Urethroplasty for Failed Hypospadias Repair Related Strictures in Adults: A Retrospective Analysis With Long-term Follow-up.

Objective: To report long-term surgical outcomes after urethroplasty for failed hypospadias repair (FHR) related strictures in adults.

Materials And Methods: A database of all adult (≥18 years) men who underwent urethroplasty since 2000 at Ghent University Hospital was created (prospective data since 2008). Patients with a follow-up <1 year or non-FHR related strictures were excluded.

Independent risk factors for failure after anterior urethroplasty: a multivariate analysis on prospective data.

Purpose: To identify independent risk factors for urethroplasty failure in a prospective dataset.

Methods: Since 2008, data of all male patients undergoing urethroplasty at Ghent University Hospital have been prospectively recorded and maintained. This analysis excluded: posterior strictures, strictures of the perineostomy, urethral malignancy-related strictures, age < 18 years and follow-up < 1 year.

Primary versus Redo Urethroplasty: Results from a Single-Center Comparative Analysis.

Objectives: To explore the differences between primary and redo urethroplasty and to directly compare according stricture-free survival (SFS). . Data of all male patients who underwent urethroplasty at Ghent University Hospital were collected between 2000 and 2018.

Perineal Urethrostomy for Complicated Anterior Urethral Strictures: Indications and Patient's Choice. An Analysis at a Single Institution.

Objectives: To explore indications for a definitive perineal urethrostomy (PU). To objectify the proportion of patients not completing the final stage procedure in an intended multi-stage urethroplasty. To analyze the incentives for both of these scenarios.

A Comprehensive Review Emphasizing Anatomy, Etiology, Diagnosis, and Treatment of Male Urethral Stricture Disease.

To date, urethral stricture disease in men, though relatively common, represents an often poorly managed condition. Therefore, this article is dedicated to encompassing the currently existing data upon anatomy, etiology, symptoms, diagnosis, and treatment of the disease, based on more than 40 years of experience at a tertiary referral center and a PubMed literature review enclosing publications until September 2018.

Vessel-sparing Excision and Primary Anastomosis.

Urethroplasty is considered to be the standard treatment for urethral strictures since it provides excellent long-term success rates. For isolated short bulbar or posterior urethral strictures, urethroplasty by excision and primary anastomosis (EPA) is recommended. As EPA only requires the excision of the narrowed segment and the surrounding spongiofibrosis, a full-thickness transection of the corpus spongiosum, as performed in the traditional transecting EPA (tEPA), is usually unnecessary.

Update on early instillation of chemotherapy after transurethral resection of non-muscle-invasive bladder cancer.

Non-muscle-invasive bladder cancer (NMIBC) is a highly recurrent disease. Early bladder chemotherapy instillation (EBCI) after transurethral resection (TURB) is an efficient way to diminish recurrence. However, this method is often challenged.

Single ablative intravesical electromotive mitomycin C administration for small non-muscle-invasive bladder cancer: a prospective study.

Objectives To explore the effect of electromotive drug administration of mitomycin C (EMDA-MMC) using a single dose of intravesical mitomycin C (MMC) to avoid transurethral resection (TURBT) for small non-muscle-invasive bladder cancer. Material and methods All patients presenting small (<2 cm), single or multiple papillary bladder tumors were proposed to undergo a single EMDA-MMC instillation with 60 mg MMC before planning TURBT. The end point is complete disappearance of all papillary tumors at 2-4 weeks after EMDA-MMC.

Perspective on cytoreduction and metastasis-directed therapy in node positive and metastatic urothelial carcinoma of the bladder.

The outcome of node positive or metastatic urothelial carcinoma of the bladder (mUCB) is poor and palliative chemotherapy has long been considered the only treatment option for this patient group. Cytoreduction and metastasis-directed therapy, either by surgery or radiotherapy, has been successfully applied in other metastatic solid tumors in order to increase survival. In this article, we explore the literature supporting cytoreduction and metastasis-directed therapy in node positive and mUCB and try to define a patient cohort that could benefit from these treatments.

Nontransecting Anastomotic Repair in Urethral Reconstruction: Surgical and Functional Outcomes.

Purpose: We evaluated the surgical and functional outcomes, and the effect of the learning curve of nontransecting anastomotic repair for short bulbar and posterior urethral strictures.

Materials And Methods: A total of 75 patients were treated with nontransecting anastomotic repair for short bulbar strictures in 55 and for posterior strictures in 20. Surgical morbidity was scored using the Clavien-Dindo classification at 3 months.

Duration of urethral catheterization after urethroplasty: how long is enough?

Background: To report the impact of duration of urethral catheterization (DUC) on the rate of extravasation on voiding cysto-urethrography (VCUG) and the subsequent need of catheter replacement in urethroplasty.

Methods: Two hundred nineteen consecutive patients undergoing urethroplasty between October 2010 and November 2014 were evaluated for the impact of DUC. Patients were divided into 2 groups, based on the scheduled DUC≤10 days (group 1, N.

Increasing age is not associated with toxicity leading to discontinuation of treatment in patients with urothelial non-muscle-invasive bladder cancer randomised to receive 3 years of maintenance bacille Calmette-Guérin: results from European Organisation for Research and Treatment of Cancer Genito-Urinary Group study 30911.

Objective: To determine the relationship of age to side-effects leading to discontinuation of treatment in patients with stage Ta-T1 non-muscle-invasive bladder cancer (NMIBC) treated with maintenance bacille Calmette-Guérin (BCG).

Patients And Methods: We evaluated toxicity for 487 eligible patients with intermediate- or high-risk Ta-T1 (without carcinoma in situ) NMIBC randomised to receive 3 years of maintenance BCG therapy (247 BCG alone and 240 BCG + isoniazid) in European Organisation for Research and Treatment of Cancer Genito-Urinary Group trial 30911. The percentage of patients who stopped for toxicity and the number of treatment cycles that they received were compared in four age groups, ≤60, 61-70, 71-75 and >75 years, using the Mantel-Haenszel chi-square test for trend.

Managing the adverse events of intravesical bacillus Calmette-Guérin therapy.

This paper provides recommendations on the management of complications arising from intravesical treatment with bacillus Calmette-Guérin (BCG) for nonmuscle-invasive bladder tumors. There is minimal recommendations currently available as randomized trials on the side effects of intravesical BCG are lacking and severe complications are usually described in case reports only. All physicians giving intravesical BCG should be aware of the possible complications that could arise and how to treat these.

Anastomotic Repair versus Free Graft Urethroplasty for Bulbar Strictures: A Focus on the Impact on Sexual Function.

Objectives. To evaluate alterations in sexual function and genital sensitivity after anastomotic repair (AR) and free graft urethroplasty (FGU) for bulbar urethral strictures. Methods.

Varicocele: the origin of benign prostatic hypertrophy? Testosterone dosages in the periprostatic plexus.

Objectives: In 2008, Gat et al. wrote the hypothesis that benign prostatic hypertrophy (BPH) was caused by reflux from high free testosterone containing blood from varicocele. The purpose of this study is to measure testosterone at the prostatic veins in patients operated for large BPH, confirming Gat's theory.

EORTC Nomograms and Risk Groups for Predicting Recurrence, Progression, and Disease-specific and Overall Survival in Non-Muscle-invasive Stage Ta-T1 Urothelial Bladder Cancer Patients Treated with 1-3 Years of Maintenance Bacillus Calmette-Guérin.

Background: There are no prognostic factor publications on stage Ta-T1 non-muscle-invasive bladder cancer (NMIBC) treated with 1-3 yr of maintenance bacillus Calmette-Guérin (BCG).

Objective: To determine prognostic factors in NMIBC patients treated with 1-3 yr of BCG after transurethral resection of the bladder (TURB), to derive nomograms and risk groups, and to identify high-risk patients who should be considered for early cystectomy.

Design, Setting, And Participants: Data for 1812 patients were merged from two European Organization for Research and Treatment of Cancer randomized phase 3 trials in intermediate- and high-risk NMIBC.

Systematic Review and Individual Patient Data Meta-analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa-pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation?

Context: The European Association of Urology non-muscle-invasive bladder cancer (NMIBC) guidelines recommend that all low- and intermediate-risk patients receive a single immediate instillation of chemotherapy after transurethral resection of the bladder (TURB), but its use remains controversial.

Objective: To identify which NMIBC patients benefit from a single immediate instillation.

Evidence Acquisition: A systematic review and individual patient data (IPD) meta-analysis of randomized trials comparing the efficacy of a single instillation after TURB with TURB alone in NMIBC patients was carried out.

Ablative Intravesical Chemotherapy for Small Recurrent Non-Muscle-Invasive Bladder Cancer: A Prospective Study.

Objective: The efficacy of intravesical chemotherapy in abolishing small papillary recurrences of non-muscle-invasive bladder cancer (NMIBC), the disease-free interval in responders and patients' preferences were explored.

Methods: When a small (≤1 cm) papillary recurrence of a NMIBC was diagnosed, the patient could choose between immediate transurethral resection of the bladder (TURB) or four weekly intravesical instillations with mitomycin C (MMC) or epirubicin (ERC). Control cystoscopy was scheduled 2-3 weeks after the last instillation.

Perineal urethrostomy: surgical and functional evaluation of two techniques.

Introduction: PU is an option to manage complex and/or recurrent urethral strictures and is necessary after urethrectomy and/or penectomy. PU is generally assumed to be the last option before abandoning the urethral outlet.

Method: Between 2001 and 2013, 51 patients underwent PU.

Transurethral resection of the prostate in recurrent acute bacterial prostatitis.

Objective: To explore the outcome of transurethral resection of the prostate (TURP) in the treatment of refractory recurrent acute bacterial prostatitis.

Patients And Methods: From 2004 to 2013, 23 TURP for this indication were performed in 21 patients; two patients underwent it twice. The files of these patients were retrospectively analysed for outcome and side effects.