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We describe the use of a pedicled tunica vaginalis flap to cover the anastomotic area after progressive elaborated perineal bulboprostatic anastomotic urethroplasty. Urethroplasty is completed in the standard technique. The tunica is opened longitudinally and dissected away as a rectangular flap from the testis and wrapped around the urethra.
To evaluate in an in vitro study the irrigation and drainage capabilities of a variety of available catheters. Three-way Foley catheters are used when irrigation of the bladder is anticipated to prevent or manage blood clots in the bladder. Six operators applied maximal one-handed pressure irrigation with a catheter-tip syringe through the irrigation and drainage ports of the Bardex and Dover three-way...
To attach galactosyl residues to pentosan polysulfate (PPS) and heparin so that these drugs will bind to the endogenous lectins in the bladder. The increased binding may improve their efficacy for treating interstitial cystitis. The anionic polysaccharides, PPS, and heparin were modified by attachment of lactose. The covalent modification was by chemical linking of lactose derivatives or by beta-lactosyl...
To evaluate, in a prospective study, the effectiveness of a bladder training program. Daytime and/or nighttime wetting as a consequence of functional urinary incontinence is a common problem in childhood. Various treatment options are available, including with cognitive-behavioral “bladder training.” Sixty patients (age 8 to 12 years) with urge incontinence or dysfunctional voiding were evaluated...
To present a modification of our previously published technique of nerve-sparing endoscopic extraperitoneal radical prostatectomy (nsEERPE). The technique enables puboprostatic ligament preservation, leaving intact the puboprostatic ligaments, endopelvic fascia, periprostatic fascia, and neurovascular bundles (intrafascial dissection). The modification of nsEERPE was performed in 50 consecutive...
To compare bipolar plasmakinetic (PK) with standard monopolar transurethral resection of the prostate (TURP). A total of 70 patients were prospectively randomized into two groups: 35 patients underwent PK TURP with the Gyrus device, and 35 patients underwent standard monopolar TURP. We evaluated the time to catheter removal and hospital discharge, operating time, blood loss, postoperative irrigation,...
We report an unusual case of recurrent primary focal segmental glomerulosclerosis in an apparent low-risk cadaveric renal allograft recipient only 2 days after transplantation, who did not respond to repeated courses of plasmapheresis.
Radical cystectomy has emerged as a standard treatment option for patients with muscle invasive bladder cancer. The impact of nerve-sparing cystectomy with urethra and vaginal sparing has not been quantified with validated questionnaires. We report our experience with nerve-sparing orthotopic radical cystectomy and the impact on postoperative sexual function.
To determine the prevalence of osteopenia and osteoporosis by central (spine and hip) and peripheral (radius) bone mineral density (BMD) in men with prostate cancer undergoing androgen-deprivation therapy (ADT). Low BMD and fractures are prevalent in this group of men. Most published studies on ADT-related bone loss have documented the loss of BMD in the spine and hip as measured by dual x-ray absorptiometry...
We report a novel surgical technique used to repair a rectourethral fistula associated with two short-segment urethral strictures located in the anterior and posterior segments of the urethra in a patient with prior unsuccessful repairs. The anterior urethral stricture was reconstructed with a ventral onlay of buccal mucosa in the exaggerated lithotomy position. In a modified prone position, the...
To evaluate the outcomes of hand-assisted laparoscopic nephrectomy in patients with significant complicating clinical factors. We performed a retrospective review of 322 hand-assisted laparoscopic nephrectomy cases that were completed at a single institution from 1998 to 2004. Patients with a history of extensive abdominal surgery or prior procedures on the affected kidney, evidence of perirenal...
To describe a retrospective review of a single-institution, single-surgeon (M.G.) experience with 44 simplified Indiana pouch with multiple teniamyotomies without detubularization and reconfiguration. From April 1999 to May 2003, 44 patients underwent radical cystectomy and continent urinary diversion with a simplified Indiana pouch technique using teniamyotomies without detubularization and reconfiguration...
To evaluate variables that may predict the Gleason score of radical prostatectomy specimens in patients with more than two different Gleason scores in the positive cores of their biopsy specimens. We reviewed the pathologic data of 98 patients who had more than two different Gleason scores in 12-site biopsy specimens. We assessed the following biopsy parameters: the greatest Gleason score on the...
We report a rare case of metastatic renal cell carcinoma involving the nose and ethmoid sinus, 17 years after initial nephrectomy and diagnosis of Stage T1N0 clear cell renal cell carcinoma. The patient complained of nasal obstruction and epistaxis. Intensity-modulated radiotherapy (IMRT) was delivered using a higher-than-conventional daily fraction size concurrently with interferon and thalidomide...
To perform a retrospective study to assess the outcome and safety of 64 nephrostomy tube-free percutaneous nephrolithotomies (PCNLs) in 62 patients with calculi 3 cm or greater. Between March 2001 and June 2004, 365 consecutive patients underwent 389 PCNLs at our hospital. Electrocauterization of the access tract was performed at the end of the operation in every patient. No nephrostomy tube was...
To assess the impact of lifestyle on health-related quality of life (HR-QOL), perceived stress, and self-reported sexual function in men with early-stage prostate cancer electing active surveillance. A total of 44 intervention and 49 usual-care control participants were enrolled in a randomized clinical trial examining the effects of lifestyle changes on prostate cancer progression. The intervention...
To investigate the inhibitory role of gamma (γ)-carboxyglutamic acid (Gla) in the Gla domain of urinary prothrombin in the formation of calcium oxalate crystals. Morpholine and formaldehyde at different concentrations were added to the solution of prothrombin to cause the conversion of Gla to γ-methyleneglutamic acid (MGlu). The extent of the modification was controlled by the relative amount of...
Percutaneous thermal ablation is increasingly being studied in the treatment of renal tumors. Because radiofrequency ablation is a minimally invasive and nephron-sparing procedure, it is ideally suited for patients with a single kidney, multiple tumors, or contraindications to conventional surgery. We report on a patient with recurrent renal cell carcinoma in a transplanted kidney that was successfully...
Ureteropelvic junction obstruction can be associated with renal anomalies. We present a case of symptomatic ureteropelvic junction obstruction associated with a duplicated collecting system that was successfully treated by laparoscopic pyeloplasty and concomitant pyelopyelostomy. The operative time was 210 minutes, and the blood loss was 20 mL. The inpatient stay was 4.5 days, and the patient returned...
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