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379
SAFETY OF OPTICAL URETHROTOMY UNDER SPONGIOSUM BLOCK
$WKHU+=HKUL$$ The Aga Khan University Hospital, Dept. of Surgery, Section of Urology, Karachi, Pakistan, 2The Aga Khan University Hospital, Dept. of Surgery, Karachi, Pakistan
1
Introduction & Objectives: 2SWLFDO XUHWKURWRP\ LV VWDQGDUG WUHDWPHQW IRU PRVW VKRUWXUHWKUDOVWULFWXUHVLWLVJHQHUDOO\SHUIRUPHGXQGHUJHQHUDORUPDMRUUHJLRQDO DQHVWKHVLD:HGHWHUPLQHGWKHVDIHW\DQGHᚑFDF\RIRSWLFDOXUHWKURWRP\XVLQJD VSRQJLRVXPEORFNIRUDQWHULRUXUHWKUDOVWULFWXUHLQDFRPSDUDWLYHQRQUDQGRPL]HG VWXG\ Material & Methods: ,Q SDWLHQWV ZLWK DQWHULRU XUHWKUDO VWULFWXUH RSWLFDO XUHWKURWRP\ZDVSHUIRUPHGXQGHUJHQHUDOPDMRUUHJLRQDODQHVWKHVLDLQSDWLHQWV JURXS RU XVLQJ D VSRQJLRVXP EORFN LQ JURXS ,Q JURXS D WRWDO RI WR PO OLGRFDLQH ZDV VORZO\ LQMHFWHG LQWR WKH JODQV SHQLV 6WDQGDUG RSWLFDO XUHWKURWRP\ ZDV SHUIRUPHG LPPHGLDWHO\ ZLWK D FROG FXW NQLIH 3DLQ VFRUH XVLQJ 9$6ZDVGHWHUPLQHGLQWKHUHFRYHU\URRP(ᚑFDF\RIWUHDWPHQWDVVHVVHGDW DQG PRQWKV XVLQJ XURᚐRZPHWU\ 7KH WRWDO RSHUDWLYH WLPH ZDV FDOFXODWHG IURP WKHWLPHWKHSDWLHQWZDVZKHHOHGLQWKHRSHUDWLQJURRPWLOOWKHWLPHKHZDVZKHHOHG RXW Results: 7KHJURXSVZHUHPDWFKLQJLQWHUPVRISDWLHQWDJHDQGVWULFWXUHFDXVH DQGOHQJWK2SWLFDOXUHWKURWRP\ZDVVXFFHVVIXOO\FRPSOHWHGLQDOOSDWLHQWVLQJURXS DQGLQRILQJURXS,QJURXSSDWLHQWV KDGQRSDLQRUGLVFRPIRUW 2QH SDWLHQW UHSRUWHG PRGHUDWH GLVFRPIRUW DQG WKH SURFHGXUH ZDV DEDQGRQHG ,QJURXSQRQHRIWKHSDWLHQWVUHTXLUHGSDUHQWDODQDOJHVLDSRVWSURFHGXUH7KH ᚏUVW \HDU UHFXUUHQFH ZDV QRW VLJQLᚏFDQWO\ GLᚎHUHQW LQ WKH JURXSV S 7KH DQHVWKHWLF HᚎHFW ODVWHG IRU DERXW DQ KRXU DQG ZDV VDWLVIDFWRU\ ZLWKRXW DQ\ FRPSOLFDWLRQV3DLQVFRUHRQWKHYLVXDODQDORJXHVFDOHZDVQRWGLᚎHUHQWLQWKH JURXSV7KHWRWDORSHUDWLYHWLPHZDVVKRUWHULQJURXSS Conclusions: 2SWLFDO XUHWKURWRP\ XVLQJ D VSRQJLRVXP EORFN LV DV VDIH DQG HᚎHFWLYHDVXVLQJUHJLRQDORUJHQHUDODQHVWKHVLDSDUWLFXODUO\LQSDWLHQWVZKRDUH PRUHLOO7KHVKRUWHURSHUDWLYHWLPHLQWKHORFDODQHVWKHVLDJURXSFRXOGDOVRPDNH LWFRVWHᚎHFWLYH
380
MINIMIZING THE RISK OF RECURRENCE OF URETHRAL STRICTURES AND URINE INCONTINENCE DURING SURGERY FOR LONG POSTERIOR URETHRAL STRICTURES
.RJDQ0,0LWXVRY99.UDVXOLQ99$IRNR$$/DYUXV0$7DPSXRUL-% Rostov State Medical University, Dept. of Urology, Rostov on Don, Russia Introduction & Objectives: 5HVHFWLRQRIORQJSRVWHULRUXUHWKUDOVWULFWXUHV/386 DQG F\VWRXUHWKURDQDVWRPRVLV ZLWKRXW SXEHFWRP\ LV TXLHW D GLᚑFXOW VXUJLFDO WHFKQLTXH6XFKVXUJHULHVKDYHDULVNRIUHFXUUHQWXUHWKUDOVWULFWXUHV586 DQGULVNRIXULQHLQFRQWLQHQFH Material & Methods: :HGLGDUHWURVSHFWLYHDQDO\VLVRILQWUDSHULQHDOUHVHFWLRQRI /386DQGF\VWRXUHWKURDQDVWRPRVLVIURPWRSDWLHQWVDJHGWR \HDUVZHUHLQFOXGHGLQWKLVVWXG\7KHDHWLRORJ\RI/386LQFOXGHGWUDXPDWLF UXSWXUH RI SURVWDWH DQG WKH QHFN RI WKH EODGGHU SDWLHQWV IDLOHG UHSDLU RIXUHWKUDOVWULFWXUHV UHWURSXELFSURVWDWHFWRP\ 7853IRU SDWLHQWVZLWK%3+ FDVHV/HQJWKRIVWULFWXUHWRFPPHDQ s /RFDOL]DWLRQ EXOERXUHWKUDO PHPEUDQRXV DQG SURVWDWLF QRW OHVV WKDQ WZR SDUWVRIWKHXUHWKUDDᚎHFWHGDWWKHVDPHWLPH RIWKHSDWLHQWVKDGF\VWRVWRPV )UHTXHQF\RISUHYLRXVVXUJHU\IURPWRWLPHV7RWDOQXPEHURIRSHUDWLRQV RSHUDWLRQVSHUSDWLHQW RSHQVXUJHU\HQGRVFRSLFVXUJHU\DQGGLODWLRQ RIWKHXUHWKUDZLWKEXJLHFDVHV$OOSDWLHQWVZHUHRSHUDWHGE\WKHVDPHWHDP $IWHUWKHUHVHFWLRQRIWKHVFDUWLVVXHVDQGPRELOL]DWLRQRIWKHEXOERXUHWKUDDQGWKH EODGGHUQHFNLQWKHSHULQHXPZHVXWXUHGWKHDQDVWRPRVLVXVLQJDQLQVWUXPHQW ZH GHVLJQHG NQRZQ DV ಯEXJLHQHHGOHರ 7KLV LQVWUXPHQW HQDEOHG XV WR SDVV WKH VXWXUHWKURXJKWKHEODGGHUQHFNORQJLWXGLQDOO\WRWKHH[WHQWRIWRFP2QWKH EODGGHUQHFNZHSODFHGVXWXUHVPRQRFU\O 7KHGLVWDOHQGRIWKHXUHWKUDZDV WKHQ VXWXUHGE\VWDQGDUG PHWKRGV7KLVPHWKRGHQDEOHG XVWRIRUP D PXVFXODU ಯPRXQGರIURPWKHGHWUXVRUZDOO Results: $OOWKHSDWLHQWVKDGWKHXUHWKURYHVLFDOVHJPHQWVUHWDLQHG7KHDYHUDJH WLPHIRUVXUJHU\ZDVsPLQXWHV0HDQOHQJWKRIWUHDWPHQWsGD\V SDWLHQWV KDG WRWDO LQFRQWLQHQFH RI XULQH DW WKH WLPH RI GLVFKDUJH 7KHUH ZHUH QR UHFXUUHQW VWULFWXUHV DIWHU \HDUV PRQLWRULQJ RI SDWLHQWV FRQVLGHUHGWKHPVHOYHVDVFRPSOHWHO\FXUHG1RWDVLQJOHSDWLHQWDIWHURQH\HDUಬV PRQLWRULQJFRPSODLQHGRIWRWDOXULQHLQFRQWLQHQFHRIWKHSDWLHQWVGHYHORSHG VWUHVV LQFRQWLQHQFH 6, EXW RQO\ FRPSODLQHG RI VRFLDO GLVFRPIRUW %HWWHUIXQFWLRQDOUHVXOWVZHUHVHHQZKHUH/386GHYHORSHGDVDUHVXOWRIWUDXPDWR
Eur Urol Suppl 2010;9(2):142
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381
DORSAL OR VENTRAL OR DORSAL PLUS VENTRAL BUCCAL MUCOSA GRAFT BULBAR URETHROPLASTY USING A VENTRAL SAGITTAL URETHROTOMY APPROACH
3DOPLQWHUL(%HUGRQGLQL('H1XQ]LR&%DUEDQWL*)UDQFR* *HQWLOH9 1 Center for Urethral and Genital Reconstructive Surgery, Dept. of Urethral Surgery, Arezzo, Italy, 2Hospital Sant’Andrea, Sapienza University, Dept. of Urology, Rome, Italy, 3Hospital of Siena, Dept. of Urology, Siena, Italy, 4Sapienza University, U.Bracci Dept. of Urological Sciences, Rome, Italy Introduction & Objectives: 7RUHYLHZWKHRXWFRPHRIGRUVDORUYHQWUDOJUDIWRU GRUVDO SOXV YHQWUDO GRXEOH JUDIW RI EXFFDO PXFRVD %0 LQ EXOEDU XUHWKURSODVW\ XVLQJDYHQWUDOVDJLWWDOXUHWKURWRP\DSSURDFK Material & Methods: 2ISDWLHQWVZLWKEXOEDUXUHWKUDOVWULFWXUHVZKRXQGHUZHQW RQHVWDJH %0 JUDIW XUHWKURSODVW\ XVLQJ D YHQWUDO VDJLWWDO XUHWKURWRP\ DSSURDFK XQGHUZHQW GRUVDO JUDIW XUHWKURSODVW\ '*8 XQGHUZHQW YHQWUDO JUDIW XUHWKURSODVW\ 9*8 DQG XQGHUZHQW GRUVDO SOXV YHQWUDO JUDIWXUHWKURSODVW\'9*8 &OLQLFDORXWFRPHZDVFRQVLGHUHGDIDLOXUHZKHQDQ\ SRVWRSHUDWLYHSURFHGXUHZDVQHHGHGLQFOXGLQJGLODWLRQ7KHQRQSDUDPHWULF&KL VTXDUHWHVWZDVXVHGIRUVWDWLVWLFDODQDO\VLV Results: )ROORZXSZDVDWOHDVW\HDUPHDQPRUDQJHWR 2I FDVHV ZHUH VXFFHVVIXO DQG IDLOXUHV 2I '*8V ZHUHVXFFHVVIXODQG IDLOXUHV2I9*8V ZHUH VXFFHVVIXODQG IDLOXUHV2I'9*8V ZHUHVXFFHVVIXODQG IDLOXUHV1RVWDWLVWLFDOO\VLJQLᚏFDQWGLᚎHUHQFHZDVGHWHFWHGDPRQJWKH JURXSVS EXWVXFFHVVUDWHVKRZHGWRGHFUHDVHZLWKWKHVWULFWXUHOHQJWK Conclusions: %0JUDIWEXOEDUXUHWKURSODVWLHVVKRZHGDQRYHUDOOVXFFHVV UDWH%0JUDIWVFDQEHSODFHGRQWKHGRUVDORUYHQWUDORUGRUVDOSOXVYHQWUDOXUHWKUDO VXUIDFH GHSHQGLQJ RQ WKH VWULFWXUH ORFDWLRQ DQG LWV FKDUDFWHULVWLF 7KH YHQWUDO VDJLWWDOXUHWKURWRP\DSSURDFKLVHDV\WRSHUIRUPDQGDOORZVWRRSWLQWUDRSHUDWLYHO\ IRU DQ\ RQH RI WKH GLᚎHUHQW JUDIW SODFHPHQWV ZKLFK VKRZHG D VLPLODU VXFFHVV UDWH
382
TWO STAGE HYPOSPADIAS CRIPPLES BUCCAL MUCOSA GRAFT REPAIR
*LQJX&3DWUDVFRLX6&KLEHOHDQ&6XUFHO&+DU]D00DQX0$=RJDV 9'RPQLVRU/&HUHPSHL97LFD'%DOVDQX&6LQHVFX, Fundeni Clinical Institute, Center of Urological Surgery, Dialysis and Renal Transplantation, Bucharest, Romania Introduction & Objectives: &RPSOLFDWLRQVDIWHUIDLOHGK\SRVSDGLDVVXUJHU\FRXOG EHVHYHUHLQFOXGLQJDQWHULRUXUHWKUDOVWULFWXUHVZLWKREVWUXFWLRQLQXULQHDQGVHPHQ HOLPLQDWLRQXUHWKUDOᚏVWXODXUHWKUDOOLWKLDVLVXUHWKULWLVUHFXUUHQW87,WKHWUHDWPHQW RI WKHVH FDVHV EHLQJ H[WUHPHO\ GLᚑFXOW 7KH XUHWKUDO UHFRQVWUXFWLRQ UHTXLUHV FRPSOHWH H[FLVLRQ RI WKH VFDUHG ORFDO WLVVXHV DQG XVH RI H[WUDJHQLWDO WLVVXHV IRU UHSDLU Material & Methods: %HWZHHQ-DQXDU\DQG-DQXDU\ZHKDYHSHUIRUPHG XUHWKURSODVWLHVIRUK\SRVSDGLDVFULSSOH,QFDVHVWKHXUHWKUDOSODWHDQGORFDO WLVVXHVZHUHVFDUUHGSRRUYDVFXODUL]HGLQIHFWHGRUZLWKKDLUJURZWKDQGOLWKLDVLV UHTXLULQJFRPSOHWHH[FLVLRQDQGWZRVWDJHXUHWKURSODVW\$OOWKHFDVHVKDGEHWZHHQ IDLOHG RSHUDWLRQV VFURWDO DQG SUHSXFH ᚐDSV RU 6QRGJUDVV RSHUDWLRQ :H XVHGEXFFDOPXFRVDKDUYHVWHGIURPWKHFKHFNIRUWKHᚏUVWVWDJH$IWHUDPLQLPXP PRQWKVLQWHUYDOZHSHUIRUPHGWKHVHFRQGVWDJHದJUDIWWXEXODUL]DWLRQ9HQWUDORU GRUVDOGDUWRVᚐDSVZHUHPRELOL]HGIRUZDWHUSURRᚏQJWKHVXWXUHOLQH Results: 7KH ᚏUVW VWDJH FRPSOLFDWLRQV ZHUH JUDIW VKULQNDJH RU JUDIW QHFURVLV UHTXLULQJ SDUWLDO UHJUDIWLQJ LQ FDVHV 7KH VHFRQG VWDJH FRPSOLFDWLRQV ZHUH VNLQ QHFURVLV ZLWK ᚏVWXOD DQG JODQV GHKLVFHQFH LQ FDVHV 7KH VROYLQJRIWKHVHFDVHVUHTXLUHGDQRWKHURQHWZRWKUHHRUPRUHRSHUDWLRQV)LQDO UHVXOWV DIWHU FRPSOLFDWLRQ PDQDJHPHQW ZHUH JRRG IURP IXQFWLRQDO SRLQW RI YLHZ DOOSDWLHQWVYRLGLQJHDVLO\ZLWKRXWSRVWYRLGLQJUHVLGXDOXULQH7KHFRVPHWLFUHVXOWV ZHUHJRRGLQFDVHVDQGVDWLVIDFWRU\LQFDVHV Conclusions: 'HVSLWHRIDKLJKUDWHRIFRPSOLFDWLRQVa LQRXUH[SHULHQFH WKH VWDJHG DSSURDFK UHSUHVHQWV D VDOYDJH VXUJHU\ ZLWK JRRG IXQFWLRQDO DQG FRVPHWLFRXWFRPHLQWKHWUHDWPHQWRIVHYHUHIRUPVRIK\SRVSDGLDVFULSSOHV)RU WKHEHVWUHVXOWVWKHSDWLHQWVPXVWEHUHIHUUHGWRWKHFHQWHUVH[SHULHQFHGLQXUHWKUDO UHFRQVWUXFWLYHVXUJHU\