Abdulmalik M. Tayib

Novel augmentation ileocystoplasty technique to manage non- compliant bladders in the presence of obstructed megaureters: The "fez procedure"

To show the efficacy and safety of a novel modification of Studers neobladder, herein defined as the “fez procedure.”

Botulinum Toxin A Intradetrusor Injection for Treating Neurogenic Detrusor Overactivity, A Single Centre Experience

To evaluate the efficacy and safety of Botulinum Toxin A (BoNTA) intradetrusor injections in patients with neurogenic detrusor overactivity.

Laparoscopic Pyelolithotomy for Partial Staghorn Stones

Objective: To confirm the feasibility and safety of laparoscopic pyelolithotomy in partial staghorn stones. Patients and Methods: Seventeen patients who underwent laparoscopic pyelolithotomy for partial staghorn stone were included in the prospective study at King Abdulaziz University Hospital in the period between May 2007 and Feb 2009. Preoperatively all patients had blood work, urine culture, ultrasonography and CT renal stone study. Inclusion criteria included stones with largest diameter of more than 25 mm (measured by CT), branching into one or more group of calices, and no contraindication for laparoscopic surgery. All patients underwent cystoscopy, double J stent insertion prior to the procedure, while prophylactic antibiotics were provided for all the patients with or without positive urine culture. Results: All patients were completed laparoscopically where none required conversion to open surgery or developed intraoperative complications. The largest diameter of the stones varied between 29 and 48 mm with mean diameter of 41 mm, and the number of stones removed was 1–4 with mean of 1.3. The mean operative time was 175 minutes (range 125–240 minutes) and the estimated blood loss was 20–150 ml with mean of 49 ml. All patients cleared from their stones except 2 patients had small residual stones of 5 and 7 mm which were managed later by extracorporeal shock wave lithotripsy. One patient developed ileus postoperatively. Conclusion: Laparoscopic removal of partial staghorn stones is safe and feasible and has an equal outcome to open surgery.

Modified Stoma of Mitrofanoff Continent Diversion

Objective: To create a modified Mitrofanoff continent stoma with minimal incidence of stoma stenosis and incontinence. Materials and Methods: A new modified surgical technique was used to construct a catheterizable channel based on the Mitrofanoff principle at King Abdulaziz University Hospital in Jeddah. Twelve boys, 2 girls, and 1 adult were included in the study. The children’s ages varied between 6 and 13 years (mean 9 years) with different underlying etiologies, while the adult patient was 36 years old after several failed ure-throplasties. The ileal segment was isolated with its segmental blood supply, the channel constructed over 8, 10 or 12F catheters, and the selected ileal segment tapered over the catheter except for its distal part which was left tubularized, and a nipple technique was used to create the stoma. Twelve patients underwent simultaneous ileocystoplasty and 1 patient bladder neck closure. Results: Postoperative complications unrelated to stoma occurred in 5 patients including wound infection in 2 patients, metabolic acidosis with hy-perkalemia in 1 patient, vesicocutaneous fistula in 1 patient, and intestinal obstruction in 1 patient. Bladder emptying was easy to perform in 11 patients while 4 patients required recatheterization of the channel for an additional 14 days. Conclusion: Our modified surgical technique for construc-tion of a catheterizable stoma based on the Mitrofanoff principle was successful in creating a continent easy catheteriz-able non-stenotic stoma.

Cowper's syringocele (cyst of the bulbar urethra): a case report and literature review.

owper’s glands are two bulbourethral glands that lie superior to the perineal membrane and are invested in the broad base of the external urethral sphincter muscles. 1 During sexual excitement these glands secrete clear mucous into the bulbous urethra. A syringocele is a deformity in the male urethra in which there is a distention of the bulbourethral Cowper’s glands. In 1684, Merry described the bulbourethral gland. A complete description of the gland was published in 1699 by Cowper. 1 The syringocele was first described by Fenwick. 2 A literature review found that Cowper’s syringocele may be more common than currently realized. 3 We report a case of bulbous urethral cyst arising from the Cowper’s gland in a 34-year old male patient.