Bladder exstrophy and epispadias
Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg in Operative Pediatric Surgery, 2020
After radical soft-tissue reconstruction and epispadias repair, the penis is enclosed in a foam or adhesive dressing for 1 week. The ureteric stents are left on drainage and removed after 1 week, and the bladder remains on free drainage for a further 3 weeks. At this time, the urethral stent is removed and the suprapubic Malecot catheter is clamped intermittently. When this is possible for 3 hours and the child has voided urethrally (checked by US), the suprapubic catheter is removed. Continence and bladder capacity will evolve with time, and regular evaluations at approximately 3-month intervals are required. Cystoscopic evaluation of the bladder outlet is performed with a fine cystoscope (8 Fr) at 3–6 months.
Endoscopic evaluation of neurogenic bladder
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Some specialized centers no longer perform incisional sphincterotomies, preferring endoluminal stents instead (i.e., Urolume—AMS). The techniques and results with these stents are detailed in Chapter 49. It is usually easy to introduce a flexible cystoscope through these stents, which “disappear” completely after a few months as the device is epithelialized through and in between its pores: 90%–100% of epithelialization of the stent has been demonstrated in 47.1% of cases 3 months after insertion, and in 87.7% of cases 12 months after insertion. Mild epithelial hyperplasia can occur (34%–44.4%) after stent insertion and may look like an obstructed urethra. Much less frequently, these strictures are severe (3.1%), requiring urethrotomy and sometimes insertion of a second stent at the same level as the first.3 Occasionally, however, and even several years later, part of the stent may remain visible, but usually does not cause any problem. Calcifications of the stents are rare. No stone formation has been reported.3 A study was carried out by Denys and colleagues,4 to evaluate another type of urethral stent, the Ultraflex, for detrusor sphincter dyssynergia. In that study, endoscopic evaluation proved to be very valuable. The mean follow-up of 39 patients was 1.73 ± 1.11 years. No stone encrustation or stenosis of stent extremities was observed. Nonobstructive granulation tissue was identified in 6.8%. The mean percentage of epithelialization of the stent was 90.8% ± 19.7%. No migration of the stent into the bladder was seen in that study, however, minimal displacement of the stent compared to the initial position was observed in 21.7% of cases.
Neurogenic Lower Urinary Tract and Sexual Dysfunction
Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple in Basic Urological Sciences, 2021
Management options for DSD:Urethral stent (with sheath catheter)External sphincterotomyIntravesical toxins and intermittent self-catheterisation (ISC)Cystoplasty and ISCIndwelling catheter
Extended TIP vs. Standard TIP for primary distal hypospadias repair: randomized study for comparing functional and cosmetic outcomes
Published in Scandinavian Journal of Urology, 2021
Yasser A. Noureldin, Tarek Mohamed Gharib, Kareem Ali El Attar, Tarek Mohammed El Karamany, Ahmed Mahmoud Al Adl
In brief, first measurements of the UP width and length, and maximal transverse glans diameter (TGDmax) were taken (Figure 1(a,b)). Adopting the previously described e-TIP technique [4,5], starting from within the hypospadiac meatus and extended up to the apical part of the glans tip, the UP vertical midline incision was made and tubularization initiated from the distal end ensuring adequate diameter of the future neomeatus using a 7/0 polyglactin suture (Figure 1(c–e)). The neourethra was then covered with a second layer of dartos flap. A 6 F or 8 F urethral stent was left for 5–7 days, with a non-compressive dressing for 48 h. Unless necessary, all patients were discharged the next morning of surgery. A third-generation cephalosporin was given to all patients until the urethral stent was removed. After this, patients were examined at 1 month, 3 months and six months. All cases were performed by four consultants ‘Y.N, T.Gh, T.E, A.A’ with experience in hypospadias repair.
Drug-delivering devices in the urinary tract: A systematic review
Published in Arab Journal of Urology, 2021
Panagiotis Kallidonis, Constantinos Adamou, Sara Villarrova Castillo, Despoina Liourdi, Evangelos Liatsikos, Dirk Lange
Another frequent condition affecting the lower urinary tract is urethral stricture formation related to high re-stenosis rates. A minimally invasive treatment for this is mechanical dilatation with a balloon or placing a urethral stent [2], which are fraught with the same problems as ureteric stents, with rates of re-stenosis despite stent-placement being relatively high [3].
Related Knowledge Centers
- Benign Prostatic Hyperplasia
- Lower Urinary Tract Symptoms
- Transurethral Microwave Thermotherapy
- Urinary Retention
- Urination
- Urethra
- Stent
- Transurethral Needle Ablation of The Prostate
- Transurethral Resection of The Prostate
- Prostate Cancer