Surgical strategies in artificial urinary sphincter revision surgery: troubleshooting the complications.

Post-prostatectomy urinary incontinence (PPUI) is an important issue in the urological practice and imposes a negative effect on quality of life (QoL). Despite recent technological advances, PPUI remains a common complication and the artificial urinary sphincter (AUS) is regarded as the most effective long-term surgical treatment for moderate-to-severe stress urinary incontinence. Success rates for AUS as defined by a continence status of zero to one pad per day range from 59% to 90%.

Animal Model Standardization for Studying Avascular Necrosis of the Femoral Head in Legg-Calvé-Perthes Disease.

 Testing an experimental model for ischemic necrosis of the femoral head in Legg-Calvé-Perthes disease by evaluating gait, imaging and morphohistology.  The operation was done in 11 piglets. Necrosis by cerclage in the right femoral neck was induced.

Transcutaneous tibial nerve electrical stimulation versus vaginal electrical stimulation in women with overactive bladder syndrome: Is there a role for short-term interventions?

Objective: To assess the efficacy of vaginal electrical stimulation (VS) versus transcutaneous tibial nerve electrical stimulation (TTNS) in women with overactive bladder syndrome (OAB).

Material And Methods: Sixty-nine patients were randomized to receive 12 sessions of VS versus TTNS, or no treatment (control group-CG), over 6 weeks. OAB impact according to international consultation on incontinence questionnaire overactive bladder module (ICIQ-OAB), symptoms discomfort scores and voiding diaries were evaluated at baseline, 6 weeks and 1-month post-treatment.

Can platelet-rich plasma coating improve polypropylene mesh integration? An immunohistochemical analysis in rabbits.

Purpose: Despite high success rates in the treatment of urinary incontinence, complications related to the use of polypropylene (PP) meshes are still a concern, especially in vaginal prolapses surgeries. The objective of this study was to assess the effect of autologous platelet-rich plasma (PRP) coating on the integration of PP meshes implanted in the vaginal submucosa of rabbits.

Materials And Methods: Thirty adult New Zealand rabbits were randomly divided into two groups (n=15): PP, implanted with conventional PP meshes; and PRP, implanted with autologous PRP coated PP meshes.

Hybrid Sling for the Treatment of Concomitant Female Urethral Complex Diverticula and Stress Urinary Incontinence.

This study aims to present an alternative technique with the use of a transobturator hybrid sling (autologous fascia lata with a synthetic sling) in two patients with complex urethral diverticulum (CUD), urinary stress incontinence (SUI) and a large incisional infraumbilical hernia. Staged procedures could be performed, but considering the risk of persistence or worsening SUI, and no standard management strategy of SUI associated with CUD; simultaneous treatment was proposed. It is preferable to use autologous materials in such cases.

Independent validation of a predictive nomogram for risk of reinfection in women with recurrent non-complicated urinary tract infections.

Aims: Independent external validation of a predictive nomogram for risk of reinfection in women with a history of non-complicated recurrent urinary tract infection (UTI).

Methods: A retrospective longitudinal study was conducted to validate the LUTIRE nomogram in a Brazilian female cohort. The nomogram was applied to 81 women presenting non-complicated recurring UTI screened at a urological clinic.

Laparoscopic Boari flap for treatment of benign midureter stricture.

Introduction:: Laparoscopic ureteral reconstructive surgery represents a real challenge for most of the urologists as it requires advanced skills. Impacted stones (>2 months) and endoscopic procedures are known major risk factors for ureteral strictures. Boari flap is a good alternative, due to the high recurrence of kidney stone disease, as it preserves the feasibility of ureteroscopy.

Is There a Link Between Carotid Atherosclerosis and Idiopathic Overactive Bladder Among Women with Metabolic Syndrome?

Purpose: To evaluate the association between increased intima-media thickness (IMT) and atherosclerotic carotid plaque (CP) with idiopathic overactive bladder syndrome (OAB) in women with metabolic syndrome (MetS).

Methods: This is a cross-sectional study, which included consecutive women aged 40-75 years with MetS, seeking medical assistance at a reference center between April and December 2016. OAB-V8 questionnaire was used to estimate the prevalence of OAB symptoms, which were defined by a score ≥8 points.

Effect of the platelet-rich plasma covering of polypropylene mesh on oxidative stress, inflammation, and adhesions.

Introduction And Hypothesis: Polypropylene mesh (PPM) is often used for urogynecological repair; however, it can cause complications. An approach to reduce complications is to coat PPM with anti-inflammatory and wound-healing molecules. Platelet-rich plasma (PRP) is inexpensive and improves wound healing.

Effect of platelet-rich plasma on polypropylene meshes implanted in the rabbit vagina: histological analysis.

Purpose: The polypropylene mesh (PPM) is used in many surgical interventions because of its good incorporation and accessibility. However, potential mesh-related complications are common. Platelet-rich plasma (PRP) improves the healing of wounds and is inexpensive.

Endoscopic use of cyanoacrylate glue in the treatment of urethral fistula.

Purpose: The aim of this video is to demonstrate an endoscopic and minimally invasive repair of an urethrocutaneous fistula with cyanoacrylate glue.

Materials And Methods: A 56 year-old-man with post-infectious urethral stricture and recurrent perineal abscess formation due to urethral fistulas.

Results: The operative time was 60 minutes, no major complications were observed perioperatively and postoperatively.

Small-bowel obstruction and bladder injury due to retropubic sling malposition in the peritoneal cavity.

We report a case of small-bowel obstruction caused by an internal hernia produced by the presence of an intraperitoneal sling mesh. A woman with a history of multiple abdominal surgeries was referred from another center after a sling procedure. On the fifth day after surgery, she developed small-bowel obstruction.

The help-seeking by women with urinary incontinence in Brazil.

Introduction And Hypothesis: Lower tract urinary symptoms are underestimated by women as well as health professionals. The objective of this study was to evaluate the behavior of adult women with urinary incontinence and overactive bladder symptoms in seeking medical treatment.

Methods: Two hundred ninety-two women between 20 and 82 years old were interviewed.

Influence of sling material on inflammation and collagen deposit in an animal model.

Aim: Compare inflammation and collagen production induced by four sling materials in female rats.

Methods: Adult female rats (n=144) were submitted to a urinary incontinence model and neutering. After four weeks they were randomized in 5 groups: Sham; autologous sling; Marlex; swine intestinal submucosa (SIS), and polypropylene mesh (TVT).