Mohamad Salkini

The effect of sildenafil citrate on bladder outlet obstruction: a mouse model

To investigate if sildenafil citrate can inhibit the functional and structural changes of the detrusor in a murine model of bladder outlet obstruction (BOO). Phosphodiesterase type 5 (PDE‐5) inhibitors have recently been used for treating urinary symptoms associated with prostatic obstruction, but it is unclear whether PDE‐5 inhibition acts on the prostatic urethra or the bladder.

Angiotensin II plays a role in acute murine experimental autoimmune cystitis

To investigate whether angiotensin II (AII) receptor antagonism decreases the inflammation and oedema in acute murine experimental autoimmune cystitis (EAC), as interstitial cystitis (IC) might have an autoimmune component and AII has been implicated in autoimmune‐mediated vascular congestion, oedema and scarring.

Chronic sacral nerve stimulation prevents detrusor structural and functional changes associated with bladder outlet obstruction--a rat model.

Bladder outlet obstruction (BOO) can mediate structural and functional detrusor changes, which can lead to bothersome lower urinary tract symptoms. We investigate if sacral nerve stimulation (SNS) can prevent these structural and functional changes in a rat model of BOO.

Motion Planning System for Minimally Invasive Surgery

Minimally invasive procedures are highly effective when performed by well trained surgeons. However, with the subjective nature of surgical training and performance assessment, it is difficult to determine when a trainee surgeon has attained a satisfactory level of competency. We propose a computer-based training and performance assessment system where we apply configuration space based techniques to determine optimal paths for the maneuver of surgical instruments to perform predefined tasks

MP24-02 ROBOTIC NEOCYSTOSTOSTOMY WTIH URETERAL SUBSTITUTION WITH ROBOTIC BOARI FLAP, FEASIBILTY AND OUTCOME

INTRODUCTION AND OBJECTIVES: Buccal mucosa is wellsuited for grafting in the urinary tract as it is compatible with a wet environment, has a thick epithelium that facilitates tissue handling, and has a highly vascular lamina propria that promotes imbibition and inosculation. Despite this, the use of buccal mucosa grafts in ureteral reconstruction has been limited. We report our multi-institutional experience with robotic ureteroplasty with buccal mucosa graft. METHODS: We retrospectively reviewed 25 patients who underwent robotic ureteroplasty with buccal mucosa graft by three primary surgeons at three institutions between October 2013 and October 2016. Indication for the procedure was a proximal or mid ureteral stricture not amenable to primary anastomosis secondary to length of stricture or extensive fibrosis. On follow-up, patients were assessed for: clinical success, the absence of symptoms from ureteral pathology; and radiological success, the absence of ureteral obstruction on imaging, which included renal scan, CT urogram, and/or ultrasound. RESULTS: In 21/25 (84.0%) cases, the diseased ureter was incised and a buccal mucosa graft was onlayed over the defect. In 4/25 (16.0%) cases, the diseased ureter was transected, a plate of healthy ureter was brought together, and buccal mucosa graft was used to perform an augmented ureteroplasty. Eighteen of 25 (72.0%) patients had proximal and 9/27 (28.0%) patients had mid ureteral strictures. Ten of 25 (40.0%) patients had previously undergone a failed ureteral reconstruction. The median length of stricture was 4.0 cm (range 2.0-8.0 cm), and length of buccal mucosa graft harvested was 4.0 cm (range 2.5-8.0 cm). The buccal mucosa graft was onlayed ventrally in 21/25 (84.0%) and dorsally in 4/25 (16.0%) patients. The anastomosis was reinforced with peri-renal fat in 1/25 (4.0%), omentum and appendix in 1/25 (4.0%), and only omentum in 23/25 (92.0%) cases. The median operative time was 203 min (range 136-397 min), estimated blood loss was 100 ml (range 25-420 ml), and length of stay was 2 days (range 115 days). There were no intraoperative complications. At a median follow-up of 8 months (range 0-32 months), 23/25 (92.0%) cases were clinically and radiologically successful. CONCLUSIONS: Robotic ureteroplasty with buccal mucosa graft is an effective technique for managing complex proximal and mid ureteral strictures with excellent short-medium term outcomes.

Method for tracking nanogel particles in vivo and in vitro

Hydrogels made of N‐isopropylacrylamide (NIPA) can be synthesized in the form of highly monodispersed nanoparticles. After synthesis, NIPA hydrogel nanoparticles (nanogels) can be labeled by Alexa Fluor® 488 carboxylic acid, 2,3,5,6‐tetrafluorophenyl ester through amine‐terminated functional groups. This choice of dye is complementary to other biological labeling methods for in vivo studies. When the nanogel/dye nanoparticles are injected into rabbits, they can be imaged via tissue sectioning and confocal microscopy, while nanoparticle concentration can be determined by fluorescent microplate assays. Time‐course persistence of nanoparticles in the circulatory system can be readily tracked by direct assay of plasma and urine samples using 485 nm excitation and 538 emission wavelengths to keep background fluorescence to nearly the same level as that found using an empty well. Depending upon how the nanoparticles are injected, circulatory system concentrations can reach high concentrations and diminish to low levels or gradually increase and gradually decrease over time. Injection in the femoral artery results in a rapid spike in circulating nanogel/dye concentration, while injection into the renal artery results in a more gradual increase.