Modified anatrophic nephrolithotomy for management of staghorn calculi: is renal function preserved?

Purpose: We report the results of modified anatrophic nephrolithotomy in select patients with complex staghorn calculi.

Materials And Methods: From 1987 to 1997 modified anatrophic nephrolithotomy, including 1 bilateral procedure, was performed in 15 patients at San Francisco General Hospital. Preoperative imaging included excretory urography, sonography and computerized tomography.

Indications for nonoperative management of renal stab wounds.

Purpose: During the last 20 years 2,732 patients have presented to San Francisco General Hospital with renal trauma. Of these patients 198 sustained unilateral and 1 had bilateral stab wounds for a total of 200 renal injuries. We evaluated this subgroup of penetrating renal trauma cases to characterize the nature of the injuries and establish treatment guidelines for successful management.

Obliterative vesicourethral strictures following radical prostatectomy for prostate cancer: reconstructive armamentarium.

Purpose: We report the reconstructive techniques used to correct obliterative vesicourethral strictures related to prostate cancer surgery.

Materials And Methods: Four men with anastomotic obliteration after radical prostatectomy underwent primary excision with end-to-end anastomosis, penile fasciocutaneous flap, free-graft urethroplasty with rectus muscle flap or anterior bladder tube with omental pedicle flap procedure.

Results: At mean followup of 33.

Reconstruction of resistant strictures of the fossa navicularis and meatus.

Purpose: We evaluate the long-term efficacy of an integrated 1-stage approach for the reconstruction of resistant strictures of the fossa navicularis and meatus.

Materials And Methods: In 19 men with resistant glanular urethral strictures of varied origin reconstruction was tailored to the individual characteristics of the urethral stricture and glans. Urethral reconstruction was performed with a ventral transverse island fasciocutaneous penile flap in 16 cases, resection and primary end-to-end anastomosis in 2, and a buccal mucosal graft in 1.

Penile circular fasciocutaneous skin flap in 1-stage reconstruction of complex anterior urethral strictures.

Purpose: We review the applications and outcomes of penile circular fasciocutaneous flap urethroplasty in 66 patients at our institution.

Materials And Methods: We used a circular distal penile skin flap for urethral reconstruction in 66 men with complex urethral strictures. Average stricture length in this series was 9.

American Urological Association symptom index in the assessment of urethroplasty outcomes.

Purpose: In men undergoing urethroplasty we used the American Urological Association (AUA) symptom index to assess the magnitude of symptoms and determine the validity of this index as an outcome assessment tool.

Materials And Methods: The AUA symptom index was completed by individual interview of 50 men a mean of 41 years old who underwent urethral reconstruction. Symptom scores were then correlated with radiographic retrograde urethrograms and urinary flow rates to determine whether changes in the score were consistent with these other clinical indicators of success or failure.

Failed anterior urethroplasty: guidelines for reconstruction.

Purpose: We analyzed the methods and outcomes of repeat urethroplasty in men with recurrent stricture after the failure of previous anterior urethroplasty.

Materials And Methods: In 31 men with recurrent stricture after previous urethroplasty anterior urethral reconstruction was performed. Reconstructive methods varied according to stricture length and location.

Role of preoperative sonourethrography in bulbar urethral reconstruction.

Purpose: The accuracy of sonourethrography for the evaluation of bulbar urethral strictures has been well documented. Thus, we sought to define the role of preoperative sonourethrography in establishing objective criteria for procedure selection during bulbar urethral reconstruction.

Materials And Methods: Sonourethrography was performed preoperatively, just before incision, in 67 men selected for bulbar urethroplasty.