Is it the Surgeon? A Re-examination of Mid-urethral Sling Complications.

Objective: To identify potential technical factors during initial mid-urethral sling (MUS) placement that contribute to subsequent sling revision procedures.

Methods: A retrospective chart review was performed examining synthetic MUS reoperations at a single institution from 2008-2020. The implanting surgeon's operative note, when available, was critically reviewed with respect to trocar placement, sling location, and tensioning technique.

Urinary undiversion by conversion of the incontinent ileovesicostomy to augmentation ileocystoplasty in spinal cord injured patients.

Spinal cord injury (SCI) patients with neurogenic bladder and the inability to self-catheterize may require incontinent diversion to provide low-pressure drainage while avoiding the use of indwelling catheters. We demonstrate that in patients with significant functional improvement, the ileovesicostomy can be a reversible form of diversion, with simultaneous bladder augmentation using the same segment of ileum utilized for the ileovesicostomy. Multidisciplinary management should be utilized to assure mastery of intermittent catheterization before urinary undiversion.

The Use of Tissue Flaps in the Management of Urinary Tract Fistulas.

Urinary tract fistulas represent a complex group of pathologies that present significant management challenges. While most such fistulas ultimately require definitive surgical management, compromised local tissue quality or other factors often render straightforward simple one layered closure challenging with a substantial risk of failure. Interpositional tissue flaps have become a mainstay of treatment in these circumstances, enabling the delivery of healthy tissue from other locations to the site of pathology.

Medical evaluation and management of male and female voiding dysfunction: a review.

A significant workforce shortage of urologists available to serve the US population has been projected to occur over the next decade. Accordingly, much of the management of urologic patients will need to be assumed by other specialties and practitioners. Since primary care physicians are often first evaluate common urologic complaints, it makes sense that these physicians are in an excellent position to intervene in the management of these patients when appropriate.

Adjuvant versus salvage radiation therapy for prostate cancer patients with adverse pathologic features: comparative analysis of long-term outcomes.

Objectives: To compare long-term outcomes of men with adverse pathologic features after adjuvant radiation therapy (ART) versus salvage radiation therapy (SRT) after radical prostatectomy at our institution.

Methods: Patients treated with postprostatectomy radiation therapy with pT3 tumors, or pT2 with positive surgical margins, were identified. Cumulative freedom from biochemical failure (FFBF), freedom from metastatic failure (FFMF), and overall survival rates were estimated utilizing the Kaplan-Meier method.

Risk factors for wound complications after ankle fracture surgery.

Background: The overall rate of complications after ankle fracture fixation varies between 5% and 40% depending on the population investigated, and wound complications have been reported to occur in 1.4% to 18.8% of patients.

Laparoscopic pelvic nephrectomy: essential preoperative and intraoperative considerations.

Pelvic kidneys are typically asymptomatic, but surgical intervention may be required in select cases. Laparoscopic pelvic nephrectomy is a feasible option. Given the highly variable vascular anatomy, careful surgical planning and meticulous technique are necessary.

Face, content, and construct validation of the da Vinci Skills Simulator.

Objective: To report on assessments of face, content, and construct validity for the commercially available da Vinci Skills Simulator (dVSS).

Methods: A total of 38 subjects participated in this prospective study. Participants were classified as novice (0 robotic cases performed), intermediate (1-74 robotic cases), or expert (≥ 75 robotic cases).