrocolpopexy: A Randomized Controlled Trial. [So] Source: Obstet Gynecol;131(1):31-38, 2018 Jan. [Is] ISSN: 1873-233X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To evaluate 1- and 2-year urinary continence rates after Burch retropubic urethropexy compared with a retropubic midurethral sling for women with urinary incontinence undergoing sacrocolpopexy. METHODS: We conducted a planned secondary analysis of a multicenter, randomized, single-blind trial comparing Burch with a sling that enrolled participants from June 2009 to August 2013. Objective outcome measures of continence were assessed at 1- and 2-year follow-up through office visits and validated questionnaires. Overall continence was defined as a negative stress test, no retreatment for stress incontinence, and no self-reported urinary incontinence (International Consultation on Incontinence Questionnaire, Short Form, score, 0). Stress-specific continence was defined as fulfillment of the first two criteria and no self-reported stress-related incontinence. Primary outcomes were assessed with intention-to-treat and within-protocol analyses. Comparisons between groups were evaluated using χ or Fisher exact test. RESULTS: The two groups were similar in all measured baseline features. Outcome assessments at 2 years were available for 48 of 57 patients (84%) in the sling group and 45 of 56 patients (80%) in the Burch group. With intention-to-treat analysis, the sling group had significantly higher rates of overall continence than the Burch group (49% [28/57] vs 29% [16/56]; 95% CI for absolute risk difference 3.0-38.1; P=.03) at 1- but not 2-year follow-up (47% [27/57] vs 32% [18/56]; 95% CI for absolute risk difference -2.6 to 33.1; P=.10). The sling group had significantly higher rates of stress-specific continence than the Burch group at 1-year (70% [40/57] vs 46% [26/56]; 95% CI for absolute risk difference 6.1-41.4; P=.01) and 2-year (70% [40/57] vs 45% [25/56]; 95% CI for absolute risk difference 7.9-43.2; P=.006) follow-up. No difference was detected in prolapse recurrence, voiding dysfunction, antimuscarinic medication use, urgency incontinence, or patient satisfaction. CONCLUSION: Among women with baseline urinary incontinence undergoing sacrocolpopexy, the retropubic midurethral sling resulted in higher stress-specific continence rates than Burch retropubic urethropexy at 1- and 2-year follow-up. [Mh] Termos MeSH primário: Colposcopia/métodos Qualidade de Vida Slings Suburetrais Incontinência Urinária por Estresse/cirurgia Incontinência Urinária de Urgência/cirurgia [Mh] Termos MeSH secundário: Idoso Feminino Seguimentos Seres Humanos Meia-Idade Satisfação do Paciente/estatística & dados numéricos Medição de Risco Índice de Gravidade de Doença Método Simples-Cego Telas Cirúrgicas Fatores de Tempo Resultado do Tratamento Uretra/cirurgia Incontinência Urinária por Estresse/diagnóstico Incontinência Urinária de Urgência/diagnóstico Urodinâmica Procedimentos Cirúrgicos Urológicos/métodos [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180108 [Lr] Data última revisão: 180108 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171208 [St] Status: MEDLINE [do] DOI: 10.1097/AOG.0000000000002415

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[PMID]: 29245347 [Au] Autor: Kang SK; Cho KS; Kang DH; Jung HD; Kwon JK; Lee JY [Ad] Endereço: aDepartment of Urology, Severance HospitalbDepartment of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, SeoulcDepartment of Urology, Inha University School of Medicine, IncheondDepartment of Urology, Yongin Severance Hospital, Yonsei University Health System, YongineDepartment of Urology, Severance Check-Up, Yonsei University Health System, Seoul, Korea. [Ti] Título: Systematic review and meta-analysis to compare success rates of retrograde intrarenal surgery versus percutaneous nephrolithotomy for renal stones >2 cm: An update. [So] Source: Medicine (Baltimore);96(49):e9119, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: We performed a systematic review and meta-analysis comparing stone-free rates between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using updated, more reliable evidence. MATERIALS AND METHODS: Randomized controlled trials comparing RIRS and PCNL for >2 cm stones were identified from electronic databases. Stone-free rates for the procedures were compared by qualitative and quantitative syntheses (meta-analyses). Outcome variables are shown as risk ratios (RRs) with 95% confidence intervals (CIs). RESULTS: Eleven articles were included in this study. Most recently published studies exhibited relatively low quality during quality assessment. For the meta-analysis comparing success (stone-free) rates between PCNL and RIRS, the forest plot using the random-effects model showed an RR of 1.11 (95% CI 1.02-1.21, P < .014) favoring PCNL. After determining the among-study heterogeneity, subgroup analysis was performed of 9 studies with less heterogeneity: the stone-free rate of PCNL was superior to that of RIRS using a fixed-effect model (RR 1.07, 95% CI 1.01-1.14, P < .019) for these studies. CONCLUSIONS: RIRS can be a safe and effective procedure for selected patients with large renal stones. However, in this meta-analysis, the postoperative stone-free rate of PCNL was higher than that of RIRS in patients with >2 cm renal stones. [Mh] Termos MeSH primário: Cálculos Renais/cirurgia Procedimentos Cirúrgicos Urológicos/métodos [Mh] Termos MeSH secundário: Seres Humanos Nefrolitotomia Percutânea/métodos Ensaios Clínicos Controlados Aleatórios como Assunto [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180105 [Lr] Data última revisão: 180105 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171217 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009119

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[PMID]: 27778491 [Au] Autor: Raheem AA; Alatawi A; Kim DK; Sheikh A; Rha KH [Ad] Endereço: Department of Urology, Tanta University Medical School, Egypt. [Ti] Título: Feasibility of Robot - assisted Segmental Ureterectomy and Ureteroureterostomy in Patient with High Medical Comorbidity. [So] Source: Int Braz J Urol;43(4):779-780, 2017 Jul-Aug. [Is] ISSN: 1677-6119 [Cp] País de publicação: Brazil [La] Idioma: eng [Ab] Resumo: INTRODUCTION AND OBJECTIVES: Nephroureterectomy remains the gold standard treatment option for upper tract tumors. However, segmental ureterectomy may be another option in patients with single kidney, borderline renal function or high medical comorbidities. The aim of this video is to assess the feasibility of robotic surgery as a minimally invasive technique in treatment of a high comorbid patient with ureteric tumor. MATERIALS AND METHODS: Eighty-year old male patient, with a medical history of chronic hypertensive and uncontrolled Diabetes Mellitus, was referred to our department for treatment of ureteric tumor. Patient underwent robot-assisted radical prostatectomy 5 years ago. Patient's Charlson comorbidity index score was 9. Computed tomography showed a 2.5cm right ureteral luminal filling enhancing lesion at lower part of upper 1/3 ureter. We performed diagnostic flexible cystoscopy under local anesthesia to exclude associated lower urinary tract carcinoma, and bladder wash was negative for malignancy. Under general anesthesia patient underwent diagnostic flexible ureteroscopy to confirm mass location, and a retrograde pyelography to rule out additional tumors on the right collecting system. Then, the patient was placed in the full lateral flank position without Table flexion. Ports placement were inserted as follow: a "12mm" optical trocar at pararectal line superior and lateral to umbilicus, two "8mm" robotic trocars cranial and caudal to optical trocar (8cm distance), a "8mm" robotic trocar towards anterior superior ischial spine, and a "12mm" assistant trocar was inserted between umbilicus and pubic bone. The surgical steps are shown in the video. RESULTS: The procedure was performed easily. The total operative time and consol time were 100 and 60 minutes, respectively. Blood loss was 50ml. No reported intraoperative or postoperative complications. Notably, we took full precautions in case of intraoperative failure to complete the procedure successfully, nephroureterectomy was our second option. Postoperative serum creatinine was 1.2mg/dL and length of hospital stay was 2 days. The frozen biopsy showed that the tumor was resected with safe proximal and distal surgical margins. Final histopathology revealed high grade (G3) urothelial carcinoma (pT3), measures (1.3x1.2x0.2cm), associated with carcinoma in situ. CONCLUSION: We affirm that robotic segmental ureterectomy and ureteroureterostomy could be offered safely as a minimally invasive treatment for patients with ureteric tumors and high-risk medical comorbidities. It provides excellent perioperative outcomes and early oncological safety with regard to surgical margins. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos Robóticos/métodos Neoplasias Ureterais/diagnóstico Procedimentos Cirúrgicos Urológicos/métodos [Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais Comorbidade Seres Humanos Masculino Resultado do Tratamento Ureter/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171221 [Lr] Data última revisão: 171221 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161026 [St] Status: MEDLINE [do] DOI: 10.1590/S1677-5538.IBJU.2016.0026

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[PMID]: 29169446 [Au] Autor: Johnson SC; Smith ZL; Sack BS; Steinberg GD [Ad] Endereço: Department of Surgery, Section of Urology, The University of Chicago, 5841 South Maryland Avenue, MC-6038, Chicago, IL 60637, USA. Electronic address: scott.johnson@uchospitals.edu. [Ti] Título: Tissue Engineering and Conduit Substitution. [So] Source: Urol Clin North Am;45(1):133-141, 2018 Feb. [Is] ISSN: 1558-318X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Radical cystectomy (RC) with urinary diversion is associated with significant morbidity, much of which arises from the interposition of bowel segments in the urinary system. A tissue-engineered alternative for urinary diversion could dramatically reduce the perioperative and long-term morbidity associated with RC. Attempts at developing a tissue-engineered incontinent urinary conduit (TEUC) have involved mechanical scaffolds and promoting tissue growth within them. Despite some preclinical success, significant obstacles remain before a TEUC is ready for clinical use. A further understanding of tissue and materials engineering may help overcome these obstacles or help to develop a new approach to tissue engineering entirely. [Mh] Termos MeSH primário: Engenharia Tecidual Tecidos Suporte Procedimentos Cirúrgicos Urológicos [Mh] Termos MeSH secundário: Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171214 [Lr] Data última revisão: 171214 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171125 [St] Status: MEDLINE

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[PMID]: 28466617 [Au] Autor: Sukhotnik I; Aranovich I; Mansur B; Matter I; Kandelis Y; Halachmi S [Ad] Endereço: Department of Pediatric Surgery, Bnai Zion Medical Center, Haifa, Israel. [Ti] Título: Laparoscopic Surgery of Urachal Anomalies: A Single-Center Experience. [So] Source: Isr Med Assoc J;18(11):673-676, 2016 Nov. [Is] ISSN: 1565-1088 [Cp] País de publicação: Israel [La] Idioma: eng [Ab] Resumo: BACKGROUND: The traditional surgical approach to the excision of persistent urachal remnants is a lower midline laparotomy or semicircular infraumbilical incision. OBJECTIVES: To report our experience with laparoscopic/open urachus excision as a minimally invasive diagnostic and surgical technique. METHODS: This was a retrospective study involving patients who were diagnosed with persistent urachus and underwent laparoscopic/open excision. The morbidity, recovery, and outcomes of surgery were reviewed. RESULTS: Eight patients (males:females 6:2) with an age range of 1 month to 17 years underwent laparoscopic or open excision (six and two patients respectively). All patients presented with discharge from the umbilicus. Although three patients had no sonographic evidence of a patent urachus, diagnostic laparoscopy detected a patent urachus that was excised laparoscopically. The operative time of laparoscopic surgery ranged from 19 to 71 minutes (the last case was combined with bilateral laparoscopic inguinal hernia repair), and the mean duration of hospital stay was 2.0 ± 0.36 days. Pathological examination confirmed a benign urachal remnant in all cases. CONCLUSIONS: Laparoscopy is a useful alternative for the management of persistent or infected urachus, especially when its presence is clinically suspected despite the lack of sonographic evidence. The procedure is associated with low morbidity, although a small risk of bladder injury exists, particularly in cases of severe active inflammation. [Mh] Termos MeSH primário: Laparoscopia/métodos Úraco/cirurgia Procedimentos Cirúrgicos Urológicos/métodos [Mh] Termos MeSH secundário: Adolescente Criança Pré-Escolar Feminino Seres Humanos Lactente Tempo de Internação Masculino Duração da Cirurgia Estudos Retrospectivos Resultado do Tratamento Úraco/anormalidades Úraco/diagnóstico por imagem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171128 [Lr] Data última revisão: 171128 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170504 [St] Status: MEDLINE

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