Functional Penile Length After Penile Plication: "Empha-sizing" What Matters.

Objective: To reassess penile length changes after penile plication (PP), we defined a novel measurement of functional penile length (FPL) and compared preoperative and postoperative measurements. PP reduces penile curvature in Peyronie's Disease (PD) patients, but is traditionally thought to reduce overall penile length. However, the literature on PD lacks a standardization for penile length measurement techniques, leading to high inter-study variability.

Robot-Assisted Laparoscopic Distal Ureteroureterostomy for Distal Benign Ureteral Strictures with Long-Term Follow-Up.

To demonstrate feasibility of robot-assisted laparoscopic (RAL) ureteroureterostomy (UU) for benign distal ureteral strictures (DUS) in our robotic reconstruction series with long-term follow-up. In a retrospective review of our prospectively maintained RAL ureteral reconstruction database, we followed patients between June 2012 and February 2019 who underwent a UU for DUS. In addition to patient demographics, we recorded the etiology, stricture length, and recurrence rates.

Management of symptomatic adult penile urethral arteriovenous malformation.

We present the Case of a 23-year-old male with a history of recurrent spontaneous urethral bleeding due to an arteriovenous malformation (AVM) of his corpus spongiosum which abutted his penile urethra. AVMs are often congenital but can also be related to prior trauma. The literature on male genital AVMs is primarily limited to pediatric AVMs of the scrotum or glans penis with one report of adult urethral AVM in the setting of known trauma.

Robotic Ureteral Bypass Surgery with Appendiceal Graft for Management of Long-Segment Radiation-Induced Distal Ureteral Strictures: A Case Series.

Surgical management of long-segment radiation-induced distal ureteral strictures (RIDUS) is challenging. Pelvic radiation can damage the bladder, inhibiting the utilization of typical reconstruction techniques such as a psoas hitch and/or Boari flap. Also, radiation can cause scarring that can make ureterolysis difficult.

Nephrobiliary fistula resulting from a gunshot wound in a young healthy male: A case report.

Biliary fistulas are most commonly caused by cholelithiasis. Other causes include malignancies and peptic ulcer disease. A biliary fistula caused by a penetrating trauma is a rare entity, and a post-traumatic biliary fistula to the renal collecting system is extremely uncommon.

Urinary retention after AdVance™ Sling: A multi-institutional retrospective study.

Aims: To identify risk factors for urinary retention following AdVance™ Sling placement using preoperative urodynamic studies to evaluate bladder contractility.

Methods: A multi-institutional retrospective review of patients who underwent an AdVance Sling for post-prostatectomy stress urinary incontinence from 2007 to 2019 was performed. Acute urinary retention (AUR) was defined as the complete inability to void or elevated post-void residual (PVR) leading to catheter placement or the initiation of intermittent catheterization at the first void trial postoperatively.

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 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.

Ureteral Reimplantation via Robotic Nontransecting Side-to-Side Anastomosis for Distal Ureteral Stricture.

To describe a novel technique of ureteral reimplantation through robotic nontransecting side-to-side anastomosis. Although the standard approach to ureteroneocystostomy has a high rate of success, it involves transection of the ureter that may impair vascularity and contribute to recurrent strictures. Our method seeks to maximally preserve distal ureteral blood flow that may reduce this risk.

Robot-assisted distal ureteral reconstruction for benign pathology: Current state.

Distal ureteral reconstruction for benign pathologies such as stricture disease or iatrogenic injury has posed a challenge for urologist as endoscopic procedures have poor long-term outcomes, requiring definitive open reconstruction. Over the past decade, there has been an increasing shift towards robot-assisted laparoscopy (RAL) with multiple institutions reporting their outcomes. In this article, we reviewed the current literature on RAL distal ureteral reconstruction, focusing on benign pathologies only.

The use of indocyanine green during robotic ureteroenteric reimplantation for the management of benign anastomotic strictures.

Purpose: We describe our technique for using intraureteral and intraurinary diversion indocyanine green (ICG) during robotic ureteroenteric reimplantation and report our outcomes.

Methods: We retrospectively reviewed eight patients who underwent ten robotic ureteroenteric reimplantations between August 2013 and July 2017. ICG was injected antegrade and/or retrograde into the lumen of the ureter, and retrograde into the lumen of the urinary diversion.

A Review of Buccal Mucosa Graft Ureteroplasty.

Purpose Of Review: We review the buccal mucosa graft (BMG) ureteroplasty literature to evaluate its utility in the management of ureteral strictures, identify indications for which it is particularly useful, and highlight refinements in surgical technique.

Recent Findings: Recent reports have described the efficacy of robotic BMG ureteroplasty and the utilization of near-infrared fluorescence to assist with precise identification of the ureteral stricture margins. BMG ureteroplasty is well-suited for ureteral reconstruction as it allows for minimal disruption of the delicate ureteral blood supply and facilitates a tension-free anastomosis.

Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-institutional Experience.

Background: Minimally invasive treatment of long, multifocal ureteral strictures or failed pyeloplasty is challenging. Robot-assisted buccal mucosa graft ureteroplasty (RBU) is a technique for ureteral reconstruction that avoids the morbidity of bowel interposition or autotransplantation.

Objective: To evaluate outcomes for RBU in a multi-institutional cohort of patients treated for revision ureteropelvic junction obstruction and long or multifocal ureteral stricture at three tertiary referral centers.

Robotic Ureteroplasty with Buccal Mucosa Graft for the Management of Complex Ureteral Strictures.

Purpose: Surgical management of proximal and mid ureteral strictures that are not amenable to primary excision and anastomosis is challenging. Although a buccal mucosa graft is commonly used during substitution urethroplasty, its use in substitution ureteroplasty is limited. We describe our technique of robotic ureteroplasty with a buccal mucosa graft to manage complex ureteral strictures and we report our outcomes.

Robotic Buccal Ureteroplasty: a Review of the Current Literature.

Purpose Of Review: This study aimed to provide an overview of the literature on buccal mucosal ureteroplasty for ureteral stricture disease, with a specific focus on the application of the robotic platform to buccal ureteroplasty.

Recent Findings: In our review, we highlight the results of Zhao et al. from the New York University School of Medicine Department of Urology, as well as our own results from Temple University Hospital.

Case Report: Conversion of a Low-Flow to High-Flow Priapism.

Priapism is defined as an erection lasting for more than 4 hours and can be grouped into 3 distinct subtypes: ischemic (low-flow), stuttering and non-ischemic (high-flow). Herein, we present an interesting case of conversion from a low-flow to high-flow priapism after a distal shunting procedure. This is a rare phenomenon that has a paucity of documented cases.

A Case Series of Spontaneous Rupture of the Urinary Bladder.

We report 2 cases of spontaneous bladder rupture related to chronic outlet obstruction and urinary retention. In both cases, focal perforation was identified within diverticula. Bladder rupture in the absence of trauma is a rare and serious event with a mortality rate approaching 50%.

Successful Surgical Management of Giant Condyloma Acuminatum (Buschke Lowenstein Tumor) in the Urethra of a Female Patient: A Case Report.

The Buschke-Lowenstein tumor (BLT) is a slow-growing, locally destructive verrucous plaque that typically appears on the penis but may occur elsewhere in the anogenital region. It most commonly is considered to be a regional variant of verrucous carcinoma. It is rare but accounts for 5-24% of all penile cancers.

Primary Ureteral Lymphoma Presenting with Acute Flank Pain.

Non-Hodgkin's lymphoma (NHL) represents 4% of newly diagnosed cancer in 2013 with a 59-82% 5-year survival depending on the tumor location. Primary presentation of lymphoma consists of lymphadenopathy or swelling of the lymph nodes and non-specific systemic symptoms such as fevers, night sweats, and weight loss. Less commonly, NHL arises from non-lymphoid tissue.

Procidentia as a Cause of Obstructive Uropathy and Acute Kidney Injury.

Pelvic organ prolapse can affect urinary tract function by reducing flow rates and increasing post void residual urine volumes secondary to outlet obstruction. If the diagnosis is missed or left untreated, pelvic organ prolapse can lead to acute renal injury, chronic renal failure or even end stage renal disease. Herein, we present a case of a patient who presented to Albert Einstein Medical Center in Philadelphia, PA with urinary retention and acute kidney injury secondary to complete uterine prolapse, also referred to as procidentia.

False-Positive Cystoscopic Diagnosis of Ureteral Obstruction After Hysterectomy Due to a Nonfunctional Kidney.

Background: An estimated 0.2% of the population may have a unilateral nonfunctional kidney. This pre-existing condition may lead to the mistaken presumption that a ureteral injury has occurred when performing cystoscopy after hysterectomy.

SIU/ICUD Consultation on Urethral Strictures: Anterior urethra-lichen sclerosus.

We reviewed the current literature on lichen sclerosus as it related to urethral stricture disease using MEDLINE and PubMed (U.S. National Library of Medicine, National Institutes of Health) up to the current time.