The utility of Martius fat pad in the repair of urogenital fistulae: review of current evidence.

Objective: To present the contemporary evidence on transvaginal urogenital fistulae (UGF) repair with Martius fat pad (MFP), compared to direct graftless fistula repair.

Methods: We reviewed all available studies reporting lower UGF repair via the transvaginal approach in MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). The primary outcome of interest was the fistula closure rates.

Intravesical onabotulinumtoxinA injections in patients on antiplatelet and anticoagulation therapy.

Aims: To determine the bleeding risk in patients taking anticoagulants (AC) and antiplatelets (AP) before onabotulinumtoxinA (BoNT-A) injections and improve peri-operative decision making and counseling.

Methods: We performed a retrospective review of patients having intravesical BoNT-A in three teaching hospitals from January 2016 to July 2018. Demographic data, indication for intravesical BoNT-A injection, and side-effects of significant bleeding requiring intervention were recorded.

Functional outcomes of vaginal surgery for urethral extrusion of mid-urethral tape in women.

Introduction And Hypothesis: We aim to determine the presentation of and immediate and longer-term outcomes of vaginal surgical excision of urethral extrusion of mid-urethral tape (MUT).

Methods: We performed a retrospective analysis of all patients with urethral extrusion of MUT having vaginal surgical excision between 2007 and 2018. The MUT was removed either partially (via vaginal approach) or completely (via combined vaginal and laparoscopic approach).

Pad weight gain in asymptomatic continent women is far less than the current ICS definition.

Aims: To investigate typical pad weight gain (PWG) in asymptomatic women who have never reported any episodes of urinary incontinence.

Methods: An observational study was performed by measuring the increase in weight of small sanitary pads worn by 35 healthy, female volunteers of a median age 36 (range, 23-56) years. Each pad was worn for a minimum of 5 h which is the typical maximum duration of an ambulatory urodynamics study.

A comparison of flow rate curve shape and video-urodynamic findings in women with lower urinary tract symptoms: can flow rate curve shape predict female bladder outflow obstruction or detrusor underactivity?

Purpose: To establish the correlation between flow rate curve shape and video-urodynamic findings in women with lower urinary tract symptoms (LUTS).

Methods: A retrospective review of consecutive women with LUTS who performed a free flow study immediately before undergoing video-urodynamic investigations over a 28-month period. Flow rate curve shape and video-urodynamic parameters were analysed.

The efficacy of onabotulinumtoxinA in patients with previous failed augmentation cystoplasty: Cohort series and literature review.

Aims: To investigate the role of onabotulinumtoxinA (BTX-A) injections in patients with failed augmentation cystoplasty for neuropathic or idiopathic detrusor overactivity (NDO or IDO).

Methods: A retrospective review of all cystoplasty patients who underwent onabotulinumtoxinA injection at a tertiary center between 2008 and 2019 was performed. Details including indications and time from cystoplasty, video-urodynamic parameters, onabotulinumtoxinA dose, and clinical outcomes were analyzed.

Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?

Purpose: To investigate pre-operative urodynamic parameters in male sling patients to ascertain whether this might better predict surgical outcomes and facilitate patient selection.

Methods: We performed a retrospective, case notes and video-urodynamics, review of men who underwent AdVanceXP male sling in three London hospitals between 2012 and 2019. Urodynamics were performed in all centres, while retrograde leak point pressure (RLPP) was performed in one centre.

Ureteric reimplantation via vaginal route: a new surgical technique.

Vesicovaginal fistulae (VVF) and ureteric reimplantation are two rare complications of obstetric surgery. VVF can be repaired via a vaginal approach utilizing Martius fat pad interposition to minimize urethral complications and improve surgical outcomes, while ureteric reimplantation into the bladder classically necessitates an abdominal or laparoscopic approach. We present a new technique of ureteric reimplantation via vaginal approach with concomitant repair of a 5-cm VVF in a 25-year-old woman after an emergency caesarean section with bladder injury and ureteric transection.

The medium- to long-term functional outcomes of women who have had successful anatomical closure of vesicovaginal fistulae.

Context: While much has been published on vesicovaginal fistula (VVF), little is known about the urinary, bowel, and sexual functional outcomes following successful anatomical closure.

Aims: We assessed the medium- to long-term urological, sexual, and bowel function outcomes following the successful anatomical closure of VVF.

Patients And Methods: We conducted interviews with 36 women (median age - 47.

Appendix or Ileum-Which is the Best Material for Mitrofanoff Channel Formation in Adults?

Purpose: We report long-term data on a large cohort of adults who underwent formation of a continent catheterizable channel for various indications. We examined outcomes according to the tissue used for channel formation.

Materials And Methods: We retrospectively reviewed the case notes of 176 consecutive adult patients in whom a continent catheterizable channel was created using the Mitrofanoff principle for a broad range of indications a median of 142 months (range 54 to 386) previously.

Correlation of MRI features of urethral diverticulum and pre- and post-operative stress urinary incontinence.

Aims: The complexity of urethral diverticulectomy depends on location, size, and degree of circumferential involvement. MRI features were examined to predict functional outcome after surgery for urethral diverticulum (UD).

Methods: A prospectively acquired database was of all patients who have had surgical excision of UD at a tertiary center since 2004 was reviewed.

Pelvic fracture urethral injury in males-mechanisms of injury, management options and outcomes.

Pelvic fracture urethral injury (PFUI) management in male adults and children is controversial. The jury is still out on the best way to manage these injuries in the short and long-term to minimise complications and optimise outcomes. There is also little in the urological literature about pelvic fractures themselves, their causes, grading systems, associated injuries and the mechanism of PFUI.

Describing the learning curve for bulbar urethroplasty.

Background: Learning curves have been described for a number of urological procedures including radical prostatectomy and laparoscopic nephrectomy but rarely for urethroplasty. We describe the learning curve for bulbar urethroplasty in a single surgeon series.

Methods: A retrospective case note review was performed of 91 consecutive men median age 32 years (range, 15-66 years) having bulbar urethroplasty performed by a single surgeon.

Preliminary report on the effect of urethral diverticulum magnetic resonance imaging configuration on the incidence of new onset urodynamic stress urinary incontinence following excision.

Context: Excision of urethral diverticulum in females has been reported to be associated with new onset urodynamic stress urinary incontinence (USUI) in up to 49%.

Aims: We have assessed the incidence of new onset USUI in all patients having urethral diverticulum excision with Martius fat pad interposition under the care of a single surgeon between May 1, 2007, and December 1, 2011. The incidence of new onset USUI has been correlated with the preoperative magnetic resonance imaging (MRI) appearance of the urethral diverticulum.

Patient treatment preferences for symptomatic refractory urodynamic idiopathic detrusor overactivity.

Introduction: There is a multiplicity of treatments currently available for patients with symptomatic refractory urodynamic idiopathic detrusor overactivity (SRU IDO). We have assessed patient treatment preferences and their outcomes over a 12-month period from January 1 2009 to December 31 2009.

Patients And Methods: A retrospective database of all patients with SRU IDO was reviewed for patient demographics, treatment preference, and outcome.

Ventral-onlay buccal mucosa graft substitution urethroplasty for urethral stricture in women.

Objective: To present our outcomes of ventral-onlay buccal mucosa graft (BMG) substitution urethroplasty in treating female urethral stricture (FUS).

Patients And Methods: We conducted a review of a prospectively collected database of 22 consecutive women (median [range] age 50 [34-72] years) with urethral stricture who underwent ventral onlay BMG substitution urethroplasty after June 2012 and who had a minimum follow-up of 6 months (median 21.5, range 6-51 months).

Definition of Success after Surgery for Female Stress Incontinence or Voiding Dysfunction: An Attempt at Standardization.

Context: There is currently no standardized definition of success for surgery for stress urinary incontinence (SUI) and voiding dysfunction (VD) in women.

Objective: To review the use of outcome measures (OMs) and definitions of success in the literature on SUI and VD surgery in women in an attempt to provide recommendations for future publications.

Evidence Acquisition: A PubMed search of all English language full-text articles on SUI and VD surgery in women published between 2010 and 2015 was performed.

Does the appearance of the urethral pressure profile trace correlate with the sphincter EMG findings in women with voiding dysfunction?

Aims: Women with functional voiding dysfunction often experience a "catching" sensation when catheterising and are in general investigated with both urethral pressure profilometry (UPP) and sphincter electromyography (EMG). It is unknown whether the pattern of the UPP trace correlates with this sensation of "catching" or with sphincter EMG findings.

Methods: We reviewed the database of all women with voiding dysfunction who had undergone both sphincter EMG and UPP to assess for any relationship between pattern of UPP trace and "catching" on catheterization and/or sphincter EMG findings.

Developing and validating a new nomogram for diagnosing bladder outlet obstruction in women.

Objective: To develop and validate a nomogram for assessing bladder outlet obstruction (BOO) in women derived from concurrent P and Q based on radiographic evidence of increased urethral resistance.

Patients And Methods: Retrospective analysis of prospectively acquired video-urodynamics and clinical data of 185 women (development cohort) was performed. The P were plotted against Q and cluster analysis was performed to determine an axis that best divided the definitively obstructed and unobstructed.

A systematic review of the literature on cystodistension in bladder pain syndrome.

Introduction And Hypothesis: There is significant variability in technique for cystodistension and an international discrepancy in the role in its treatment of bladder pain syndrome (BPS). The authors evaluate the evidence base for the use of cystodistension for BPS with particular reference to patient-related outcomes.

Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement, a prospective search and evaluation protocol was prepared and registered with the PROSPERO database (ID CRD42017053710).

Can filling phase urodynamic parameters predict the success of the bulbar artificial urinary sphincter in treating post-prostatectomy incontinence?

Objective: To evaluate whether filling phase urodynamic parameters can predict the success of the artificial urinary sphincter (AUS) in treating post-prostatectomy incontinence (PPI).

Materials And Methods: We reviewed the pre-AUS urodynamics of 99 patients with PPI at two tertiary referral centers. We documented the peak DO pressure (P ), capacity, and compliance (C).

Urethral diverticulectomy with Martius labial fat pad interposition improves symptom resolution and reduces recurrence.

Objective: To assess the presenting features and medium-term symptomatic outcomes in women having excision of urethral diverticulum with Martius labial fat pad (MLFP) interposition.

Patients And Methods: We reviewed our prospective database of all female patients having excision of a symptomatic urethral diverticulum between 2007 and 2015. Data on demographics, presenting symptoms and clinical features were collected, as well as postoperative outcomes.