UrethroNAV: the aetiology and extent of idiopathic urethral stricture in an Australian population.

Background: Lichen sclerosus (LS) is considered a causative factor in 10% of cases of idiopathic urethral stricture disease (IUSD), which is important for determining management strategies due to the underlying pathophysiology. Traditional excision urethroplasty may not be effective as inflammation often extends beyond the macroscopic stricture. This pilot study aims to answer two research questions: is LS an underlying cause of some idiopathic cause of strictures, and, if there is histological evidence suggesting predisposition of the surrounding tissue to strictures.

Laparoscopic strategies in complex upper urinary tract obstruction.

Objectives: We enumerate the various laparoscopic strategies to resolve upper urinary tract (UUT) obstruction in the context of variations in anatomy and report their outcomes.

Patients And Methods: Retrospective review of primary laparoscopic UUT reconstructions performed between May 2012 and May 2021. Anomalies included: malrotated kidney (MRK), horseshoe kidney (HSK), duplex kidney (DK), pure intrarenal pelvis (IRP) and mid-ureteric stenosis (MUS).

An observational study on the sexual, genital and fertility outcomes in bladder exstrophy and epispadias patients.

Introduction: Bladder exstrophy and epispadias complex (BEEC) is a spectrum of congenital malformations ranging from an isolated epispadias to a full exstrophy. It is an uncommon disease and little is known on how patients cope with its implications later in life.

Objective: The goal of this study is to assess the sexual, continence and fertility outcomes of BEEC patients, who had reconstructive bladder surgery during childhood.

First-Year Experience of Managing Urology Patients With Home Uroflowmetry: Descriptive Retrospective Analysis.

Background: Lower urinary tract symptoms affect a large number of people of all ages and sexes. The clinical assessment typically involves a bladder diary and uroflowmetry test. Conventional paper-based diaries are affected by low patient compliance, whereas in-clinic uroflowmetry measurement face challenges such as patient stress and inconvenience factors.

Long-term risks of childhood surgery.

Introduction: Several patients, who underwent major reconstruction under the care of an experienced pediatric urologist are now, as adults, several years later, appearing with long term problems and complications. This consensus process was undertaken to give an overview of long term consequences (and their management) of urological childhood surgery.

Material And Methods: Several known urologists with experience in life-long follow up and revisional surgery of patients with congenital conditions were asked to review literature and comment based on their experience about several complications of childhood surgery.

Ticket to perform: an explorative study of trainees' engagement in and transfer of surgical training.

Background: Research suggests that simulation-based surgical skills training translates into improved operating room performance. Previous studies have predominantly focused on training methods and design and subsequent assessable performances and outcomes in the operating room, which only covers some aspects of training engagement and transfer of training. The purpose of this qualitative study was to contribute to the existing body of literature by exploring characteristics of first-year trainees' engagement in and perceptions of transfer of surgical skills training.

Evolution of testicular asymmetry during puberty in adolescents without and with a left varicocele.

Objectives: To assess the evolution of the Testicular Atrophy Index (TAI) in adolescent boys with and without a left varicocele with special attention for the currently postulated cut-off value of 20%.

Subjects And Methods: During 2015-2019, 364 adolescent boys aged 11-16 years were recruited. Genital examination and scrotal ultrasonography were repeatedly performed (≥4 month intervals).

Glans Preserving Buccal Mucosa Urethroplasty for Glandular and Distal Urethral Strictures.

Background: To describe a step-by-step approach for glans preserving urethroplasty with a dorsal inlay graft used for distal urethral strictures. Description of the Technique: The reconstruction was performed through a keyhole incision in the urethra. In this way, we achieve maximal exposure by a minimal incision and saving of the glans.

The Influence of Electrode Configuration Changes on the Sensory and Motor Response During (Re)Programming in Sacral Neuromodulation.

Objectives: This study aimed to assess the neurophysiological basis behind troubleshooting in sacral neuromodulation (SNM). Close follow-up of SNM patients with program parameter optimization has proven to be paramount by restoring clinical efficacy and avoiding surgical revision.

Materials And Methods: A total of 34 successful SNM patients (28 overactive bladder wet, six nonobstructive urinary retention) with an implantable pulse generator were included.

Primary Hyperparathyroidism Secondary to a Sestamibi-Negative Cystic Parathyroid Adenoma.

The most common cause of primary hyperparathyroidism (PHPT) is a solid parathyroid adenoma. Less than 2% of cases of PHPT are caused by cystic parathyroid adenomas formed from degeneration of pre-existing solid parathyroid adenomas. Cystic parathyroid adenomas are non-functional in over 90% of cases.

Peak retrograde flow a potential objective management tool to identify young adults with varicocele 'at risk' for a high sperm DNA fragmentation.

Introduction: Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who would benefit most from surgery. Since conventional semen parameters, have been limited in their ability to evaluate the negative effects of varicocele on fertility, specialized laboratory tests have emerged.

Objective: To identify clinical and ultrasound parameters (including PRF) which would negatively influence standard and functional semen variables in young adults with a varicocele.

Narrowing in on urethral strictures.

Background: Urethral strictures have affected men for millennia, and they are commonly iatrogenic, idiopathic or traumatic in nature. When left untreated, urethral strictures can devastate the health and function of the urinary tract. For centuries, simple urethral dilation and endoscopic urethrotomy have provided temporary relief.

Remote training in laparoscopy: a randomized trial comparing home-based self-regulated training to centralized instructor-regulated training.

Background: Simulation-based surgical training (SBST) is key to securing future surgical expertise. Proficiency-based training (PBT) in laparoscopy has shown promising results on skills transfer. However, time constraints and limited possibilities for distributed training constitute barriers to effective PBT.

Trainees' surgical activity and opportunity to transfer after simulation-based training.

Introduction: Simulation-based surgical training (SBST) is predicated on the assumption that trainees transfer their acquired skills and competencies into the operating room. Research on transfer of surgical training has focused on trainees' performance improvements and not on their actual opportunity to transfer their trained skills.

Methods: This was a retrospective study conducted using data on surgical procedures performed by first-year trainees in abdominal surgery, gynaecology and urology in the Central Denmark Region.

Fertility and sexuality issues in congenital lifelong urology patients: female aspects.

Purpose: With advances in treatment modalities and medical knowledge, girls with congenital urologic disorders are living well into adulthood. Although, sexual and reproductive function in this population is still poorly understood. The aim is to review existing literature about fertility and sexuality in women with congenital genitourinary disorders, including spina bifida (SB), bladder exstrophy-epispadias complex (BEEC) and congenital adrenal hyperplasia (CAH).

A Supervised 3 Weeks Test Phase in Sacral Neuromodulation with a 1-Year Followup.

Purpose: We sought to determine whether prolonged interventional test phase increases cumulative success rate and compared success rates between early responders (ie within 1 week) and those in need for reprogramming (due to lack of efficacy) of sacral neuromodulation after 1-year followup.

Materials And Methods: In a single tertiary center prospective study (August 2015 to November 2018) 90 patients refractory to first line treatment were eligible for sacral neuromodulation, including 48 overactive bladder wet (53%), 8 overactive bladder dry (9%) and 34 nonobstructive urinary retention (38%). Patients were evaluated at weekly intervals during test phase and those not successful were reprogrammed.

'Elimination signals' in healthy, NON toilet trained children aged 0-4 years: A systematic review.

Objective: An early start of toilet training, which is related to a younger age of acquiring full bladder control, can generate important health advantages. Children display different 'elimination signals' related to voiding or defaecation. The aim of this systematic review is to map these 'elimination signals' in young, healthy children aged 0-4 years.

Fertility and sexuality issues in congenital lifelong urology patients: male aspects.

Purpose: To review existing literature about fertility and sexuality of boys born with complex congenital genitourinary anomalies.

Methods: A Pubmed review was performed in December 2018 to identify the most relevant original manuscripts regarding male complex congenital conditions affecting the urogenital system in male patients including spina bifida (SB), bladder exstrophy-epispadias complex (BEEC) and hypospadias. A comprehensive review was drafted exploring sexual dysfunction from a medical, psychosexual, surgical and reproductive point of view during transition from childhood (or adolescence) to adulthood.

Prone posterior retroperitoneoscopic access to the kidney in children: the controlled optical trocar approach.

Introduction: Conventional access for renal surgery through the retro-peritoneum includes the blind percutaneous approach using a haemostatic clip and the Gaur balloon dissection technique or alternatively the open cut-down approach. The authors present a video detailing the technique of optical access into the retro-peritoneum.

Objective: Demonstration of the optical access technique into the retroperitoneal space using the optical trocar.