The management of bilateral ureteric injury following radical hysterectomy.

Iatrogenic ureteric injury is a well-recognised complication of radical hysterectomy. Bilateral ureteric injuries are rare, but do pose a considerable reconstructive challenge. We searched a prospectively acquired departmental database of ureteric injuries to identify patients with bilateral ureteric injury following radical hysterectomy.

A porcine model of bladder outlet obstruction incorporating radio-telemetered cystometry.

Objective: To present a novel porcine model of bladder outlet obstruction (BOO) with a standardized bladder outlet resistance and real-time ambulatory radio-telemetered cystometry, as BOO is a common condition with many causes in both adults and children, with significant morbidity and occasional mortality, but attempts to model this condition in many animal models have the fundamental problem of standardising the degree of outlet resistance.

Materials And Methods: BOO was created in nine castrated male pigs by dividing the mid-urethra; outflow was allowed through an implanted bladder drainage catheter containing a resistance valve, allowing urine to flow across the valve only when a set pressure differential was generated across the valve. An implantable radio-telemetered pressure sensor monitored the pressure within the bladder and abdominal cavity, and relayed this information to a remote computer.

A simple technique for accurate diathermy destruction of urethral meatal warts.

The use of surgical diathermy in the fulguration of penile warts is well established. The use of diathermy has been associated with urethral meatal stenosis resulting from circumferential thermal injury to the meatus. We describe the use of a plastic quill as a shield to prevent such circumferential thermal injuries.

Continence and classic bladder exstrophy treated with staged repair.

Purpose: Urinary continence rates after reconstruction of the urinary tract for classic bladder exstrophy are variable. We review our experience with procedures required to optimize continence.

Materials And Methods: We retrospectively reviewed the charts of patients with classic bladder exstrophy undergoing staged reconstruction between 1976 and 2001.

Cowper's syringocele causing painful haematuria in an adult.

A Cowper's syringocele in an adult is rare. Ten cases are reported in the world literature. The authors report a case of painful haematuria due to the presence of a Cowper's syringocele in an adult.

Two bladders and two vaginas in two planes: one urogenital sinus.

We report 2 cases of persistent urogenital sinus (UGS) with duplication of the bladder and vagina in different planes. Cystoscopy and vaginoscopy were used to diagnose persistent UGS with bladder and vaginal duplication in 2 infants with recurrent urinary tract infection. Surgical repair was done by way of a midline abdominal and perineal approach using tubularized UGS to reconstruct the urethra.

Reconstruction after total penile amputation and emasculation.

Amputation of the penis and testes is a rare injury in the pediatric population. The authors describe a case of traumatic amputation of the penis and testes presenting late for surgical reconstruction. The surgical reconstruction of this phallus involved advancement of the residual erectile tissue by division of the suspensory ligaments of the penis to lengthen the phallus.

Acromioclavicular joint sprains: the post-injury recovery interval.

Acromioclavicular joint (ACJ) sprains occur after injuries to the shoulder girdle. Current practice is to treat such injuries conservatively. This study determines the recovery interval of ACJ sprains treated conservatively.

Intravesical phallus in cloacal exstrophy.

We report a case of a fused phallus located within the urinary bladder in a child with cloacal exstrophy. Surgical exploration revealed a phallus formed by fusion of the left and right corpus cavernosum and completely covered by bladder urothelium. The phallus was surgically separated from the bladder and mobilized to a more normal position and a neourethra created from tubularized bladder urothelium.

Liposomal delivery of heat shock protein 72 into renal tubular cells blocks nuclear factor-kappaB activation, tumor necrosis factor-alpha production, and subsequent ischemia-induced apoptosis.

Heat shock protein 72 (HSP72) is a stress-inducible protein capable of protecting a variety of cells from toxins, thermal stress, and ischemic injury. The cytoprotective role and mechanism of action of HSP72 in renal cell ischemic injury remain unclear. To study this, HSP72 was introduced (liposomal transfer) or induced (thermal stress, 43 degrees Cx1 hour) in renal tubular cells (LLC-PK1) with Western blot confirmation.

The Indiana experience with artificial urinary sphincters in children and young adults.

Purpose: We reviewed a 22-year single institutional experience with the artificial urinary sphincter in children and adolescents. To our knowledge this report represents the largest series in the world in children.

Materials And Methods: Between 1980 and 2002, 142 patients underwent implantation of an artificial urinary sphincter, of whom 93 males and 41 females with a median age of 10 years (range 3 to 39) were available for analysis.