Outcomes of women diagnosed with primary bladder neck obstruction based on video urodynamic criteria.

Objective: Functional and anatomic bladder outlet obstruction (BOO) in women are more prevalent than previously suspected and remain a diagnostic challenge. Several urodynamic diagnostic criteria for female BOO have been proposed, but studies validating the criteria by assessing treatment outcomes are lacking. We sought to correlate video urodynamic (VUD) diagnostic criteria with symptom improvement in women with functional bladder outlet obstruction.

Dorsal Onlay Oral Mucosa Graft Urethroplasty for Female Urethral Stricture.

Objective: To describe and assess the outcomes of dorsal onlay oral mucosa graft urethroplasty for female urethral stricture.

Methods: We retrospectively reviewed the charts of all female patients who underwent dorsal onlay oral (buccal or lingual) mucosa urethroplasty for urethral stricture between 2011 and 2020 at two academic institutions. The primary endpoint was clinical success defined as any subjective improvement in LUTS self-assessed by the patients 1-3 months after catheter removal.

Intermediate-term outcomes after robotic ureteral reconstruction for long-segment (≥4 centimeters) strictures in the proximal ureter: A multi-institutional experience.

Purpose: To report our intermediate-term, multi-institutional experience after robotic ureteral reconstruction for the management of long-segment proximal ureteral strictures.

Materials And Methods: We retrospectively reviewed our Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database to identify all patients who underwent robotic ureteral reconstruction for long-segment (≥4 centimeters) proximal ureteral strictures between August 2012 and June 2019. The primary surgeon determined the specific technique to reconstruct the ureter at time of surgery based on the patient's clinical history and intraoperative findings.

Robotic Ureteral Reconstruction.

Robotically assisted laparoscopic techniques may be used for proximal and distal ureteral strictures. Distal strictures may be approached with ureteroneocystotomy, psoas hitch, and Boari flap. Ureteroureterostomy, buccal mucosa graft ureteroplasty, and appendiceal flap ureteroplasty are viable techniques for strictures anywhere along the ureter.

Robotic Ureteral Reconstruction in Patients with Radiation-Induced Ureteral Strictures: Experience from the Collaborative of Reconstructive Robotic Ureteral Surgery.

Management of radiation-induced ureteral stricture (RIUS) is complex, requiring chronic drainage or morbid definitive open reconstruction. Herein, we report our multi-institutional comprehensive experience with robotic ureteral reconstruction (RUR) in patients with RIUSs. In a retrospective review of our multi-institutional RUR database between January 2013 and January 2020, we identified patients with RIUSs.

The New PGY-1 Year: Lessons Learned.

Purpose Of Review: Describe the ACGME's changes to the PGY-1 year in urology and discuss the benefits and challenges faced by training programs.

Recent Findings: There are no publications detailing the integration of the PGY-1 year in urology; however, response of other surgical subspecialties to their own integration has been studied. Benefits of integration include earlier exposure to techniques and knowledge specific to urology, potentially leading to increased preparedness for next steps in training and exams.

Prolapse repair in the elderly patient: contemporary trends and 30-day perioperative complications.

Introduction And Hypothesis: Pelvic organ prolapse is common and increases with age. Although conservative options exist for management, surgery remains a mainstay of treatment. Understanding how surgical repair affects the elderly is increasingly important as the population ages.

Functional characterization and physiological roles of the single Shaker outward K channel in Medicago truncatula.

The model legume Medicago truncatula possesses a single outward Shaker K channel, whereas Arabidopsis thaliana possesses two channels of this type, named AtSKOR and AtGORK, with AtSKOR having been shown to play a major role in K secretion into the xylem sap in the root vasculature and with AtGORK being shown to mediate the efflux of K across the guard cell membrane, leading to stomatal closure. Here we show that the expression pattern of the single M. truncatula outward Shaker channel, which has been named MtGORK, includes the root vasculature, guard cells and root hairs.

Primary Bladder Neck Obstruction.

Primary bladder neck obstruction (PBNO) is a functional obstruction caused by abnormal opening of the bladder neck during the voiding phase of micturition. PBNO may present with a variety of symptoms including voiding symptoms (slow urinary stream, intermittent stream, incomplete emptying), storage symptoms (frequency, urgency, urgency incontinence, nocturia), and/or pelvic pain and discomfort. The diagnosis of PBNO can be made with videourodynamic testing, which demonstrates elevated voiding pressures with low flow, and fluoroscopic imaging demonstrating obstruction at the level of the bladder neck.

Impact of preoperative urodynamics on women undergoing pelvic organ prolapse surgery.

Introduction And Hypothesis: Preoperative urodynamic studies (UDS) are frequently performed before pelvic organ prolapse (POP) surgery to assess urethral and bladder function. The primary goal of this study is to examine how preoperative UDS are utilized and what value these studies have in patient treatment and/or counseling.

Methods: We retrospectively reviewed patients who underwent prolapse surgery and had preoperative UDS between June 2010 and February 2015.

Exploring stress urinary incontinence outcomes after sling excision for perforation or exposure.

Objective: This study assessed stress urinary incontinence (SUI) outcomes after sling excision for urinary tract perforation or vaginal exposure, and compared the outcomes of concomitant versus staged autologous fascia pubovaginal sling (AFPVS).

Methods: A retrospective chart review of all patients who underwent midurethral sling (MUS) excision for urinary tract perforation or vaginal exposure at a tertiary referral center between 2010 and 2015 was performed. Therapeutic strategies were categorized as concomitant AFPVS, staged AFPVS, and no anti-incontinence procedure.

Current Role of Urethrolysis and Partial Excision in Patients Seeking Revision of Anti-Incontinence Sling.

Objectives: Stress urinary incontinence is highly prevalent and sling surgery has increased since 2000. Urethrolysis traditionally had been standard management of complications after anti-incontinence surgery; however, partial excision is a less aggressive option. This study describes the different populations in a contemporary cohort that undergo sling excision and urethrolysis and their surgical outcomes.

Clinical Case Discussion: Failure of a Midurethral Sling Procedure for Stress Urinary Incontinence in a Female Patient.

The patient should have an autologous fascia sling as her next procedure because she has recurrent stress urinary incontinence after two prior transobturator synthetic slings, current urethral erosion, and intrinsic sphincter deficiency.

Use of Concomitant Stress Incontinence Surgery at Time of Pelvic Organ Prolapse Surgery Since Release of the 2011 Notification on Serious Complications Associated with Transvaginal Mesh.

Purpose: There is controversy regarding the performance of concomitant anti-incontinence procedures at the time of pelvic organ prolapse repair. Data support improvement in stress urinary incontinence with a concomitant sling but increased adverse events. We assessed trends in preoperative stress urinary incontinence evaluation, concomitant anti-incontinence procedure at pelvic organ prolapse surgery and postoperative anti-incontinence procedures at our institution before and after the 2011 FDA (U.

Nod Factor Effects on Root Hair-Specific Transcriptome of Medicago truncatula: Focus on Plasma Membrane Transport Systems and Reactive Oxygen Species Networks.

Root hairs are involved in water and nutrient uptake, and thereby in plant autotrophy. In legumes, they also play a crucial role in establishment of rhizobial symbiosis. To obtain a holistic view of Medicago truncatula genes expressed in root hairs and of their regulation during the first hours of the engagement in rhizobial symbiotic interaction, a high throughput RNA sequencing on isolated root hairs from roots challenged or not with lipochitooligosaccharides Nod factors (NF) for 4 or 20 h was carried out.

Validation of the Innocor device for noninvasive measurement of oxygen consumption in children and adults.

Outpatient measurements of oxygen consumption (VO2) and cardiac output (CO) are valuable in the management of pediatric cardiac disease. Current methods are inaccurate and cumbersome or require invasive procedures. New devices to measure these variables in adults have not been rigorously tested for children.