scholarly journals Dorsally Placed Buccal Mucosal Graft Urethroplasty in Treatment of Long Urethral Strictures Using One-Stage Transperineal Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Kamyar Tavakkoli Tabassi ◽  
Alireza Ghoreifi
Keyword(s):  
Success Rate ◽  
Operative Procedure ◽  
Transmitted Disease ◽  
Lichen Sclerosus ◽  
Sexually Transmitted ◽  
One Stage ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
The Mean

Objectives. To evaluate the results of one-stage buccal mucosal urethroplasty in treatment of long urethral strictures. Methods. This retrospective study was carried out on 117 patients with long urethral strictures who underwent one-stage transperineal urethroplasty with dorsally placed buccal mucosal grafts (BMG). Success was defined as no need for any intervention during the follow-up period. Results. Among 117 patients with mean age of 39.55±15.98 years, the strictures were located in penile urethra in 46 patients (39.32%), bulbar urethra in 33 (28.20%) and were panurethral in 38 (32.48%). The etiology of the urethral stricture was sexually transmitted disease (STD) in 17 (14.53%), lichen sclerosus in 15 (12.82%), trauma in 15 (12.82%), catheterization in 13 (11.11%), transurethral resection (TUR) in 6 (5.13%), and unknown in 51 (43.59%). The mean length of strictures was 9.31±2.46 centimeters. During the mean followup of 18.9±6.7 months success rate was 93.94% in bulbar strictures, 97.83% in penile strictures, and 84.21% in panurethral strictures (P value: 0.061). Conclusions. The success rate of transperineal urethroplasty with dorsally placed buccal mucosal grafts is equal in different sites of strictures with different etiologies. So reconstruction of long urethral strictures may be safely and effectively performed at a simple single operative procedure using this method of urethroplasty.

scholarly journals Outcome of One Stage Urethroplasty Using Buccal Mucosa for Long Segment Urethral Stricture

2020 ◽  
Vol 18 (2) ◽  
pp. 68-73
Author(s):  
Md Sirajul Islam ◽  
Md Faisal Islam ◽  
Anamur Rashid Choudhury ◽  
Sarforaj Ali Khan ◽  
Pranashis Saha
Keyword(s):  
Retrospective Study ◽  
Physical Examination ◽  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Private Hospital ◽  
One Stage ◽  
Buccal Mucosal Graft ◽  
The Mean

Objective: To assess the outcome of one stage urethroplasty using buccal mucosa for long segment (>2cm) urethral stricture. Material & Method: This retrospective study was done in a private Hospital at Jessore from May, 2010 to October, 2012. Twenty nine patients were managed with one stage dorsal on lay buccal mucosal graft (BMG). Patients were followed up 3 monthly with history, physical examination and relevant investigations. The mean duration of follow up was 23 months. Result: The age of the patients ranged from18 years to 65 years with mean of 35years. The length of the stricture ranged from 2.5cm to 10 cm with mean length 5.5 cm. The mean duration operative period was 3.5 hours with range from 2 hours to 4.5 hours. Of the 29 patients, 15 patients (51.7%) had bulbar urethral stricture, 10 patients (34.5%) had penile urethral stricture and 4 patients (13.8) had pan urethralstricture. Success was defined as normal voiding without further procedure. The rate of recurrence noted in this study was 10.34%. Conclusion: One stage dorsal on lay BMG urethroplsaty is a reliable and satisfactory procedure for the management of long segment urethral stricture with minimum complication. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.68-73

scholarly journals Role of dorsal onlay buccal mucosal graft urethroplasty for long anterior urethral strictures

2021 ◽  
Vol 9 (10) ◽  
pp. 3110
Author(s):  
Vedamurthy Reddy Pogula ◽  
Ershad Hussain Galeti ◽  
Venkatesh Velivela ◽  
Bhargava Reddy Kanchi
Keyword(s):  
Statistical Difference ◽  
Age Groups ◽  
Factors Affecting ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Significant Difference ◽  
Dorsal Onlay ◽  
The Mean

Background: Treatment of the urethral strictures is challenging and with appropriate evaluation preoperatively and surgery planning it is possible to achieve good results. The objective of the study was to evaluate the efficacy of dorsal onlay buccal mucosal graft urethroplasty in treating long anterior urethral strictures.Methods: Between August 2018 to July 2019 a total of 25 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤ 7 cm, and > 7 cm), and site of the stricture were assessed as the factors affecting the success rate.Results: The clinical outcome as Success was defined as the patient not needing any form of urethral instrumentation postoperatively. The mean follow-up period was 18 months. Of 25 patients, 22 (92%) were successful and 3 (8%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p=0.21 and p=0.444). The statistical difference was significant for the site and length of the stricture by means of success (p=0.005 and p=0.025).Conclusions: Our results show stricture length and localization are the most important variables for good success. Because of less failure rate, single-stage dorsal onlay buccal mucosal graft urethroplasty may be offered as an alternative to staged urethroplasty in case of long urethral strictures.  

scholarly journals Revisiting One-Stage Urethroplasties for Distal Urethral Strictures

2021 ◽  
Vol 10 (24) ◽  
pp. 5905
Author(s):  
Matthias D. Hofer ◽  
Lauren Folgosa Cooley ◽  
Ayman Elmasri ◽  
Francisco E. Martins
Keyword(s):  
Surgical Technique ◽  
Operative Time ◽  
Scar Tissue ◽  
Urethral Reconstruction ◽  
One Stage ◽  
Urethral Strictures ◽  
Average Operative Time ◽  
The Mean ◽  
Flap Repairs

Background: Reconstructive approaches for distal urethral strictures range from simple meatotomy to utilizing grafts or flaps depending on the etiology, length and location. We describe a contemporary cohort of distal urethral strictures and report a surgical technique termed distal one-stage urethroplasty developed to address the majority of distal urethral strictures encountered. Methods: Thirty-four patients were included. The mean age was 56.7 years (range 15.7–84.9 years), the mean stricture length was 1.1 cm (0.5–1.5) and the mean follow-up was 42.5 months (28–61.3). Results: The vast majority of distal strictures (27/34 (79.4%)) were treated with our hybrid one-stage approach combining a distal urethral reconstruction with excision of the scar tissue without the need to use grafts or flaps. The average stricture length was 0.68 cm and average operative time was 24.43 min. Post-operative spraying was reported in a minority of patients (4/27 (14.8%)). The length of stricture and surgery were significantly longer in those 7/34 (20.6%) patients in whom grafts or flaps were used (2.88 cm and 154.8 min, respectively, p < 0.001 for both when compared to the hybrid one-stage approach). We noted 6/34 (17.6%) recurrences of distal urethral strictures, all of which were treated successfully with graft and flap repairs. Conclusions: The vast majority of distal urethral strictures are amenable to a distal one-stage urethroplasty, avoiding the use of grafts and/or flaps while achieving reasonable outcomes. This limited approach, at least initially, is associated with shorter operative time and time of catheter placement and avoids morbidity associated with graft or flap harvesting. Spraying of urine is seldomly encountered and comparable to other approaches addressing distal urethral strictures.

scholarly journals Outcomes of Dorsal and Ventral Buccal Graft Urethroplasty at a Tertiary Hospital in Uganda

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
S. Kaggwa ◽  
M. Galukande ◽  
H. Dabanja ◽  
H. Luweesi
Keyword(s):  
Success Rate ◽  
Buccal Mucosa ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Team Approach ◽  
Sexually Transmitted ◽  
Urethral Strictures ◽  
Sub Saharan ◽  
A Prospective Study

Purpose. Although the use of buccal mucosa in substitution urethroplasty has been practiced for some years, it has not been free of controversy over which surgical technique is the most appropriate to use. There is paucity of data in Sub-Saharan Africa about its success; this study presents the outcomes of dorsal and ventral buccal graft urethroplasty at a sub-Saharan tertiary hospital. Methods. This is a prospective study in which buccal mucosa was used for ventral and dorsal grafts; followup was up to two years. All patients provided informed written consent for the procedures. Results. Seventy-two patients with bulbar urethral strictures underwent buccal graft one-stage urethroplasty. Mean age was 55 years; etiology of the strictures was postinflammatory due to urethritis from sexually transmitted infections 97% (70/72) and trauma 3% (2/72). Buccal mucosa grafts were harvested from the cheek using a two-team approach. Grafts were placed on the ventral and dorsal urethral surfaces in 32 and 40 cases, respectively; the success rate was 84 and 80%, respectively. Repeated urethroplasty was successfully done among 10% (7/72) and patients reported resolution of symptoms in the follow-up period. Conclusion. There was no difference between dorsal and ventral onlay buccal graft outcomes for bulbar urethral strictures. The success rate was 80 to 84%.

scholarly journals Outcome of OMG Urethroplasty by Asopa, Barbagli and Kulkarni Technique for Management of Anterior Urethral Stricture : Are Results Affected by the Surgical Technique?

2020 ◽  
Vol 19 (1) ◽  
pp. 23-27
Author(s):  
Md Shariful Islam ◽  
Md Asaduzzamman ◽  
Md Ruhul Quddus ◽  
Waliul Islam ◽  
Pranashis Saha
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Urethral Stricture ◽  
Significant Variation ◽  
Operative Procedure ◽  
Lichen Sclerosus ◽  
Team Approach ◽  
Anastomotic Site ◽  
Stricture Recurrence

Objective: To determine outcome of OMG urethroplasty by different surgical technique comparing ASOPA, BARBAGLI and KULKARNI TECHNIQUE in the management of anterior urethral stricture. Materials and Methods: A total of 62 patients with an average age of 42 yr(21-55) underwent OMG urethroplasty between 2008 to 2015 for anterior urethral stricture of different etiology. 2 patient lost durig follow up patient with lichen sclerosus and failed hypospadias were not included. OMG was always harvested from cheek using 2 team approach graft were placed using surgical technique of ASOPA, BARBAGLI and KULKARNI technique in 21,27 and 12 patients respectively clinical outcome was considered success or failure at the time any post operative procedure needed mean follow up was 45 month (6-95) Results: Out of 60 cases 51(85%) considered success and 9(15%) were considered failure. success rate were 85.7%,85%,and 83.5% in ASOPA, BARBAGLI and KULKARNI Technique and failure rate were 14.3%,15% and 16.7% respectively. Failure involve in the anastomotic site (2 in distal and 3 in proximal) were managed by OIU and involving whole length in 3 patient managed with staged urethropllasty. Conclusion: In our series, success rate of ASOPA, BARBAGLI and KULKARNI technique has no statistically significant variation. more over stricture recurrence was uniformly distributed in all group. so the outcome is not significantly affected by different technique used in OMG urethroplasty for anterior urethral stricture. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.23-27

RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

2011 ◽  
pp. 100-104
Author(s):  
Thi Thu Nguyen ◽  
Viet Hien Vo ◽  
Thi Em Do
Keyword(s):  
Success Rate ◽  
Key Words ◽  
Triamcinolone Acetonide ◽  
Lower Eyelid ◽  
Upper Eyelid ◽  
Interventional Trial ◽  
The Mean ◽  
First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

Surgical correction of severe congenital ptosis using a modified frontalis muscle advancement technique: A single-arm trial

2021 ◽  
pp. 112067212199575
Author(s):  
Lei Zhang ◽  
Mingyu Ren ◽  
Yuqing Yan ◽  
Wenjuan Zhai ◽  
Lihong Yang ◽  
...  
Keyword(s):  
Success Rate ◽  
Advancement Flap ◽  
Orbicularis Muscle ◽  
Congenital Ptosis ◽  
Inferior Margin ◽  
Field Of Vision ◽  
Vertical Incision ◽  
Registration Number ◽  
The Mean

Purpose: To describe our experience with a modified frontal muscle advancement flap to treat patients with severe congenital ptosis. Methods: Analysis of the clinical charts of 154 patients who underwent a modified frontal muscle advancement flap. The FM was exposed by a crease incision. The FM flap was created by deep dissection between the orbicularis muscle and orbital septum from the skin crease incision to the supraorbital margin and subcutaneous dissection from the inferior margin of the eyebrow to 0.5 cm above the eyebrow. No vertical incision was made on the FM flap to ensure an intact flap wide enough to cover the entire upper tarsal plate. Contour, symmetry of height, marginal reflex distance (MRD1), and complications were assessed. Mean follow-up was 10 months. Results: The mean patient age was 7.6 ± 5.6 (range, 2–18) years. The mean MRD1 was 3.2 ± 1.3 mm after the operation. All bilateral cases achieved symmetry and optimal lid contour; 17 unilateral cases were under corrected, with a success rate of 89.0%. Complications such as entropion, exposure keratitis, FM paralysis, frontal hypoesthesia, severe haematoma, and entropion were not observed in our series. Conclusion: A modified frontal muscle advancement flap produced a high success rate with a clear field of vision, mild trauma, and few complications. This technique is relatively simple and should be considered for correcting severe congenital ptosis. Date of registration: 29-03-2020 Trial registration number: ChiCTR2000031364 Registration site: http://www.chictr.org/

scholarly journals Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oriel Spierer ◽  
Abraham Spierer
Keyword(s):  
Young Children ◽  
Success Rate ◽  
Lateral Rectus ◽  
Intermittent Exotropia ◽  
Age At Surgery ◽  
Surgical Methods ◽  
Before And After ◽  
The Mean ◽  
Consecutive Esotropia

Abstract Background Different surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Methods The charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented. Results Mean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years. Conclusions In children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.

scholarly journals LONG-TERM OUTCOMES OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT FOR COMPLEX FISTULA-IN-ANO: MODIFIED OPERATIVE PROCEDURE EXPERIENCE

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Ke WEN ◽  
Yun-Fei GU ◽  
Xue-Liang SUN ◽  
Xiao-Peng WANG ◽  
Shuai YAN ◽  
...  
Keyword(s):  
Success Rate ◽  
Operative Procedure ◽  
Cleveland Clinic ◽  
Fistula Tract ◽  
Long Term Outcomes ◽  
Fistula In Ano ◽  
Complex Fistula ◽  
Intersphincteric Fistula

ABSTRACT Background: It is important but difficult to treat complex fistula-in-ano due to the high recurrent rate and following incontinence. Ligation of the intersphincteric fistula tract (LIFT), a novel surgical procedure with the advantage of avoiding anal incontinence, has a variable success rate of 57-94.4 %. Aim: To evaluate the long-term outcomes of modified LIFT operative procedure - ligation of intersphincteric fistula tract - to treat complex fistula-in-ano. Methods: Retrospective analysis of 62 cases of complex fistula-in-ano. The group was treated with the modified approach of LIFT (curved incision was made in the anal canal skin; purse-string suture was performed around the fistula; the residual fistulas were removed in a tunnel-based way) and had a follow-up time of more than one year. Patient´s preoperative general condition, postoperative efficacy and their anal function were compared. Results: The median age of the participants was 34, and 43 (69.4%) cases were male. Forty-one (66.1%) cases were of high transsphincteric fistula, four (6.5%) cases of high intrasphincter fistula, and 17 (27.4%) cases of anterior anal fistula in female. The median follow-up duration was 24.5 (range, 12-51) months. The success rate in the end of follow-up was 83.9% (52/62). The anorectal pressure and Cleveland Clinic Florida Fecal Incontinence (CCF-FI) evaluated three months before and after the operation did not find apparent changes. Conclusions: Compared with LIFT, the modified LIFT remarkably reduces postoperative failure and the recurrence rate of complex fistula with acceptable long-term outcomes.

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