BAES Scrotal flap: anatomical bases and usefulness in complex urethral reconstruction.

Objective: To describe the anatomical characteristics and vascularization of the biaxial hair free scrotal flap (BAES-flap) and to detail its surgical application to reconstruction of the more complex urethral strictures.

Methods: We performed macro and micro anatomical dissections of the scrotum in 15 cryopreserved cadavers for the study of the arterial microvascularization of the BAES flap, and this anatomical knowledge has been implemented with the aim to improve the anterior and posterior urethra reconstructive surgical technique. For scrotal skin conditioning we performed definitive hair removal with the alexandrite laser.

Arteries of the scrotum: a microvascular study and its application to urethral reconstruction with scrotal flaps.

Objective: To study scrotal microvascularization and apply the findings to the design of reliable skin flaps for reconstructive surgery of complex urethral or panurethral stenoses.

Materials And Methods: In 15 cryopreserved male cadavers, scrotal skin vascularization was explored using macro- and microdissections, and the scrotal sac made transparent using the Spalteholtz method. A meticulous descriptive analysis of the arterial network was conducted out in all cases to evaluate the number, distribution and anastomosis of the cutaneous arteries of the scrotum.

Total anterior urethral reconstruction with the 'BAES flap' in a spinal cord-injured patient.

Study Design: A case report of urethral destruction in a spinal cord injured (SCI) patient.

Objectives: To report the reconstruction of the whole anterior urethra in one-stage using an epilated scrotal flap.

Setting: Institut Guttmann, Hospital de Neurorehabilitació, Barcelona, Spain.

A new biaxial epilated scrotal flap for reconstructive urethral surgery.

Purpose: We describe a new type of perineum based scrotal flap with biaxial vascularization supplied by both superficial perineal arteries. Flap length of up to 20 cm. may be attained for urethral reconstruction.

Scrotal flap epilation in urethroplasty: concepts and technique.

Purpose: We describe our technique of scrotal epilation and the advantages of using the resultant glabrous scrotal skin in reconstructive urethral surgery.

Materials And Methods: An insulated needle model adapted to scrotal hair characteristics and a thermocoagulation current generator were used.

Results: An average of 3 epilatory sessions with a 4-week interval between treatments was the optimal schedule.

Ejaculation in men: a dynamic endorectal ultrasonographical study.

Objective: To study the ejaculatory mechanisms in men using a dynamic endorectal ultrasonographical approach.

Subjects And Methods: Seven recordings were made of a young healthy volunteer during ejaculation, scanning the longitudinal plane from the bladder neck to the bulbous urethra.

Results: The study demonstrated the existence of a pre-ejaculatory phase characterized by a notable decrease in echogenicity of the inner prostate gland, due to the contraction of the pre-prostatic sphincter 13-25 s before ejaculation.

[Current controversies on the treatment of urinary lithiasis].

With the discovery during the 1960s of an access to the renal sinus and intra-operative radiological monitoring, the lithiasis surgery reached its summit of technical perfection. A comparative study on the various therapeutical options is presented: NLP, URN, ESWL and open surgery, as the single or combined treatment in complex renal lithiasis. Also, intrasinusal and transparenquimatous accesses to the intrarenal tract are compared, evaluating the morbidity, surgical time and economical interpretation of both techniques.

[BCG in superficial carcinoma of the bladder. Authors' experience].

Contribution of 95 patients with surface vesical tumour managed with UTR and endovesical BCG. The response was absence of recurrence in 68.4% cases in Ta stage, 63% in T1 and 66.

[Cyst of the prostatic utricle].

Presentation of a case of prostatic utriculus cyst which due to its size and the patient's history suggested a differential diagnosis with a urethral or vesical diverticulum. Awareness of frequent association to urethral malformations and azoospermia would be very useful when choosing a treatment strategy in such cases.

Orthotopic renal transplant and results in 139 consecutive cases.

Although a commonly performed technique, heterotopic renal transplantation may be a cause of late graft failure owing to ureteral stenosis, urinary fistula and vesicoureteral reflux secondary to the immune response. The new retroperitoneal lumbar approach to the splenic vessels has allowed the orthotopic technique to be developed using the splenic artery or aorta, the renal vein and a pyelo-pyelic anastomosis. In this manner the renal graft is located in an anatomical position that is well protected, and with the recipient urinary tract the normal physiology is preserved with comparatively low complication and mortality rates.

New surgical approach for treatment of complex vesicovaginal fistula.

Complex vesicovaginal fistulas still represent a management problem, since most of the cases have been operated on previously and because of the lack of a completely successful surgical technique. A new procedure for vesical autoplasty is presented. A flap is obtained from the posterosuperior bladder wall that slides down to cover large lesions, even in low capacity reservoirs.