1/8. Treatment of anastomotic strictures and urinary incontinence after radical prostatectomy with urolume wallstent and AMS 800 artificial sphincter.Anastomotic strictures and urinary incontinence are severe complications after a radical prostatectomy. We report on two patients suffering from both complications. We treated the anastomotic stricture with a Urolume Wallstent and inserted an AMS 800 artificial sphincter prosthesis 4 to 6 months later for treating urinary incontinence. Finally, the patients were fully continent with no evidence of recurrent strictures.- - - - - - - - - - ranking = 1keywords = urinary incontinence, incontinence (Clic here for more details about this article) |
2/8. Successful closure of a bladder neck fistula complicated by urethral and vaginal stenosis, using oxidized cellulose (Surgicel) for reinforcement.We describe a case of a bladder neck fistula in a 25-year-old lady presenting with true urinary incontinence, vaginal constriction and induration, with vaginal length reduced to only 1.5 cm. There was an 8-mm fistula involving upper urethra and bladder neck, with fibrosis all around. Using Schuchardt incision, the fistula was reached and mobilization tried. As there was less available tissue, a 3 x 2-cm layer of oxidized cellulose was stitched between the bladder and the vaginal mucosa for reinforcement and to achieve a watertight closure of fistula.- - - - - - - - - - ranking = 0.16666666666667keywords = urinary incontinence, incontinence (Clic here for more details about this article) |
3/8. Technique and results of urethroplasty for female stricture disease.PURPOSE: urethral stricture disease in females is uncommon and is often treated with repeat dilation or internal urethrotomies. Various surgical techniques to repair strictures have been described with successful results. However, these techniques are cumbersome to use. The vaginal inlay flap is simple and easy to learn. To our knowledge this is the first report of its use and clinical results in a series of patients from 2 institutions. MATERIALS AND methods: Eight symptomatic women with a history of traumatic or difficult catheterization, a history of at least 1 urethral dilation or urethrotomy and difficult or a failed attempt at catheter placement underwent urethroplasty. The technique consisted of incising the posterior aspect of the stricture and advancing a vaginal inlay flap. A retrospective chart review was performed. RESULTS: Followup was 1 to 9 years. All patients had subjective relief of symptoms and could easily catheterize with a 14Fr catheter. Average caliber of the urethra increased from 9.25Fr to 16.5Fr and post-void residual urine decreased from 130 to 15 cc. One patient with a hypotonic bladder was in retention, which resolved during 3 months. One patient underwent repeat dilation once 3 weeks after the primary procedure with no recurrence. No patient had stress urinary incontinence. There were no immediate or delayed serious complications. CONCLUSIONS: urethral stricture disease in females is an uncommon entity that can cause voiding symptoms, recurrent infections, retention and renal impairment. This method of surgical repair offers a durable result and has a low incidence of complications.- - - - - - - - - - ranking = 0.16666666666667keywords = urinary incontinence, incontinence (Clic here for more details about this article) |
4/8. Complete urethral stricture of the membranous urethra: a different perspective.Seven patients with complete rupture of the membranous urethra secondary to trauma were treated by internal optical urethrotomy (OU). All underwent initial suprapubic catheter drainage. The diagnosis of complete urethral rupture was confirmed by ascending and descending urethrograms and subsequent urethroscopy. OU was performed 3 weeks to 8 years following injury. Although all patients required further OUs for recurrent strictures, all can pass urine satisfactorily. Two patients have slight stress incontinence. This technique is a viable alternative to more conventional procedures for this condition.- - - - - - - - - - ranking = 0.02275002946307keywords = incontinence (Clic here for more details about this article) |
5/8. Urethral strictures secondary to pelvic injury in children.Surgical repair of a membranous urethral stricture is difficult because of the location and potential risks of incontinence, impotence and infertility. The treatment of 2 such strictures by the Badenoch pull-through urethroplasty is presented. The technique is described and its apparent advantages over other methods of repair are discussed.- - - - - - - - - - ranking = 0.02275002946307keywords = incontinence (Clic here for more details about this article) |
6/8. Repair of obliterative vesicourethral stricture after radical prostatectomy: a technique for preservation of continence.We present the open surgical repair of complete obstruction of the bladder neck unresponsive to endoscopic management. By combining abdominal and perineal dissection, partial pubectomy, and omental wrapping, repeat anastomosis is possible without the need for bladder tubularization. Two patients have been repaired successfully. Although both men presented with indwelling suprapubic tubes and a defect of greater than 1.5 cm, they are now voiding normally at 18 and 7 months post-operatively without the need for pads, medication, or instrumentation. Complete obliteration of the bladder neck after radical prostatectomy can be functionally reconstructed. Postoperative continence will depend on the function of the membranous urethra. If incontinence occurs, this can be managed in a reconstructed open urethra.- - - - - - - - - - ranking = 0.02275002946307keywords = incontinence (Clic here for more details about this article) |
7/8. Sacral dysgenesis associated with occult spinal dysraphism causing neurogenic bladder dysfunction.A case of a neurogenic bladder in a 20-year-old man is described. The patient had difficulty in voiding and incontinence, with a history of several urinary infections. Misdiagnoses included stricture and posterior urethral valves. Early treatment included urethral dilation, a transurethral resection and a left ureteral implantation. Throughout this time the neurological examinations were essentially normal. Final diagnosis was sacral dysgenesis with associated occult spinal dysraphism, after the discovery of a small pock mark over the sacrum and an abnormal pelvic x-ray. urinary diversion was done.- - - - - - - - - - ranking = 0.02275002946307keywords = incontinence (Clic here for more details about this article) |
8/8. Repair of extensive traumatic membranous urethral disruption with endourethroplasty and artificial sphincter: case report.We report a case of extensive traumatic membranous urethral obliteration with a 4-cm gap that was successfully treated with a transperineal-transurethral puncture technique to reestablish urethral continuity in association with endourethroplasty to repair the long fibrotic gap. The injury also involved the bladder neck, and the patient had subsequent stress urinary incontinence. Because endourologic treatment of his stricture did not require mobilization of the bulbous urethra, an artificial sphincter was placed 13 months later without difficulty. The patient is continent and remains stricture free at 3 years. This case illustrates the potential of endourologic treatment for severe membranous urethral disruptions.- - - - - - - - - - ranking = 0.16666666666667keywords = urinary incontinence, incontinence (Clic here for more details about this article) |