transcorporal-artificial-urinary-sphincter-cuff-placement-case

Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy

Artificial urethral sphincter (AUS) implantation is the definitive management of male stress urinary incontinence (SUI). Under the long-term pressure of ...

Shanghai Jiaotong University School of Medicine

Ischemic priapism is a rare occurrence which can cause severe erectile dysfunction (ED) without timely treatment. This retrospective study reports our experience in treating prolonged ischemic priapism and proposes our further considerations. In this paper, a total of nine patients with prolonged ischemic priapism underwent one to three types of surgical shunts, including nine Winter shunts, two Al-Ghorab shunts and one Grayhack shunt. During the follow-up visit (after a mean of 21.11 months), all patients' postoperative characters were recorded, except one patient lost for death. Six postoperative patients accepted a 25-mg oral administration of sildenafil citrate. The erectile function of the patients was evaluated by their postoperative 5-item version of International Index of Erectile Function Questionnaire (IIEF-5), which were later compared with their premorbid scores. All patients had complete resolutions, and none relapsed. The resolution rate was 100%. Seven patients were resolved with Winter shunts, one with an Al-Ghorab shunt and one with a Grayhack shunt. The mean hospital stay was 8.22 days. There was only one urethral fistula, and the incidence of postoperative ED was 66.67%. Four patients with more than a 72-h duration of priapism had no response to the long-term phosphodiesterase type 5 (PDE-5) inhibitor treatment. These results suggest that surgical shunts are an efficient approach to make the penis flaccid after prolonged priapism. However, the severe ED caused by prolonged duration is irreversible, and long-term PDE-5 inhibitor treatments are ineffective. Thus, we recommend early penile prosthesis surgeries for these patients.

Unsatisfactory outcomes of prolonged ischemic priapism without early surgical shunts: our clinical experience and a review of the literature.

It is still debatable whether single- or two-stage urethroplasty is a more suitable technique for treating hypospadias with severe chordee after urethral plate transection. This retrospective study evaluated these two techniques. A total of 66 patients of proximal hypospadias with severe chordee were divided into two groups according to the techniques they underwent: 32 and 34 patients underwent single-stage (Duckett) or two-stage urethroplasty, respectively. Median ages at presentation were 7.5 years and 11.0 years in single-stage and two-stage repair groups, respectively. Median follow-ups were 28.5 months (20-60 months) and 35 months (18-60 months) in the single-stage and two-stage groups, respectively. The meatus of the neourethra was located at the top of the glans in all patients. No recurrence of chordee was found during follow-up, and all patients or parents were satisfied with the penile length and appearance. Complications were encountered in eight patients in both groups, with no statistically significant differences between the two techniques. The late complication rate of stricture was higher after the single-stage procedure (18.75% vs 0%). The complication rate after single-stage repairs was significantly lower in the prepubescent subgroup (10.52%) than in the postpubescent cohort (46.15%). These results indicate that the urethral plate transection effectively corrects severe chordee associated with proximal hypospadias during the intermediate follow-up period. Considering the higher rate of stricture after single-stage urethroplasty, two-stage urethroplasty is recommended for proximal hypospadias with severe chordee after urethral plate transection.

Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience.

To investigated the peripheral stromal cell conditioned medium (CM) -stimulated c-kit-JAK2-STAT1 pathway in prostate cancer.

Normal peripheral prostate stromal cells stimulate prostate cancer development: roles of c-kit signal.

To evaluate the therapeutic effect of surgery in patients with advanced penile cancer, who have a dismal prognosis.

Surgical treatment of advanced penile cancer.

Till date, there have been few reports of comparative studies on the outcomes of these different treatment modalities. In this study, we have aimed to comparatively evaluate the quality-of-life parameters, including sexual function, urinary function, and health-related quality of life (HRQOL), in patients with early stage penile cancers who underwent two different organ-sparing surgeries.

A Comparative study of two types of organ-sparing surgeries for early stage penile cancer: Wide local excision vs partial penectomy.

We report a case series study on five patients who underwent combined transurethral and transvaginal approaches to repair their vesicovaginal fistulas. All of them had failed the previous surgical treatments for their fistulas. Combined transurethral and transvaginal approaches successfully repaired their vesicovaginal fistulas, with minimal intraoperative bleeding and rapid postoperative recoveries. All the clinical symptoms had resolved. Bladder saline infusion tests and cystogram examinations confirmed the successful closure of their fistulas. Follow-up examinations up to one and a half years showed no return of clinical symptoms. Combined transurethral and transvaginal approaches could be successfully applied to patients who failed previous surgical treatments for the vesicovaginal fistula, when the fistula was smaller than 3cm and was located more than 0.5cm from the ureteral orifice.

Vesicovaginal fistula repair through combined transurethral and transvaginal approaches: A case series study.

Male genital skin loss is a common disease in urology. However, male genital skin loss accompanying a penile urethra defect is rarely reported. Herein, we describe a novel surgical technique using a composite local flap and oral mucosal graft to reconstruct the penis, which may provide a new solution for patients with similar conditions.

Staged male genital reconstruction with a local flap and free oral graft: a case report and literature review.

Extramammary Paget's disease (EMPD) is a rare malignant intraepidermal adenocarcinoma that is poorly understood. Regulatory long noncoding RNAs (lncRNAs) are characterized in many species and shown to be involved in processes such as development and pathologies, revealing a new layer of regulation in different diseases, especially in cancer studies. In the present study, we used high-throughput sequencing to reveal the lncRNA-mRNA interaction network in extramammary Paget's disease.

Article	Year
Unsatisfactory outcomes of prolonged ischemic priapism without early surgical shunts: our clinical experience and a review of the literature. Asian journal of andrology\| PubMed ID: 22922321	2013
Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience. Asian journal of andrology\| PubMed ID: 25248656	2015
Normal peripheral prostate stromal cells stimulate prostate cancer development: roles of c-kit signal. American journal of translational research\| PubMed ID: 26045890	2015
Surgical treatment of advanced penile cancer. Journal of cancer research and clinical oncology\| PubMed ID: 28493019	2017
A Comparative study of two types of organ-sparing surgeries for early stage penile cancer: Wide local excision vs partial penectomy. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology\| PubMed ID: 29656798	2018
Vesicovaginal fistula repair through combined transurethral and transvaginal approaches: A case series study. Journal of gynecology obstetrics and human reproduction\| PubMed ID: 29783034	2018
Staged male genital reconstruction with a local flap and free oral graft: a case report and literature review. BMC urology\| PubMed ID: 31664996	2019
Transcriptome sequencing reveals a lncRNA-mRNA interaction network in extramammary Paget's disease. BMC medical genomics\| PubMed ID: 34895219	2021

Hai-jun Yao

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