DiseaseOn SIU 2007: Male and female urethra reconstruction: from simple to complexUroToday.com – The instructional course on urethral stricture disease, September 3, 2007 at the Centenary Congress of the Societe Internationale Urology in Paris follow this web-site . It was. Chair Richard Santucci from Wayne State in Detroit Richard Santucci began the session with a simplified, uniform approach for urethral stricture disease. Although Richard 22 different 22 different urethroplasty techniques for the treatment of stricture disease in his practice, he achieved achieved good results with the use of just four. The first is buccal mucosa urethroplasty, either ventral in the bulbar urethra or dorsal in the pendulous urethra. He has given up the use of the anastomoses occur or end-to-end urethroplasty due to concerns about an increased incidence of new erectile dysfunction and the development of the notochord in 6 percent of cases. His recurrence rate with EPA was 7 percent and 0 percent with bulbar urethroplasties. The fourth method number 2 is that first and the second stage Johanson urethroplasties is displayed when insufficient penile skin is available for other repairs or the strictures too long for buccal mucosa repairs. These repairs are used to temporize the toughest strictures and in many cases, patients choose not to go ahead with the second stage. Some tips for a successful repair include a 3cm dorsal urethral plate, almost always leaving the diseased urethral plate and multiply it with buccal mucosa, and any attempt to protect the ventral glans if possible and to make tunnel repairs under this instead. He had a few things on perineal urethrostomy and calls for a side view instead of a perineal urethrostomy end perineal urethrostomy be performed due to a very high rate of stenosis of the latter.
Procedure 3 is the anastomotic urethroplasty for pelvic fracture distraction defects used. This method in detail by in detail by the second speaker of the session. The fourth method, fasciocutaneous flap urethroplasty the circular seems soon to leave Richard Armour also because it has a failure rate of 20-40 percent , which he is dissatisfied, reported. He has the use the use incisional again urethrotomy and dilatation unless relief is the only goal, as the success rate for the second and third attempt at the best of strictures close to 100 percent. Next Sanjay Kulkarni from Pune, India discussed urethral Distraction Injury: Practical Issues fro the treatment of the most devastating injuries. He began with a continuation of the debate about delayed management versus an attempt primary realignment. Quoting stricture rates of 5# percent and a 36 percent incidence of ED, he continues to of immediate of immediate suprapubic urinary diversion with delayed reconstruction 3 6 months after the injury followed. He does admit that primary realignment may be useful to reduce severely greatly deflected. Urethra ends more in the plane at the time of delayed repair in the bladder.point to document the preoperative erectile status and that of the history and use of duplex Doppler sonography. He also uses pre-operative CT , where it suspects the presence of bone fragments in the bladder. He uses the four-step approach to the length between the urethral ends with step one is to reduce the mobilization of the urethra of the erectile bodies of the peno – scrotal junction, step two of the separation of the crural bodies, step three pubectomy four, four, rarely used urethra re routing the leg. Extremely rarely, using a transpubic repair and omental wrapping of the anastomosis in these cases recommended. Expected success rates are around 90 percent with the vast majority of failures in the first six months. Failures are usually anastomosis constraints due to inadequate because of inadequate scar excision. Finally, if these injuries occur in women severe cases approach suprameatal and has a high index of suspicion for concomitant bladder injury with the finding of bone fragments in the bladder.
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Just 1.2 % of respondents reported need to another operation which does not support other allegations, fail that half those procedures to Rattner. Our results let us say, if the operation by an expert after operating team performed with a high disk Centre is the result for most patients is very well. Rattner has professor of surgery at at Harvard Medical School. Study co-authors are author conducting Denise Gee, MGH Department of Surgery, and Michael Andreoli, Boston University School of Medicine.