The feasibility and efficacy of catheterizable stoma's in adults
Purpose of review
A continent vesicostomy represents a useful alternative for adult patients with impaired bladder emptying who are unable to perform clean intermittent (self-) catheterization through the urethra. In a pediatric setting, there exists a vast experience in these procedures. But experience with continent catheterizable vesicostomies is less abundant in adult patients. We want to give an overview and discuss recent literature about catheterizable conduits in the adult population.
Recent findings
Adult patients who undergo continent vesicostomy comprise a diverse cohort. Because of this very heteroge...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research
Success factors for abdominal wall diversions, including ureterocutaneostomy
Purpose of review
To review the most recent data on urinary diversions (UD) surgical outcomes performed at time of radical cystectomy (RC).
Recent findings
Looking at the recent specific literature, the most recent factors introduced in the field of UDs are the preoperative assessment of patient's frailty and the use of the robotic system. According to the available evidence, frailty status is a good preoperative predictor of surgical outcomes and patient recovery. Several questionaries measuring patient's frailty status have been evaluated as a proxy to prevent RC complications and to improve the choice of the ...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research
Editorial: Medical, technical and functional aspect of various types of urinary diversion
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: MEDICAL, TECHNICAL AND FUNCTIONAL ASPECT OF VARIOUS URINARY DIVERSIONS: Edited by John P.F.A. Heesakkers and Fred Witjes Source Type: research
Update on robotic cystectomy
This article aims to discuss recently published (2019–2021) studies on robot-assisted radical cystectomy (RARC) with attention to evidence comparing intracorporeal (ICUD) and extracorporeal urinary diversion (ECUD) in terms of intraoperative and perioperative metrics.
Recent findings
RARC produces equivalent oncological outcomes compared to open radical cystectomy (ORC). The benefits of RARC are most pronounced perioperatively. ICUD has been increasingly used at centers of excellence as it reduces intestinal exposure, which may incrementally minimize morbidity compared to ECUD or ORC. As the learning curve for ICU...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: ROBOTIC SURGICAL TECHNIQUES: Edited by David M. Albala Source Type: research
Robotic sacrocolpopexy in pelvic organ prolapse: a review of current literature
Purpose of review
Recently, robotic sacrocolpopexy has become the gold standard for treating genital prolapse. Despite this, there is still much interest in this procedure, and many questions remain unanswered. This review focuses on the most critical articles on this issue that have been published in the last 2 years.
Recent findings
A summary of 23 articles is provided. There were no differences in total postoperative complications, postoperative stress incontinence, mesh erosion, and the success of the two surgical techniques in long-term investigations. Obesity modestly increases robotic approach difficulty ...
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: ROBOTIC SURGICAL TECHNIQUES: Edited by David M. Albala Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 11, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research
New perspectives on the surgical treatment of posterior urethral obstruction
Purpose of review
Posterior urethral obstruction (PUO) from prostate surgery for benign and malignant conditions poses a significant reconstructive challenge. Endoscopic management demonstrates only modest success and often definitive reconstructive solutions are necessary to limit morbidity and firmly establish posterior urethral continuity. This often demands a combined abdominoperineal approach, pubic bone resection, and even sacrifice of the external urinary sphincter and anterior urethral blood supply. Recently, a robotic-assisted approach has been described. Enhanced instrument dexterity, magnified visualization,...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Update on the management of complex strictures of the bulbar urethra
Purpose of review
This narrative review summarizes the most relevant literature published in 2019–2020 regarding urethroplasty for bulbar strictures.
Recent findings
We identified relevant papers focussing on new insights in the field of excision and primary anastomosis, graft augmentation urethroplasty and perineostomy for bulbar strictures and bulbomembranous strictures after radiotherapy or surgery for benign prostatic hyperplasia.
Summary
Respecting the vascularity of the anterior urethra and maintaining the integrity of surrounding structures during bulbar urethroplasty does not appear to deteriora...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
The emerging role of robotics in upper and lower urinary tract reconstruction
Purpose of review
Developments in robotic reconstructive urology have introduced novel treatments for complex upper and lower urinary tract disease. Short-term and mid-term data demonstrates excellent outcomes and minimal morbidity, suggesting the advanced instrumentation and visualization of robotics represent a new treatment paradigm in patients that are historically difficult to treat. Here we review recent developments in the robotically assisted surgical management of urethral and ureteral strictures.
Recent findings
The minimally invasive approach, enhanced precision and reach, and near-infrared fluorescen...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Advancements in transurethral management of urethral stricture disease
Purpose of review
To explore and report the recent evolution of transurethral management of urethral stricture disease.
Recent findings
In recent years, new promising techniques in the transurethral management of urethral stricture disease have emerged including adjuvant therapies to direct vision internal urethrotomy, regenerative therapy with buccal mucosa cells and minimally invasive transurethral urethroplasty procedures that avoid skin incisions.
Summary
Although further work is needed, the expanding field of transurethral therapies for urethral stricture disease demonstrates early promising results ...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Tissue engineering: recent advances and review of clinical outcome for urethral strictures
Purpose of review
Urethrotomy remains the first-line therapy in the treatment of a urethral stricture despite data showing no real chance of a cure after repeated urethrotomies. An anastomotic or an augmentation urethroplasty using oral mucosa can be offered to patients following failed urethrotomy. The potential for a tissue engineered solution as an alternative to native tissue has been explored in recent years and is reviewed in this article.
Recent findings
More than 80 preclinical studies have investigated a tissue-engineered approach for urethral reconstruction mostly using decellularized natural scaffolds...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Update on the management of penile and meatal strictures
Purpose of review
Treatment of penile and distal urethral strictures including the fossa navicularis and the meatus remains challenging due to their adverse etiology and lack of ventral tissue support. In this contemporary review, we summarize the available evidence and recent advancements in reconstructive techniques.
Recent findings
Over the last years, several refinements of already established techniques have been added to the reconstructive armamentarium in the management of penile urethral strictures. These include the single-stage combination of flap and graft, the additional use of tissue glue, or an opt...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Update on female urethral reconstruction
Purpose of review
Female urethral stricture (FUS) is not frequent but can be the cause of significant morbidity. A somewhat overlooked condition for years, it has received significant attention in recent times. In this review, we update the current evidence surrounding FUS management.
Recent findings
It is estimated that FUS is present in about 1% of all women having check-ups for lower urinary tract symptoms. Etiology is considered as idiopathic in half of the cases, iatrogenic in one-third, whereas infection/inflammation and trauma account for the rest. Symptoms presented are usually nonspecific and nondiagnos...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Long-term outcome of urethral and genital reconstruction in hypospadias and exstrophy-epispadias complex
Purpose of review
Although immediate surgical outcomes of genitourinary reconstruction used to be the main focus in hypospadias and exstrophy-epispadias complex (EEC), recent research demonstrates rising concerns about long-term functional and psychosexual outcomes. Recent results about long-term outcomes of complex genitourinary reconstruction in those children transitioning into adulthood are summarized and discussed in this comprehensive review.
Recent findings
Long-term outcomes in hypospadias focus on psychosexual satisfaction and decisional regret. Interestingly, uncomplicated hypospadias repair results in...
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
Editorial: Advances in reconstructive urology
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 6, 2021 Category: Urology & Nephrology Tags: RECONSTRUCTIVE UROLOGY: Edited by Margit M. Fisch, Allen F. Morey and Benjamin M. Dropkin Source Type: research
