Artificial urinary sphincter erosion: the role of corticosteroids in an unusual presentation.

Glucocorticosteroid use has proven beneficial for the management of many medical conditions. Unfortunately its anti-inflammatory properties also profoundly affect many aspects of wound healing. We present a case of an unusual presentation of an artificial urinary sphincter erosion in a patient treated with chronic high-dose steroids.

Incontinent ileovesicostomy: Long-term outcomes and complications.

Aims: Incontinent ileovesicostomy was popularized in the mid-1990s as a surgical option for patients with neurogenic voiding dysfunction who lack the dexterity to perform clean catheterization. There are several case series in the literature, but few studies look at the long-term outcomes and complications associated with this procedure.

Methods: We review the outcomes of 12 patients who underwent incontinent ileovesicostomy for management of neurogenic voiding dysfunction since its introduction at our institution in 1998.

Female urethral stricture disease.

Female urethral stricture disease is a rare entity. The most common etiologies are traumatic injury, iatrogenic injury, and inflammatory disease resulting in periurethral fibrosis. Hallmark symptoms are frequency and urgency, and may also be dysuria, hesitancy, slow stream, incontinence, and recurrent urinary tract infections.

Self-reported urinary continence outcomes for repeat midurethral synthetic sling placement.

Objective: To evaluate our experience with tension-free transvaginal tape (TVT) placement for the management of stress urinary incontinence (SUI) in women who had previously undergone a failed midurethral synthetic sling (MUS) procedure.

Materials And Methods: Ten women underwent retropubic TVT insertion for continued or recurrent SUI following a prior MUS procedure. No attempt was made to remove the previously placed sling at the time of surgery.

Limited anterior cystotomy: a useful alternative to the vaginal approach for vesicovaginal fistula repair.

In developed nations, vesicovaginal fistulas are most commonly encountered as a complication after gynecologic surgery. Most fistulas are corrected using a transvaginal approach; however, complicated cases often require intraabdominal repair. A novel abdominal approach is described, using a small anterior cystotomy and omental pedicle interposition.

Renal cortical deterioration in children with spinal dysraphism: analysis of risk factors.

Background/objective: Because hydronephrosis and reflux are reversible, we believe cortical loss represents true renal deterioration in children with spinal dysraphism. Our goal was to better define risk factors for cortical loss.

Methods: After institutional review board approval, we reviewed the medical records of 272 children with spinal dysraphism.

Umbilical stomal stenosis: a simple surgical revision technique.

Stenosis of stomas sited at the umbilicus presents a surgical challenge. A paucity of literature exists on the surgical management of this problem, despite its relatively frequent occurrence. A simple technique is described, using scar incision and advancement of an umbilical skin flap, to accomplish stomal revision.

Artificial urinary sphincter placement in elderly men.

Objectives: To evaluate the outcomes of primary artificial urinary sphincter (AUS) placement for the treatment of postprostatectomy stress urinary incontinence in patients aged 75 years or older at surgery.

Methods: From September 1987 through June 2005, 33 men aged 75 years or older underwent AUS insertion for postprostatectomy stress urinary incontinence. Through retrospective chart review and personal/family interview, the patients' outcomes with regard to continence, complications, and the need to deactivate the AUS for medical or social reasons were determined.

Early outcomes of mid-urethral slings for female stress urinary incontinence stratified by valsalva leak point pressure.

Aims: To assess the early results of mid-urethral slings placed via the transobturator approach (TVT-O) for stress urinary incontinence (SUI) in women with high (>60 cm H(2)O) and low (
Materials And Methods: Forty-three women with urodynamically proven SUI underwent TVT-O. Patients were divided into either high (>60 cm H(2)O) or low ( View Article and Find Full Text PDF

Transverse myelitis in children: long-term urological outcomes.

Purpose: Urological complications are well documented in patients with traumatic spinal cord injury. We examined the long-term urological outcomes in a large population of children affected by transverse myelitis.

Materials And Methods: We retrospectively reviewed the medical history, imaging studies and urodynamic findings in 22 children with transverse myelitis.

Vesicostomy revisited: the best treatment for the hostile bladder in myelodysplastic children?

Objective: To evaluate the effects of vesicostomy on the urinary tract of myelodysplastic children in whom conservative bladder management with clean intermittent catheterization (CIC) has failed to preserve upper and lower urinary tract function.

Patients And Methods: Sixteen children with myelodysplasia underwent vesicostomy. Indications included worsening hydronephrosis, vesico-ureteric reflux (VUR), recurrent urinary tract infections (UTIs), and increasing renal insufficiency despite CIC and/or difficulty with CIC.

An assessment of the use of a continent catheterizable stoma in female tetraplegics.

Objectives: To evaluate the success of a continent catheterizable stoma in females with cervical spinal cord injury which resulted in neurogenic bladder dysfunction, the management of which may require clean intermittent catheterization despite altered hand function.

Patients And Methods: Six female tetraplegic patients with a lesion at C7 or above (age range 12-22 years) had a continent catheterizable abdominal stoma formed as part of their bladder management. As an objective measure of effectiveness, the time to complete catheterization was assessed before and after surgery.

Spinal cord injury in children: long-term urodynamic and urological outcomes.

Purpose: Urological complications in adults with spinal cord injuries (SCIs) are well documented. We sought to determine the effect of SCI on the developing bladder and kidneys in the child.

Materials And Methods: We retrospectively reviewed cases of SCI with 1-year minimum followup.

Colonic tubes for the antegrade continence enema: comparison of surgical technique.

Purpose: The Malone antegrade continence enema has revolutionized the management of intractable fecal incontinence and constipation. When the appendix is absent, surgical options are limited. Small series with short-term followup have demonstrated the feasibility but not the reliability of the continent colonic tube.