Background: Urethroplasty is often successful for the treatment of male urethral stricture disease, but limited data exists on recurrence management. Our goal was to evaluate direct visual internal urethrotomy (DVIU) as a treatment option for isolated, recurrent strictures after urethroplasty.
Methods: We retrospectively identified male patients who underwent urethroplasty from 1999 to 2013 and developed an isolated, recurrent stricture at the urethroplasty site treated with DVIU. Success was defined as lack of symptomatology and no subsequent intervention. Comparative analysis identified characteristics and stricture properties associated with success.
Results: A total of 436 urethroplasties were performed in 401 patients at our institution between 1999 and 2013. Stricture recurrence was noted in 64 (16%) patients. Of these, 47 (73%) underwent a DVIU. A total of 37 patients met inclusion criteria and underwent 50 DVIU procedures at the urethroplasty site. A single DVIU was successful in 13 of 37 patients (35%). A total of 4 of 6 patients required a second DVIU (67%). Overall, 17 of 43 (40%) of the total DVIUs were successful after urethroplasty. Success did not differ by age, stricture length or location, surgical technique, radiation history, prior urethroplasty or DVIU, time to failure, or etiology.
Conclusions: Post-urethroplasty DVIU for isolated, recurrent strictures may be offered as a minimally invasive treatment option. Approximately 40% of patients were spared further intervention.
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http://dx.doi.org/10.1177/1756287216679946 | DOI Listing |
Cureus
December 2024
Community Medicine, Terna Medical College, Navi Mumbai, IND.
Recurrent isolated sleep paralysis (RISP) is a rare but distressing condition characterized by episodes of temporary immobility during transitions between wakefulness and sleep. This report describes a 30-year-old female presenting frequently with nightmares, sleep paralysis, and associated stress, successfully managed with a holistic approach incorporating yoga, meditation, chanting, and vitamin D3 supplementation. The patient's significant history of osteoporosis (in February 2019, bone density T-score <-2.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Department of Respiratory Diseases, KU Leuven University Hospitals Leuven Gasthuisberg Campus, Leuven, Belgium
We report on a fatal case of invasive fungal rhinosinusitis with after lung transplantation. After endoscopic treatment and adjuvant medical therapy with isavuconazole, caspofungin and an investigational antifungal drug, there was a good clinical response with absence of endoscopic and radiographic disease. However, the patient developed disease recurrence, with signs of intracranial involvement on MRI, for which urgent endoscopic sinus surgery was performed and isavuconazole was restarted.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Dentistry, All India Institute of Medical Sciences Mangalagiri, Mangalagiri, Andhra Pradesh, India
Methicillin-resistant (MRSA) osteomyelitis of the maxilla is a rare condition in paediatric patients, with limited evidence available for optimal treatment protocols. We present the case of a paediatric patient in the early childhood age group with post-traumatic maxillary osteomyelitis caused by MRSA. The child developed facial swelling following trauma, and imaging revealed maxillary sinus wall thickening and bone erosions.
View Article and Find Full Text PDFSurgery
January 2025
Hepatobiliary Surgery and Liver Transplantation Department, Sorbonne University, Pitié Salpêtrière Hospital, Paris, France.
Background: Histologic microscopic positive resection margin is a debated prognostic factor in patients resected for colorectal liver metastases. This study aimed to assess whether patients with R1 resection experience recurrence at the site of the resection (on-site recurrence) and to identify predictive factors for recurrence profiles in patients with R1 margins after resection of colorectal liver metastases.
Methods: All surgical colorectal liver metastasis resection cases with R1 parenchymal margin from September 2014 to March 2020 in our center were retrospectively included.
Infect Immun
January 2025
Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada.
is a predominant cause of post-operative surgical site infections and persistent bacteremia. Here, we describe a patient who experienced three episodes of infection over a period of 4 months following a total knee arthroplasty. The initial bloodstream isolate (SAB-0429) was a clonal complex 5 (CC5) and methicillin-resistant (MRSA), whereas two subsequent isolates (SAB-0485 and SAB-0495) were CC5 isolates but methicillin-sensitive .
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