Christopher C. Roth

Regional variations in small intestinal submucosa evoke differences in inflammation with subsequent impact on tissue regeneration in the rat bladder augmentation model.

To examine the histological differences in the inflammatory response and regenerative outcomes of distal vs proximal porcine small intestinal submucosa (SIS) grafts in the rat bladder, as SIS from distal small intestine yields reliable and reproducible bladder regeneration, while SIS from proximal portions of small intestine does not provide similar results.

Temporal differentiation and maturation of regenerated rat urothelium

To determine if porcine small intestinal submucosa (SIS)‐regenerated urothelium expresses markers of urothelial differentiation, uroplakin and zona occludens‐1 (ZO‐1), and whether their expression correlates with the histological appearance of the urothelium.

Body Mass Index as a Predictive Value for Complications Associated With Reconstructive Surgery in Patients With Myelodysplasia

PURPOSE Patients with myelodysplasia often have urological pathology, with 25% to 40% requiring reconstructive procedures to achieve urinary and/or fecal continence. Complication rates from these major reconstructive procedures range between 10% and 50%. Additionally many of these patients have significant comorbidities, including a nonambulatory status that leads to an increased body mass index. It is currently unknown whether a high body mass index is associated with increased surgical complications. In this study we compare body mass index and postoperative complications. MATERIALS AND METHODS We retrospectively reviewed the charts of all patients with myelodysplasia undergoing urinary or fecal reconstructive procedures. We analyzed data for body mass index and any documented complication occurring during hospitalization or at any time during followup. Patients were categorized based on body mass index as normal weight (less than 85th percentile), overweight (85th to 95th percentile) or obese (greater than 95th percentile). Statistical analyses using chi-square and Fishers exact tests were then performed. RESULTS Reconstructive procedures were carried out in 66 patients with myelodysplasia between 1997 and 2005. A total of 48 bladder augmentations were performed with a total of 101 stomas created. Mean followup was 39 months. Height and weight were available for body mass index calculation in 60 patients. Obesity was common in our patients with myelodysplasia, affecting 33% of the population (20 of 60 patients). We found a total of 53 complications in 31 patients (52%). There was a significant association between presence of complications and weight category, with complications occurring in 40% of normal weight, 40% of overweight and 75% of obese patients (p = 0.0380). An association between stomal stenosis and weight category was also found (p = 0.0373). In addition, multiple complications were more prevalent in obese patients. Of the 15 patients (25%) with 2 or more complications 10 (67%) were obese (p = 0.0066). CONCLUSIONS Patients with myelodysplasia have a high incidence of obesity. Since obesity is associated with a higher complication rate, weight loss programs are highly recommended for obese patients with myelodysplasia before and after any reconstructive surgery.

Successful Removal of a Penile Constriction Ring in a 14-Year-Old Male

Penile strangulation is a rarely described medical emergency, especially in the adolescent population. This case demonstrates the successful removal of a constricting metal ring from the penis of a 14-year-old male with a diamond blade equipped orthopedic oscillating saw while under ketamine anesthesia in the emergency department.

BLADDER REGENERATION IN A CANINE MODEL USING HYALURONIC ACID/POLY(LACTIC-CO-GLYCOLIC) ACID NANOPARTICLE-TREATED PORCINE SMALL INTESTINAL SUBMUCOSA

Christopher C. Roth*, Fadee G. Mondalek*, Yusuf Kibar † , Richard A. Ashley*, Cardin H. Bell*, John A. Califano*, Sundar V. Madihally , Dominic Frimberger*, Hsueh-Kung Lin* and Bradley P. Kropp* *Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, ‡ School of Chemical Engineering, Oklahoma State University, Stillwater, OK, USA, and † Department of Urology, Gulhane Military Medical Academy, Ankara, Turkey Accepted for publication 7 May 2010