Objective
To compare dorsal onlay (conventional Barbagli) and one‐sided dorsolateral onlay (Kulkarni technique) buccal mucosa substitution urethroplasty techniques for the treatment of long anterior ...urethral strictures.
Methods
Demographic data, treatment outcomes and success rates of patients who underwent either conventional Barbagli or Kulkarni urethroplasty for the treatment of an anterior urethral stricture longer than 8 cm between January 2010 and March 2019 in our center were retrospectively reviewed.
Results
Demographic parameters of patients who underwent the conventional Barbagli (n = 37) or Kulkarni procedure (n = 31) did not differ. The mean surgical duration and hospital stay were shorter for patients treated with the Kulkarni technique (179.5 ± 30.0 and 3.5 ± 1.2 vs 195.5 ± 28.9 min and 4.4 ± 1.8 days; P = 0.037, P = 0.002). Mean intraoperative blood loss and perioperative complication rates were signficantly lower in patients who underwent the Kulkarni technique than those who underwent the conventional Barbagli technique (164.3 ± 62.9 vs 202.4 ± 78.1 mL; P = 0.033 and 16.1% vs 37.8%; P = 0.046). The mean follow‐up time period was 59.8 ± 24.7 and 63.5 ± 26.8 months for Kulkarni and conventional Barbagli techniques, respectively. Success rates based these follow‐up time periods were 27 (87.1%) and 26 (70.3%) for the Kulkarni and conventional Barbagli techniques, respectively.
Conclusion
The Kulkarni technique should be more preferred for the treatment of long anterior urethral strictures over the conventional Barbagli technique based on surgical outcomes and success rates.
Background
To investigate the use of internet resources by surgeons for continuing professional development (CPD).
Results
This cross-sectional study was carried out between July 1, 2021, to October ...31, 2021, at the Department of Medicine, Health Sciences University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, with participants from nine surgical specialties: General surgery, neurosurgery, orthopedics, urology, plastic surgery, ear-nose-throat surgery, cardiovascular surgery, ophthalmology, and anesthesiology. All study participants were asked to complete a questionnaire comprising 23 questions regarding their age, duration of work experience, appointment status, venue, and time spent on internet resources and preferred online resources for CPD purposes. In addition, participants were divided into two groups according to their appointment status: academic faculty and staff surgeons. Data analysis was performed using IBM SPSS Statistics version 17.0. The target population consisted of 216 specialists. The survey was completed by 204 (94.4%) surgical specialists. The majority of the specialists (
n
= 137, 67.2%) reported using the internet for work-related purposes every day. Daily time spent on internet resources was reported to be 30–60 min by 39.2% (
n
= 80) participants, whereas 52 (25.5%) reported spending less than 30 min. The participants wished to spend more time on internet resources. The majority of surgeons found the hospital and home equally effective in using the internet and preferred to engage alone. The mean age, English language level, usage of online resources, and the attitude score toward the perceived credibility and usefulness of e-resources were significantly higher in the academic faculty group than staff surgeons (
p
< 0.005). On the other hand, the use of Google/Google scholar was similar between the two groups (
p
= 0.192). Technical difficulties such as slow internet, need for website registration, and article fees were considered drawbacks for internet resources among all the participants.
Conclusions
This study showed that most surgeons use internet resources daily for CPD and stated they would like to engage longer despite technical difficulties. Institutions should address these technical difficulties.
Objective: The goal of this study is to evaluate the risk factors that cause positive surgical margin (PSM) after partial nephrectomy (PN) and the
effect of PSM on oncological outcomes in a ...single-centre cohort.
Materials and Methods: Patients with PSM (group 1) were identified and contrasted with the negative surgical margin (group 2). Further, the
Kaplan-Meier curves and Cox regression models were used to estimate the differences in survival analysis.
Results: A total of 302 patients had PN, of which 38 (12.6%) had PSM. In addition, the non-ischaemic procedures in group 1 were higher (p<0.001).
Multivariate analysis showed that RENAL nephrometry score (OR: 1.438, p=0.037) and C-index value (OR: 0.224, p=0.012) were important predictive
factors for PSM. Moreover, the recurrence rate was 7.9% for group 1 at a median follow-up of 85.2 months and 3.4% for group 2 at a median
follow-up of 83.7 months (p=0.181). In a multivariate analysis, the overall survival decreased with co-morbidity index (HR: 1.343, p<0.001) and high
tumour stage (HR: 3.886, p=0.003), while cancer-specific survival decreased with mid-renal tumours (HR: 4.157, p=0.007), high tumour stage (HR:
6.274, p=0.017) and recurrence (HR: 5.038, p=0.018). Furthermore, pathological T stage and C-index value were independent risk factors influencing
recurrence-free survival.
Conclusion: C-index and RENAL nephrometry score are independent risk factors for PSM. Additionally, PSM does not affect the recurrence or
survival outcomes.
To study the effect of female sexual abnormalities on the etiology of penile fracture, which is an important urological emergency.
The sexual function of the partners of patients with penile fracture ...(study group, n = 90) treated at our clinic and healthy women (control group, n = 90) were evaluated on a voluntary basis. In both groups, sexual function was evaluated with the Female Sexual Function Index (FSFI). Each substance of the FSFI was evaluated separately by comparing both groups and the effect on the development of penile fracture was investigated.
There was no difference in demographic and clinical characteristics between the study and control groups. Evaluation of sexual function with FSFI revealed that the scores of vaginal lubrication, orgasm, satisfaction, and pain subscales were lower in the study group (p < .001). Among these subscales, anorgasmia was determined as the factor with the largest effect on the development of penile fracture (OR = 7.333, 95% CI = 2.666-20.166, p < .001). No correlation was found between the largest dimension of penile fracture and FSFI total and subscale scores in the study group.
We believe that female vaginal dryness and dyspareunia in particular are factors which could cause the development of penile fracture during sexual intercourse. The treatment could prevent the development of penile fracture in the male.
Purpose
We aimed to assess the success rates and functional outcomes of ReDo buccal mucosal graft urethroplasty (BMGU) following failed primary BMGU and evaluate the oral morbidity and changes in ...quality of life (QoL) after this surgery.
Materials and methods
Data of the patients with recurrent anterior urethral stricture who underwent ReDo BMGU after failed primary BMGU were retrospectively reviewed. The collected data included the results of the urethral stricture surgery patient-reported outcome measure-lower urinary tract symptoms (USS-PROM-LUTS) and euro-quality of life visual analog scale (EQ-VAS) questionnaires performed preoperatively before and one year after surgery. The cohort was divided into two groups according to procedural success, and these groups were compared.
Results
Thirty-two men patients were included. Among these, twenty-seven (84.3%) cases were considered successful following ReDo BMGU. The pre-ReDo BMGU mean stricture length was significantly longer in the failure group (2.3 ± 0.6 vs. 4.4 ± 1.2 cm,
p
= 0.001). Except for one patient with persistent oral numbness, no severe complication was reported postoperatively in the first year. The mean USS-PROM-LUTS score decreased significantly, while the mean LUTS-related quality of life score increased significantly following ReDo BMGU (
p
< 0.001,
p
< 0.001). In addition, the mean total EQ-VAS score increased significantly from 62.75 to 78.45, indicating remarkable improvement (
p
< 0.001).
Conclusions
Although less favorable outcomes can be anticipated in ReDo BMGU due to extensive scar tissue formation and reduced vascularity, high success and patient satisfaction rates and low oral morbidity rates were detected in ReDo BMGU cases.
This study aimed to compare the success and postoperative complication rates of the novel non-transecting urethroplasty (NTU) technique and conventional excision-primary anastomosis (EPA) in the ...surgical treatment of short bulbar urethral strictures.
Data of the patients who underwent excision-primary anastomosis or NTU procedures at our center for the surgical treatment of bulbar urethral strictures shorter than 3 cm between January 2010 and December 2018 were retrospectively reviewed.
Forty-seven patients fulfilled the eligibility criteria for this study. Among these patients, 22 underwent NTU procedure while 25 underwent EPA. There was no difference between the two groups regarding age, stricture length, etiology, past surgical history, and duration of follow-up. The surgical success rates were 88% and 87,2% in the NTU and EPA groups, respectively (p = 0,603). The complication rates were 12% and 13,6% in NTU and EPA groups, respectively. Two groups were similar concerning complication rates (p = 0,603).
The novel NTU and conventional EPA techniques are similar regarding surgical success and complication rates in the surgical treatment of bulbar urethral strictures shorter than three centimeters.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background and Objectives:
We analyzed the factors affecting the decision on surgical approach such as hilum dissection, vessel clamping, and the warm ischemia time (WIT) in laparoscopic partial ...nephrectomy (LPN) for small renal masses (SRMs).
Methods:
Patients who underwent LPN for SRMs between 2011 and 2021 in two centers were retrospectively screened. Standardized R.E.N.A.L. nephrometry score (RNS) and each of the components were scored on a Likert scale and the effect on the surgical approach was examined by using them separately.
Results:
A total of 133 patients, 85 of whom were on-clamp and 48 were off-clamp, were included in the study. Greater tumor size, low BMI, higher RNS, upper pole tumor, low exophytic rate, and nearness to the collecting system were statistically significant for both on/off-clamp and hilar dissection decisions. In multivariate analysis, greater tumor size, upper pole tumor, lower rate of exophytic part (E2), nearness to the collecting system (N3) were independent risk factors for vessel clamping. Greater tumor size and lower exophytic tumor rate (E2) were independent risk factors for hilum dissection. We could not identify any factor affecting WIT.
Conclusion:
Individual components of RNS may serve as a better tool for decision-making on vessel clamping and hilum dissection during LPN for SRMs.
Objective: The goal of this study is to evaluate the risk factors that cause positive surgical margin (PSM) after partial nephrectomy (PN) and the effect of PSM on oncological outcomes in a ...single-centre cohort. Materials and Methods: Patients with PSM (group 1) were identified and contrasted with the negative surgical margin (group 2). Further, the Kaplan-Meier curves and Cox regression models were used to estimate the differences in survival analysis. Results: A total of 302 patients had PN, of which 38 (12.6%) had PSM. In addition, the non-ischaemic procedures in group 1 were higher (p<0.001). Multivariate analysis showed that RENAL nephrometry score (OR: 1.438, p=0.037) and C-index value (OR: 0.224, p=0.012) were important predictive factors for PSM. Moreover, the recurrence rate was 7.9% for group 1 at a median follow-up of 85.2 months and 3.4% for group 2 at a median follow-up of 83.7 months (p=0.181). In a multivariate analysis, the overall survival decreased with co-morbidity index (HR: 1.343, p<0.001) and high tumour stage (HR: 3.886, p=0.003), while cancer-specific survival decreased with mid-renal tumours (HR: 4.157, p=0.007), high tumour stage (HR: 6.274, p=0.017) and recurrence (HR: 5.038, p=0.018). Furthermore, pathological T stage and C-index value were independent risk factors influencing recurrence-free survival. Conclusion: C-index and RENAL nephrometry score are independent risk factors for PSM. Additionally, PSM does not affect the recurrence or survival outcomes. Keywords: Partial nephrectomy, Positive surgical margin, Survival Amac: Parsiyel nefrektomi (PN) sonrasi pozitif cerrahi sinira (PSM) neden olan risk faktorlerini ve PSM'nin onkolojik sonuclar uzerindeki etkisini tek merkezli bir kohortta degerlendirmek. Gerec ve Yontem: PSM'li hastalar (grup 1) belirlendikten sonra negatif cerrahi sinirli (grup 2) hastalar ile karsilastirildi. Kaplan-Meier egrileri ve Cox-regresyon modelleri, sagkalim analizindeki farkliliklari tahmin etmek icin kullanildi. Bulgular: Toplam 302 hastaya PN yapildi ve bunlarin 38'inde (%12,6) PSM vardi. Grup 1'de iskemik olmayan operasyonlar daha fazlaydi (p<0,001). Cok degiskenli analiz, RENAL nefrometri skorunun (OR: 1,438, p=0,037) ve C-indeksi degerinin (OR: 0,224, p=0,012) PSM icin onemli prediktif faktorler oldugunu gosterdi. Nuks orani, 85,2 aylik medyan takip suresinde grup 1'de %7,9 ve 83,7 aylik medyan takip suresinde grup 2'de %3,4 idi (p=0,181). Cok degiskenli analizde genel sagkalim; komorbidite indeksi (HR: 1,343, p<0,001) ve yuksek tumor evresi (HR: 3,886, p=0,003) ile azalirken kansere ozgu sagkalim; orta zon tumorler (HR: 4,157, p=0,007), yuksek tumor evresi (HR: 6,274, p=0,017) ve nuks (HR: 5,038, p=0,018) ile azaldi. Patolojik-T evresi (HR: 32,956, p<0,001) ve C-indeksi degeri (HR: 0,352, p=0,045) rekurrenssiz sagkalimi etkileyen bagimsiz risk faktorleriydi. Sonuc: RENAL nefrometri skoru ve C-indeksi degeri PSM icin bagimsiz risk faktorudur. Calismamizdaki veriler, PSM'nin rekurrens veya sagkalim sonuclarini etkilemedigini gostermektedir. Anahtar Kelimeler: Parsiyel nefrektomi, Pozitif cerrahi sinir, Sagkalim
Paratesticular Leiomyoma; A Rare Case Report Ekenci, Berk Yasin; Kokurcan, Alihan; Durak, Hüseyin Mert ...
Üroonkoloji bülteni,
12/2022, Letnik:
21, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Paratesticular leiomyomas are rare tumors and originated from the subcutaneous smooth muscles and tunica dartos. Patients usually present with the complaint of a long-standing palpable painless mass ...and it is important to differentiate it from testicular masses. A 35-year-old male patient presented to our clinic with a palpabl mass, which he has realized since 15 year-old in scrotum that it growth 3-4 times over the last month. Physical examination revealed a palpable solid mass of approximately 3 cm, regular bordered, painless and localized inferiorly in the scrotum. Scrotal Doppler ultrasonography scan showed a 3x2.5 cm solid mass localized inferiorly in the scrotum, which has an internal blood supply. The inguinal exploration was planned due to malignancy risk. When the inguinal exploration was performed, we observed that the paratesticular mass was not connected with the testis. The mass, which was adherent to the scrotal skin, was excised together with the scrotal skin tissue with a safe surgical margin. In the pathology report, it was diagnosed as leiomyoma. The treatment for the vast majority of scrotal masses is radical inguinal orchiectomy. Testis preserving surgical procedures performing is critical for protecting both the fertility and the hormonal level of patients who have benign scrotal masses. Although physical examination suggests malignant neoplasms in patients presenting with a paratesticular mass, it should be kept in mind that benign neoplasms may also be present.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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