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Dorsal free graft urethroplasty

PURPOSE Dorsal free graft urethroplasty was performed to reduce the incidence of urethrocele. MATERIALS AND METHODS We treated 12 patients with penile and 13 with bulbous strictures. Of the 13 patients with a bulbous stricture 6 received a dorsally placed tube graft and 7 received a patch graft. RESULTS Temporary fistulas were seen on postoperative urethrography in 5 cases but they all resolved spontaneously. At a mean followup of 35.8 months clinical and radiological findings were excellent in 23 cases and good in 2. No signs of graft weakening, such as post-void dribbling or diminished ejaculation, were apparent. CONCLUSIONS The use of free skin grafts for urethral reconstruction is anatomically healthier in the dorsal than in the ventral position.

Reoperative Surgery for Recurrent Strictures of the Penile and Bulbous Urethra

PURPOSE We evaluated the outcome of reoperation for anterior urethral strictures. MATERIALS AND METHODS Strictures that recurred after urethroplasty were repaired by various procedures in 20 patients (penile urethra in 8 and bulbous urethra in 12, mean followup 57 months). RESULTS Of the recurrent penile urethral strictures 3 showed excellent and 5 satisfactory results, compared to 9 and 3, respectively, for bulbous urethral strictures. Overall 60% of the cases had an excellent outcome and no failures were documented. CONCLUSIONS Any type of urethroplasty may fail even after a considerable period but reoperation with proper indications can offer a lasting solution.

Urinary incontinence after ischemic stroke: Clinical and urodynamic studies

To investigate the frequency, the prognostic effect on functional status and the urodynamic patterns of post‐stroke urinary incontinence (UI) in a sample of in‐patients affected by ischemic stroke.

Use of sigmoid colon in orthotopic neobladder reconstruction: Long-term results

To present our experience with a sigmoid orthotopic neobladder.

Duplications of the Bulbous Urethra: Clinicoradiologic Findings and Therapeutic Options

OBJECTIVES We evaluated the clinical and radiological aspects of isolated duplications of the bulbous urethra and assessed the results of surgical treatment. METHODS The experience with 11 male patients presenting with duplications of the bulbous urethra is reported. The duplications were incomplete in 7 cases and complete in 4, the accessory channel was ventral in 8 patients and dorsal in 3. The presenting symptoms were seldom indicative of the condition. Surgical treatment was performed in 10 cases and consisted in transurethral resection of the septum between the two channels in 2 patients, one-stage urethroplasty in 6 and two-stage urethroplasty in 2. RESULTS With a follow-up ranging between 1 and 4 years the results were considered satisfactory in 4 cases and excellent in 6. CONCLUSIONS Duplications of the bulbous urethra deserve careful evaluation of the cost-benefit ratio when surgical treatment is considered. The goal of reconstructive surgery, which can be open or transurethral, should be a functional urethral channel.

Undiversion with ileocecal segment following high transureteroureterostomy

A boy presenting with a small bladder and refluxing blind-ending ureteral stumps following multiple attempts at ureteral reimplantation and supravesical diversion with a high left-to-right transureteroureterostomy and right cutaneous ureterostomy underwent successful undiversion. Surgery consisted of bilateral ureterectomy and ileocecocystoplasty, with intussusception of the ileocecal valve and anastomosis of the ileal tail to the right renal pelvis.