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Sample records for congenital urethral valves

  1. Radiological findings of congenital urethral valves

    International Nuclear Information System (INIS)

    Yeon, Kyung Mo; Kook, Shin Ho

    1990-01-01

    Congenital urethral valve is the common cause of hydronephrosis in newborn infants and the most common cause of bladder outlet obstruction in male children. We reviewed and analysed radiological findings and associated anomalies of 16 cases of congenital urethral valve which were examined during the period from January 1985 to December 1989. The most frequent age was under one year old (56%). The main symptoms were urinary dribbing (37.5%), weak stream (25%) and urinary frequency and incontinence (25%). Anterior urethral valve (AUV) was 5 cases (31%) and posterior urethral valve (PUV) was 11 cases(69%), in which 10 cases were Type I and one case was Type III. Bladder wall thickening was seen in all cases and its severity was partly correlated with the degree of vesicoureteral reflux (VUR). VUR was observed in 12 cases (75%), and relatively severe in older age group. The degree of VUR was milder in AUV than PUV. Hydronephrosis was more severe in PUV than in anterior one, and its degree was correlated with the severity of VUR. Associated anomalies were ectopic urethral opening (2 cases), PDA (1 case), congenital megacolon (1 case) and patent urachus (1 case) in PUV. So early diagnosis and treatment of congenital urethral valve is essential to the prevention of renal damage

  2. Congenital anterior urethral valves and diverticula: Diagnosis and ...

    African Journals Online (AJOL)

    Conclusion: We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms of general condition as opposed to patients of posterior urethral valves. The diagnosis is easily established by VCUG and the severity is revealed by a sonogram. Open surgical excision is the method of ...

  3. Congenital scaphoid megalourethra associated with posterior urethral valve: A case report

    Directory of Open Access Journals (Sweden)

    Apoorva Achyut Kulkarni

    2018-01-01

    Full Text Available Congenital scaphoid megalourethra is a very rare congenital anomaly of the anterior urethra in males. Here, a case of scaphoid megalourethra and posterior urethral valves is presented. A one and half year old male child came to us with complaints of ballooning at the tip of penis since birth. Micturating cystourethrogram showed a dilated glanular urethra. The patient underwent a Nesbitt’s longitudinal reduction urethroplasty with a single-staged, single layered repair. Post-operatively, the child passed a healthy stream of urine without straining

  4. Posterior Urethral Valves

    Directory of Open Access Journals (Sweden)

    Steve J. Hodges

    2009-01-01

    Full Text Available The most common cause of lower urinary tract obstruction in male infants is posterior urethral valves. Although the incidence has remained stable, the neonatal mortality for this disorder has improved due to early diagnosis and intensive neonatal care, thanks in part to the widespread use of prenatal ultrasound evaluations. In fact, the most common reason for the diagnosis of posterior urethral valves presently is the evaluation of infants for prenatal hydronephrosis. Since these children are often diagnosed early, the urethral obstruction can be alleviated rapidly through catheter insertion and eventual surgery, and their metabolic derangements can be normalized without delay, avoiding preventable infant mortality. Of the children that survive, however, early diagnosis has not had much effect on their long-term prognosis, as 30% still develop renal insufficiency before adolescence. A better understanding of the exact cause of the congenital obstruction of the male posterior urethra, prevention of postnatal bladder and renal injury, and the development of safe methods to treat urethral obstruction prenatally (and thereby avoiding the bladder and renal damage due to obstructive uropathy are the goals for the care of children with posterior urethral valves[1].

  5. Congenital anterior urethral valves and diverticula: Diagnosis and management in six cases

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    Rawat Jiledar

    2009-01-01

    Full Text Available Background: Anterior urethral valves (AUVs are rare congenital anomalies causing lower urinary tract obstruction in children. Although they are referred to as valves, these obstructive structures often occur in the form of a diverticulum. The urethra in these cases shows saccular or bulbar dilatation known as anterior urethral diverticulum (AUD. They typically occur where there is a defect in the corpus spongiosum, leaving a thin-walled urethra. This segment of the urethra balloons out during voiding, simulating a mass that is sometimes visible along the ventral wall of the penis. The swelling is fluctuant and urine dribbles from the meatus on compression. The present study highlights the clinical approach in identifying the condition and its treatment options, especially for those, presenting with urethral diverticula. Materials and Methods: We have studied children with congenital anterior urethral valves and diverticula. Six patients of AUVs with diverticula were admitted during the period of 2000-2007 and were prospectively evaluated. The mean age of presentation was 16 months (15 days to 4 years. Straining at micturition and a palpable penile swelling were the most common presenting features. The diagnosis was established by voiding cystourethrogram (VCUG and supported by ultrasonography (USG. All patients were treated with single-stage open surgical excision except one who died preoperatively due to urosepsis. Initial lay opening of the penoscrotal urethra and delayed repair were done in one patient. Results: The surgical outcome was successful in all but one patient, who died of delayed presentation with severe back pressure changes, urinary ascitis and urosepsis. On long-term follow-up, all patients demonstrated good stream of urine. The renal functions were normal and the patients had no evidence of urinary infections. Conclusion: We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms

  6. Congenital anterior urethral diverticulum

    International Nuclear Information System (INIS)

    Jung, Hyun Sub; Chung, Young Sun; Suh, Chee Jang; Won, Jong Jin

    1985-01-01

    Two cases of congenital anterior urethral diverticular which have occurred in a 4 year old and one month old boy are presented. Etiology, diagnostic procedures, and its clinical results are briefly reviewed

  7. Anterior Urethral Valves

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    Vidyadhar P. Mali

    2006-07-01

    Full Text Available We studied the clinical presentation and management of four patients with anterior urethral valves; a rare cause of urethral obstruction in male children. One patient presented antenatally with oligohydramnios, bilateral hydronephrosis and bladder thickening suggestive of an infravesical obstruction. Two other patients presented postnatally at 1 and 2 years of age, respectively, with poor stream of urine since birth. The fourth patient presented at 9 years with frequency and dysuria. Diagnosis was established on either micturating cystourethrogram (MCU (in 2 or on cystoscopy (in 2. All patients had cystoscopic ablation of the valves. One patient developed a postablation stricture that was resected with an end-to-end urethroplasty. He had an associated bilateral vesicoureteric junction (VUJ obstruction for which a bilateral ureteric reimplantation was done at the same time. On long-term follow-up, all patients demonstrated a good stream of urine. The renal function is normal. Patients are continent and free of urinary infections. Anterior urethral valves are rare obstructive lesions in male children. The degree of obstruction is variable, and so they may present with mild micturition difficulty or severe obstruction with hydroureteronephrosis and renal impairment. Hence, it is important to evaluate the anterior urethra in any male child with suspected infravesical obstruction. The diagnosis is established by MCU or cystoscopy and the treatment is always surgical, either a transurethral ablation or an open resection. The long-term prognosis is good.

  8. Blocked Urethral Valves

    Science.gov (United States)

    ... if any damage has occurred to the upper urinary tract. Your pediatrician will consult with a pediatric nephrologist (kidney specialist) or nurologist, who may recommend surgery to remove the obstructing valves and prevent further infection or damage to the kidneys or urinary system. ...

  9. Posterior Urethral Valves in Children: Pattern of Presentation and ...

    African Journals Online (AJOL)

    of congenital lower urinary tract outflow obstruction in male infants with an ... Talabi, et al.: Surgical treatment and initial outcome of posterior urethral valve in children. 152 ... stabilizing the patients by controlling infection, correction of fluid, electrolyte ..... have predictive value or be responsible for the long term development ...

  10. Anterior urethral valves: not such a benign condition…

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    Omar eCruz-Diaz

    2013-11-01

    Full Text Available Purpose: Anterior urethral valves (AUV is an unusual cause of congenital obstruction of the male urethra, being 15 to 30 times less common than posterior urethral valves (PUV. It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV.The long term prognosis of anterior urethral valves is not clear in the literature. In this report we describe our experience and long-term follow up of patients with AUV.Materials and methods: We retrospectively identified 13 patients who presented with the diagnosis of AUV in our institutions between 1994 and 2012. From the 11 patients included, we evaluated the gestational age, ultrasound and voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine and clinical follow up.Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves, where 11 patients (7.3% had AUV and an adequate follow up. Mean follow up is 6.3 years. 5 patients (45.4% had pre-natal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder.The mean gestational age was 37.6 weeks. Postnatally, 90% had trabeculated bladder, 80% hydronephrosis and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in 5 patients (45.4%.7 patients (63.6% had primary transurethral valve resection or laser ablation and 3 patients (27.2% had primary vesicostomies. One boy (9.1% had urethrostomy with urethral diverticulum excision. 2 patients (18.2% developed end-stage renal disease (ESRD.Conclusions: Early urinary tract obstruction resulted in ESRD in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUV we recommend long-term follow up and close evaluation of patient’s bladder and renal function.

  11. Anterior urethral valves without diverticulum, a rare cause of infravesical obstruction and vesicoureteral reflux in children: Report of two cases and literature review

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    Jyoti Bothra

    2017-09-01

    Full Text Available Congenital anterior urethral valve is a rare condition causing significant obstructive uropathy in pediatric age group. It is much rarer than posterior urethral valve. However, the clinical course is similar. We present two cases of anterior urethral valves in children

  12. Management of Posterior Urethral Valves in Rural Kenya

    African Journals Online (AJOL)

    Management of Posterior Urethral Valves in Rural. Kenya .... Antwi S. Audit of Posterior Urethral Valve (PUV) in Children at ... Community Paediatrics Committee, Infectious. Diseases ... Effect of Circumcision on Risk of Urinary Tract. Infection in ...

  13. Adult posterior urethral valve: a case report

    Science.gov (United States)

    Kilciler, Mete; Basal, Seref; Irkilata, Hasan Cem; Zor, Murat; Istanbulluoglu, Mustafa Okan; Dayanc, Murat

    2010-01-01

    Introduction: Posterior urethral valve (PUV) is a congenital obstructive defect of the male urethra with an incidence of 1/8,000 to 1/25,000 live births. PUV is the most common cause of lower urinary tract obstruction in neonates. The diagnosis of PUV is usually made early, and PUV cases have rarely been detected in adults. Case presentation: Here we report the case of a 35 years old man presented with obstructive urinary symptoms. In spite of bladder neck rejection uroflowmetry pointed out infravesical obstruction with max. flow rate 9 ml/s and average flow rate 6 ml/s in uroflowmetry. During cystoscopy mild bladder trabeculation and resected bladder neck were seen. While the cystoscope was taken off, PUV were obtained. Conclusion: Since PUV is a rare condition in adults and the diagnosis of PUVs is also difficult in these groups we must consider this situation during evaluation of adult patients with obstructive symptoms especially during cystourethroscopy. PMID:20379394

  14. Adult posterior urethral valve: a case report

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    Dayanc, Murat

    2010-03-01

    Full Text Available Introduction: Posterior urethral valve (PUV is a congenital obstructive defect of the male urethra with an incidence of 1/8,000 to 1/25,000 live births. PUV is the most common cause of lower urinary tract obstruction in neonates. The diagnosis of PUV is usually made early, and PUV cases have rarely been detected in adults. Case presentation: Here we report the case of a 35 years old man presented with obstructive urinary symptoms. In spite of bladder neck rejection uroflowmetry pointed out infravesical obstruction with max. flow rate 9 ml/s and average flow rate 6 ml/s in uroflowmetry. During cystoscopy mild bladder trabeculation and resected bladder neck were seen. While the cystoscope was taken off, PUV were obtained. Conclusion: Since PUV is a rare condition in adults and the diagnosis of PUVs is also difficult in these groups we must consider this situation during evaluation of adult patients with obstructive symptoms especially during cystourethroscopy.

  15. Late presentation of posterior urethral valves.

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    Jalbani, Imran Khan; Biyabani, Syed Raziuddin

    2014-05-01

    Presence of posterior urethral valves (PUV) is the most common cause of urinary tract obstruction in the male neonate. Late presentation occurs in 10% of cases. We present a case of PUVs in an adult male who presented with history of obstructive lower urinary tract symptoms and hematuria. On evaluation, he was found to have raised serum creatinine level. A voiding cystourethrogram (VCUG) could not be completely performed because of narrowing in the posterior urethra. A rigid urethrocystoscopy was performed at which he was found to have type-I posterior urethral valve which were fulgurated. A repeat uroflowmetry revealed maximum flow rate of 12 ml/second. This case highlights that PUVs is not solely a disease of infancy but may also present late. VCUG is the radiological investigation of choice but the diagnosis may be missed. A urethrocystoscopy is advised if there is a high index of suspicion.

  16. Congenital urethral polyps: a report of two cases

    International Nuclear Information System (INIS)

    Cano, D.; Vivas, I.; Torres, E.; Garcia, L.; Fernandez-Villa, T.

    1999-01-01

    Congenital urethral polyps are uncommon lesions, very few cases of which have been previously reported in the literature. We present two cases of congenital urethral polyps in children, describing the clinical and radiological features and the diagnostic method employed, as well as reviewing the literature. (Author) 6 refs

  17. Posterior urethral valves: search for a diagnostic reference standard

    NARCIS (Netherlands)

    de Jong, Tom P. V. M.; Radmayr, Christian; Dik, Pieter; Chrzan, Rafal; Klijn, Aart J.; de Kort, Laetitia

    2008-01-01

    To test the agreement among pediatric urologists regarding endoscopic findings concerning posterior urethral valves. A total of 25 experienced pediatric urologic surgeons observed 11 video fragments of cystourethroscopy in boys. For most of these boys, a strong suspicion of urethral obstruction had

  18. A rare case of congenital Y-type urethral duplication

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    Charu Tiwari

    2015-11-01

    Full Text Available Duplication of urethra is a rare congenital anomaly. We report a case of Y-type of urethral duplication with the accessory urethra arising from posterior urethra and opening in the perineum. The orthotopic urethra was normal. The accessory urethral tract was cored, transfixed and divided. At 1 year of follow-up, the patient has no urinary complaints

  19. Long-term bladder dysfunction and renal function in boys with posterior urethral valves based on urodynamic findings

    NARCIS (Netherlands)

    M.A.I. Ghanem (Mazen); K.P. Wolffenbuttel (Katja); A. de Vylder (Ann); R.J.M. Nijman (Rien)

    2004-01-01

    textabstractPurpose: Posterior urethral valves are the most common cause of congenital obstructive uropathy leading to renal failure in childhood. We investigate the influence of bladder dysfunction on renal function impairment. Materials and Methods: We retrospectively reviewed the records of 116

  20. Long-term bladder dysfunction and renal function in boys with posterior urethral valves based on urodynamic findings

    NARCIS (Netherlands)

    Ghanem, MA; Wolffenbuttel, KP; De Vylder, A; Nijman, RJ

    Purpose: Posterior urethral valves are the most common cause of congenital obstructive uropathy leading to renal failure in childhood. We investigate the influence of bladder dysfunction on renal function impairment. Materials and Methods: We retrospectively reviewed the records of 116 patients with

  1. Posterior urethral valves: Risk factors for progression to renal failure.

    Science.gov (United States)

    Bilgutay, Aylin N; Roth, David R; Gonzales, Edmond T; Janzen, Nicolette; Zhang, Wei; Koh, Chester J; Gargollo, Patricio; Seth, Abhishek

    2016-06-01

    Posterior urethral valves (PUVs) are the most common etiology for congenital urethral obstruction and congenital bilateral renal obstruction. PUVs produce a spectrum of urologic and renal sequelae. Our aims were to assess outcomes of PUV patients, to determine whether vesicoureteral reflux (VUR) is a risk factor for progression to renal failure, and to identify other risk factors for poor outcomes. We conducted a retrospective analysis of PUV patients from 2006 to 2014. Data collected included demographics, initial renal ultrasound (RUS) findings, creatinine at presentation and nadir, pre- and postoperative VUR status, presence or absence of recurrent urinary tract infections (UTIs), and surgical intervention(s). Univariate and multivariate analyses were used to determine risk factors for renal failure. Of 104 patients, 42.3% (44/104) were diagnosed prenatally, 31.8% (14/44) of whom underwent prenatal intervention. Postnatally, 90.4% (94/104) initially underwent transurethral resection of PUVs (TUR-PUVs). Vesicostomy was the next most common index surgery (4.8%). Forty-two percent (44/104) required >1 surgery. The predominant second surgery was repeat TUR-PUV in 16 patients. At last follow-up (mean 28.8 months after initial surgery), 20.2% had chronic kidney disease (CKD) of at least stage IIIA, and 8.6% had progressed to end-stage renal disease (ESRD). Antenatal diagnosis, prematurity, abnormal renal cortex, and loss of corticomedullary differentiation (CMD) on initial RUS were associated with CKD and ESRD on univariate analysis, as were elevated creatinine on presentation and at nadir. Presence of pre- or postoperative VUR and recurrent UTIs were associated with the need for multiple surgeries, but not with poor renal outcomes. On multivariate analysis, nadir creatinine was the only independent predictor of final renal function. Our finding that creatinine is the only independent risk factor for poor renal outcomes in PUV patients is consistent with the

  2. Posterior urethral valves and Down syndrome | Lazarus | African ...

    African Journals Online (AJOL)

    The broad range of renal and urinary tract abnormalities associated with Down syndrome are not well known. We present two cases from a single institution of posterior urethral valves associated with Down syndrome. The cases illustrate the potential for delayed diagnosis and the management challenges. The literature is ...

  3. Aggressive diagnosis and treatment for posterior urethral valve as an etiology for vesicoureteral reflux or urge incontinence in children.

    Science.gov (United States)

    Nakai, Hideo; Hyuga, Taiju; Kawai, Shina; Kubo, Taro; Nakamura, Shigeru

    2017-06-01

    Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although posterior urethral valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transurethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.

  4. Aggressive diagnosis and treatment for posterior urethral valve as an etiology for vesicoureteral reflux or urge incontinence in children

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    Hideo Nakai

    2017-06-01

    Full Text Available Vesicoureteral reflux (VUR is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although posterior urethral valve (PUV is well known as a cause of the secondary VUR, it is controversial that minor urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transurethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3 and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.

  5. Late presentation of posterior urethral valve: two case reports

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    Carlos Márcio Nóbrega de Jesus

    Full Text Available CONTEXT: Posterior urethral valve (PUV is a widely known condition affecting males that generally presents prenatally or at birth. PUVs have also been occasionally described in literature in cases diagnosed during adolescence or adulthood. CASE REPORT: This report presents two late PUV cases, one in a teenager and the other in an adult. Both cases had had clinical signs of urinary tract infection and obstructive urinary symptoms. The diagnoses were made by means of voiding cystourethrography and urethrocystoscopy. Endoscopic valve fulguration was the treatment chosen for both. Their follow-up was uneventful.

  6. Posterior urethral valves and Down syndrome

    African Journals Online (AJOL)

    J. Lazarus

    2015 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B.V. All rights reserved. Introduction. The first description of Down syndrome (DS) was in 1866 by the. British physician Dr. John Langdon Down [1]. Despite this long his- tory, the association of DS with congenital anomalies of the kidney.

  7. Válvula de uretra anterior Anterior urethral valves

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    Silvio Tucci Jr.

    2003-02-01

    Full Text Available Objetivo: apresentar os aspectos clínicos, diagnósticos e terapêuticos de pacientes portadores de válvula da uretra anterior. Descrição: em dois neonatos, o diagnóstico presuntivo de patologia obstrutiva do trato urinário foi sugerido pela ultra-sonografia realizada no período pré-natal, confirmando-se o diagnóstico de válvula de uretra anterior pela avaliação pós-natal. Os pacientes foram submetidos a tratamento cirúrgico paliativo, com vesicostomia temporária e, posteriormente, definitivo, pela fulguração endoscópica das válvulas. Ambos evoluíram com função renal normal. Comentários: a válvula da uretra anterior é anomalia rara que deve ser considerada em meninos com quadro radiológico pré-natal sugestivo de obstrução infravesical, secundariamente à hipótese mais comum de válvula da uretra posterior. Ressaltamos a utilização da vesicostomia como derivação urinária temporária nestes casos, prevenindo potenciais complicações pela manipulação da uretra do recém-nascido.Objective: to discuss clinical signs, diagnostic tools and therapeutics of anterior urethral valves, an obstructive anomaly of the urinary system in males. Description: signs of urinary tract obstruction were identified on pre-natal ultrasound in two male fetuses and the diagnosis of anterior urethral valves was made through post-natal evaluation. As an initial treatment, vesicostomy was performed in both patients. Later, the valves were fulgurated using an endoscopic procedure. During the follow-up period both patients presented normal renal function. Comments: anterior urethral valves are a rare form of urethral anomaly that must be ruled out in boys with pre-natal ultrasound indicating infravesical obstruction. Vesicostomy used as an initial treatment rather than transurethral fulguration may prevent potential complications that can occur due to the small size of the neonatal urethra.

  8. A CLINICAL STUDY OF POSTERIOR URETHRAL VALVE AND ITS IMPACT ON RENAL FUNCTION

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    Nischal Prasad Reddy

    2015-05-01

    Full Text Available OBJECTIVES: T he most common congenital anomaly is Posterior Urethral valve (PUV and has as incidence of 1 in 8000 male births. It is the most common obstructive cause of end stage renal disease in children. Vesicoureteric reflux, recurrent UTI, voiding dysfunction and late onset renal failure are the long term major problems in these children. There are few long term outcome studies of children with PUV from India. These studies mainly concentrate on the surgical aspects. The study is aimed to assess the long term impact of PUV on renal function and th e growth of these children. METHODS: The study was conducted at AJ hospital, Mangalore between July 2010 - June 2011. Thirty children, with posterior urethral valve, five years or more post - surgery were included in the study. The details of children were obtained from records regarding age, presenting symptoms serum creatinine, presence of or absence of vesicoureteric reflux. Outcomes measured were stunting, renal failure (GFR, tubular functions and bladder functions. Results were analysed. RESULTS: Thirt y children were analysed. The age at presentation varied from antenatal detection to six years. About 46.6% of patients presented between 0 - 1 month, 36.6% between one month to one year, 16.8% between one to six years. The median age at presentation was thr ee months. Primary surgery done in the neonatal period in 33% children. Of the 28 children who had antenatal ultrasound, 20 had normal USS and eight had antenatally detected hydronephrosis (28.6%. Five out of eight had associated oligohydramnios. All thes e five children had GFR <90 m/m/1.73m 2 at follow up. CONCLUSION: Poor bladder function was seen in one - third of patients. Interventions as and when needed on follow - up are important in the management of all children with posterior urethral valve. Comprehen sive care should be the rule by a team comprising paediatrician, pediatric surgeon and pediatric nephrologists

  9. Congenital posterior urethral diverticula causing bladder outlet obstruction in a young male

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    Saurabh Agrawal

    2008-01-01

    Full Text Available We present a case of 26-year-old male presenting with mild renal failure. Ultrasound findings were suggestive of posterior urethral valve, but micturating cystourethrogram and endoscopic evaluation confirmed the diagnosis of posterior urethral diverticulae. Transurethral resection of diverticulae was performed. Patient is voiding well and his renal function has stabilized.

  10. Study of prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves

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    Divya Bhadoo

    2015-01-01

    Full Text Available Aims: Study on prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves. Materials and Methods: Antenatally diagnosed hydronephrosis patients were included. Postnatally, they were divided into two groups, posterior urethral valve (PUV and non-PUV. The studied parameters were: Gestational age at detection, surgical intervention, ultrasound findings, cord blood and follow up plasma renin activity (PRA values, vesico-ureteric reflux (VUR, renal scars, and glomerular filtration rate (GFR. Results: A total of 25 patients were included, 10 PUV and 15 non-PUV. All infants with PUV underwent primary valve incision. GFR was less than 60 ml/min/1.73 m 2 body surface area in 4 patients at last follow-up. Keyhole sign, oligoamnios, absent bladder cycling, and cortical cysts were not consistent findings on antenatal ultrasound in PUV. Cord blood PRA was significantly higher (P < 0.0001 in PUV compared to non-PUV patients. Gestational age at detection of hydronephrosis, cortical cysts, bladder wall thickness, and amniotic fluid index were not significantly correlated with GFR while PRA could differentiate between poor and better prognosis cases with PUV. Conclusions: Ultrasound was neither uniformly useful in diagnosing PUV antenatally, nor differentiating it from cases with non-PUV hydronephrosis. In congenital hydronephrosis, cord blood PRA was significantly higher in cases with PUV compared to non-PUV cases and fell significantly after valve ablation. Cord blood PRA could distinguish between poor and better prognosis cases with PUV.

  11. Dual Pathology Causing Congenital Bladder Outlet Obstruction.

    Science.gov (United States)

    Kwong, Ruth; Johal, Navroop S; Upasani, Anand; Paul, Anu; Cuckow, Peter

    2017-12-07

    Anterior urethral syringocele is an uncommon congenital deformity characterised by cystic dilatation of bulbo-urethral gland ducts and is usually asymptomatic. We present a case on 4-day-old male neonate who presented with bilateral antenatal hydroureteronephrosis and renal impairment and found to have urethral syringocele and posterior urethral valves (PUV). Copyright © 2017. Published by Elsevier Inc.

  12. The prognosis of posterior urethral valves, associated to vesicoureteral reflux in children.

    Science.gov (United States)

    Masca, Aurelia; Indrei, L L; Brânzaniuc, Klara

    2011-01-01

    Posterior urethral valves represent a congenital barrier at the level of the posterior urethra, which opposes miction. They are located near the prostatic urethra, originating at the verumontanum level, affecting male patients. The ureters are inconstantly dilated; vesicoureteral reflux is met in 2/3 of the cases. The reflux can be secondary to the sub-bladder barrier, but it can also be considered primitive, determined by the intra bladder ectopy of the ureter. The presence of the reflux is interpreted as a severe associated factor. Semiology is rather unusual, positive diagnosis is based on early discovery or antenatally of the impairment, by fetal echography starting from the 28th week of pregnancy, postnatal echography followed by miction cystography, retrograde urethrography and creatinine dosage complete the diagnosis. The treatment is surgical: endoscopic ablation of the valves (in the absence of renal failure), percutaneous pyelostomy, high lateral ureterostomy, and in severe cases vesicostomy and renal transplant. Prognosis depends on how early the impairment is detected, on the degree of pulmonary hypoplasia, on the presence of the vesicoureteral reflux and the possibility of recovering renal function; 1/3 of the newborns develop in time Chronic Renal Failure which requires renal transplant. The studied group comprised male children diagnosed with vesicoureteral reflux their ages ranking between 0 -18 years, admitted to the Pediatric Clinic, Tg. Mures during the last 10 years and children diagnosed and operated with posterior urethra valves at the Surgical Clinic of the "M. S. Curie" Hospital, Bucharest during the last 20 years. Our results show that out of the total number of studied children 25 presented posterior urethra valves and 9 children presented vesicoureteral reflux. We can conclude that the presence of the vesicoureteral reflux is an unfavorable prognosis regarding the degree of renal failure.

  13. Concordant posterior urethral valves in male monochorionic twins with secondary prune belly syndrome.

    Science.gov (United States)

    Nouaili, Emira Ben Hamida; Chaouachi, Sihem; Nouira, Faouzi; Benmassoud, Ines; Laabidi, Kamel; Chaouachi, Beji; Marrakchi, Zahra

    2008-12-01

    Posterior urethral valves (PUVs), the most common congenital cause of lower urinary tract obstruction, have been described to occur in identical and nonidentical twins. Until now, reports have been published on 15 cases of PUVs. We report a new case of concordant PUVs in one set of male monochorionic twins with secondary Prune Belly Syndrome. The twins were born by elective cesarean section at 38 weeks of gestation to a 36-year-old mother, gravida 6, para 6. On ultrasound perfomed at 18 weeks's gestation, both fetuses showed signs of PUVs. At birth, physical examination of both revealed a secondary Prune Belly Syndrome (PBS). Postnatal renal ultrasound confirmed the diagnosis of PUV. The two infants underwent transurethral resection of the valves after a cystoscopic evaluation of the urethra. Since this procedure, their voiding has been unremarkable with stable renal function and sterile urine until their discharge. We have documented a rare association between VUP and PBS in two monochiorionic twins. More studies are needed to throw light on the significance of the present associated anomalies.

  14. Laser ablation of posterior urethral valves by fetal cystoscopy.

    Science.gov (United States)

    Martínez, José María; Masoller, Narcis; Devlieger, Roland; Passchyn, Esther; Gómez, Olga; Rodo, Joan; Deprest, Jan A; Gratacós, Eduard

    2015-01-01

    To report the results of fetal cystoscopic laser ablation of posterior urethral valves (PUV) in a consecutive series in two referral centers. Twenty pregnant women with a presumptive isolated PUV were treated with fetal cystoscopy under local anesthesia. Identification and fulguration of the PUV by one or several firing-contacts with diode laser were attempted. Perinatal and long-term outcomes were prospectively recorded. The median gestational age at procedure was 18.1 weeks (range 15.0-25.6), and median operation time was 24 min (range 15-40). Access to the urethra was achieved in 19/20 (95%) cases, and postoperative, normalization of bladder size and amniotic fluid was observed in 16/20 (80%). Overall, there were 9 (45%) terminations of pregnancy and 11 women (55%) delivered a liveborn baby at a mean gestational age of 37.3 (29.1-40.2) weeks. No infants developed pulmonary hypoplasia and all were alive at 15-110 months. Eight (40% of all fetuses, 72.7% of newborns) had normal renal function and 3 (27.3%) had renal failure awaiting renal transplantation. Fetoscopic laser ablation for PUV can achieve bladder decompression and amniotic fluid normalization with a single procedure in selected cases with anyhydramnios. There is still a significant risk of progression to renal failure pre or postnatally. © 2014 S. Karger AG, Basel.

  15. Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum

    Directory of Open Access Journals (Sweden)

    Diana Bancin

    2015-03-01

    Full Text Available Congenital obstructive posterior urethral membranes (COPUM is a complex disease closely related to several pathological changes in kidney development and function, as a result of urinary reflux since in utero. This congenital anomaly of urinary tract potentially causes hydroureteronephrosis that is often associated with recurrent urinary tract infections and, ultimately, one of the most common causes of end-stage renal disease in children.1,2 Congenital hypertrophy of the verumontanum as part of COPUM is very rare. Only a few reports have been written on congenital hypertrophy of the vermontanum causing congenital obstructive uropathy.3-6

  16. Rare copy number variants implicated in posterior urethral valves.

    Science.gov (United States)

    Boghossian, Nansi S; Sicko, Robert J; Kay, Denise M; Rigler, Shannon L; Caggana, Michele; Tsai, Michael Y; Yeung, Edwina H; Pankratz, Nathan; Cole, Benjamin R; Druschel, Charlotte M; Romitti, Paul A; Browne, Marilyn L; Fan, Ruzong; Liu, Aiyi; Brody, Lawrence C; Mills, James L

    2016-03-01

    The cause of posterior urethral valves (PUV) is unknown, but genetic factors are suspected given their familial occurrence. We examined cases of isolated PUV to identify novel copy number variants (CNVs). We identified 56 cases of isolated PUV from all live-births in New York State (1998-2005). Samples were genotyped using Illumina HumanOmni2.5 microarrays. Autosomal and sex-linked CNVs were identified using PennCNV and cnvPartition software. CNVs were prioritized for follow-up if they were absent from in-house controls, contained ≥ 10 consecutive probes, were ≥ 20 Kb in size, had ≤ 20% overlap with variants detected in other birth defect phenotypes screened in our lab, and were rare in population reference controls. We identified 47 rare candidate PUV-associated CNVs in 32 cases; one case had a 3.9 Mb deletion encompassing BMP7. Mutations in BMP7 have been associated with severe anomalies in the mouse urethra. Other interesting CNVs, each detected in a single PUV case included: a deletion of PIK3R3 and TSPAN1, duplication/triplication in FGF12, duplication of FAT1--a gene essential for normal growth and development, a large deletion (>2 Mb) on chromosome 17q that involves TBX2 and TBX4, and large duplications (>1 Mb) on chromosomes 3q and 6q. Our finding of previously unreported novel CNVs in PUV suggests that genetic factors may play a larger role than previously understood. Our data show a potential role of CNVs in up to 57% of cases examined. Investigation of genes in these CNVs may provide further insights into genetic variants that contribute to PUV. © 2015 Wiley Periodicals, Inc.

  17. A large extra-abdominal prevesical pseudo-cyst in a newborn with posterior urethral valves.

    NARCIS (Netherlands)

    Binkhorst, M.; Gier, R.P.E. de

    2010-01-01

    A male newborn is described, in whom a large extra-abdominal prevesical pseudo-cyst as well as prune-belly features were present, both of which were supposedly secondary to posterior urethral valves. It is postulated that the subvesical obstruction caused pressure build-up in the urinary tract,

  18. Posterior urethral valve in a six year old boy with nocturnal ...

    African Journals Online (AJOL)

    We report a case of posterior urethral valve (PUV) in a six year old boy with nocturnal eneuresis and failure to thrive as the only presenting symptoms. The clinically occult lesion was only unravelled when micturating cystourethrogram revealed a dilated posterior urethra with a distal narrow stream of opacified urine, bilateral ...

  19. Urethritis

    Science.gov (United States)

    ... urethritis. Organisms—such as Neisseria gonorrhoeae , which causes gonorrhea —can spread to the urethra during sexual intercourse ... Sometimes people have no symptoms. In men, when gonorrhea or chlamydia is the cause, there is usually ...

  20. The protective arm of the renin-angiotensin system may counteract the intense inflammatory process in fetuses with posterior urethral valves.

    Science.gov (United States)

    Rocha, Natalia P; Bastos, Fernando M; Vieira, Érica L M; Prestes, Thiago R R; Silveira, Katia D da; Teixeira, Mauro M; Simões E Silva, Ana Cristina

    2018-03-11

    Posterior urethral valve is the most common lower urinary tract obstruction in male children. A high percentage of patients with posterior urethral valve evolve to end-stage renal disease. Previous studies showed that cytokines, chemokines, and components of the renin-angiotensin system contribute to the renal damage in obstructive uropathies. The authors recently found that urine samples from fetuses with posterior urethral valve have increased levels of inflammatory molecules. The aim of this study was to measure renin-angiotensin system molecules and to investigate their correlation with previously detected inflammatory markers in the same urine samples of fetuses with posterior urethral valve. Urine samples from 24 fetuses with posterior urethral valve were collected and compared to those from 22 healthy male newborns at the same gestational age (controls). Renin-angiotensin system components levels were measured by enzyme-linked immunosorbent assay. Fetuses with posterior urethral valve presented increased urinary levels of angiotensin (Ang) I, Ang-(1-7) and angiotensin-converting enzyme 2 in comparison with controls. ACE levels were significantly reduced and Ang II levels were similar in fetuses with posterior urethral valve in comparison with controls. Increased urinary levels of angiotensin-converting enzyme 2 and of Ang-(1-7) in fetuses with posterior urethral valve could represent a regulatory response to the intense inflammatory process triggered by posterior urethral valve. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Role of vesicostomy in the management of posterior urethral valve in Sub-Saharan Africa.

    Science.gov (United States)

    Lukong, C S; Ameh, E A; Mshelbwala, P M; Jabo, B A; Gomna, A; Anumah, M A; Nmadu, P T; Mfuh, A Y

    2014-02-01

    To review the role of vesicostomy in the management of posterior urethral valve (PUV), in neonates and infants, given the limitations for endoscopic treatment in this setting. A review of 35 patients who presented with posterior urethral valve over a 10-year period. Demographic and clinical information were prospectively recorded on a structured pro forma, and the data extracted analysed using SPSS 11.0. The 35 boys were aged 3 days to 10 years (median 3 weeks). Twenty-three (65.7%) had a vesicostomy (age range 3 days-3 years, median 3 weeks). The mode of presentation was poor urinary stream 15 (65.2%), urinary retention 4 (17.4%), and renal failure 6 (26.1%). Main findings were palpable bladder 23 (100%), hydronephrosis 4 (17.4%). Abdominal ultrasound confirmed hydronephrosis and thickened bladder wall, and voiding/expressive cystourethrogram confirmed dilated posterior urethra and vesicoureteric reflux in all 23 patients. Complications following vesicostomy were stoma stenosis 1 (4.3%), bladder mucosal prolapse 1 (4.3%), perivesicostomy abscess 1 (4.3%); there was no mortality. Following vesicostomy, 10 (43.5%) patients had excision of the valves and vesicostomy closure at age 2-8 years (median 4 years). They are well, with normal renal ultrasonographic findings, bladder capacity range 115-280 ml, and normal urea, serum electrolytes, creatinine, at 3 years of follow up. Thirteen (56.5%) are still awaiting valvotomy but have remained well and with normal ultrasonographic renal findings. Vesicostomy is a useful temporising mode of urinary diversion in neonates and infants with posterior urethral valve (in the absence of unobstructed upper tracts) when facilities for endoscopic valve ablation are not readily available. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Severe congenital penile torsion with anterior urethral diverticulum ...

    African Journals Online (AJOL)

    On examination, he was found to be a case of severe congenital penile torsion with diversion and rotation of median raphae in a counterclockwise fashion upto the midline dorsally confirming 180◦ torsion. During voiding, there was appearance of a swelling in distal penile region with passage of urinary drops while ...

  3. [Significance of early diagnosis of posterior urethral valves in fetus for further development - own experience].

    Science.gov (United States)

    Krzemień, Grażyna; Szmigielska, Agnieszka; Wawer, Zofia; Roszkowska-Blaim, Maria

    2013-01-01

    The incidence of posterior urethral valves is estimated to be from 3:1000 to 8:1000 and this is one of the most common causes of obstruction of urinary tract in boys. About 13-17% of children with posterior urethral valves develop end stage renal failure. We present a  6-month-old boy with late diagnosis of posterior urtehral valves. Antenatal ultrasound investigation of the urinary tract was normal. A small degree of oligohydramnios was found during delivery. At the age of six months the boy was admitted to hospital because of urinary tract infection, hypertension (130/90 mmHg) and acute kidney injury (urea - 46 mg/dL, creatinine - 1.1 mg/dL, GFR - 35.5 mL/min/1.73 m2 ). Bilateral hydronephrosis and megaureters, low-capacity bladder with hypertrophied wall were seen on ultrasound examination. Voiding cystourethrograhy revealed vesicoureteral refluxes (III/V), hypertrophy of the bladder wall with numerous diverticula and dilated posterior urethra. During urethroscopy urethral valves were resected. Increased intravesical pressure (leak point up to 305 cm H2 O) was found on urodynamic test. Renal scintigraphy (99mTc-EC) revealed decreased intake of isotope in the left kidney (5%), and the right kidney intake was 95% ERPF. The patient was qualified for left-sided nephrectomy, which was postponed because of high leak point and high risk of worsening of vesicoureteral reflux to right kidney after nephrectomy. Anticholinergic and α-blocker treatment was started. At the age of 11 months left-side nephrectomy was performed because of recurrent urinary tract infections. After 3.5-year follow-up blood pressure, physical development, kidney function tests, and urinalysis are normal. Additionally to this investigation the significance of early diagnosis including prenatal (PUV) for further development as well as further therapeutic procedure is discussed.

  4. Primary vesicoureteral reflux in Blacks with posterior urethral valves: Does it occur?

    International Nuclear Information System (INIS)

    Nancarrow, P.A.; Lebowitz, R.L.

    1988-01-01

    Primary vesicoureteral reflux (VUR) is thought to be largely independent of obstruction. Therefore, in patients with urethral obstruction due to posterior urethral valves (PUV) the occurrence of VUR is coincidental. In addition, primary VUR is reported to be uncommon in black children. If these two premises are correct, then primary VUR should be rare in black males with PUV. To test this hypothesis, we reviewed the medical records and radiographs of 43 males with PUV. Twenty-one of the 37 non-black males with PUV had VUR, of which 67% was primary and 33% was secondary. Three of the six Blacks with PUV had VUR of which none was primary and all was secondary. Thus, Blacks with PUV lend credence to the theory that primary VUR is not caused by obstruction and support the observation that primary VUR is rare in black children, even those with PUV. (orig.)

  5. Severe congenital penile torsion with anterior urethral diverticulum: A case report

    Directory of Open Access Journals (Sweden)

    Amilal Bhat

    2018-03-01

    Full Text Available Introduction: We present a rare case of severe penile torsion of 180° along with giant congenital anterior urethral diverticula. Presentation of these two rare anomalies together is extremely rare and has not been reported yet. The extreme rarity of the case and its management warrants this presentation. Observation: A 5 years old boy presented to us as a case of epispadias with post-void dribbling and wetting of the underwears. On examination, he was found to be a case of severe congenital penile torsion with diversion and rotation of median raphae in a counterclockwise fashion upto the midline dorsally confirming 180° torsion. During voiding, there was appearance of a swelling in distal penile region with passage of urinary drops while compressing it. Micturating cystourethrogram showed diverticula in penile and bulbar urethra. Torsion was completely corrected by penile de-gloving in a plane between two layers of buck fascia and mobilization of the urethra along with spongiosum proximally upto the penoscrotal junction and distally upto the glans. Diverticula was laid open and underwent urethroplasty along with double breasting of thickened diverticular tissue. Torsion was completely corrected after surgery. Post-operative recovery was uneventful. Urine culture was sterile and uroflowmetry showed maximal urinary flow of 12 ml/s at 3 months postoperatively. Conclusions: Penile de-gloving and adequate urethral mobilization corrects the severe penile torsion of 180°. Correction of severe torsion and urethroplasty is feasible in a single stage with good results. Keywords: Penile torsion, Urethral diverticula, Congenital anomalies, Mobilization of urethra, Urethroplasty, Double Breasting, Correction of penile torsion

  6. Congenital tricuspid valve disease and testicular agenesis: a case ...

    African Journals Online (AJOL)

    This is a report of a case of congenital tricuspid valve disease presenting with heart failure and pulmonary hypertension. Cardinal clinical features include breathlessness, easy fatigability since childhood, stunted growth, cyanosis, finger clubbing, a pansystolic murmur loudest at the left sternal edge in the fourth intercostal ...

  7. The Endoscopic Morphological Features of Congenital Posterior Urethral Obstructions in Boys with Refractory Daytime Urinary Incontinence and Nocturnal Enuresis.

    Science.gov (United States)

    Nakamura, Shigeru; Hyuga, Taiju; Kawai, Shina; Kubo, Taro; Nakai, Hideo

    2016-08-01

    Purpose This study aims to evaluate the endoscopic morphological features of congenital posterior urethral obstructions in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. Patients and Methods A total of 54 consecutive patients underwent endoscopy and were diagnosed with a posterior urethral valve (PUV) (types 1-4). PUV type 1 was classified as severe, moderate, or mild. A transurethral incision (TUI) was mainly performed for anterior wall lesions of the PUV. Voiding cystourethrography and pressure flow studies (PFS) were performed before and 3 to 4 months after TUI. Clinical symptoms were evaluated 6 months after TUI, and outcomes were assessed according to PFS waveform pattern groups (synergic pattern [SP] and dyssynergic pattern [DP]). Results All patients had PUV type 1 and/or 3 (i.e., n = 34 type 1, 7 type 3, and 13 types 1 and 3). There were severe (n = 1), moderate (n = 21), and mild (n = 25) cases of PUV type 1. According to PFS, SP and DP were present in 43 and 11 patients, respectively. TUI was effective in the SP group and symptoms improved in 77.4 and 69.3% of patients with daytime incontinence and nocturnal enuresis, respectively. Almost no effect was observed in the DP group. A significant decrease in the detrusor pressure was observed at maximum flow rate using PFS in the SP group. Conclusions PUV type 1 encompassed lesions with a spectrum of obstructions ranging from severe to mild, with mild types whose main obstructive lesion existed at the anterior wall of urethra occurring most frequently in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. Georg Thieme Verlag KG Stuttgart · New York.

  8. Posterior urethral valve with unilateral vesicoureteral reflux and patent urachus: A rare combination of urinary tract anomaliess

    Directory of Open Access Journals (Sweden)

    Mutiu O Atobatele

    2015-01-01

    Full Text Available Posterior urethral valve (PUV is a common cause of lower urinary tract obstruction in male infants with an incidence of 1:5000-8000. PUV continues to be a significant cause of morbidity and ongoing renal damage in infants and children. It can coexist with vesicoureteral reflux (VUR in about 50% of cases and also with patent urachus in about one-third of cases. It is a case of a 22-day-old full-term male child who presented with poor urinary stream and progressive abdominal distension of 5-day duration as well as leakage of clear fluid from umbilicus of 1-day duration. Abdominopelvic ultrasonography showed bilateral hydronephrosis. Micturating cystourethrogram also showed features of bladder outlet obstruction and PUV. In addition, a grade V left VUR and a fistulous tract between the dome of the urinary bladder and the umbilicus, which was consistent with a patent urachus was demonstrated. In conclusion, this case demonstrates a rare combination of congenital urinary tract anomalies involving PUV, left VUR and patent urachus.

  9. Advantages of fulguration of posterior urethral valves by Nd: YAG laser

    Directory of Open Access Journals (Sweden)

    D K Gupta

    2000-01-01

    Full Text Available Posterior Urethral Valves (PUV are one of the com-monest urolgical problems seen in children and the electro-coagulation, which is the most widely preferred modality to ablate the valves, may not be feasible in small-for-date and low-birth-weight neonates as the suitable size resec-toscope/cystoscope may not available. With the availa-bility of Nd: YAG laser at our institute recently, we started performing the laser fulguration instead of electrocoagu-lation of the valves. We reviewed our experience with the emerging role of the Nd: YAG laser in the fulguration of PUV, comparing the results with a historical control group who underwent the classical electrocoagulation of the PUV. The boys (n=50 diagnosed to have PUV by VCUG were confirmed by Wolf 8.5 size cystoscope, underwent Nd: YAG laser fulguration of the valves with a bare fiber, as a day-care procedure without postoperative catheteri-zation. Historical controls (n=50 who had undergone classical electrocoagulation using 9.5 size Wolf resectos-cope served as the controls. The mean age was 1.3 y and 2.6 y in laser and electrocoagulation group respectively. The mean hospital stay of the electrocoagulation group was 3.8 d. Three patients after electrocoagulation devel-oped hematuria and 4 required refulguration whereas in the laser group 5 required refulguration and none devel-oped hematuria. In conclusion, endoscopic laser fulgura-tion of PUV is technically feasible even in neonates and small children. Laser offers excellent results that are com-parable to the time-honored electrocoagulation procedure. This has the additional advantage forfulgurating the PUV in smaller caliber urethra as this can be performed with the smaller available cystoscope that has a side channel, admitting the laser fiber.

  10. Posterior urethral valves: Morphological normalization of posterior urethra after fulguration is a significant factor in prognosis.

    Science.gov (United States)

    Menon, Prema; Rao, K L N; Vijaymahantesh, S; Kanojia, R P; Samujh, R; Batra, Y K; Sodhi, K S; Saxena, A K; Bhattacharya, A; Mittal, B R

    2010-07-01

    To assess the changes in urethral morphology 3 months post fulguration of posterior urethral valves (PUVs) on micturating cystourethrogram (MCUG) and correlate these changes with the overall clinical status of the patient. A total of 217 children, managed for PUVs during a period of 6 years in a single surgical unit were prospectively studied. The ratio of the diameters of the prostatic and bulbar urethras (PU/BU) was calculated on the pre- and post-fulguration MCUG films. They were categorized into three groups based on the degree of normalization of posterior urethra (post-fulguration PU/BU ratio). Of the 133 patients, 131 had normal urinary stream and 4 (3%) had nocturnal enuresis. Vesicoureteral reflux (VUR), initially seen in 83 units (31% units), regressed completely at a mean duration of 6 months in 41 units (49%). Of the 152 non-VUR, hydroureteronephrosis (HUN) units, 11 were poorly functioning kidneys. Persistent slow but unobstructed drainage was seen in 23 units (16%) over a period of 1.5-5 years (mean 2.5 years). Group B: All the 11 patients had a normal stream. Four (36.4%) had daytime frequency for a mean duration of 1 year and one (9%) had nocturnal enuresis for 1 year. Grade IV-V VUR was seen in five patients (three bilateral), which regressed completely by 3 months in five units (62.5%). In the non-VUR, HUN patients, slow (but unobstructed) drainage was persistent in two units (14%) at 3 years. Group C: Of the 16 patients, only 5 (31.3%) were asymptomatic. Six patients (nine units) had persistent VUR for 6 months to 3 years. Of the 20 units with HUN, 17 (85%) were persistent at 1-4 years (mean 2 years). Eight patients (50%) required a second fulguration while 3 (18.7%) required urethral dilatation for stricture following which all parameters improved. Adequacy of fulguration should be assessed by a properly performed MCUG. A postop PU/BU ratio >3 SD (1.92) should alert to an incomplete fulguration or stricture. Patients within normal range ratio

  11. Posterior urethral valves: Morphological normalization of posterior urethra after fulguration is a significant factor in prognosis

    Directory of Open Access Journals (Sweden)

    Menon Prema

    2010-01-01

    Full Text Available Aim: To assess the changes in urethral morphology 3 months post fulguration of posterior urethral valves (PUVs on micturating cystourethrogram (MCUG and correlate these changes with the overall clinical status of the patient. Materials and Methods: A total of 217 children, managed for PUVs during a period of 6 years in a single surgical unit were prospectively studied. The ratio of the diameters of the prostatic and bulbar urethras (PU/BU was calculated on the pre- and post-fulguration MCUG films. They were categorized into three groups based on the degree of normalization of posterior urethra (post-fulguration PU/BU ratio. Results: Group A: Of the 133 patients, 131 had normal urinary stream and 4 (3% had nocturnal enuresis. Vesicoureteral reflux (VUR, initially seen in 83 units (31% units, regressed completely at a mean duration of 6 months in 41 units (49%. Of the 152 non-VUR, hydroureteronephrosis (HUN units, 11 were poorly functioning kidneys. Persistent slow but unobstructed drainage was seen in 23 units (16% over a period of 1.5-5 years (mean 2.5 years. Group B: All the 11 patients had a normal stream. Four (36.4% had daytime frequency for a mean duration of 1 year and one (9% had nocturnal enuresis for 1 year. Grade IV-V VUR was seen in five patients (three bilateral, which regressed completely by 3 months in five units (62.5%. In the non-VUR, HUN patients, slow (but unobstructed drainage was persistent in two units (14% at 3 years. Group C: Of the 16 patients, only 5 (31.3% were asymptomatic. Six patients (nine units had persistent VUR for 6 months to 3 years. Of the 20 units with HUN, 17 (85% were persistent at 1-4 years (mean 2 years. Eight patients (50% required a second fulguration while 3 (18.7% required urethral dilatation for stricture following which all parameters improved. Conclusions: Adequacy of fulguration should be assessed by a properly performed MCUG. A postop PU/BU ratio >3 SD (1.92 should alert to an incomplete

  12. Aortic valve prosthesis-patient mismatch and exercise capacity in adult patients with congenital heart disease

    NARCIS (Netherlands)

    van Slooten, Ymkje J.; Melle, van Joost P.; Freling, Hendrik G.; Bouma, Berto J.; van Dijk, Arie P. J.; Jongbloed, Monique R. M.; Post, Martijn C.; Sieswerda, Gertjan T.; in 't Veld, Anna Huis; Ebels, Tjark; Voors, Adriaan A.; Pieper, Petronella G.

    Objectives To report the prevalence of aortic valve prosthesis patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis

  13. Aortic valve prosthesis-patient mismatch and exercise capacity in adult patients with congenital heart disease

    NARCIS (Netherlands)

    van Slooten, Ymkje J.; van Melle, Joost P.; Freling, Hendrik G.; Bouma, Berto J.; van Dijk, Arie Pj; Jongbloed, Monique Rm; Post, Martijn C.; Sieswerda, Gertjan T.; Huis In 't Veld, Anna; Ebels, Tjark; Voors, Adriaan A.; Pieper, Petronella G.

    2016-01-01

    To report the prevalence of aortic valve prosthesis-patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis later in

  14. Long-term followup of bilateral high (Sober) urinary diversion in patients with posterior urethral valves and its effect on bladder function

    NARCIS (Netherlands)

    Ghanem, MA; Nijman, RJM

    Purpose: Although valve ablation is the treatment of choice in patients with posterior urethral valves (PLTV), temporary high (ureterostomy) diversion remains controversial. In this study we evaluated the effect of bilateral Sober high urinary diversion on renal and bladder function. Materials and

  15. Presentation, management, and outcome of posterior urethral valves in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Agbugui Jude Orumuah

    2015-01-01

    Full Text Available Background: Posterior urethral valves (PUV remain the most common cause of bladder outlet obstruction and renal insufficiency in male children. The aim of this study was to evaluate the presentation, management, challenges, and outcome of the disease in a Nigerian tertiary health institution. Patients and Methods: Retrospectively, medical records of male children with a diagnosis of PUVs over a 10 year period (2003-2012 were retrieved. All data in relation to the study objectives were recorded and analyzed. Results: A total of 44 patients was managed for PUV within the period. The mean age of presentation was 3.95 years with 56.8% of the patients presenting after the age of 1 year. Voiding dysfunction noted in 40 (91.0% patients was the most common mode of presentation. The most common finding on physical examination was a palpable bladder while urinary tract infection noted in 23 (52.3% patients was the most common complication noted. Abdominal ultrasonography revealed dilated posterior urethra in 16 (36.4% cases, while micturating cystourethrogram revealed a dilated proximal urethra in all 35 cases in which it was done, diverticulum in 6 and vesicoureteric reflux in 9. The creatinine value at presentation ranged between 0.4 mg/dl and 4.0 mg/dl with a mean of 1.02 ± 0.93 mg/dl. Urethroscopy in 37 patients confirmed type I and type III PUV in 35 and 2 patients, respectively. Valve ablation with a diathermy bugbee electrode provided relief of obstructions in the 37 patients who underwent the procedure without any significant immediate complication. The period of follow-up ranged between 2 weeks and 3 years with a mean of 10.2 months. There was sustained improvement in urine stream, reduction in the mean creatinine concentration and incidence of UTI during follow-up. However, patients with significantly impaired renal function had a poorer outcome. Conclusion: Many patients with PUV presented late within the reviewed period. Valve ablation

  16. Presentation, management, and outcome of posterior urethral valves in a Nigerian tertiary hospital.

    Science.gov (United States)

    Orumuah, Agbugui Jude; Oduagbon, Obarisiagbon Edwin

    2015-01-01

    Posterior urethral valves (PUV) remain the most common cause of bladder outlet obstruction and renal insufficiency in male children. The aim of this study was to evaluate the presentation, management, challenges, and outcome of the disease in a Nigerian tertiary health institution. Retrospectively, medical records of male children with a diagnosis of PUVs over a 10 year period (2003-2012) were retrieved. All data in relation to the study objectives were recorded and analyzed. A total of 44 patients was managed for PUV within the period. The mean age of presentation was 3.95 years with 56.8% of the patients presenting after the age of 1 year. Voiding dysfunction noted in 40 (91.0%) patients was the most common mode of presentation. The most common finding on physical examination was a palpable bladder while urinary tract infection noted in 23 (52.3%) patients was the most common complication noted. Abdominal ultrasonography revealed dilated posterior urethra in 16 (36.4%) cases, while micturating cystourethrogram revealed a dilated proximal urethra in all 35 cases in which it was done, diverticulum in 6 and vesicoureteric reflux in 9. The creatinine value at presentation ranged between 0.4 mg/dl and 4.0 mg/dl with a mean of 1.02 ± 0.93 mg/dl. Urethroscopy in 37 patients confirmed type I and type III PUV in 35 and 2 patients, respectively. Valve ablation with a diathermy bugbee electrode provided relief of obstructions in the 37 patients who underwent the procedure without any significant immediate complication. The period of follow-up ranged between 2 weeks and 3 years with a mean of 10.2 months. There was sustained improvement in urine stream, reduction in the mean creatinine concentration and incidence of UTI during follow-up. However, patients with significantly impaired renal function had a poorer outcome. Many patients with PUV presented late within the reviewed period. Valve ablation provided relief of obstruction in most of the cases. There is a need to

  17. Abnormal antenatal sonogram: an indicator of disease severity in children with posterior urethral valves

    International Nuclear Information System (INIS)

    Harvie, S.; McLeod, L.; Acott, P.; Walsh, E.; Abdolell, M.; Macken, M.B.

    2009-01-01

    To review the association of an abnormal prenatal sonogram with most recent serum creatinine in patients with proven posterior urethral valves (PUV). Since 1992, all live-born patients between 1992-2004 with clinically proven PUV, with postnatally proven PUV, from 2 pediatric tertiary care centers, were reviewed for age at diagnosis, most recent serum creatinine, presence of chronic renal failure (CRF) (serum creatinine >2 standard deviations above normal for age), or end stage renal disease (dialysis or transplant). Available antenatal reports from the 2 centres and surrounding community hospitals were reviewed for gestational age (GA) at the time of ultrasound, volume of amniotic fluid, and urinary-tract abnormality. Thirty-four patients with proven PUV and prenatal sonograms were identified (1992-2004). Eighteen patients had abnormalities on their prenatal sonogram, with poor outcome in 5 (mean follow-up, 8 years [1-13 y]). No specific features were identified on prenatal sonogram. Sixteen patients had normal prenatal sonograms, with poor outcomes in 2 (mean follow-up, 8 years [3-13 y]). There is an increased risk of an abnormal serum creatinine among those patients with an abnormal prenatal study, odds ratio (OR) 2.6 (95% confidence interval, 0.35-32). PUV represents a spectrum of disease severity. A normal prenatal ultrasound does not preclude PUV. The majority of patients with a normal prenatal examination have good outcomes. The OR suggests that there may be increased risk for poor outcome in those with an abnormal prenatal examination. A multicenter study is necessary to obtain a larger sample size and more precise ORs. (author)

  18. Abnormal antenatal sonogram: an indicator of disease severity in children with posterior urethral valves

    Energy Technology Data Exchange (ETDEWEB)

    Harvie, S. [Peterborough Health Centre, Dept. of Radiology, Peterborough, Ontario (Canada); McLeod, L. [IWK Health Centre, Dept. of Obstetrics and Gynaecology, Halifax, Nova Scotia (Canada); Acott, P. [IWK Health Centre, Dept. of Nephrology, Halifax, Nova Scotia (Canada); Walsh, E. [Dr. Charles A. Janeway Children' s Health Centre, Dept. of Radiology, St. John' s, Newfoundland (Canada); Abdolell, M. [QE II Health Sciences Centre, Dept. of Radiology, Halifax, Nova Scotia (Canada); Macken, M.B., E-mail: mmacken@dal.ca [IWK Health Centre, Dept. of Diagnostic Imaging, Halifax, Nova Scotia (Canada)

    2009-10-15

    To review the association of an abnormal prenatal sonogram with most recent serum creatinine in patients with proven posterior urethral valves (PUV). Since 1992, all live-born patients between 1992-2004 with clinically proven PUV, with postnatally proven PUV, from 2 pediatric tertiary care centers, were reviewed for age at diagnosis, most recent serum creatinine, presence of chronic renal failure (CRF) (serum creatinine >2 standard deviations above normal for age), or end stage renal disease (dialysis or transplant). Available antenatal reports from the 2 centres and surrounding community hospitals were reviewed for gestational age (GA) at the time of ultrasound, volume of amniotic fluid, and urinary-tract abnormality. Thirty-four patients with proven PUV and prenatal sonograms were identified (1992-2004). Eighteen patients had abnormalities on their prenatal sonogram, with poor outcome in 5 (mean follow-up, 8 years [1-13 y]). No specific features were identified on prenatal sonogram. Sixteen patients had normal prenatal sonograms, with poor outcomes in 2 (mean follow-up, 8 years [3-13 y]). There is an increased risk of an abnormal serum creatinine among those patients with an abnormal prenatal study, odds ratio (OR) 2.6 (95% confidence interval, 0.35-32). PUV represents a spectrum of disease severity. A normal prenatal ultrasound does not preclude PUV. The majority of patients with a normal prenatal examination have good outcomes. The OR suggests that there may be increased risk for poor outcome in those with an abnormal prenatal examination. A multicenter study is necessary to obtain a larger sample size and more precise ORs. (author)

  19. Nadir creatinine in posterior urethral valves: How high is low enough?

    Science.gov (United States)

    Coleman, R; King, T; Nicoara, C-D; Bader, M; McCarthy, L; Chandran, H; Parashar, K

    2015-12-01

    Large retrospective studies of people with posterior urethral valves (PUV) have reported chronic renal insufficiency (CRI) in up to one third of the participants and end-stage renal failure in up to one quarter of them. Nadir creatinine (lowest creatinine during the first year following diagnosis) is the recognised prognostic indicator for renal outcome in PUV, the most commonly used cut-off being 1 mg/dl (88.4 umol/l). To conduct a statistical analysis of nadir creatinine in PUV patients in order to identify the optimal cut-off level as a prognostic indicator for CRI. Patients treated by endoscopic valve ablation at the present institution between 1993 and 2004 were reviewed. Chronic renal insufficiency was defined as CKD2 or higher. Statistical methods included receiver operating characteristic (ROC) curve analysis, Fisher exact test and diagnostic utility tests. Statistical significance was defined as P creatinine was identified in 96 patients. The median follow-up was 9.4 (IQR 7.0, 13.4) years. A total of 29 (30.2%) patients developed CRI, with nine (9.4%) reaching end-stage renal failure. On ROC analysis, Nadir creatinine was highly prognostic for future CRI, with an Area Under the Curve of 0.887 (P creatinine >88.4 umol/l compared with 19 of 86 (22.2%) patients with lower nadir creatinine (P creatinine cut-off of 88.4 umol/l gave a specificity of 100%, but poor sensitivity of 34.5%. Lowering the cut-off to 75 umol/l resulted in improvement in all diagnostic utility tests (Table). All 14 (100%) patients with nadir creatinine >75 umol/l developed CRI, compared with 15 of 82 (18.3%) patients with lower nadir creatinine (P creatinine creatinine >75 umol/l (OR 48.988; CI 4.9-490.11) to be independent risk factors for progression to CRI. Using cut-off values of 35 umol/l and 75 umol/l, patients can be stratified into low-, intermediate- and high-risk groups, with development of CRI in 5.3%, 28.3% and 100%, respectively (P creatinine >75 umol/l (0.85

  20. Congenital absence of anterior papillary muscle of the tricuspid valve and surgical repair with artificial chordae.

    Science.gov (United States)

    Tian, Chuan; Pan, Shiwei

    2017-02-01

    We report the case of a 26-year old woman who underwent successful tricuspid valve repair for the absence of the anterior papillary of the tricuspid valve. Preoperative echocardiography revealed grade IV tricuspid valve regurgitation, caused by congenital absence of the anterior papillary muscle and prolapse of the anterior leaflet. Tricuspid valve repair was performed using artificial chords consisting of two polytetrafluoroethylene sutures and a concomitant ring annuloplasty. Postoperative echocardiography revealed mild tricuspid valve regurgitation. This approach represented a safe and effective technique for tricuspid valve repair in congenital absence of papillary muscle. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  1. A New Technique for Reconstruction of the Tricuspid Valve Ring in Congenital Tricuspid Insufficiency

    OpenAIRE

    Montero, C. G.; Tellez, G.; Simarro, E.; Juffé, A.; Amau, J. G.; Gurgos, R.; Figuera, D.; Cortina, A.

    1983-01-01

    A 50-year-old man was treated for a dysplasia-type congenital tricuspid insufficiency. The tricuspid valve ring was repaired with a perforated Teflon patch graft and the valve was replaced. The patient was discharged in good condition and is well after 18 months of follow-up.

  2. Concomitant anterior and posterior urethral valves in pediatrics: A single center experience over 12 years and long-term follow up after endoscopic treatment.

    Science.gov (United States)

    Kajbafzadeh, Abdol-Mohammad; Hosseini Sharifi, Seyed Hossein; Keihani, Sorena; Soltani, Mohammad Hossein; Tajali, Afshin; Salavati, Alborz; Payabvash, Seyedmehdi; Mehdizadeh, Mehrzad

    2015-05-01

    To report our 12-year experience with endoscopic management of patients with concomitant anterior and posterior urethral valves. We retrospectively reviewed the charts of patients referred to us for management of urethral valves from 2000 to 2012 to find cases with concomitant anterior and posterior valves. The diagnosis of valves was first suspected on voiding cystourethrography and confirmed by urethrocystoscopy. We collected available data on patients' age at diagnosis, clinical presentations, ultrasound and urodynamic findings, and surgical treatments. The final outcome at last follow up was also recorded. From 38 cases with anterior urethral valve, six (15.8%) presented concomitant anterior and posterior valves. The age at diagnosis in these patients ranged from antenatal diagnosis to 13 years. Initial presenting symptoms were recurrent urinary tract infection, incontinence, urosepsis and poor urinary stream. All valves were ablated by transurethral fulguration/resection using small-sized urethrocystoscopes. Among those with concomitant anterior and posterior valves, four patients had vesicoureteral reflux at presentation that resolved in two patients after valve ablation. One patient progressed to renal failure and required dialysis. Bladder hypercontractility and detrusor overactivity were the main urodynamic patterns in these patients. Concomitant anterior and posterior valves seem to be more prevalent than previously assumed, and might be missed on initial assessment. Oblique view voiding cystourethrography with full-length delineation of the urethra is of paramount diagnostic importance when obstruction is suspected. A meticulous urethrocystoscopy should follow for confirming the diagnosis and endoscopic ablation/resection of the valves. © 2015 The Japanese Urological Association.

  3. Interventional therapy for congenital urinary obstruction in children

    International Nuclear Information System (INIS)

    Qin Zenhui; Huang Sui; Liu Fan; Yang Jinyuan

    2005-01-01

    Objective: To investigate the interventional therapy in children's congenital urinary obstruction and its efficacy. Methods: Thirty-three children with congenital obstruction of ureteropelvic junction were treated through percutaneous dilation and/or stent placement, and 42 cases with posterior urethral valves were treated through trans-urethra dilation. Results: Thirty-three cases with upper urinary obstruction were improved with symptoms disappeared and stable efficacy on long-term follow-up of 1-7 years. Another 2 cases with the upper urethral obstruction had not been relieved of symptoms and resorted to surgical operation. For patients with posterior urethral valves, the lower urethral obstruction was totally got rid of after interventional therapy with stable efficacy on long-term follow-up of 1-10 years. Conclusions: Interventional therapy is safe , micro-invasive and efficient in treating congenital urinary obstruction with stable efficacy on long-term follow-up. (authors)

  4. Prosthetic valves in adult patients with congenital heart disease : Rationale and design of the Dutch PROSTAVA study

    NARCIS (Netherlands)

    Freling, H. G.; van Slooten, Y. J.; van Melle, J. P.; Mulder, B. J. M.; van Dijk, A. P. J.; Hillege, H. L.; Post, M. C.; Sieswerda, G. Tj; Jongbloed, M. R. M.; Willems, T. P.; Pieper, P. G.

    2012-01-01

    Data on long-term complications in adult patients with congenital heart disease (ACHD) and a prosthetic valve are scarce. Moreover, the influence of prosthetic valves on quality of life (QoL) and functional outcome in ACHD patients with prosthetic valves has not been studied. The primary objective

  5. Flail Tricuspid Valve in an Adult Patient with Congenitally Corrected Transposition of the Great Arteries.

    Science.gov (United States)

    Meloni, Luigi; Abbruzzese, Piero A.; Pirisi, Raimondo; Cherchi, Angelo

    1997-01-01

    We describe a case of a 50-year-old woman with congenitally corrected transposition of the great vessels, in whom severe left-sided tricuspid (systemic atrioventricular) valve insufficiency was the only associated anomaly. The tricuspid valve was dysplastic and abnormally oriented toward the interventricular septum, without the downward displacement of Ebstein's anomaly. The mechanism of atrioventricular regurgitation was unusual in that it consisted of the rupture of chordae tendineae of both the anterior and septal leaflets. The left-sided tricuspid valve was replaced with a St. Jude prosthesis and the postoperative course was uneventful.

  6. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease

    NARCIS (Netherlands)

    Yap, Sing-Chien; Drenthen, Willem; Pieper, Petronella G.; Moons, Philip; Mulder, Barbara J. M.; Klieverik, Loes M.; Vliegen, Hubert W.; van Dijk, Arie P. J.; Meijboom, Folkert J.; Roos-Hesselink, Jolien W.

    Background and aim of the study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

  7. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease

    NARCIS (Netherlands)

    Yap, Sing-Chien; Drenthen, Willem; Pieper, Petronella G.; Moons, Philip; Mulder, Barbara J. M.; Klieverik, Loes M.; Vliegen, Hubert W.; van Dijk, Arie P. J.; Meijboom, Folkert J.; Roos-Hesselink, Jolien W.

    2007-01-01

    Background and aim of the study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

  8. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease.

    NARCIS (Netherlands)

    Yap, S.C.; Drenthen, W.; Pieper, P.G.; Moons, P.; Mulder, B.J.M.; Klieverik, L.M.; Vliegen, H.W.; Dijk, A.P.J. van; Meijboom, F.J.; Roos-Hesselink, J.W.

    2007-01-01

    BACKGROUND AND AIM OF THE STUDY: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

  9. Long-term tricuspid valve prosthesis-related complications in patients with congenital heart disease

    NARCIS (Netherlands)

    van Slooten, Ymkje J.; Freling, Hendrik G.; van Melle, Joost P.; Mulder, Barbara J. M.; Jongbloed, Monique R. M.; Ebels, Tjark; Voors, Adriaan A.; Pieper, Petronella G.

    2014-01-01

    In patients with acquired valvar disease, morbidity and mortality rates after tricuspid valve replacement (TVR) are high. However, in adult patients with congenital heart disease, though data concerning outcome after TVR are scarce, even poorer results are suggested in patients with Ebstein anomaly.

  10. Long-term tricuspid valve prosthesis-related complications in patients with congenital heart disease

    NARCIS (Netherlands)

    van Slooten, Ymkje J.; Freling, Hendrik G.; van Melle, Joost P.; Mulder, Barbara J. M.; Jongbloed, Monique R. M.; Ebels, Tjark; Voors, Adriaan A.; Pieper, Petronella G.

    OBJECTIVES: In patients with acquired valvar disease, morbidity and mortality rates after tricuspid valve replacement (TVR) are high. However, in adult patients with congenital heart disease, though data concerning outcome after TVR are scarce, even poorer results are suggested in patients with

  11. Posterior urethral valves: 10 years audit of epidemiologic, diagnostic and therapeutic aspects in Yaoundé gynaeco-obstetric and paediatric hospital.

    Science.gov (United States)

    Tambo, Faustin Felicien Mouafo; Tolefac, Paul Nkemtendong; Ngowe, Marcelin Ngowe; Minkande, Jacqueline Ze; Mbouche, Landry; Guemkam, Georgette; Telelen, Neville Alemnju; Angwafo, Fru Fobuzshi; Sosso, Aurelien Maurice

    2018-05-21

    The incidence of posterior urethral valve (PUV) is estimated at 1:5000-1:8000 males. It is the most common paediatric urologic urgency and the most common cause of male obstructive uropathy and chronic renal failure in children. The study aimed to describe the experience of Yaoundé gynaeco-obstetrics and paediatric hospital in the management of PUV. Retrospectively, medical records were retrieved over a ten year period and all data recorded and analyzed for study objectives. Patients were called and evaluated for outcomes regarding morbidity and mortality. A total of 18 patients all males were managed over the ten year period, given prevalence of 13 cases/100,000 admissions and an admission rate of 2 per annum. The median age at presentation was 22 months and 13 (72.2%) participants presented late. Voiding urethrocystogram was done in all the participants where it showed dilated and elongated posterior urethral valves in 16 (88.9%) of the cases. Endoscopic valve ablation resulted in the relief of obstruction in all but 3 (16.7%) participants that had residual valves and 2 (11.2%) participants that had urethral stenosis. Type I valves were most common in 14 (78.0%) participants. The mean duration of follow up was 34.56 ± 21.47 months. Complications at final follow up were: 10 (55.6%) chronic renal failure, 2 (11.2%) end-stage renal failure. The case fatality rate was 5.6%. Many patients present late in our setting with already established complications. There is the need to counsel parents/guardians on the importance of long-term follow up after relief of obstruction.

  12. Results of aortic valve repair using decellularized bovine pericardium in congenital surgery.

    Science.gov (United States)

    Nordmeyer, Sarah; Murin, Peter; Schulz, Antonia; Danne, Friederike; Nordmeyer, Johannes; Kretzschmar, Johanna; Sumbadze, Daria; Schmitt, Katharina Rose Luise; Miera, Oliver; Cho, Mi-Young; Sinzobahamvya, Nicodeme; Berger, Felix; Ovroutski, Stanislav; Photiadis, Joachim

    2018-04-30

    The search for an optimal patch material for aortic valve reconstruction (AVR) is an ongoing challenge. In this study, we report our experience of AVR using decellularized bovine pericardial patch material in congenital heart surgery. Data of 40 consecutive patients who underwent AVR using the CardioCel® patch (Admedus Regen Pty Ltd, Perth, WA, Australia) between February 2014 and August 2016 were retrospectively reviewed. The median age of the patients at operation was 9 (2-34) years, and 18 patients were younger than 7 years. Twenty-six patients initially presented with aortic valve insufficiency (AI) and 14 with stenosis. Clinical and echocardiographic data were available until August 2017 for a median postoperative follow-up (FU) of 22 (6-42) months. Nine of 40 (23%) patients experienced an event during FU (death: n = 1, 2.5%; reoperation: n = 8, 20%). Overall, the probability of freedom from reoperation or death was 97 ± 3%, 76 ± 9% and 57 ± 12% at 12, 24 and 36 months of FU, respectively. Reason for reoperation was stenosis in 3 (37.5%) patients, insufficiency in 4 (50%) patients and 1 (12.5%) patient was diagnosed with aortic valve endocarditis. Of the remaining 31 patients, 2 patients are scheduled for reoperation (aortic valve stenosis: n = 1 and AI: n = 1) and 9 patients exhibit worsening of aortic valve function with moderate AI. Freedom from developing combined end point [death/reoperation/moderate degree of aortic valve dysfunction (aortic valve stenosis, AI)] after AVR was 92 ± 5%, 55 ± 9% and 28 ± 9% at 12, 24 and 36 months, respectively. AVR using decellularized bovine pericardial patch material in patients with congenital aortic valve disease show unsatisfactory results within the first 3 years of FU.

  13. Long-term outcome of posterior urethral valves ablation using the ...

    African Journals Online (AJOL)

    Les problemes remarqués au cours d'examens de contrôles a long terme sont: infections urinaire périodique en 35% des cas, insuffisance rénale aigue et chronique en 5% et 15% respectivement, rachitisme, anémie, sousalimentation et rétrécissement urétral. Conclusion: Les enfants qui ont subi une ablation des valves ...

  14. Unusual giant prostatic urethral calculus | Bello | Journal of Surgical ...

    African Journals Online (AJOL)

    Giant vesico-prostatic urethral calculus is uncommon. Urethral stones rarely form primarily in the urethra, and they are usually associated with urethral strictures, posterior urethral valve or diverticula. We report a case of a 32-year-old man with giant vesico-prostatic (collar-stud) urethral stone presenting with sepsis and ...

  15. Cardiac Hemodynamics in the Pathogenesis of Congenital Heart Disease and Aortic Valve Calcification

    Science.gov (United States)

    Nigam, Vishal

    2011-11-01

    An improved understanding of the roles of hemodynamic forces play in cardiac development and the pathogenesis of cardiac disease will have significant scientific and clinical impact. I will focus on the role of fluid dynamics in congenital heart disease and aortic valve calcification. Congenital heart defects are the most common form of birth defect. Aortic valve calcification/stenosis is the third leading cause of adult heart disease and the most common form of acquired valvular disease in developed countries. Given the high incidence of these diseases and their associated morbidity and mortality, the potential translational impact of an improved understanding of cardiac hemodynamic forces is very large. Division of Pediatric Cardiology, Rady Children's Hospital, San Diego

  16. Pictorial essay: Congenital anomalies of male urethra in children

    Science.gov (United States)

    Jana, Manisha; Gupta, Arun K; Prasad, Kundum R; Goel, Sandeep; Tambade, Vishal D; Sinha, Upasna

    2011-01-01

    Congenital anomalies of the male urogenital tract are common. Some lesions like posterior urethral valve or anterior urethral diverticulum tend to present early in infancy and are often easily diagnosed on conventional contrast voiding cystourethrograms. Other conditions like posterior urethral diverticulum or utricle can be relatively asymptomatic and therefore present late in childhood. We present the spectrum of imaging findings of common and uncommon anomalies involving the male urethra. Since the pediatric radiologist is often the first to make the diagnosis, he or she should be well aware of these conditions. PMID:21431032

  17. Pictorial essay: Congenital anomalies of male urethra in children

    International Nuclear Information System (INIS)

    Jana, Manisha; Gupta, Arun K; Prasad, Kundum R; Goel, Sandeep; Tambade, Vishal D; Sinha, Upasna

    2011-01-01

    Congenital anomalies of the male urogenital tract are common. Some lesions like posterior urethral valve or anterior urethral diverticulum tend to present early in infancy and are often easily diagnosed on conventional contrast voiding cystourethrograms. Other conditions like posterior urethral diverticulum or utricle can be relatively asymptomatic and therefore present late in childhood. We present the spectrum of imaging findings of common and uncommon anomalies involving the male urethra. Since the pediatric radiologist is often the first to make the diagnosis, he or she should be well aware of these conditions

  18. Pictorial essay: Congenital anomalies of male urethra in children

    Directory of Open Access Journals (Sweden)

    Manisha Jana

    2011-01-01

    Full Text Available Congenital anomalies of the male urogenital tract are common. Some lesions like posterior urethral valve or anterior urethral diverticulum tend to present early in infancy and are often easily diagnosed on conventional contrast voiding cystourethrograms. Other conditions like posterior urethral diverticulum or utricle can be relatively asymptomatic and therefore present late in childhood. We present the spectrum of imaging findings of common and uncommon anomalies involving the male urethra. Since the pediatric radiologist is often the first to make the diagnosis, he or she should be well aware of these conditions.

  19. Aortic valve prosthesis-patient mismatch and exercise capacity in adult patients with congenital heart disease.

    Science.gov (United States)

    van Slooten, Ymkje J; van Melle, Joost P; Freling, Hendrik G; Bouma, Berto J; van Dijk, Arie Pj; Jongbloed, Monique Rm; Post, Martijn C; Sieswerda, Gertjan T; Huis In 't Veld, Anna; Ebels, Tjark; Voors, Adriaan A; Pieper, Petronella G

    2016-01-01

    To report the prevalence of aortic valve prosthesis-patient mismatch (PPM) in an adult population with congenital heart disease (CHD) and its impact on exercise capacity. Adults with congenital heart disease (ACHD) with a history of aortic valve replacement may outgrow their prosthesis later in life. However, the prevalence and clinical consequences of aortic PPM in ACHD are presently unknown. From the national Dutch Congenital Corvitia (CONCOR) registry, we identified 207 ACHD with an aortic valve prosthesis for this cross-sectional cohort study. Severe PPM was defined as an indexed effective orifice area ≤0.65 cm2/m2 and moderate PPM as an indexed orifice area ≤0.85 cm2/m2 measured using echocardiography. Exercise capacity was reported as percentage of predicted exercise capacity (PPEC). Of the 207 patients, 68% was male, 71% had a mechanical prosthesis and mean age at inclusion was 43.9 years ±11.4. The prevalence of PPM was 42%, comprising 23% severe PPM and 19% moderate PPM. Prevalence of PPM was higher in patients with mechanical prostheses (pHeart Association (NYHA) class remained stable in most patients. PPM showed no significant effect on death or hospitalisation during follow-up (p=0.218). In this study we report a high prevalence (42%) of PPM in ACHD with an aortic valve prosthesis and an independent association of PPM with diminished exercise capacity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. The management of vesicoureteral reflux in the setting of posterior urethral valve with emphasis on bladder function and renal outcome: a single center cohort study.

    Science.gov (United States)

    Tourchi, Ali; Kajbafzadeh, Abdol-Mohammad; Aryan, Zahra; Ebadi, Maryam

    2014-01-01

    To represent our experience in the management of posterior urethral valves and concomitant vesicoureteral reflux (VUR). A total of 326 children with posterior urethral valve who had underwent valve ablation/bladder neck incision were studied, and those who had persistent VUR and were categorized under 3 main groups were followed up. Group 1 (n = 71) received prophylactic antibiotic, group 2 (n = 50) underwent Deflux injection (2a) (n = 28): Deflux injection alone, group 2b (n = 22) Deflux with concomitant autologous blood injection (HABIT), and group 3 (n = 19) underwent ureteroneocystostomy before referral and was followed up conservatively. VUR resolution, incidence of urinary tract infections (UTI), and bladder function were assessed. Mean duration of follow-up was 3.8 years; VUR resolution occurred in 66.1%, 86.0%, and 94.0% of groups 1-3, respectively (P = .013). Resolution rate in group 2b was significantly higher than group 2a (90.9% vs 78.5%). Patients in group 2 experienced a longer UTI-free period compared with others (P <.05). Urodynamic studies demonstrated significant decrease in maximum voiding detrusor pressure and detrusor overactivity in all groups (P <.001). Children in group 3 ended up with lower compliance compared with others (P <.001). After toilet training, only 2.8%, 21.4%, 13.6%, and 27% children were diagnosed with lower urinary tract dysfunction in groups 1-3, respectively (P = .027). Myogenic failure developed only in 3 boys in group 3. Ablation/bladder neck incision leads to significant improvement in VUR status in part because of improvement in bladder function. After successful valve removal, conservative therapy can be regarded as the mainstay of reflux treatment, whereas HABIT is recommended for high grade VUR associated with febrile UTI or deterioration in renal function. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Efficiency of aortic valve commissurotomy for congenital aortic valve stenosis in pediatric population

    Directory of Open Access Journals (Sweden)

    А. А. Лукьянов

    2015-10-01

    Full Text Available Background. This study was designed to evaluate short-term and long-term outcomes after open aortic valve commissurotomy in the pediatric patients at our center over a period of 10 years. Methods. A retrospective study of 94 patients who underwent open surgical commissurotomy because of aortic valve stenosis between 2003 and 2013 is presented. Follow-up time was in the range of 1 to 7 years. Results. The open aortic valve commissurotomy combined with debridement of leaflet free edge 36.1 %, LVOT myectomy 11.7%, leaflet suture plastic 7.4%, modified Konno procedure 6.3%, Brom's aortoplasty 4.2% was performed for all patients. Average cardiopulmonary bypass time was 59.2 30.7 min. Median aortic cross-clamping time was 31.52 15.1 min. Hospital complications were observed in 38.2% of cases. ICU time was in the range of 1 to 31 (mean 3.2 5.1 day. Artificial lung ventilation time varied from 2 to 76 (mean 15.3 18.3 hours. Inotropic support was needed in 26.5% of cases. Mean hospital stay time was 17.1 7.3 days. At follow-up between 2 and 7 years, reoperations were required for 3 patients who underwent a Ross procedure. Conclusions. The results evidence that open surgical commissurotomy is an effective way of treatment for aortic valve stenosis, considering the accuracy of plasty and additional techniques of leaflet correction. The best children age group for this type of operation is from first to five years of life.

  2. [Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].

    Science.gov (United States)

    Wyller, Vegard Bruun; Aaberge, Lars; Thaulow, Erik; Døhlen, Gaute

    2011-07-01

    Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects. Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009. Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then. Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.

  3. Management of tricuspid regurgitation in congenital heart disease: is survival better with valve repair?

    Science.gov (United States)

    Said, Sameh M; Dearani, Joseph A; Burkhart, Harold M; Connolly, Heidi M; Eidem, Ben; Stensrud, Paul E; Schaff, Hartzell V

    2014-01-01

    Tricuspid valve (TV) regurgitation in congenital heart disease includes a heterogeneous group of lesions, and few series have documented the outcomes. We reviewed the records of 553 patients with congenital heart disease who had undergone TV surgery for tricuspid regurgitation from January 1993 to December 2010. Patients with Ebstein malformation were excluded. Their mean age was 32 ± 21 years, and 300 were female (54%). The most common diagnoses were conotruncal anomaly in 216 patients (39%), previous ventricular septal defect closure in 83 (15%), atrioventricular septal defect in 77 (14%), and pulmonary atresia with an intact ventricular septum in 11 (2%). Preoperative right-sided heart failure was present in 124 patients (22%), and 55 patients (10%) had pulmonary hypertension. TV repair was performed in 442 (80%) and TV replacement in 111 (20%) patients. Repeat sternotomy was performed in 415 patients (75%). Previous TV repair was present in 44 patients (8%); of these, 17 (38.6%) underwent repeat TV repair. The overall early mortality was 3.1% (17 patients) and was 2.5% for TV repair and 5.4% for TV replacement (P = .001). The mean follow-up period was 4.5 ± 4.1 years (maximum, 18). The overall survival at 1, 5, and 10 years was 97%, 93%, and 85%, respectively. Survival was better for patients with repair than with replacement. TV repair was an independent predictor of better survival (P = .001). Important tricuspid regurgitation can occur with a variety of congenital diagnoses. Early mortality is low and late survival is superior with tricuspid repair than with valve replacement. Surgical treatment of tricuspid regurgitation in congenital heart disease should be performed before the onset of heart failure. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  4. Dual-Source Computed Tomography Evaluation of Children with Congenital Pulmonary Valve Stenosis

    International Nuclear Information System (INIS)

    Sun, Zhanguo; Xu, Wenjian; Huang, Shuran; Chen, Yueqin; Guo, Xiang; Shi, Zhitao

    2016-01-01

    Despite dual-source computed tomography (DSCT) technology has been performed well on adults or infants with heart disease, specific knowledge about children with congenital pulmonary valve stenosis (PS) remained to be established. This original research aimed to establish a professional approach of DSCT performing technology on children and to assess the image quality performed by DSCT to establish a diagnostic evaluation for children with PS. Ninety-eight children with congenital PS referred to affiliated hospital of Jining medical college were recruited from October 2013 to March 2015. Participants were divided into four groups according to different ages (0 - 1, 1 - 3, 3 - 7, 7 - 14), or three groups according to different heart rates (< 90, 90 - 110, > 110). Image quality of pulmonary valves was assessed based on a four-point grading scale (1 - 4 points). Those cases achieving a score of ≥ 3 points were selected for further investigation, which played a critical role in our analysis. Correlation analysis was used to identify the effects of age and heart rate on image quality. Additionally, the results evaluated by DSCT were compared with those evaluated from the operation, further confirming the accuracy of DSCT. Seventy-two cases (73.4%) achieved a score of ≥ 3 points based on pulmonary valve imaging, which were available for further diagnosis. There was a statistically significant difference (P < 0.05) between the four groups except 0 - 1 group and 1 - 3 group, 3 - 7 group and 7 - 14 group, and the image quality of elder group was higher than younger group. Image score was gradually decreased with increased heart rate (F = 19.05, P < 0.01). Heart rate was negatively correlated with pulmonary valve scores (r = -0.391, P < 0.001), while there was no correlation between age and scores (r = 0.185, P = 0.070). The number, shape, commissure, and opening status of pulmonary valves evaluated by DSCT were the same as the results of operation. Heart rate serves a

  5. Surgical Results of Trabeculectomy and Ahmed Valve Implantation Following a Previous Failed Trabeculectomy in Primary Congenital Glaucoma Patients

    OpenAIRE

    Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae; Kim, Chan Yun

    2015-01-01

    Purpose To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. Methods A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. Results The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9...

  6. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Directory of Open Access Journals (Sweden)

    Huang J

    2015-06-01

    Full Text Available Jingjing Huang,1 Jialiu Lin,1 Ziqiang Wu,2 Hongzhi Xu,3 Chengguo Zuo,1 Jian Ge1 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Advanced Eye Care, Carson City, NV, USA; 3Institute of Child Health Policy, University of Florida, Gainesville, FL, USA Purpose: The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries.Patients and methods: Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1 intraocular pressure (IOP ≥6 and ≤21 mmHg; 2 IOP reduction of at least 30% relative to preoperative values; and 3 without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications.Results: Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80 mm, corneal diameter was 14.71±1.07 (13.0–16.0 mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0, and IOP was 39.5±5.7 (30–55 mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18 months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001 postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan–Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28

  7. Contemporary results of aortic valve repair for congenital disease: lessons for management and staged strategy.

    Science.gov (United States)

    Vergnat, Mathieu; Asfour, Boulos; Arenz, Claudia; Suchowerskyj, Philipp; Bierbach, Benjamin; Schindler, Ehrenfried; Schneider, Martin; Hraska, Victor

    2017-09-01

    Any aortic valve (AoV) operation in children (repair, Ross or mechanical replacement) is a palliation and reinterventions are frequent. AoV repair is a temporary solution primarily aimed at allowing the patient to grow to an age when more definitive solutions are available. We retrospectively analysed AoV repair effectiveness across the whole age spectrum of children, excluding neonates and AoV disease secondary to congenital heart disease. From 2003 to 2015, 193 consecutive patients were included. The mean age was 9.2 ± 6.9 years (22% disease. The procedures performed were commissurotomy shaving (n = 74; 38%), leaflet replacement (n = 78; 40%), leaflet extension (n = 21; 11%) and neocommissure creation (n = 21; 11%). Post-repair geometry was tricuspid in 137 (71%) patients. The 10-year survival rate was 97.1%. Freedom from reoperation and replacement at 7 years was, respectively, 57% (95% confidence interval, 47-66) and 68% (95% confidence interval, 59-76). In multivariate analysis, balloon dilatation before 6 months, the absence of a developed commissure, a non-tricuspid post-repair geometry and cross-clamp duration were predictors for reoperation and replacement. After a mean follow-up period of 5.1 ± 3.0 years, 145 (75%) patients had a preserved native valve, with undisturbed valve function (peak gradient <40 mmHg, regurgitation ≤mild) in 113 (58%). Aortic valve repair in children is safe and effective in delaying the timing for more definitive solution. Surgical strategy should be individualized according to the age of the patient. Avoidance of early balloon dilatation and aiming for a tricuspid post-repair arrangement may improve outcomes. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  8. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Science.gov (United States)

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    Purpose The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Patients and methods Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Results Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80) mm, corneal diameter was 14.71±1.07 (13.0–16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0), and IOP was 39.5±5.7 (30–55) mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pglaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications. PMID:26082610

  9. Genome-Wide DNA Methylation Analysis and Epigenetic Variations Associated with Congenital Aortic Valve Stenosis (AVS.

    Directory of Open Access Journals (Sweden)

    Uppala Radhakrishna

    Full Text Available Congenital heart defect (CHD is the most common cause of death from congenital anomaly. Among several candidate epigenetic mechanisms, DNA methylation may play an important role in the etiology of CHDs. We conducted a genome-wide DNA methylation analysis using an Illumina Infinium 450k human methylation assay in a cohort of 24 newborns who had aortic valve stenosis (AVS, with gestational-age matched controls. The study identified significantly-altered CpG methylation at 59 sites in 52 genes in AVS subjects as compared to controls (either hypermethylated or demethylated. Gene Ontology analysis identified biological processes and functions for these genes including positive regulation of receptor-mediated endocytosis. Consistent with prior clinical data, the molecular function categories as determined using DAVID identified low-density lipoprotein receptor binding, lipoprotein receptor binding and identical protein binding to be over-represented in the AVS group. A significant epigenetic change in the APOA5 and PCSK9 genes known to be involved in AVS was also observed. A large number CpG methylation sites individually demonstrated good to excellent diagnostic accuracy for the prediction of AVS status, thus raising possibility of molecular screening markers for this disorder. Using epigenetic analysis we were able to identify genes significantly involved in the pathogenesis of AVS.

  10. Genome-Wide DNA Methylation Analysis and Epigenetic Variations Associated with Congenital Aortic Valve Stenosis (AVS).

    Science.gov (United States)

    Radhakrishna, Uppala; Albayrak, Samet; Alpay-Savasan, Zeynep; Zeb, Amna; Turkoglu, Onur; Sobolewski, Paul; Bahado-Singh, Ray O

    2016-01-01

    Congenital heart defect (CHD) is the most common cause of death from congenital anomaly. Among several candidate epigenetic mechanisms, DNA methylation may play an important role in the etiology of CHDs. We conducted a genome-wide DNA methylation analysis using an Illumina Infinium 450k human methylation assay in a cohort of 24 newborns who had aortic valve stenosis (AVS), with gestational-age matched controls. The study identified significantly-altered CpG methylation at 59 sites in 52 genes in AVS subjects as compared to controls (either hypermethylated or demethylated). Gene Ontology analysis identified biological processes and functions for these genes including positive regulation of receptor-mediated endocytosis. Consistent with prior clinical data, the molecular function categories as determined using DAVID identified low-density lipoprotein receptor binding, lipoprotein receptor binding and identical protein binding to be over-represented in the AVS group. A significant epigenetic change in the APOA5 and PCSK9 genes known to be involved in AVS was also observed. A large number CpG methylation sites individually demonstrated good to excellent diagnostic accuracy for the prediction of AVS status, thus raising possibility of molecular screening markers for this disorder. Using epigenetic analysis we were able to identify genes significantly involved in the pathogenesis of AVS.

  11. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure.

    Science.gov (United States)

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56-30.80) mm, corneal diameter was 14.71±1.07 (13.0-16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9-1.0), and IOP was 39.5±5.7 (30-55) mmHg. The mean follow-up time was 18.29±10.96 (5-44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (Pvalve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28.6% cases. AGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications.

  12. Management of female congenital short patulous urethra with urethral tapering and pubovaginal sling: A report of two cases.

    Science.gov (United States)

    Gahlawat, Sumit; Goel, Hemant; Khattar, Nikhil

    2018-01-01

    Congenital short patulous urethra is a rare entity and may be associated with developmental anomalies of mullerian ducts or urogenital sinus. We report the management of two cases of congenital short patulous urethra with stress urinary incontinence (SUI). Both the patients presented with SUI; one was diagnosed with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome and the other had uterus didelphys with longitudinally septated vagina. Both patients were successfully managed by excisional tapering of the urethra and pubovaginal sling placement. SUI with congenital short patulous urethra can be managed with excisional tapering of urethra and pubovaginal sling placement.

  13. Surgical results of trabeculectomy and Ahmed valve implantation following a previous failed trabeculectomy in primary congenital glaucoma patients.

    Science.gov (United States)

    Lee, Naeun; Ma, Kyoung Tak; Bae, Hyoung Won; Hong, Samin; Seong, Gong Je; Hong, Young Jae; Kim, Chan Yun

    2015-04-01

    To compare the surgical results of trabeculectomy and Ahmed glaucoma valve implantation after a previous failed trabeculectomy. A retrospective comparative case series review was performed on 31 eye surgeries in 20 patients with primary congenital glaucoma who underwent trabeculectomy or Ahmed glaucoma valve implantation after a previous failed trabeculectomy with mitomycin C. The preoperative mean intraocular pressure was 25.5 mmHg in the trabeculectomy group and 26.9 mmHg in the Ahmed glaucoma valve implantation group (p = 0.73). The 48-month postoperative mean intraocular pressure was 19.6 mmHg in the trabeculectomy group and 20.2 mmHg in the Ahmed glaucoma valve implantation group (p = 0.95). The 12-month trabeculectomy success rate was 69%, compared with 64% for Ahmed glaucoma valve implantation, and the 48-month success rates were 42% and 36% for trabeculectomy and valve implantation, respectively. The success rates following the entire follow-up period were not significantly different between the two groups (p > 0.05 by log rank test). Postoperative complications occurred in 25% of the trabeculectomy-operated eyes and 9% of the Ahmed-implanted eyes (p = 0.38). There was no significant difference in surgical outcome between the trabeculectomy and Ahmed glaucoma valve implantation groups, neither of which had favorable results. However, the trabeculectomy group demonstrated a higher prevalence of adverse complications such as post-operative endophthalmitis.

  14. Urethral Injuries

    Science.gov (United States)

    ... the bladder and the urethra ( cystoscopy ). Treatment Bladder drainage tube Sometimes surgery (to repair urethral tears) For urethral bruises that do not result in any leakage of urine, a doctor can place a catheter ... days to drain the urine while the urethra heals. For urethral ...

  15. Y-type congenital urethral duplication with normal dorsal urethra and small ventral fistula to perineal skin – 28th reported case

    Directory of Open Access Journals (Sweden)

    Donald E. Meier

    2016-05-01

    Full Text Available There are numerous types of urethral duplication previously described in the literature including a Type IIA2Y where a large ventral channel branches from the hypoplastic, dorsal, orthotopic urethra. There have been 27 previously reported cases of a similar defect, called “congenital posterior urethrocutaneous fistula” (CUPF with the only difference being that the ventral urethra is hypoplastic and the dorsal, orthotopic one normal. The difference in treatment for these 2 entities is markedly different, and preoperative identification of the appropriate abnormality is essential. Treatment of CUPF requires only safe excision of the ventral segment, but treatment for a Type IIA2Y duplication requires resection of the hypoplastic, orthotopic urethra and transposition of the larger ventral segment into the dorsal orthotopic position. The outcome for treatment of CUPF is much better than for treatment of Type IIA2Y entities. We herein present the 28th case of CUPF in the English literature with discussion of the anatomy, appropriate diagnostic criteria, and safe method of treatment for these entities.

  16. Urethral trauma

    International Nuclear Information System (INIS)

    Carrington, B.M.; Hricak, H.; Dixon, C.; McAninch, J.W.

    1990-01-01

    This paper evaluates the role of MR imaging in posterior urethral trauma. Fifteen patients with posttraumatic membranous urethral strictures underwent prospective MR imaging with a 1.5-T unit before open urethroplasty. All patients had transaxial T1-weighted (500/20) and T2-weighted (2,500/70) spin-echo images and T2-weighted sagittal and coronal images (matrix, 192 x 256; section thickness, 4 mm with 20% gap). Conventional retrograde and cystourethrography were performed preoperatively. Compared with conventional studies, MR imaging defined the length and location of the urethral injury and provided additional information regarding the direction and degree of prostatic and urethral dislocation

  17. The Impact of Obesity on Postoperative Outcomes in Adults with Congenital Heart Disease Undergoing Pulmonary Valve Replacement.

    Science.gov (United States)

    Buelow, Matthew W; Earing, Michael G; Hill, Garick D; Cohen, Scott B; Bartz, Peter J; Tweddell, James S; Ginde, Salil

    2015-01-01

    The impact of obesity on surgical morbidity in adults with congenital heart disease is currently unknown. The aim of our study was to investigate the impact of obesity on postoperative outcomes in adults with congenital heart disease undergoing reoperation for pulmonary valve replacement. A retrospective analysis was performed assessing the influence of obesity on surgical outcomes. Obesity was defined as a body mass index ≥30 kg/m2. The mean body mass index of the cohort was 25.9 ± 6.9 kg/m2 . The cohort included 71 patients with 17 patients (24%) being obese. There was no postoperative mortality. Obese patients had a longer hospital length of stay (6.6 vs. 4.7 days; P obesity was independently associated with hospital length of stay >5 days (odds ratio [OR] = 5.2; 95% confidence interval [CI]: 1.5-18.2, P = .01) and with increased postoperative arrhythmias (OR = 4.2; 95% CI: 1.7-40, P Obesity is associated with increased morbidity in adults with congenital heart disease undergoing pulmonary valve replacement, including longer hospitalization and higher risk for postoperative arrhythmias. © 2015 Wiley Periodicals, Inc.

  18. Minimally invasive surgical approach to treat posterior urethral diverticulum

    Directory of Open Access Journals (Sweden)

    Ossamah Alsowayan

    2015-01-01

    Full Text Available Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS in managing posterior urethral diverticulum.

  19. Predicting postnatal renal function of prenatally detected posterior urethral valves using fetal diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient determination.

    Science.gov (United States)

    Faure, Alice; Panait, Nicoleta; Panuel, Michel; Alessandrini, Pierre; D'Ercole, Claude; Chaumoitre, Kathia; Merrot, Thierry

    2017-07-01

    The objective of this study was to evaluate the accuracy of fetal diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient (ADC) determination to predict postnatal renal function (nadir creatinine at 1 year and eGFR) of men with posterior urethral valves (PUV). Between 2003 and 2014, 11 MRI were performed on fetuses (between 28 and 32 weeks) in whom second trimester sonography suggested severe bilateral urinary tract anomalies, suspected of PUV. The ADC of the 11 fetuses ranged from 1.3 to 2.86 mm 2  s -1 (median = 1.79 mm 2  s -1 , normal range for fetal kidney: 1.1-1.8). Two pregnancies with ADC > 2.6 mm 2  s -1 were interrupted; the autopsy confirmed PUV and Potter syndrome. For the remaining nine babies, the follow-up was 5.4 years (0.8-10). Four children with abnormal ADC (1.8-2.3) had chronic kidney disease. The remaining five cases with normal nadir creatinine and eGFR had normal ADC. One case with unilateral elevated ADC had a poor ipsilateral renal function on dimercaptosuccinic acid scan. Here, it seems that diffusion-weighted magnetic resonance imaging with ADC determination could be useful in accurately evaluating fetal kidneys in PUV and predicting renal function. It may be an additional, non-invasive method when biologic and sonographic findings are inconclusive, especially in the case of oligohydramnios. Further studies are needed to confirm our data. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

  20. Boston keratoprosthesis and Ahmed glaucoma valve for visual rehabilitation in congenital anterior staphyloma

    Directory of Open Access Journals (Sweden)

    Bhaskar Srinivasan

    2012-01-01

    Full Text Available Congenital anterior staphyloma entails grave visual prognosis. The majority of reported patients have undergone enucleation. We report a promising result of staphylectomy with implantation of a keratoprosthesis and a glaucoma drainage device in a seven-month-old child with a large, congenital anterior staphyloma.

  1. Single left coronary ostium and an anomalous prepulmonic right coronary artery in 2 dogs with congenital pulmonary valve stenosis.

    Science.gov (United States)

    Visser, Lance C; Scansen, Brian A; Schober, Karsten E

    2013-06-01

    A coronary artery anomaly characterized by the presence of a single left coronary ostium with absence of the right coronary ostium and an anomalous prepulmonic right coronary artery course was observed in two dogs with concurrent congenital pulmonary valve stenosis. This unique coronary artery anatomy is similar to the previously described single right coronary ostium with anomalous prepulmonic left coronary artery, the so-called type R2A anomaly, in that an anomalous coronary artery encircles the pulmonary valve annulus. Both dogs of this report, a boxer and an English bulldog, were of breeds known to be at risk for the type R2A anomaly. As such, veterinarians should be aware that the echocardiographic presence of a left coronary ostium in a dog with pulmonary valve stenosis does not exclude the possibility of a prepulmonic coronary artery anomaly that may enhance the risk of complications during balloon pulmonary valvuloplasty. A descriptive naming convention for coronary artery anomalies in dogs is also presented, which may be preferable to the older coding classification scheme. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Urethral stricture

    Science.gov (United States)

    ... It can also occur after a disease or injury. Rarely, it may be caused by pressure from a growing tumor near the urethra. Other factors that increase the risk for this condition include: Sexually ... Injury to the pelvic area Repeated urethritis Strictures that ...

  3. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    OpenAIRE

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    Jingjing Huang,1 Jialiu Lin,1 Ziqiang Wu,2 Hongzhi Xu,3 Chengguo Zuo,1 Jian Ge1 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Advanced Eye Care, Carson City, NV, USA; 3Institute of Child Health Policy, University of Florida, Gainesville, FL, USA Purpose: The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve...

  4. The occurrence and suspected mode of inheritance of congenital subaortic stenosis and tricuspid valve dysplasia in Dogue de Bordeaux dogs.

    Science.gov (United States)

    Ohad, D G; Avrahami, A; Waner, T; David, L

    2013-08-01

    The Dogue de Bordeaux (DdB) breed has gone through several genetic 'bottle necks' and has a relatively small effective population size. Importing new stock into Israel has been limited, further narrowing the already restricted local gene-pool and increasing the chances of inherited defects. In 56 DdB dogs examined between 2003 and 2010, the authors sought to study the proportion congenital subaortic stenosis (SAS) and tricuspid valve dysplasia (TVD). The aim was also to identify a probable mode of inheritance (MOI) using segregation and pedigree analyses of genealogical data available from 13/21 DdB dogs diagnosed with these conditions between 2004 and 2007. Among all breeds in the country, TVD was highest in the DdB breed, which also displayed the second highest proportion of SAS. Echocardiographic measurements and selected physical examination findings from 26 normal DdB dogs, 18 DdB dogs with SAS, and 12 DdB dogs with TVD are reported. Based on pedigree and segregation analyses, the most probable MOI appeared to be autosomal recessive. Pedigree analyses helped to identify three ancestors that might have introduced these two congenital heart defects into the local DdB population. Excluding those three dogs and their progeny from future mating could therefore reduce the prevalence of these diseases in the DdB population in Israel. The unusual local breeding circumstances may offer a unique opportunity to identify associated SAS and TVD genes in the DdB, as well as in other dog breeds. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. TRICHOMONAS URETHRITIS IN MALES

    Science.gov (United States)

    Le Duc, Ector

    1955-01-01

    Trichomonas urethritis in the male should be suspected in all chronic cases of urethritis. The diagnosis is easily established by the hanging-drop method of examining the urethral discharge, or the first-glass urine specimen. Curative treatment is readily accomplished by the use of urethral instillations of Carbarsone suspension using 1 capsule of Carbarsone per ounce of distilled water. PMID:13270111

  6. Neurocardiogenic Syncope and Supraventricular Tachycardia in Association with a Rare Congenital Aortic Valve Abnormality

    Directory of Open Access Journals (Sweden)

    Yashwant Agrawal

    2016-01-01

    Full Text Available We report a case of a 26-year-old woman who presented with multiple episodes of syncope over a five-months period of time. Transthoracic echocardiogram had shown a normal functioning quadricuspid aortic valve (QAV which was also confirmed on a transesophageal echocardiogram. Computed tomographic angiography of heart and coronary arteries showed the QAV with equal size of all aortic cusps and normal coronary arteries. Intermittent chest pain and palpitations warranted an exercise stress test. The stress test revealed normal aerobic exertion, with achievement of 101% of maximal peak heart rate. However, during peak stress, we noted a drop in her blood pressure significantly resulting in dizziness. No arrhythmias were noted during the stress test. With recurrent syncope episodes and palpitations, Holter monitoring was done, revealing supraventricular tachycardia (SVT. We discuss current available literature and coassociations with QAV. New association of QAV with SVT needs further analysis.

  7. Incomplete urethral duplication in an adult male.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-09-01

    Urethral duplication is a rare congenital anomaly with less than 200 cases reported. It predominantly occurs in males and is nearly always diagnosed in childhood or adolescence. It is defined as a complete second passage from the bladder to the dorsum of the penis or as an accessory pathway that ends blindly on the dorsal or ventral surface.

  8. Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results

    Directory of Open Access Journals (Sweden)

    Lorier Gabriel

    2001-01-01

    Full Text Available OBJECTIVE: To analyze late clinical evolution after surgical treatment of children, with reparative and reconstructive techniques without annular support. METHODS: We evaluated 21 patients operated upon between 1975 and 1998. Age 4.67±3.44 years; 47.6% girls; mitral insufficiency 57.1% (12 cases, stenosis 28.6% (6 cases, and double lesion 14.3% (3 cases. The perfusion 43.10±9.50min, and ischemia time were 29.40±10.50min. The average clinical follow-up in mitral insufficiency was 41.52±53.61 months. In the stenosis group (4 patients was 46.39±32.02 months, and in the double lesion group (3 patients, 39.41±37.5 months. The echocardiographic follow-up was in mitral insufficiency 37.17±39.51 months, stenosis 42.61±30.59 months, and in the double lesion 39.41±37.51 months. RESULTS: Operative mortality was 9.5% (2 cases. No late deaths occurred. In the group with mitral insufficiency, 10 (83.3% patients were asymptomatic (p=0.04. The majorit y with mild reflux (p=0.002. In the follow-up of the stenosis group, all were in functional class I (NYHA; and the mean transvalve gradient varied between 8 and 12mmHg, average of 10.7mmHg. In the double lesion group, 1 patient was reoperated at 43 months. No endocarditis or thromboembolism were reported. CONCLUSION: Mitral stenosis repair has worse late results, related to the valve abnormalities and associated lesions. The correction of mitral insufficiency without annular support showed good long-term results.

  9. Outcomes of Ahmed Valve Implant Following a Failed Initial Trabeculotomy and Trabeculectomy in Refractory Primary Congenital Glaucoma

    Science.gov (United States)

    Dave, Paaraj; Senthil, Sirisha; Choudhari, Nikhil; Sekhar, Garudadri Chandra

    2015-01-01

    Purpose: The aim was to report the outcome of Ahmed glaucoma valve (AGV) (New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation as a surgical intervention following an initial failed combined trabeculotomy + trabeculectomy (trab + trab) in refractory primary congenital glaucoma (RPCG). Materials and Methods: Retrospective chart review of 11 eyes of 8 patients who underwent implantation of AGV (model FP8) for RPCG between 2009 and 2011. Prior trab + trab had failed in all the eyes. Success was defined as an intraocular pressure (IOP) >5 and ≤ 18 mmHg during examination under anesthesia with or without medications and without serious complications or additional glaucoma surgery. Results: The mean age at AGV implantation was 15.4 ± 4.9 months. The mean preoperative IOP was 28 ± 5.7 mmHg which reduced to 13.6 ± 3.4 mmHg postoperatively at the last follow-up (P < 0.0001). The number of topical antiglaucoma medications reduced from a mean of 2.6 ± 0.5 to 1.6 ± 0.9 postoperatively (P = 0.009). The definition of qualified success was met in 10 (90%) eyes. One eye developed a shallow anterior chamber with choroidal detachment at 1-week, which resolved spontaneously with medications. None of the eyes developed a hypertensive phase. One eye had a long tube resulting in tube corneal touch that required trimming of the tube. One eye developed tube retraction, which was treated with a tube extender. The mean follow-up was 17.9 ± 9.3 (6.2-35.4) months. Conclusion: Managing RPCG remains a challenge. AGV implant was successful in a significant proportion of cases. PMID:25624676

  10. Posterior Urethral Strictures

    Directory of Open Access Journals (Sweden)

    Joel Gelman

    2015-01-01

    Full Text Available Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty.

  11. Posterior Urethral Strictures

    Science.gov (United States)

    Gelman, Joel; Wisenbaugh, Eric S.

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  12. The CT appearances of delayed amniotic fluid clearance from the lungs in an infant with absent pulmonary valve and congenital lobar emphysema

    International Nuclear Information System (INIS)

    Fink, A. Michelle; Edis, Brian; Massie, John

    2005-01-01

    Congenital lobar emphysema (CLE) is a cause of severe neonatal respiratory distress. Overexpansion of the affected pulmonary lobe in the fetus is due to narrowing of the airway, with a resultant 'ball-valve' effect. At birth, there may be delayed clearance of fetal lung fluid. Early chest radiographs show opacification of the hyperexpanded lobe. The CT findings in the immediate neonatal period have not been previously reported. We describe the imaging in a neonate with tetralogy of Fallot and absent pulmonary valve with secondary CLE. CT demonstrates the hyperexpanded lobe with initial thickening of the interlobular septa and alveolar ground glass attenuation, with subsequent clearing. This resorption of fetal lung fluid via the pulmonary interstitium should not be confused with interstitial lung disease. (orig.)

  13. The CT appearances of delayed amniotic fluid clearance from the lungs in an infant with absent pulmonary valve and congenital lobar emphysema

    Energy Technology Data Exchange (ETDEWEB)

    Fink, A. Michelle [Royal Children' s Hospital, Department of Medical Imaging, Parkville, Victoria (Australia); University of Melbourne, Melbourne, Victoria (Australia); Edis, Brian [Royal Children' s Hospital, Department of Cardiology, Parkville, Victoria (Australia); Massie, John [University of Melbourne, Melbourne, Victoria (Australia); Royal Children' s Hospital, Department of Respiratory Medicine, Parkville, Victoria (Australia); Murdoch Children' s Research Institute, Melbourne, Victoria (Australia)

    2005-09-01

    Congenital lobar emphysema (CLE) is a cause of severe neonatal respiratory distress. Overexpansion of the affected pulmonary lobe in the fetus is due to narrowing of the airway, with a resultant 'ball-valve' effect. At birth, there may be delayed clearance of fetal lung fluid. Early chest radiographs show opacification of the hyperexpanded lobe. The CT findings in the immediate neonatal period have not been previously reported. We describe the imaging in a neonate with tetralogy of Fallot and absent pulmonary valve with secondary CLE. CT demonstrates the hyperexpanded lobe with initial thickening of the interlobular septa and alveolar ground glass attenuation, with subsequent clearing. This resorption of fetal lung fluid via the pulmonary interstitium should not be confused with interstitial lung disease. (orig.)

  14. Congenital Anomalies of the Kidney and the Urinary Tract (CAKUT)

    Science.gov (United States)

    2014-01-01

    This article reviews the majority of Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) with emphasis in Pediatric Pathology describing and illustrating lesions as varied as ureteral duplications, ureteropelvic junction obstruction, horseshoe kidney, posterior urethral valve and prune belly syndrome, obstructive renal dysplasia, nonmotile ciliopathies and several syndromes associated with renal malformations (Meckel–Joubert, short rib, Bardet–Biedl, asplenia/polysplenia, hereditary renal adysplasia, Zellweger, trisomies, VACTER-L, Potter, caudal dysplasia, and sirenomelia), as well as ADPK, and ARPK. The purpose of this review is not only to describe the congenital renal anomalies, but also to analyze the more recent therapeutic interventions that may modify the natural history of some of these severe conditions. PMID:25313840

  15. Radiological findings of male urethral duplication associated with bladder duplication: case report

    International Nuclear Information System (INIS)

    Kim, Hyoung Jung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae

    2004-01-01

    Urethral duplication or accessory urethra is a rare congenital anomaly. Even rarer, is its association with bladder duplication. We report a case of urethral duplication associated with bladder duplication in a seven-year-old boy who underwent retrograde urethrography, sonography and magnetic resonance (MR) imaging. WhiIe retrograde urethrography can demonstrate the extent of the duplicated urethra, MR imaging and sonography can provide detailed information on the anatomy of the adjacent tissues as well as urethral duplication

  16. Endoscopic urethral realignment of traumatic urethral disruption: A monocentric experience

    Directory of Open Access Journals (Sweden)

    Hamed Mohamed El Darawany

    2018-01-01

    Conclusions: Endoscopic primary realignment of posterior urethral rupture is less invasive and a safer procedure, without pelvic hemorrhage or additional injuries. It has low incidence of severe urethral stricture and avoids the need for delayed open urethral reconstruction.

  17. Posterior urethral polyps and review of literature

    Directory of Open Access Journals (Sweden)

    Prashant Jain

    2007-01-01

    Full Text Available Urethral polyp is a rare finding in young children. Fibroepithelial polyps of the urethra are usually diagnosed during the first decade of life. They present with obstruction, voiding dysfunction and hematuria. They can be associated with other congenital urinary tract anomalies. They are usually benign fibroepithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy.

  18. Combined trabeculotomy-trabeculectomy versus Ahmed valve implantation for refractory primary congenital glaucoma in Egyptian patients: a long-term follow-up

    Science.gov (United States)

    Helmy, Hazem

    2016-01-01

    Introduction Primary congenital glaucoma (PCG) is the most common type of glaucoma in pediatric patients. The aim of this study was to compare the effectiveness of combined trabeculotomy-trabeculectomy versus Ahmed valve implantation for cases of PCG refractory to traditional incisional angle surgery (goniotomy and trabeculotomy) in the Egyptian population. Methods The study was conducted in the Glaucoma Clinic of the Research Institute of Ophthalmology (Egypt). The study included 66 eyes of 66 patients (in two groups) with advanced PCG who had previous failed goniotomy, trabeculotomy, or both. Group 1 included 33 patients who underwent trabeculotomy-trabeculectomy procedures; group 2 included 33 patients who underwent FP 8 Ahmed valve implantation. The main outcome measures were intraocular pressure (IOP) reduction, corneal diameter, and axial length stability in both groups. Secondary outcome measures included detection of complications in both groups. Results The average ages of the patients were 13.5 ± 3.9 months and 15.3 ± 5.8 months in groups 1 and 2, respectively. Ten patients (30.3%) in group 1 and 9 patients (27.3%) in group 2 had family histories of PCG. Positive consanguinity was present in 26 patients (78.8%) in group 1 and in 27 patients (81.8%) in group 2. In group 1, the mean intraocular pressure (IOP) value decreased from 33.6 ± 3.4 mmHg preoperatively to 13.8 ± 0.6, 16.9 ± 1.5, 18.2 ± 2.5, 19.8 ± 3.6, and 20.2 ± 3.1 mmHg in the first postoperative month and after years 1, 2, 3, and 4, respectively (p Ahmed valve implantation are suitable options in advanced PCG with failed trabeculotomy and goniotomy. Ahmed valve implanation has a better long-term survival, but trabeculotomy-trabeculectomy provides a second chance for surgical intervention. PMID:27053995

  19. Technical note: Dynamic MRI in a complicated giant posterior urethral diverticulum

    International Nuclear Information System (INIS)

    Kundum, Prasad R; Gupta, Arun K; Thottom, Prasad V; Jana, Manisha

    2010-01-01

    Congenital posterior urethral diverticulum is an uncommon anomaly, sometimes complicated by infection or calculi formation. A conventional voiding cystourethrogram (VCUG) is the most commonly used diagnostic modality. Dynamic magnetic resonance imaging (MRI) has not been frequently described in this entity. We describe a case of posterior urethral diverticulum complicated with secondary calculi, where the patient was evaluated using dynamic MRI and conventional VCUG

  20. A Giant Urethral Calculus.

    Science.gov (United States)

    Sigdel, G; Agarwal, A; Keshaw, B W

    2014-01-01

    Urethral calculi are rare forms of urolithiasis. Majority of the calculi are migratory from urinary bladder or upper urinary tract. Primary urethral calculi usually occur in presence of urethral stricture or diverticulum. In this article we report a case of a giant posterior urethral calculus measuring 7x3x2 cm in a 47 years old male. Patient presented with acute retention of urine which was preceded by burning micturition and dribbling of urine for one week. The calculus was pushed in to the bladder through the cystoscope and was removed by suprapubic cystolithotomy.

  1. Mitral valve regurgitation

    Science.gov (United States)

    ... and dentist if you have a history of heart valve disease or congenital heart disease before treatment. Some people ... the middle Heart, front view References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  2. Kidney and Urinary Tract Congenital Malformations. Diagnosis and Evolution. 1999- 2005

    International Nuclear Information System (INIS)

    Aguilera Bauza, Mirna Pilar; Pena Perez, Raul; Ramirez Prieto, Juan Romelio; Martinez Feria, Rafael; Parra Cruz, Mariela; Pena Hernandez, Miguel Antonio

    2008-01-01

    A descriptive study in 351 patients at the Nephrology and Urology Services at 'Octavio de la Concepcion de la Pedraja' Teaching Pediatric Hospital from January 1999 to December 2005, was carried out. 535 kidney and urinary tract congenital malformations of 19 types were diagnosed. Primary vesicoureteral reflux and ureteropyelic stenosis were the most frequently malformations. The majority of these patients were diagnosed during the first year of the life. The most frequently clinic manifestation was urinary tract infection. Ultrasound study and cystouretrography were effective to diagnose these malformations. The majority of patients with prenatal diagnosis had congenital hydronephrosis. Posterior urethral valves were the principal cause of chronic renal failure. The I, II and III grades of Primary Vesicoureteral Reflux disappeared spontaneously with conservative treatment. There was a direct relationship between Reflux Nephropathy and the grade of these malformations

  3. Urethral diverticulum in pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao-Xuan Xie

    2015-05-01

    Full Text Available Urethral diverticulum is rare in pregnancy. There is no clear guideline on the management of urethral diverticulum in pregnancy, but most cases were managed conservatively. We report a case of urethral diverticulum in a primigravida woman, who presented with anterior vaginal swelling at 14 weeks of gestation. She was managed conservatively and the cyst (approximately 8 cm × 13 cm was aspirated during the early stage of labor. However her labor did not progress during the second stage, which resulted in an emergency cesarean section. She underwent diverticulectomy at 1 month postpartum because of the recurrence of the swelling and persistent discomfort. We believe that her dystocia may have been caused by factors other than the diverticulum. As previously described in literature, we concluded that, even in pregnant women with a large urethral diverticulum, vaginal delivery can still be considered with prior aspiration during the early stage of labor.

  4. Retained fetal lung fluid in two neonates with congenital absence of the pulmonary valve and tetralogy of fallot

    International Nuclear Information System (INIS)

    Strife, J.L.; Towbin, R.B.; Francis, P.; Kuhn, J.P.

    1981-01-01

    Chest radiographs obtained at birth in two neonates with absent pulmonary valve and tetralogy of Fallot demonstrated asymmetrical lung aeration. This finding was attributed to delay in resorption of fetal lung fluid. It is postulated that in the initial hours of life, the dilated pulmonary artery compressed the bronchus and delayed egress of fetal lung fluid. Over a 24-hour interval, the fluid was resorbed, resulting in the more typical pattern of hyperinflated lung and markedly dilated pulmonay artery. These cases are presumably the first of their kind to be reported

  5. Retained fetal lung fluid in two neonates with congenital absence of the pulmonary valve and tetralogy of fallot

    Energy Technology Data Exchange (ETDEWEB)

    Strife, J.L.; Towbin, R.B.; Francis, P.; Kuhn, J.P.

    1981-12-01

    Chest radiographs obtained at birth in two neonates with absent pulmonary valve and tetralogy of Fallot demonstrated asymmetrical lung aeration. This finding was attributed to delay in resorption of fetal lung fluid. It is postulated that in the initial hours of life, the dilated pulmonary artery compressed the bronchus and delayed egress of fetal lung fluid. Over a 24-hour interval, the fluid was resorbed, resulting in the more typical pattern of hyperinflated lung and markedly dilated pulmonay artery. These cases are presumably the first of their kind to be reported.

  6. Bicuspid Aortic Valve Disease: A Comprehensive Review

    OpenAIRE

    Mordi, Ify; Tzemos, Nikolaos

    2012-01-01

    Bicuspid aortic valve is the commonest congenital cardiac abnormality in the general population. This paper article will discuss our current knowledge of the anatomy, pathophysiology, genetics, and clinical aspects of bicuspid aortic valve disease.

  7. Urethral Triplication Without Bladder Duplication: Endourologic Diagnosis and Management

    Science.gov (United States)

    Ortiz, Ruben; Burgos, Laura; Angulo, Jose Maria

    2018-01-01

    Abstract Urethral triplication is a rare congenital anomaly of the lower urinary system, with urethra ending in glans. At the beginning of toilet training, urine output was observed along the rectum. Rigid cystoscopy shows a perineal urethra starting in the posterior urethra. Subsequently, flexible cystoscopy showed entry of epispadic urethra in the bladder immediately superior to the bladder neck. It was running parallel to primary urethra. Then, we observed two most frequent types of urethral duplication in the sagittal plane in a single patient. PMID:29675475

  8. Urethral Cancer—Patient Version

    Science.gov (United States)

    Urethral cancer is rare and is more common in men than in women. Urethral cancer can metastasize (spread) quickly to tissues around the urethra and has often spread to nearby lymph nodes by the time it is diagnosed. Start here to find information on urethral cancer treatment.

  9. Anaerobes in men with urethritis

    OpenAIRE

    Fontaine, E A; Taylor-Robinson, D; Hanna, N F; Coufalik, E D

    1982-01-01

    Sixty-four men with non-gonococcal urethritis (NGU), seven with gonococcal urethritis (GU), and 30 who had no symptoms or signs of urethritis were studied. Chlamydia trachomatis was isolated from urethral specimens taken from 22% of the men with NGU, and 18% with GU, but not from those who did not have urethritis even though 20 (67%) of them had a history of NGU, GU, or both. The chlamydial isolation rate for men having NGU for the first time was 30%. Ureaplasma urealyticum was isolated from ...

  10. Quantification of pulmonary regurgitation and prediction of pulmonary valve replacement by echocardiography in patients with congenital heart defects in comparison to cardiac magnetic resonance imaging.

    Science.gov (United States)

    Dellas, Claudia; Kammerer, Laura; Gravenhorst, Verena; Lotz, Joachim; Paul, Thomas; Steinmetz, Michael

    2018-04-01

    Pulmonary regurgitation (PR) is common in patients with congenital heart defects (CHD) and contributes to morbidity and mortality in the long-term. We investigated in this retrospective analysis whether readily accessible echocardiographic parameters are useful for quantification of PR and for predicting pulmonary valve replacement (PVR) in comparison to the gold-standard phase contrast (PC) flow measurements from cardiovascular magnetic resonance (CMR). Continuous wave (CW) Doppler and colour flow images in echocardiograms from 53 patients with CHD were analysed. Slope and jet-to-RVOT ratio correlated significantly with CMR-assessed regurgitation fraction (RF), whereas pressure half time (PHT) showed an inverse correlation. Patients with mild PR in CMR had significantly higher PHT, lower slope and jet-to-RVOT ratio than patients with moderate or severe regurgitation. The AUC regarding PR severity was 0.778 for PHT (95% CI, 0.649-0.907; P = 0.007 for CMR-RF ≤ 35%), 0.744 for slope (95% CI, 0.603-0.885; P = 0.017 for CMR-RF > 35%) and 0.652 for jet-to-RVOT ratio (95% CI, 0.473-0.860; P = 0.168 for CMR-RF > 35%). The optimal cut-off values calculated from ROC analysis were 95 ms for PHT and 4.9 m/s 2 for slope. In logistic regression analysis, slope emerged as the most valuable parameter for predicting the indication for PVR (OR 12.9, 95% CI, 1.8-90.9, P = 0.010). In conclusion, echocardiographic assessment of PR was feasible. Both parameters, PHT and in particular slope, were predictors for PVR. Thus, echocardiography appears appropriate in the management of patients with PR.

  11. Is aortopathy in bicuspid aortic valve disease a congenital defect or a result of abnormal hemodynamics? A critical reappraisal of a one-sided argument.

    Science.gov (United States)

    Girdauskas, Evaldas; Borger, Michael A; Secknus, Maria-Anna; Girdauskas, Gracijus; Kuntze, Thomas

    2011-06-01

    Although there is adequate evidence that bicuspid aortic valve (BAV) is an inheritable disorder, there is a great controversy regarding the pathogenesis of dilatation of the proximal aorta. The hemodynamic theory was the first explanation for BAV aortopathy. The genetic theory, however, has become increasingly popular over the last decade and can now be viewed as the clearly dominant one. The widespread belief that BAV disease is a congenital disorder of vascular connective tissue has led to more aggressive treatment recommendations of the proximal aorta in such patients, approaching aortic management recommendations for patients with Marfan syndrome. There is emerging evidence that the 'clinically normal' BAV is associated with abnormal flow patterns and asymmetrically increased wall stress in the proximal aorta. Recent in vitro and in vivo studies on BAV function provide a unique hemodynamic insight into the different phenotypes of BAV disease and asymmetry of corresponding aortopathy even in the presence of a 'clinically normal' BAV. On the other hand, there is a subgroup of young male patients with BAV and a root dilatation phenotype, who may present the predominantly genetic form of BAV disease. In the face of these important findings, we feel that a critical review of this clinical problem is timely and appropriate, as the prevailing BAV-aortopathy theory undoubtedly affects the surgical approach to this common clinical entity. Thorough analysis of the recent literature shows a growing amount of evidence supporting the hemodynamic theory of aortopathy in patients with BAV disease. Data from recent studies requires a reevaluation of our overwhelming support of the genetic theory, and obliges us to acknowledge that hemodynamics plays an important role in the development of this disease process. Given the marked heterogeneity of BAV disease, further studies are required in order to more precisely determine which theory is the 'correct' one for explaining the

  12. Clinical evaluation of diuretic renography in infants and children with congenital urinary abnormality

    International Nuclear Information System (INIS)

    Li Jingsong; Li Jianing; Fu Hongliang; Zou Renjian; Wu Jingchuan

    2006-01-01

    Objective: The clinical application of furosemide plus 15-minute diuretic renography (F+15 DR) was evaluated in infants and children with congenital urinary abnormalities. Methods: In 163 patients with different congenital urinary abnormalities undergoing F+15 DR, 97 were operated and followed by F+15 DR reexamination. The DR imaging characteristics were analyzed and, based on those analyses, hydronephrosis was classified into five degrees. Follow-up data were analyzed both quantitatively and qualitatively. Results: Each renal abnormality (kidney duplication 60, horseshoe kidney 6, multiple cysts of kidney 5, hypoplasia 35, ureterocele 20, displacement of ureter opening 13, megaloureter 20, valve of ureter 26) exhibited its unique characteristics on DR imaging. Renal functions of those patients were improved dur- ing the follow-up after surgical operations. Patients with duplex kidney and ureter abnormalities had better prognosis than those with urethral valve. Conclusion: F + 15 DR imaging may reveal characteristic changes of congenital urinary abnormalities and helps in the qualitative or quantitative evaluation of the treatments. (authors)

  13. Transrectal ultrasound in male urethritis.

    OpenAIRE

    Ghaly, A F; Taylor, P M; Goorney, B P; Haye, K R

    1994-01-01

    OBJECTIVE--To assess the prevalence of prostatic abnormalities in men with gonococcal and non-gonococcal urethritis using trans-rectal ultrasonic markers. DESIGN--A case control study of patients attending a department of genitourinary medicine with symptoms of urethritis. SETTING--Department of Genitourinary Medicine and Department of Radiology in Manchester Royal Infirmary. RESULTS--A total of 42 patients were recruited to the study: 26 with urethritis and 16 controls. Of the 26 study patie...

  14. Female urethral carcinoma

    International Nuclear Information System (INIS)

    Saitoh, Masahiko; Kondo, Atsuo; Sakakibara, Toshihumi

    1988-01-01

    Urethral carcinoma in 2 females has been treated with irradiation together with adjunct chemotherapy. In case 1, a 73-year-old female with squamous cell carcinoma was successfully treated with irradiation of 4,000 rad and peplomycin of 60 mg intravenously given. She has been free from the disease for the past 43 months. In case 2, a 61-year-old female with transitional cell carcinoma was initially treated with irradiation of 5,000 rad together with peplomycin 90 mg, which was followed by another 5,000 rad irradiation. The tumor recurred and the patient was operated on for cystourethrectomy and partial resection of the vagina. A further chemotherapy of cisplatin, peplomycin, and mitomycin C was instituted. She died of the tumor recurrence 23 months after the first visit to our clinic. Diagnosis and treatment modalities on the female urethral carcinoma are briefly discussed. (author)

  15. Calculi in female urethral diverticulum

    DEFF Research Database (Denmark)

    Hansen, B J; Hørby, J; Brynitz, S

    1989-01-01

    A case of two calculi found in the same urethral diverticulum in a 41-year-old woman with recurrent urinary tract infections is reported. The diagnostic procedures are discussed.......A case of two calculi found in the same urethral diverticulum in a 41-year-old woman with recurrent urinary tract infections is reported. The diagnostic procedures are discussed....

  16. Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Osama M Sarhan

    2013-01-01

    Full Text Available Association between Prune belly syndrome (PBS and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction.

  17. Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: A case report and review of literature.

    Science.gov (United States)

    Sarhan, Osama M; Al-Ghanbar, Mustafa S; Nakshabandi, Ziad M

    2013-10-01

    Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction.

  18. Prune belly syndrome associated with bilateral multicystic dysplastic kidneys and urethral obstruction: A case report

    Directory of Open Access Journals (Sweden)

    Arzu Akdag

    2015-06-01

    Full Text Available Prune belly syndrome is a rare congenital disorder defined by a characteristic clinical triad: Abdominal muscle deficiency, severe urinary tract abnormalities, and bilateral cryptorchidism. We describe a preterm neonate of Prune Belly syndrome who had abdominal muscle deficiency, multicystic dysplastic kidney, urethral hypoplasia and pulmonary hypoplasia. We presented this rare case with the data gathered from the literatüre.

  19. A 31-year-old woman with urethral duplication, stress urinary incontinence, uterovaginal prolapse, and rectal prolapse.

    Science.gov (United States)

    Occhino, John A; Croak, Andrew J; Gebhart, John B

    2010-04-01

    Urethral duplication is a rare finding in females, with fewer than 40 cases published since 1970. We report a case of urethral duplication in a woman with uterovaginal and rectal prolapse but without other associated congenital anomalies. On urodynamic and cystoscopic evaluation, an accessory urethra was noted to emerge from beneath the clitoral hood. The patient underwent exploratory laparotomy and transabdominal excision of the rudimentary urethral orifice with concurrent transvaginal prolapse repair and rectopexy. At 5-year follow-up, the patient continued to be continent and without prolapse.

  20. Ultrasonographic evaluation of urethral stricture

    International Nuclear Information System (INIS)

    Kim, Seung Eun; Lee, Hee Jung; Lee, Nam Hee; Tae, Seok; Shin, Kyung Ja; Lee, Sang Chun

    1990-01-01

    We studied sonography of saline filled male urethra in 21 cases, who had a urinary symptoms of urethral stricture. There were 11 cases of anterior urethral stricture, 2 cases of stricture with stone, and 8 cases of posterior urethral stricture. Sonography length of urethral stricture was compared with that of retrograde urethrography. The level and length of urethral stricture in sonography and retrograde urethrography compared to surgical findings in 7 out of 21 cases. The average lengths of anterior urethral strictures measured by sonography and retrograde urethroography were 28.15 and 18.75 mm. In cases of operation, the sonographic measurement was confirmed to be more accurate than urethrographic measurement. Sonography is easier to perform, more available in follow up and has no radiation hazard to the testis than X-ray study. Sonography is more accurate to determine the site, length and degree of anterior urethral stricture than X-ray study. As sonographic evaluations concerning posterior urethra stricture is impossible because of angulations of the urethra in posterior urethra, retrograde urethrography is preferable

  1. Ultrasonographic evaluation of urethral stricture

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Eun; Lee, Hee Jung; Lee, Nam Hee; Tae, Seok; Shin, Kyung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1990-12-15

    We studied sonography of saline filled male urethra in 21 cases, who had a urinary symptoms of urethral stricture. There were 11 cases of anterior urethral stricture, 2 cases of stricture with stone, and 8 cases of posterior urethral stricture. Sonography length of urethral stricture was compared with that of retrograde urethrography. The level and length of urethral stricture in sonography and retrograde urethrography compared to surgical findings in 7 out of 21 cases. The average lengths of anterior urethral strictures measured by sonography and retrograde urethroography were 28.15 and 18.75 mm. In cases of operation, the sonographic measurement was confirmed to be more accurate than urethrographic measurement. Sonography is easier to perform, more available in follow up and has no radiation hazard to the testis than X-ray study. Sonography is more accurate to determine the site, length and degree of anterior urethral stricture than X-ray study. As sonographic evaluations concerning posterior urethra stricture is impossible because of angulations of the urethra in posterior urethra, retrograde urethrography is preferable.

  2. Unusual Giant Prostatic Urethral Calculus

    African Journals Online (AJOL)

    2010-06-29

    Jun 29, 2010 ... Jolly type a) De novo urethral stones are generally composed ... Prepare the title page, covering letter, acknowledgement etc. using a word processor program. ... The main text of the article, beginning with the Abstract to ...

  3. Painless Urethral Bleeding During Penile Erection in an Adult Man With Klippel-Trenaunay Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Hongen Lei, MD, PhD

    2018-06-01

    Full Text Available Introduction: Klippel-Trenaunay syndrome (KTS is a rare congenital vascular disorder characterized by a triad of cutaneous port wine capillary malformations, varicose veins, and hemihypertrophy of bone and soft tissues. Aims: To report on a rare case of KTS in an adult man manifested by painless urethral bleeding during penile erection briefly review the clinical presentation and management of the genitourinary forms of this syndrome. Methods: On presentation, the clinical features of this patient, including medical history, signs and symptoms, and imaging examinations, were recorded. After diagnosis and initial treatment, a literature review of the urethral features of KTS was performed and is discussed in this report. Results: A 35-year-old man with KTS presented with painless urethral bleeding during penile erection that was associated with posterior urethral vascular malformations. The coagulation method was used to treat the malformation, and no urethral bleeding or gross hematuria occurred during a postoperative follow-up period of 6 months. Conclusion: This case demonstrates that coagulation therapy and careful follow-up can be adequate treatment approaches for urethral features of KTS. However, the long-term efficacy of coagulation for this disorder should be investigated further.Lei H, Guan X, Han H, et al. Painless Urethral Bleeding During Penile Erection in an Adult Man With Klippel-Trenaunay Syndrome: A Case Report. Sex Med 2018;6:180–183. Key Words: Urethral Bleeding, Klippel-Trenaunay Syndrome, Vascular Malformation, Posterior Urethra, Genitourinary Manifestation

  4. Advances in urethral stricture management

    Science.gov (United States)

    Gallegos, Maxx A.; Santucci, Richard A.

    2016-01-01

    Urethral stricture/stenosis is a narrowing of the urethral lumen. These conditions greatly impact the health and quality of life of patients. Management of urethral strictures/stenosis is complex and requires careful evaluation. The treatment options for urethral stricture vary in their success rates. Urethral dilation and internal urethrotomy are the most commonly performed procedures but carry the lowest chance for long-term success (0–9%). Urethroplasty has a much higher chance of success (85–90%) and is considered the gold-standard treatment. The most common urethroplasty techniques are excision and primary anastomosis and graft onlay urethroplasty. Anastomotic urethroplasty and graft urethroplasty have similar long-term success rates, although long-term data have yet to confirm equal efficacy. Anastomotic urethroplasty may have higher rates of sexual dysfunction. Posterior urethral stenosis is typically caused by previous urologic surgery. It is treated endoscopically with radial incisions. The use of mitomycin C may decrease recurrence. An exciting area of research is tissue engineering and scar modulation to augment stricture treatment. These include the use of acellular matrices or tissue-engineered buccal mucosa to produce grafting material for urethroplasty. Other experimental strategies aim to prevent scar formation altogether. PMID:28105329

  5. Presence of accessory penis, colonic duplication and several other congenital anomalies in a child: a very rare association.

    Science.gov (United States)

    Chatterjee, Sayan; Mondal, Prabodh Chandra; Pandey, Shashi Bhushan; Achar, Arun

    2014-10-01

    An accessory penis is a very rare anomaly. Only five cases have been reported thus far to our knowledge. We present the case of a child aged 2 years and 10 months who had a penis-like structure (containing phallus and glans) attached to the right buttock. Associated anomalies were a non-communicating type of colonic duplication, a paramedian stenosed anal opening, a horse-shoe kidney, posterior urethral valves, scoliosis of the lumbo-sacral spine, polydactyly and equino-varus deformity of the right foot. As far as we can tell, this is the first report of an accessory penis associated with colonic duplication and other congenital anomalies. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Heart valve surgery

    Science.gov (United States)

    ... replacement; Valve repair; Heart valve prosthesis; Mechanical valves; Prosthetic valves ... surgery. Your heart valve has been damaged by infection ( endocarditis ). You have received a new heart valve ...

  7. Urethral sensation following reconstructive pelvic surgery.

    Science.gov (United States)

    Abernethy, M G; Davis, C; Lowenstein, L; Mueller, E R; Brubaker, L; Kenton, K

    2014-11-01

    Most urethral neuromuscular function data focus on efferent rather than afferent innervation. We aimed to determine if changes exist in urethral afferent nerve function before and after reconstructive pelvic surgery (RPS). Secondarily, we compared afferent urethral innervation in women with and without stress urinary incontinence undergoing RPS. Participants underwent current perception threshold (CPT) and urethral anal reflex (UAR) testing prior to surgery and again post-operatively. Wilcoxon signed ranked test and Spearman's correlations were used and all tests were two-sided. p = 0.05 was considered to indicate statistical significance. Urethral CPT thresholds increased significantly after RPS, consistent with decreased urethral afferent function. Pre-operative urethral CPT thresholds at 5 and 250 Hz were lower in SUI women (10 [IQR 5-29], 40 [32-750]) compared with continent women (63 [14-99], 73 [51-109]; p = 0.45, p = 0.020), signifying increased urethral sensation or easier activation of urethral afferents in SUI women. Reconstructive pelvic surgery is associated with a short-term deleterious impact on urethral afferent function, as demonstrated by the higher levels of stimuli required to activate urethral afferent nerves (decreased urethral sensation) immediately after RPS. Women with SUI required lower levels of stimuli to activate urethral afferent nerves prior to RPS, although UAR latencies were similar regardless of concomitant SUI.

  8. Urethral Foreign Body Management: A Case Report

    OpenAIRE

    Chang, Andy Y.; Koh, Chester J.; Stein, John P.

    2004-01-01

    The management of urethral foreign bodies may require the use of various surgical techniques in a urologist's armamentarium. We report a unique case of a urethral foreign body requiring percutaneous and endoscopic techniques for removal.

  9. Aortic valve insufficiency in the teenager and young adult: the role of prosthetic valve replacement.

    Science.gov (United States)

    Bradley, Scott M

    2013-10-01

    The contents of this article were presented in the session "Aortic insufficiency in the teenager" at the congenital parallel symposium of the 2013 Society of Thoracic Surgeons (STS) annual meeting. The accompanying articles detail the approaches of aortic valve repair and the Ross procedure.(1,2) The current article focuses on prosthetic valve replacement. For many young patients requiring aortic valve surgery, either aortic valve repair or a Ross procedure provides a good option. The advantages include avoidance of anticoagulation and potential for growth. In other patients, a prosthetic valve is an appropriate alternative. This article discusses the current state of knowledge regarding mechanical and bioprosthetic valve prostheses and their specific advantages relative to valve repair or a Ross procedure. In current practice, young patients requiring aortic valve surgery frequently undergo valve replacement with a prosthetic valve. In STS adult cardiac database, among patients ≤30 years of age undergoing aortic valve surgery, 34% had placement of a mechanical valve, 51% had placement of a bioprosthetic valve, 9% had aortic valve repair, and 2% had a Ross procedure. In the STS congenital database, among patients 12 to 30 years of age undergoing aortic valve surgery, 21% had placement of a mechanical valve, 18% had placement of a bioprosthetic valve, 30% had aortic valve repair, and 24% had a Ross procedure. In the future, the balance among these options may be altered by design improvements in prosthetic valves, alternatives to warfarin, the development of new patch materials for valve repair, and techniques to avoid Ross autograft failure.

  10. Female urethral diverticulum containing large calculi

    Directory of Open Access Journals (Sweden)

    Shoichi Kimura

    2018-05-01

    Full Text Available Urinary stones in female urethral diverticulum are rarely seen. We report a 79-year-old woman who presented with irritative lower urinary tract symptoms and vaginal cystocele with incontinence. The urethral stones in the diverticulum were successfully extracted through the trans-urethral route and anterior tension-free vaginal mesh was applied one month later. The patient has been well, with no lower urinary symptoms or incontinence for 4 months. Keywords: Female, Urethral diverticulum, Incontinence, Calculus

  11. Valve Disease

    Science.gov (United States)

    ... blood. There are 4 valves in the heart: tricuspid, pulmonary, mitral, and aortic. Two types of problems can disrupt blood flow through the valves: regurgitation or stenosis. Regurgitation is also called insufficiency or incompetence. Regurgitation happens when a valve doesn’ ...

  12. Urethral Cancer—Health Professional Version

    Science.gov (United States)

    Urethral cancer is a rare cancer. There are three types of urethral cancer. Squamous cell carcinoma is the most common type. Transitional cell carcinoma of the urethra, and adenocarcinoma in the glands around the urethra are less common. Find evidence-based information on urethral cancer treatment.

  13. Mitral valve prolapse - report of 3 cases

    International Nuclear Information System (INIS)

    Han, Moon Hee; Im, Chung Ki; Im, Dong Ran; Han, Man Chung; Lee, Young Woo; Seo, Jung Don

    1979-01-01

    Prolapse of mitral valve is characterized by its unique auscultatory, echocardiographic and angiographic findings and may be associated with various disease entities such as congenital heart disease, coronary heart disease and Marfan's syndrome etc. Authors report recent experience of 3 cases of prolapsed mitral valve, 2 cases associated with A.S.D. and 1 case with Marfan's syndrome.

  14. Painless Urethral Bleeding During Penile Erection in an Adult Man With Klippel-Trenaunay Syndrome: A Case Report.

    Science.gov (United States)

    Lei, Hongen; Guan, Xing; Han, Hu; Qian, Xiaosong; Zhou, Xiaoguang; Zhang, Xiaodong; Tian, Long

    2018-06-01

    Klippel-Trenaunay syndrome (KTS) is a rare congenital vascular disorder characterized by a triad of cutaneous port wine capillary malformations, varicose veins, and hemihypertrophy of bone and soft tissues. To report on a rare case of KTS in an adult man manifested by painless urethral bleeding during penile erection briefly review the clinical presentation and management of the genitourinary forms of this syndrome. On presentation, the clinical features of this patient, including medical history, signs and symptoms, and imaging examinations, were recorded. After diagnosis and initial treatment, a literature review of the urethral features of KTS was performed and is discussed in this report. A 35-year-old man with KTS presented with painless urethral bleeding during penile erection that was associated with posterior urethral vascular malformations. The coagulation method was used to treat the malformation, and no urethral bleeding or gross hematuria occurred during a postoperative follow-up period of 6 months. This case demonstrates that coagulation therapy and careful follow-up can be adequate treatment approaches for urethral features of KTS. However, the long-term efficacy of coagulation for this disorder should be investigated further. Lei H, Guan X, Han H, et al. Painless Urethral Bleeding During Penile Erection in an Adult Man With Klippel-Trenaunay Syndrome: A Case Report. Sex Med 2018;6:180-183. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. [Three theses on urethral disease].

    Science.gov (United States)

    Chesa-Ponce, N

    2012-01-01

    To inform about three doctorate theses on urethral stenosis, presented in the University of Paris and Montpellier by Spanish authors. Of the Canary Island students who studied medicine in France during the xix century and beginning of the xx century, three stand out for having chosen the same subject for presentation of their doctorate thesis. We briefly analyze their biographies, placing special emphasis on the content of their doctorate thesis. Urethral stenosis was a very mentioned disease during the period studied due to its high incidence. We distinguish the therapeutic changes contributed in the three theses studied. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  16. Biodegradable urethral stent in the treatment of post-traumatic urethral strictures in a war wound rabbit urethral model

    International Nuclear Information System (INIS)

    Fu Weijun; Zhang Binghong; Gao Jiangping; Hong Baofa; Zhang Lei; Yang Yong; Meng Bo; Zhu Ning; Cui Fuzhai

    2007-01-01

    To prevent terrorism during anti-terror war, we developed a reproducible animal model for the induction of a urethral stricture in a war wound rabbit, and to evaluate the feasibility and effect of using a biodegradable urethral stent in the prophylaxis and treatment of urethral strictures in a war wound (or traumatic) rabbit urethral model. The urethral stricture rabbit model was successfully performed by a self-control explosion destructor. New biodegradable urethral stents were placed in the urethras of 20 war wound (traumatic) rabbits, but no stent was used in the 8 rabbits which formed the control group. Follow-up investigation included assessment of procedure success, stent changes, urethrascopy and retrograde urethrography, and histological findings were obtained after sacrifice at 4, 6, 8 and 12 weeks after stent placement. The urethral stricture model owing to a war wound (trauma) was tested by tissue reactions and urethroscopy. The length of the urethral strictures was 5-10 mm; the coarctatetion of the urethral lumen was more than 50%. Biodegradable stent placement was technically successful in 20 rabbits. Urethral specimens obtained from the 4 week stent placement group showed diminished inflammatory cell infiltration and decreased thickness of the papillary projections of the epithelium. There was a strong tendency towards regression of the papillary projections and regeneration of urethral mucosa epithelium in the 8 week group. In particular, the injured urethra has recovered completely in the biodegradable stent groups compared with the control group at 12 weeks. The biodegradable urethral stent seems feasible for treating and preventing urethral strictures owing to a war wound (or traumatic) urethra. There are distinct advantages in terms of safe, effective and less-invasive treatment for the reconstruction of post-traumatic urethral strictures

  17. Biodegradable urethral stent in the treatment of post-traumatic urethral strictures in a war wound rabbit urethral model

    Energy Technology Data Exchange (ETDEWEB)

    Fu Weijun [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Zhang Binghong [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Gao Jiangping [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Hong Baofa [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Zhang Lei [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Yang Yong [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Meng Bo [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China); Zhu Ning [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China); Cui Fuzhai [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China)

    2007-12-15

    To prevent terrorism during anti-terror war, we developed a reproducible animal model for the induction of a urethral stricture in a war wound rabbit, and to evaluate the feasibility and effect of using a biodegradable urethral stent in the prophylaxis and treatment of urethral strictures in a war wound (or traumatic) rabbit urethral model. The urethral stricture rabbit model was successfully performed by a self-control explosion destructor. New biodegradable urethral stents were placed in the urethras of 20 war wound (traumatic) rabbits, but no stent was used in the 8 rabbits which formed the control group. Follow-up investigation included assessment of procedure success, stent changes, urethrascopy and retrograde urethrography, and histological findings were obtained after sacrifice at 4, 6, 8 and 12 weeks after stent placement. The urethral stricture model owing to a war wound (trauma) was tested by tissue reactions and urethroscopy. The length of the urethral strictures was 5-10 mm; the coarctatetion of the urethral lumen was more than 50%. Biodegradable stent placement was technically successful in 20 rabbits. Urethral specimens obtained from the 4 week stent placement group showed diminished inflammatory cell infiltration and decreased thickness of the papillary projections of the epithelium. There was a strong tendency towards regression of the papillary projections and regeneration of urethral mucosa epithelium in the 8 week group. In particular, the injured urethra has recovered completely in the biodegradable stent groups compared with the control group at 12 weeks. The biodegradable urethral stent seems feasible for treating and preventing urethral strictures owing to a war wound (or traumatic) urethra. There are distinct advantages in terms of safe, effective and less-invasive treatment for the reconstruction of post-traumatic urethral strictures.

  18. Current management of urethral stricture disease

    Science.gov (United States)

    Smith, Thomas G.

    2016-01-01

    Introduction: Broadly defined, urethral strictures are narrowing of the urethral lumen that is surrounded by corpus spongiosum, i.e., urethral meatus through the bulbar urethra. Urethral stenosis is narrowing of the posterior urethra, i.e., membranous urethra through bladder neck/prostate junction, which is not enveloped by corpus spongiosum. The disease has significant quality of life ramifications because many times younger patients are affected by this compared to many other urological diseases. Methods: A review of the scientific literature concerning urethral stricture, stenosis, treatment, and outcomes was performed using Medline and PubMed (U.S. National Library of Medicine and the National Institutes of Health). Abstracts from scientific meetings were included in this review. Results: There is level 3 evidence regarding the etiology and epidemiology of urethral strictures, stenoses, and pelvic fracture urethral injuries. Outcomes data from literature regarding intervention for urethral stricture are largely limited to level 3 evidence and expert opinion. There is a single level 1 study comparing urethral dilation and direct vision internal urethrotomy. Urethroplasty outcomes data are limited to level 3 case series. Conclusions: Progress is being made toward consistent terminology, and nomenclature which will, in turn, help to standardize treatment within the field of urology. Treatment for urethral stricture and stenosis remains inconsistent between reconstructive and nonreconstructive urologists due to varying treatment algorithms and approaches to disease management. Tissue engineering appears to be future for reconstructive urethral surgery with reports demonstrating feasibility in the use of different tissue substitutes and grafts. PMID:26941491

  19. A brief review on anterior urethral strictures

    Directory of Open Access Journals (Sweden)

    Li Cheng

    2018-04-01

    Full Text Available The treatment of urethral strictures remains a challenging field in urology even though there are a variety of procedures to treat it at present, as no one approach is superior over another. This paper reviewed the surgical options for the management of different sites and types of anterior urethral stricture, providing a brief discussion of the controversies regarding this issue and suggesting possible future advancements. Among the existing procedures, simple dilation and direct vision internal urethrotomy are more commonly used for short urethral strictures ( <1 cm, soft and no previous intervention. Currently, urethroplasty using buccal mucosa or penile skin is the most widely adopted clinical techniques and have proved successful. Nonetheless, complications such as donor site morbidity remain problem. Tissue engineering techniques are considered as a promising solution for urethral reconstruction, but require further investigation, as does stem cell therapy. Keywords: Anterior urethral strictures, Urethral reconstruction, Tissue engineering, Urethral strictures

  20. Tight valve

    International Nuclear Information System (INIS)

    Guedj, F.

    1987-01-01

    This sealed valve is made with a valve seat, an axial valve with a rod fixed to its upper end, a thick bell surrounding the rod and welded by a thin join on the valve casing, a threated ring screwed onto the upper end of the rod and a magnet or electromagnet rotating the ring outside the bell [fr

  1. Outcome after prenatal diagnosis of congenital anomalies of the kidney and urinary tract.

    Science.gov (United States)

    Nef, Samuel; Neuhaus, Thomas J; Spartà, Giuseppina; Weitz, Marcus; Buder, Kathrin; Wisser, Josef; Gobet, Rita; Willi, Ulrich; Laube, Guido F

    2016-05-01

    Congenital anomalies of the kidney and urinary tract are common findings on fetal ultrasound. The aim of this prospective observational study was to describe outcome and risk factors in 115 patients born 1995-2001. All prenatally diagnosed children were stratified into low- and high-risk group and followed postnatally clinically and by imaging at defined endpoints. Risk factors were evaluated using odds ratios. Neonatal diagnosis included pelvi-ureteric junction obstruction (n = 33), vesicoureteral reflux (n = 27), solitary mild pelvic dilatation (postnatal anteroposterior diameter 5-10 mm; n = 25), and further diagnosis as primary obstructive megaureter, unilateral multicystic dysplastic kidney, renal dysplasia and posterior urethral valves. In 38 children with prenatal isolated hydronephrosis, ultrasound normalized at median age of 1.2 years (range 0.1-9). Surgery was performed in 34 children at median age of 0.4 years (0.1-10.8). Persistent renal anomalies without surgery were present in 43 children and followed in 36 for median time of 16 years (12.2-18). Oligohydramnios and postnatal bilateral anomalies were significantly associated with surgery and impaired renal function. The majority of children had a favourable postnatal outcome, in particular children with prenatally low risk, i.e. isolated uni- or bilateral hydronephrosis. Oligohydramnios and postnatal bilateral anomalies were risk factors for non-favourable outcome. • In congenital anomalies of the kidney and urinary tract significantly poorer outcome is known in patients with bilateral renal hypoplasia or solitary kidney associated with posterior urethral valves. • Other factors as proteinuria and vesicoureteral reflux were associated with a higher risk of progression to chronic renal failure in these patients. What is New: • Unlike other studies giving us above-mentioned information, we included all patients with any kind of prenatally diagnosed congenital anomalies of the kidney

  2. Long-term urethral catheterisation.

    Science.gov (United States)

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  3. Anastomotic Urethroplasty for an Obstructing Calculus Within a Bulbar Urethral Diverticulum and Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Pooya Banapour

    2017-01-01

    Full Text Available A 61-year-old male with prior history of endoscopic urethral calculus removal presented to the emergency room with urinary retention and a palpable perineal mass. A CT showed a large calcification within the bulbar urethra. After multiple unsuccessful attempts at foley catheter insertion, the urology service was consulted. The patient was taken to the operating room where an obstructing urethral calculus with associated urethral stricture was visualized on cystoscopy. We present an exceedingly rare case of recurrent urethrolithiasis with associated urethral stricture managed with initial suprapubic tube and delayed primary end-to-end urethroplasty, excision of urethral stricture and urethral diverticulectomy.

  4. Management strategies for idiopathic urethritis.

    Science.gov (United States)

    Henderson, L; Farrelly, P; Dickson, A P; Goyal, A

    2016-02-01

    Williams and Mikhael (1971) described idiopathic urethritis (IU) as a self-limiting condition that affects boys aged 5-15 years, with symptoms of urethrorrhagia, dysuria and haematuria. However, a proportion of boys will remain symptomatic for several years, and may develop urethral stricture (Poch et al., 2007; Palagiri et al., 2003). There is no universally effective treatment for IU, although various strategies have been employed. To review the presentation and long-term outcomes of boys with IU, and present the efficacy of management strategies that have been utilised. A retrospective review was performed of all boys with IU. It was based on clinical and cystoscopic findings for presentation, medical history, management and clinical progress. Fifty-four boys were included, with a median age of 11 years (range 5-15 years) at presentation. The median duration of symptoms was 18 months (range 2-132 months). The median follow-up was 18.5 months (range 1-120 months). Seven (13.0%) boys had early urethral stricture at initial cystourethroscopy, and one (1.9%) developed stricture during follow-up. Thirty-six boys (66.7%) had previous circumcision and four (7.4%) had meatal stenosis. Eight (14.8%) had previous hypospadias repair. Whilst 50% of boys with IU do not require any specific treatment, those with severe/unremitting symptoms may benefit from a trial of urethral steroids or short-term urethral catheterisation. The mechanisms of benefit from these modalities are unclear and they require further evaluation. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  5. Prevalence and morbidity of urethral Trichomonas vaginalis in Japanese men with or without urethritis.

    Science.gov (United States)

    Seike, Kensaku; Maeda, Shin-Ichi; Kubota, Yasuaki; Tamaki, Masayoshi; Yasuda, Mitsuru; Deguchi, Takashi

    2013-09-01

    Trichomonas vaginalis is one of the pathogens causing sexually transmitted infections. This microorganism is a common pathogen among women, but its significance as a cause of morbidity among men remains uncertain. We sought to determine the prevalence and morbidity of T. vaginalis infection in Japanese men with and without urethritis. We examined urine specimens from 215 men with urethritis and 98 men without urethritis for the presence of urethral T. vaginalis by PCR assay. Only four patients-one with gonococcal urethritis, one with non-gonococcal chlamydial urethritis, one with non-gonococcal non-chlamydial urethritis and one without urethritis-were positive for T. vaginalis. The prevalence of T. vaginalis was 1.4% in men with urethritis and 1.0% in men without urethritis. A possible relation between the appearance of T. vaginalis and clinical symptoms was not confirmed. In the present study, the incidence of urethral T. vaginalis infection appears to be rare in Japanese men with or without urethritis, and T. vaginalis may be an uncommon pathogen in male urethritis in Japan.

  6. Check valve

    Science.gov (United States)

    Upton, H.A.; Garcia, P.

    1999-08-24

    A check valve for use in a GDCS of a nuclear reactor and having a motor driven disk including a rotatable armature for rotating the check valve disk over its entire range of motion is described. In one embodiment, the check valve includes a valve body having a coolant flow channel extending therethrough. The coolant flow channel includes an inlet end and an outlet end. A valve body seat is located on an inner surface of the valve body. The check valve further includes a disk assembly, sometimes referred to as the motor driven disc, having a counterweight and a disk shaped valve. The disk valve includes a disk base having a seat for seating with the valve body seat. The disk assembly further includes a first hinge pin member which extends at least partially through the disk assembly and is engaged to the disk. The disk valve is rotatable relative to the first hinge pin member. The check valve also includes a motor having a stator frame with a stator bore therein. An armature is rotatably positioned within the stator bore and the armature is coupled to the disk valve to cause the disk valve to rotate about its full range of motion. 5 figs.

  7. Check valve

    International Nuclear Information System (INIS)

    Upton, H.A.; Garcia, P.

    1999-01-01

    A check valve for use in a GDCS of a nuclear reactor and having a motor driven disk including a rotatable armature for rotating the check valve disk over its entire range of motion is described. In one embodiment, the check valve includes a valve body having a coolant flow channel extending therethrough. The coolant flow channel includes an inlet end and an outlet end. A valve body seat is located on an inner surface of the valve body. The check valve further includes a disk assembly, sometimes referred to as the motor driven disc, having a counterweight and a disk shaped valve. The disk valve includes a disk base having a seat for seating with the valve body seat. The disk assembly further includes a first hinge pin member which extends at least partially through the disk assembly and is engaged to the disk. The disk valve is rotatable relative to the first hinge pin member. The check valve also includes a motor having a stator frame with a stator bore therein. An armature is rotatably positioned within the stator bore and the armature is coupled to the disk valve to cause the disk valve to rotate about its full range of motion. 5 figs

  8. Congenital obstructive uropathy – Diagnostics for optimal treatment ...

    African Journals Online (AJOL)

    In addition, ultrasound also offers excellent images of the lower urinary tract in the diagnosis of posterior urethral valves or ureteroceles for example. An additional tool is isotope renal scintigraphy which is method to analyse differential renal function and drainage of the kidney as well as functioning cortical mass with an ...

  9. Clinical Characteristics of Herpes Simplex Virus Urethritis Compared With Chlamydial Urethritis Among Men.

    Science.gov (United States)

    Ong, Jason J; Morton, Anna N; Henzell, Helen R; Berzins, Karen; Druce, Julian; Fairley, Christopher K; Bradshaw, Catriona S; Read, Tim Rh; Hocking, Jane S; Chen, Marcus Y

    2017-02-01

    The aim of this study was to ascertain the clinical characteristics associated with herpes simplex virus (HSV) urethritis in men and to compare those with chlamydial urethritis. We compared clinical and laboratory data from men diagnosed with polymerase chain reaction confirmed HSV urethritis with those of men with chlamydial urethritis presenting to Melbourne Sexual Health Centre between 2000 and 2015. Eighty HSV urethritis cases were identified: 55 (68%, 95% confidence interval, 58-78) were by HSV-1 and 25 (32%, 95% confidence interval, 22-42) by HSV-2. Compared with chlamydial urethritis, men with HSV urethritis were significantly more likely to report severe dysuria (20% vs 0%, P < 0.01) or constitutional symptoms (15% vs 0%, P < 0.01). Men with HSV urethritis were significantly more likely to have meatitis (62% vs 23%, P < 0.01), genital ulceration (37% vs 0%, P < 0.01), or inguinal lymphadenopathy (30% vs 0%, P < 0.01) but less likely to have urethral discharge (32% vs 69%, P < 0.01). There was no significant difference in the proportion of men who had raised (≥5) polymorphonuclear leukocytes per high-powered field between the two groups (P = 0.46). The clinical presentation of HSV urethritis in men may differ from those of chlamydial urethritis and guide testing for HSV in men presenting with non-gonococcal urethritis.

  10. Urethral alarm probe for permanent prostate implants

    International Nuclear Information System (INIS)

    Cutajar, D.; Lerch, M.; Takacs, G.

    2008-01-01

    We have developed a urethral dosimetry system for real time dose verification along the urethra during permanent implant prostate brachytherapy. The urethral alarm uses 'spectroscopic dosimetry' to calculate the dose rate along the urethra in real time. The application of spectroscopic dosimetry for the urethral alarm probe was verified using Monte Carlo calculations. In phantom depth dose measurements as well as isotropy measurements were performed to verify the usefulness of the urethra alarm probe as an in vivo real time dosimeter. (author)

  11. Urethral Leiomyoma: A Rare Clinical Entity

    Directory of Open Access Journals (Sweden)

    Ng Beng Kwang

    2016-01-01

    Full Text Available Extrauterine leiomyomas are encountered occasionally, which can pose a diagnostic dilemma and challenge to the gynaecologist. We report a rare case of urethral leiomyoma. A 31-year-old woman with history of primary subfertility presented with mass at her urethral meatus and lower urinary tract symptoms. She underwent examination under anaesthesia and excision of the urethral mass. Histopathological examination confirmed leiomyoma. Diagnosis and management of this common growth situated at a rare location were reviewed and discussed.

  12. Infectious Urethritis in Men and Women

    Science.gov (United States)

    Meares, Edwin M.

    1975-01-01

    Acute and recurrent infectious urethritis in men and women is commonly seen by physicians. Since specific therapy varies widely with the type of urethritis present, the proper diagnosis must be clearly established if curative drug therapy is to be selected. It is valuable, therefore, to review the diagnosis and therapy of the various forms of infectious urethritis that are recognized today in both men and women. PMID:1199099

  13. Control Valve

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Wayne R.

    2018-03-20

    A control valve includes a first conduit having a first inlet and a first outlet and defining a first passage; a second conduit having a second inlet and a second outlet and defining a second passage, the second conduit extending into the first passage such that the second inlet is located within the first passage; and a valve plate disposed pivotably within the first passage, the valve plate defining a valve plate surface. Pivoting of the valve plate within the first passage varies flow from the first inlet to the first outlet and the valve plate is pivotal between a first position and a second position such that in the first position the valve plate substantially prevents fluid communication between the first passage and the second passage and such that in the second position the valve plate permits fluid communication between the first passage and the second passage.

  14. Valve assembly

    International Nuclear Information System (INIS)

    Sandling, M.

    1981-01-01

    An improved valve assembly, used for controlling the flow of radioactive slurry, is described. Radioactive contamination of the air during removal or replacement of the valve is prevented by sucking air from the atmosphere through a portion of the structure above the valve housing. (U.K.)

  15. Posterior urethral valves and Down syndrome | Lazarus | African ...

    African Journals Online (AJOL)

    African Journal of Urology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 21, No 1 (2015) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  16. Comparison of 3D Echocardiogram-Derived 3D Printed Valve Models to Molded Models for Simulated Repair of Pediatric Atrioventricular Valves.

    Science.gov (United States)

    Scanlan, Adam B; Nguyen, Alex V; Ilina, Anna; Lasso, Andras; Cripe, Linnea; Jegatheeswaran, Anusha; Silvestro, Elizabeth; McGowan, Francis X; Mascio, Christopher E; Fuller, Stephanie; Spray, Thomas L; Cohen, Meryl S; Fichtinger, Gabor; Jolley, Matthew A

    2018-03-01

    Mastering the technical skills required to perform pediatric cardiac valve surgery is challenging in part due to limited opportunity for practice. Transformation of 3D echocardiographic (echo) images of congenitally abnormal heart valves to realistic physical models could allow patient-specific simulation of surgical valve repair. We compared materials, processes, and costs for 3D printing and molding of patient-specific models for visualization and surgical simulation of congenitally abnormal heart valves. Pediatric atrioventricular valves (mitral, tricuspid, and common atrioventricular valve) were modeled from transthoracic 3D echo images using semi-automated methods implemented as custom modules in 3D Slicer. Valve models were then both 3D printed in soft materials and molded in silicone using 3D printed "negative" molds. Using pre-defined assessment criteria, valve models were evaluated by congenital cardiac surgeons to determine suitability for simulation. Surgeon assessment indicated that the molded valves had superior material properties for the purposes of simulation compared to directly printed valves (p 3D echo-derived molded valves are a step toward realistic simulation of complex valve repairs but require more time and labor to create than directly printed models. Patient-specific simulation of valve repair in children using such models may be useful for surgical training and simulation of complex congenital cases.

  17. Congenital Hypothyroidism

    Science.gov (United States)

    ... Disease Featured Resource Find an Endocrinologist Search Congenital Hypothyroidism March 2012 Download PDFs English Espanol Editors Rosalind S. ... Resources MedlinePlus (NIH) Mayo Clinic What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

  18. Balloon dilatation of iatrogenic urethral strictures

    International Nuclear Information System (INIS)

    Acunas, B.; Acunas, G.; Gokmen, E.; Celik, L.

    1988-01-01

    Balloon dilatation of the urethra was performed in five patients with iatrogenic urethral strictures. The urethral strictures were successfully negotiated and dilated in all patients. Redilatation became necessary in a period ranging from 3 to 10 months. The authors believe that balloon dilatation of the urethra can be safely and successfully performed; the procedure produces minimal trauma and immediate relief of symptoms. (orig.)

  19. Hydraulic urethral dilatation after optical internal urethrotomy ...

    African Journals Online (AJOL)

    Objectives: To determine the rate of early recurrence of urethral stricture in the first six months in patients who perform hydraulic urethral dilatation(HUD) after optical internal urethrotomy (OIU) and compare the early recurrence Fate in patients who perform HUD after OIU with the recurrence rates in patients reported in the ...

  20. [Transurethral thulium laser urethrotomy for urethral stricture].

    Science.gov (United States)

    Liu, Chun-Lai; Zhang, Xi-Ling; Liu, Yi-Li; Wang, Ping

    2011-09-01

    To evaluate the effect of endourethrotomy with thulium laser as a minimally invasive treatment for urethral stricture. We treated 36 cases of urethral stricture or atresia by endourethrotomy with thulium laser, restored the urethral continuity by vaporization excision of the scar tissue, and observed the clinical effects and complications. The mean operation time was 35 min, ranging from 10 to 90 min. Smooth urination was achieved after 2-6 weeks of catheter indwelling, with no urinary incontinence. The patients were followed up for 4-24 (mean 12) months, during which 27 did not need any reintervention, 5 developed urinary thinning but cured by urethral dilation, 3 received another laser urethrotomy for previous negligence of timely urethral dilation, and the other 1 underwent open urethroplasty. Thulium laser urethrotomy is a safe and effective minimally invasive option for short urethral stricture, which is also suitable for severe urethral stricture and urethral atresia. Its short-term outcome is satisfactory, but its long-term effect remains to be further observed.

  1. Azithromycin Failure in Mycoplasma genitalium Urethritis

    Science.gov (United States)

    Jensen, Jorgen S.; Tabrizi, Sepehr N.; Read, Timothy R.H.; Garland, Suzanne M.; Hopkins, Carol A.; Moss, Lorna M.; Fairley, Christopher K.

    2006-01-01

    We report significant failure rates (28%, 95% confidence interval 15%–45%) after administering 1 g azithromycin to men with Mycoplasma genitalium–positive nongonococcal urethritis. In vitro evidence supported reduced susceptibility of M. genitalium to macrolides. Moxifloxacin administration resulted in rapid symptom resolution and eradication of infection in all cases. These findings have implications for management of urethritis. PMID:16836839

  2. Reactive arthritis associated with Mycoplasma genitalium urethritis.

    Science.gov (United States)

    Chrisment, D; Machelart, I; Wirth, G; Lazaro, E; Greib, C; Pellegrin, J-L; Bébéar, C; Peuchant, O

    2013-11-01

    Mycoplasma genitalium is an important cause of sexually transmitted infections that is gaining recognition and is an independent cause of acute and chronic nongonococcal urethritis in men. M. genitalium has been implicated as a possible causative factor in reactive arthritis. We report a case of reactive arthritis complicating M. genitalium urethritis in an HLA-B27-positive patient. © 2013.

  3. Corynebacterium propinquum associated with acute, nongonococcal urethritis.

    Science.gov (United States)

    Abdolrasouli, Alireza; Roushan, Azita

    2013-10-01

    Corynebacterium propinquum is usually considered part of the normal human oropharyngeal flora and is rarely responsible for clinical infection. We report here what seems to be the first case of acute purulent urethral discharge in a young Iranian man with urethritis acquired after orogenital contact. Attention should be devoted to less common nondiphtheriae Corynebacterium species for differential diagnosis.

  4. Bladder exstrophy associated with complete urethral duplication ...

    African Journals Online (AJOL)

    J.E. Mensah

    ees.elsevier.com/afju · www.sciencedirect.com. Case report. Bladder exstrophy associated with complete urethral duplication: Bladder can be augmented with dorsal urethral mucosa. J.E. Mensaha,∗. , K.N. Ampadua, M.Y. Kyeia, B. Edusieb.

  5. The diastal urethral stenosis in female children

    International Nuclear Information System (INIS)

    Pauer, W.

    1985-01-01

    The distal urethral stenosis in female children is a pathological reality. It is represented by the hymenal hood, the meatal stenosis and the distal urethral ring. Diagnosis and localisation of the stenosis is maintained by calibration with bougies a boule. Therapeutical consequences are: internal urethrotomy, bilateral meatotomy and excision of hymenal hoods. (Author)

  6. Contemporary Management of Primary Distal Urethral Cancer

    NARCIS (Netherlands)

    Traboulsi, S.L.; Witjes, J.A.; Kassouf, W.

    2016-01-01

    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation

  7. A clinicopathological study of urethritis in males.

    Science.gov (United States)

    Saleem, Khawer; Mumtaz, Babar; Raza, Naeem

    2009-12-01

    To determine the etiology and frequency of different types of urethritis in adult males. A case series. The Dermatology Department of PNS Shifa Hospital, Karachi, from June 2004 to December 2007. One hundred male patients having complaints of urethral discharge and dysuria reporting in the skin OPD were included in the study. Patients who had received systemic treatment for their complaints and those who had other systemic infections were excluded. A detailed history including history of sexual contact was taken. Dermatological examination including examination of external genitalia was also performed. All these patients were subjected to complete physical examination, complete urine examination, urethral pus for gram staining and culture, endo-urethral swab with urethral loop for seeing Chlamydia antigen by fluorescent microscopy, cultures for ureaplasma and Wet mount specimen microscopy for trichomonas along with HIV (serum ELISA) test. Non-gonococcal urethritis was diagnosed on the presence of more than five polymorphonuclear leucocytes per high power field in at least five fields of Gram stained urethral smear, in the absence of Gram negative diplococci. The mean age was 29.2 + or - 5.8 years. Seventy (70%) cases were diagnosed as gonococcal urethritis and 30 (30%) cases as non-gonococcal urethritis (NGU). History of illicit sexual exposure was available in 25 (25%) patients. The interval period between initiation of symptoms and reporting of patient in gonococcal urethritis was 4 to 30 days (mean 12.8 days) and 4 days to 2 months (mean 20.7 days) in non-gonococcal urethritis. The patients with gonococcal urethritis presented with purulent discharge in 66 (84%) cases, and dysuria in 49 (70%) cases. In the NGU group, 25 (80%) cases had mucoid discharge and 18 (65%) had dysuria. in 70%, Neisseria gonorrhoeae was isolated, Chlamydia trachomatis in 16%, ureaplasma in 8%, and Trichomonas vaginalis in 4%. No organism could be detected in 2% cases. HIV test was

  8. Imaging of the female urethral diverticulum

    International Nuclear Information System (INIS)

    Singla, P.; Long, S.S.; Long, C.M.; Genadry, R.R.; Macura, K.J.

    2013-01-01

    Female urethral diverticulum is a localized out-pouching of the urethra that is becoming increasingly prevalent, but often poses a diagnostic challenge. Traditionally, conventional voiding cystourethrography has been used to make the preoperative diagnosis. With the development of higher-resolution images acquired through ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), the anatomy and various abnormalities of the female urethra can be better elucidated. This article focuses on the imaging features of female urethral diverticulum, with emphasis on diagnostic pearls, particularly using MRI. Female urethral diverticulum can be best identified by their location in the posterolateral urethra and by their communication with the urethral lumen. Improved imaging techniques combined with increased physician awareness of urethral diverticulum will lead to more prompt and accurate diagnosis of this entity, leading to better treatment of affected patients

  9. URETHROPLASTY FOR COMPLICATED ANTERIOR URETHRAL STRICTURES.

    Science.gov (United States)

    Aoki, Katsuya; Hori, Shunta; Morizawa, Yosuke; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Torimoto, Kazumasa; Yoneda, Tatsuo; Tanaka, Nobumichi; Yoshida, Katsunori; Fujimoto, Kiyohide

    2016-01-01

    (Objectives) To compare efficacy and outcome of urethroplasty for complicated anterior urethral strictures. (Methods) Twelve patients, included 3 boys, with anterior urethral stricture underwent urethroplasty after the failure of either urethral dilatation or internal urethrotomy. We evaluated pre- and post-operative Q max and surgical outcome. (Results) Four patients were treated with end-to-end anastomosis, included a case of bulbar urethral elongation simultaneously, one patient was treated with augmented anastomotic urethroplasty, three patients were treated with onlay urethroplasty with prepucial flap, one patient was treated with tubed urethroplasty with prepucial flap (Ducket procedure) and three patients were treated with onlay urethroplasty with buccal mucosal graft. Postoperative Qmax improved in all patients without major complications and recurrence during follow-up periods ranging from 17 to 102 months (mean 55 months). (Conclusions) Urethroplasty is an effective therapeutic procedure for complicated anterior urethral stricture.

  10. Urethral polyp in a 1-month-old child

    Energy Technology Data Exchange (ETDEWEB)

    Beluffi, Giampiero [Department of Radiodiagnosis, IRCCS Policlinico S. Matteo, Section of Paediatric Radiology, Piazzale Golgi, 2, I-27100, Pavia PV (Italy); Berton, Francesca; Gola, Giada [University of Pavia, IRCCS Policlinico S. Matteo, Institute of Radiology, Pavia (Italy); Chiari, Giorgio; Romano, Piero; Cassani, Ferdinando [IRCCS Policlinico S. Matteo, Division of Paediatric Surgery, Pavia (Italy)

    2005-07-01

    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. (orig.)

  11. Urethral polyp in a 1-month-old child

    International Nuclear Information System (INIS)

    Beluffi, Giampiero; Berton, Francesca; Gola, Giada; Chiari, Giorgio; Romano, Piero; Cassani, Ferdinando

    2005-01-01

    Urethral polyps are a rare finding in children, particularly in the very young. They are suspected by the presence of various clinical signs such as obstruction, voiding dysfunction and haematuria. There is an association with other urinary tract congenital anomalies. They are usually benign fibro-epithelial lesions with no tendency to recur and are treated by surgical ablation, fulguration or laser therapy. We report a 1-month-old boy with an antenatally diagnosed left ectopic pelvic kidney, postnatal urinary tract infection and no clinical signs of obstruction. Voiding cystourethrography to exclude vesico-ureteric reflux showed a trabeculated bladder and a mobile filling defect in the posterior urethra. Owing to its large size, cystotomy was necessary to remove the polyp successfully. (orig.)

  12. Podophyllin induced urethral stricture in a young Nigerian male ...

    African Journals Online (AJOL)

    Urethral stricture is an abnormal narrowing or loss of distensibility due to fibrosis in the peri-urethral tissues. Some substances can induce chemical urethritis severe enough to cause stricture. We present a case of long segment anterior urethral stricture in a young Nigerian patient cause by self-application of podophyllin for ...

  13. Podophyllin induced urethral stricture in a young Nigerian male

    Directory of Open Access Journals (Sweden)

    P.O. Areo

    2015-09-01

    Full Text Available Urethral stricture is an abnormal narrowing or loss of distensibility due to fibrosis in the peri-urethral tissues. Some substances can induce chemical urethritis severe enough to cause stricture. We present a case of long segment anterior urethral stricture in a young Nigerian patient cause by self-application of podophyllin for the treatment of genital warts.

  14. Aetiology of Urethral Strictures at Moi Teaching and Refferal Hospital

    African Journals Online (AJOL)

    16.3 years. Conclusion. Urethritis, iatrogenic and accidental trauma are still the commonest causes of urethral strictures in our environment. These causes are preventable. Introduction. Urethral stricture disease is caused by any process that injures the urethral epithelium or the underlying spongiosum leading to healing by.

  15. Congenital Midureteric Stricture

    Directory of Open Access Journals (Sweden)

    Singh Shalinder

    2001-01-01

    Full Text Available Congenital midureteric obstruction is a rare entity which can be caused by either ureteric valves or strictures. We report our experience with four patients with midureteric obstruction due to stricture over a six-year period. The condition needs to be differentiated from obstruction of the pelviureteric and vesicoureteric junctions. Obstruction can be initially screened by ultrasound and confirmed by a radionuclide scan with furosemide challenge. Retrograde ureteropyelography and/or intravenous urography may be required to define the level of the stricture.

  16. MR imaging of congenital heart disease

    International Nuclear Information System (INIS)

    Kersting-Sommerhoff, B.A.; Diethelm, L.; Teitel, D.F.; Sommerhoff, C.P.; Higgins, C.B.

    1988-01-01

    Sensitivity and specificity of MR imaging for the evaluation of congenital heart disease was assessed in 51 patients (31 male and 20 female, aged 3-69 years), with a total of 115 congenital heart lesions. The true diagnosis was established by angiocardiography, catheterization, or surgery. Sensitivity at a specificity level of 90% was determined by means of receiver operating characteristic curves for great vessel relationships (100%), thoracic aorta anomalies (94%), atrial (91%) and ventricular (100%) septal defects, visceroatrial situs (100%), loop (100%), right ventricular outflow obstructions (95%), aortic valve (52%), mitral valve (62%), and tricuspid valve (76%). Spin-echo MR imaging is a reliable method for the noninvasive evaluation of congenital heart disease but is limited in the assessment of some valvular anomalies

  17. Mitral valve prolapse - report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Im, Chung Ki; Im, Dong Ran; Han, Man Chung; Lee, Young Woo; Seo, Jung Don [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-12-15

    Prolapse of mitral valve is characterized by its unique auscultatory, echocardiographic and angiographic findings and may be associated with various disease entities such as congenital heart disease, coronary heart disease and Marfan's syndrome etc. Authors report recent experience of 3 cases of prolapsed mitral valve, 2 cases associated with A.S.D. and 1 case with Marfan's syndrome.

  18. The urethral smear as a tool in diagnosing adenovirus-induced urethritis.

    Science.gov (United States)

    Tønsberg, E; Hartgill, U

    2014-12-01

    Adenovirus is a recognised cause of non-gonococcal urethritis, and is not uncommonly associated with extragenital signs and symptoms. This case report describes a patient with symptoms of conjunctivitis, meatitis and urethritis. The urethral smear revealed almost exclusively monocytes microscopically, raising the suspicion of a viral aetiology. Results confirmed the presence of adenovirus in both the eyes and urethra. Despite waning reliance on the urethral smear in sexual health clinics, it can still be an important diagnostic tool in assessing the aetiology of non-specific urethritis. Finding an obvious monocytic cell response in the urethral smear can indicate a viral cause and allow the clinician to optimise management, counsel appropriately, and potentially reduce unnecessary antibiotic use. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. A rare case of giant urethral calculus and multiple urethral diverticulum

    Directory of Open Access Journals (Sweden)

    A Agarwal

    2012-09-01

    Full Text Available Urethral stones in adults are rare and usually encountered with urethral stricture or diverticulum. We report a 54 years old gentleman who presented with urinary retention due to a large urethral calculus impacted in bulbar urethra with multiple stones in anterior and posterior urethral diverticulum. On examination a mass of size 5.5cmx4cmx3cm was palpable at anterior perineum with a fistulous tract from which pus was oozing out. On retrograde urethrogram a large urethral calculus with bulbar diverticulum and multiple radio opacity in prostatic area were revealed. Patient was managed by suprapubic cystostomy initially and later on by external urethrotomy, diverticulectomy, urethroscopic removal of multiple stones in prostatic urethral diverticulum and urethroplasty. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 46-48 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6838

  20. Urethral syndrome” in women

    Directory of Open Access Journals (Sweden)

    Sławomir Dutkiewicz

    2013-08-01

    Full Text Available A contemporary overview of knowledge is presented on the subject of the so-called urethral syndrome in women, the causes of which have yet to be clearly identified. For practical reasons, the following three forms of the syndrome have been distinguished: interstitial cystitis, the “infectious” form and the “clean” form. In women who do not show symptoms of inflammation of the reproductive organs, bacterial urethritis should be distinguished from the urethral syndrome by evaluating the symptoms, the bacteriological tests and the risk of infection.

  1. Mitral Valve Disease

    Science.gov (United States)

    ... for mitral valve replacement—mechanical valves (metal) or biological valves (tissue). The principal advantage of mechanical valves ... small risk of stroke due to blood clotting. Biological valves usually are made from animal tissue. Biological ...

  2. Urethral duplication II-A Y type with rectal urethra: ASTRA approach and tunica vaginalis flap for first stage repair.

    Science.gov (United States)

    Macedo, Antonio; Rondon, Atila; Bacelar, Herick; Ottoni, Sergio; Liguori, Riberto; Garrone, Gilmar; Ortiz, Valdemar

    2012-01-01

    Urethral duplication is a rare congenital anomaly affecting mainly boys. Generally, the duplication develops on the sagittal plane; the accessory urethra may run dorsally or ventrally to the orthotopic one. We present a patient with urethral duplication in which the orthotopic urethra was patent in the penile segment but atresic in the bulbar and prostatic segment. The patient had urinary flow from the rectum and the ectopic urethra could be well identified by anal examination. Age at surgery was 13 months. The procedure consisted of an ASTRA (anterior sagittal trans-ano-rectal) approach for dividing the urethra and rectum and was successful to move the urethra up to the perineal area. The rectum was reconstructed and the patient placed into a lithotomy position. A urethral catheter inserted in the penile urethra oriented us were the atresic urethra in bulbar area started. The scrotum was opened in the middle and the distance between the two urethral stumps proximal and distal defined the extension of no urethral tissue that consisted of 5 cm. We opened the right scrotal space and a tunica vaginalis flap was obtained and attached to the bulbar tissue for a two-stage urethroplasty strategy. Patient had a nice healing and the tunica vaginalis was nicely incorporated to the adjacent tissue, having the two urethral stumps well delineated. ASTRA approach in combination with a two-stage urethroplasty with tunica vaginalis dorsal flap proved to be an excellent combination for a rare case of urethral Y duplication having the main urethra into the rectum.

  3. Urethral duplication II-A Y type with rectal urethra: ASTRA approach and tunica vaginalis flap for first stage repair

    Directory of Open Access Journals (Sweden)

    Antonio Macedo Jr

    2012-10-01

    Full Text Available INTRODUCTION: Urethral duplication is a rare congenital anomaly affecting mainly boys. Generally, the duplication develops on the sagittal plane; the accessory urethra may run dorsally or ventrally to the orthotopic one. We present a patient with urethral duplication in which the orthotopic urethra was patent in the penile segment but atresic in the bulbar and prostatic segment. The patient had urinary flow from the rectum and the ectopic urethra could be well identified by anal examination. MATERIALS AND METHODS: Age at surgery was 13 months. The procedure consisted of an ASTRA (anterior sagittal trans-ano-rectal approach for dividing the urethra and rectum and was successful to move the urethra up to the perineal area. The rectum was reconstructed and the patient placed into a lithotomy position. A urethral catheter inserted in the penile urethra oriented us were the atresic urethra in bulbar area started. The scrotum was opened in the middle and the distance between the two urethral stumps proximal and distal defined the extension of no urethral tissue that consisted of 5 cm. We opened the right scrotal space and a tunica vaginalis flap was obtained and attached to the bulbar tissue for a two-stage urethroplasty strategy. RESULTS: Patient had a nice healing and the tunica vaginalis was nicely incorporated to the adjacent tissue, having the two urethral stumps well delineated. CONCLUSIONS: ASTRA approach in combination with a two-stage urethroplasty with tunica vaginalis dorsal flap proved to be an excellent combination for a rare case of urethral Y duplication having the main urethra into the rectum.

  4. Propionibacterium acnes endophthalmitis in Ahmed glaucoma valve.

    Science.gov (United States)

    Gutiérrez-Díaz, E; Montero-Rodríguez, M; Mencía-Gutiérrez, E; Fernández-González, M C; Pérez-Blázquez, E

    2001-01-01

    To report a case of Propionibacterium acnes endophthalmitis in a patient with an Ahmed glaucoma valve. A nine-year-old boy with bilateral congenital glaucoma, with an Ahmed glaucoma valve implanted in the left eye, had recurrent conjunctival dehiscence and endophthalmitis. Vitreous cultures demonstrated the presence of Propionibacterium acnes. This is the first reported case of Propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.

  5. Leaving Moderate Tricuspid Valve Regurgitation Alone at the Time of Pulmonary Valve Replacement: A Worthwhile Approach.

    Science.gov (United States)

    Kogon, Brian; Mori, Makoto; Alsoufi, Bahaaldin; Kanter, Kirk; Oster, Matt

    2015-06-01

    Pulmonary valve disruption in patients with tetralogy of Fallot and congenital pulmonary stenosis often results in pulmonary insufficiency, right ventricular dilation, and tricuspid valve regurgitation. Management of functional tricuspid regurgitation at the time of subsequent pulmonary valve replacement remains controversial. Our aims were to (1) analyze tricuspid valve function after pulmonary valve replacement through midterm follow-up and (2) determine the benefits, if any, of concomitant tricuspid annuloplasty. Thirty-five patients with tetralogy of Fallot or congenital pulmonary stenosis were analyzed. All patients had been palliated in childhood by disrupting the pulmonary valve, and all patients had at least moderate tricuspid valve regurgitation at the time of subsequent pulmonary valve replacement. Preoperative and serial postoperative echocardiograms were analyzed. Pulmonary and tricuspid regurgitation, along with right ventricular dilation and dysfunction were scored as 0 (none), 1 (mild), 2 (moderate), and 3 (severe). Right ventricular volume and area were also calculated. Comparisons were made between patients who underwent pulmonary valve replacement alone and those who underwent concomitant tricuspid valve annuloplasty. At 1 month after pulmonary valve replacement, there were significant reductions in pulmonary valve regurgitation (mean 3 vs 0.39, p tricuspid valve regurgitation (mean 2.33 vs 1.3, p tricuspid regurgitation 1 month postoperatively between patients who underwent concomitant tricuspid annuloplasty and those who underwent pulmonary valve replacement alone (mean 1.31 vs 1.29, p = 0.81). However, at latest follow-up (mean 7.0 ± 2.8 years), the degree of tricuspid regurgitation was significantly higher in the concomitant annuloplasty group (mean 1.87 vs 1.12, p = 0.005). In patients with at least moderate tricuspid valve regurgitation, significant improvement in tricuspid valve function and right ventricular size occurs in the first

  6. Spontaneous Thrombosis of a Bicuspid Aortic valve due to Primary Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    Sarah Farrell

    2010-08-01

    Full Text Available We present the case of a 51-year-old man who was admitted as an emergency with spontaneous thrombosis of the aortic valve and ascending aorta. At operation he was found to have a congenitally bicuspid aortic valve and subsequent investigation revealed primary antiphospholipid syndrome. He underwent successful removal of the thrombus combined with mechanical replacement of the aortic valve.

  7. Urethritis

    Science.gov (United States)

    ... groin area Tender and swollen penis A digital rectal exam will also be performed. Women will have ... Copyright 1997-2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing ...

  8. [Congenital valvular heart disease with high familial penetrance].

    Science.gov (United States)

    Dattilo, Giuseppe; Lamari, Annalisa; Tulino, Viviana; Scarano, Michele; De Luca, Eleonora; Mutone, Daniela; Busacca, Paolo

    2012-12-01

    Bicuspid valve aortic (BVA) is one of the most common congenital malformations. Only 20% of patients preserves a normal valve function throughout life. There are sporadic and familial forms, the latter to autosomal dominant. We present a case of familiarity of BVA high penetrance. Patient with aortic stenosis by BVA, is the father of two children with BVA.

  9. Transperineal Ultrasonographic findings of female urethral diverticulum

    International Nuclear Information System (INIS)

    Cho, Jin Han; Koo, Bong Sik; Nam, Ki Dong; Choi, Jong Cheol; Park, Byeong Ho; Nam, Kyung Jin; Kweon, Heon Young

    1999-01-01

    The purpose of the study was to explore the role of sonography for women with a suspected urethral diverticulum and to evaluate the transperineal ultrasonographic findings of female urethral diverticulum. Eight women (mean age, 44 years) who presented with urethral symptoms and clinically suspected urethral diverticula underwent transperineal ultrasonography; sagittal and coronal images were obtained. Sonography was done with either a 7-5 MHz curved array transducer or 10-5 MHz linear transducer, placed on the perineum at the level of the urethra. Ultrasonograms were assessed for the presence, size, location, shape, echogenicity, and septum. Five patients underwent voiding cystourethrography (VCUG). Results of the sonograms and VCUGs were compared with each other and with surgical findings. Longitudinally, all lesions were located in a middle third of the urethra. In axial plane, 4 diverticula wrapped around 50-100% of the urethra. 3 cases located posteriorly, and 1 case laterally. Seven diverticula contained echogenic debris. Three cases have septa in the diverticulum. The outer margin of the diverticula was smooth in 2 patients and was lobulated in 6 patients. In 3 of 5 cases who underwent VCUG, diverticula were filled with contrast, and appeared to be smaller than those of ultrasonography. In addition, all were single diverticulum in VCUG. Most urethral diverticulum were located in a middle third of the urethra, wrapped around the urethra or round posteriorly. Many cases appear unilocular or multilocular with echogenic debris. Transperineal ultrasonography is easy to operate and accurate for showing urethral diverticulum, and it may be useful for diagnosing this group of women with urethral symptoms and suspected urethral diverticulum. It provides information on the extent and location of the diverticulum, which are important in surgical excision.

  10. Current management of urethral stricture disease

    Directory of Open Access Journals (Sweden)

    Thomas G Smith

    2016-01-01

    Conclusions: Progress is being made toward consistent terminology, and nomenclature which will, in turn, help to standardize treatment within the field of urology. Treatment for urethral stricture and stenosis remains inconsistent between reconstructive and nonreconstructive urologists due to varying treatment algorithms and approaches to disease management. Tissue engineering appears to be future for reconstructive urethral surgery with reports demonstrating feasibility in the use of different tissue substitutes and grafts.

  11. Diagnosis and treatment of urethritis in men.

    Science.gov (United States)

    Brill, John R

    2010-04-01

    Symptoms of urethritis in men typically include urethral discharge, penile itching or tingling, and dysuria. A diagnosis can be made if at least one of the following is present: discharge, a positive result on a leukocyte esterase test in first-void urine, or at least 10 white blood cells per high-power field in urine sediment. The primary pathogens associated with urethritis are Chlamydia trachomatis and Neisseria gonorrhoeae. Racial disparities in the prevalence of sexually transmitted infections persist in the United States, with rates of gonorrhea 40 times higher in black adolescent males than in white adolescent males. Recent studies have focused on identifying causes of nongonococcal urethritis and developing testing for atypical organisms, such as Mycoplasma genitalium and Ureaplasma species. Less common pathogens identified in patients with urethritis include Trichomonas species, adenovirus, and herpes simplex virus. History and examination findings can help distinguish urethritis from other urogenital syndromes, such as epididymitis, orchitis, and prostatitis. The goals of treatment include alleviating symptoms; preventing complications in the patient and his sexual partners; reducing the transmission of coinfections (particularly human immunodeficiency virus); identifying and treating the patient's contacts; and encouraging behavioral changes that will reduce the risk of recurrence. The combination of azithromycin or doxycycline plus ceftriaxone or cefixime is considered first-line empiric therapy in patients with urethritis. Expedited partner treatment, which involves giving patients prescriptions for partners who have not been examined by the physician, is advocated by the Centers for Disease Control and Prevention and has been approved in many states. There is an association between urethritis and an increased human immunodeficiency virus concentration in semen.

  12. Iatrogenic Urethral Defect Repairment: A Case Report

    Directory of Open Access Journals (Sweden)

    Ulas Fidan

    2013-10-01

    Full Text Available    Iatrogenic urethral defect is a complication that occurs after vaginal surgical procedures. Many surgical methods according to place of defect are described in case of injury of urethra. In this article, we reported the repairment of distal urethral defect with the help of greft taken from labia minor. This defect is made by the excision of the granulation tissue that occurred after chronic paraurethral  gland infection.

  13. Chlamydia trachomatis in non-specific urethritis.

    Science.gov (United States)

    Terho, P

    1978-01-01

    Chlamydia trachomatis was isolated from 58.5% of 159 patients with non-specific urethritis (NSU) using irradiated McCoy cell cultures. Patients with persistent Chlamydia-positive NSU remained Chlamydia-positive each time they were examined before treatment and patients with Chlamydia-negative NSU remained Chlamydia-negative during the course of the illness. Neither the duration of symptoms of urethritis nor a history of previous urethritis affected the chlamydial isolation rate significantly. Of 40 patients with severe discharge 30 (75%) harboured C. trachomatis. One-third of the Chlamydia-positive patients had a severe urethral discharge, while this was present in only 15% of Chlamydia-negative patients. Complications--such as conjunctivitis, arthritis, and epididymitis--were more severe in men with Chlamdia-positive NSU than in those with Chlamydia-negative NSU. Of 64 men matched for sexual promiscuity but without urethritis, none harboured C. trachomatis in his urethra. This differs significantly (P less than 0.001) when compared with patients with NSU. C. trachomatis was isolated from the urogenital tract in 24 (42%) out of 57 female sexual contacts of patients with NSU. The presence of C. trachomatis in the women correlated significantly (P less than 0.001) with the isolation of the agent from their male contacts. These findings give further evidence for the aetiological role of C. trachomatis in non-specific urethritis and its sexual transmission. PMID:678958

  14. Urethral prolapse in dogs: a retrospective study.

    Science.gov (United States)

    Carr, Jennifer G; Tobias, Karen M; Smith, Laura

    2014-07-01

    To evaluate the signalment, clinical signs, treatment, and outcome of dogs with urethral prolapse and identify risk factors associated with prolapse or treatment. Retrospective case series. Dogs (n = 48) with urethral prolapse. Medical records (May 1995-June 2010) from 2 referral centers were reviewed. Retrieved data included signalment, clinical signs, laboratory findings, treatment, complications, results of long-term follow-up. Records from Veterinary Medical Data Base (VMDB) were evaluated to determine odds ratios. Odds ratio for urethral prolapse in English bulldogs compared to all breeds was 366.99 (95% CI: 265.83, 506.65). Of 48 affected dogs, 46 had either resection and anastomosis (43 dogs) or urethropexy (3 dogs). The most common early postoperative complication was hemorrhage (39%); postoperative hemorrhage was less common when a simple continuous pattern was used for resection and anastomosis. Prolapse recurred in 57% of dogs available for long-term follow-up; recurrence was less common in dogs that were administered postoperative butorphanol or acepromazine. Gender was not associated with urethral prolapse or postoperative complications. Urethral prolapse occurs most commonly in English bulldogs. Postoperative hemorrhage and prolapse recurrence may be reduced with use of a simple continuous pattern for urethral anastomosis and by administration of postoperative sedation, respectively. Castration status did not appear to affect prolapse development or outcome. © Copyright 2014 by The American College of Veterinary Surgeons.

  15. Congenital tuberculosis

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-06-20

    Jun 20, 2012 ... Key words: Congenital tuberculo- sis, case report, miliary tuberculosis. Introduction. Congenital tuberculosis defines tuberculosis in infants of .... tary TB and otitis media, resulting in seizures, deafness, and death. It is therefore not surprising that the index case who presented at twelve weeks of age, had ...

  16. Congenital Abnormalities

    Science.gov (United States)

    ... tube defects. However, there is also a genetic influence to this type of congenital anomaly. Unknown Causes The vast majority of congenital abnormalities have no known cause. This is particularly troubling for parents who plan to have more children, because there is no way to predict if ...

  17. Comparison of urethral diameters for calculating the urethral dose after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Tanaka, Osamu; Hayashi, Shinya; Matsuo, Masayuki; Nakano, Masahiro; Kubota, Yasuaki; Maeda, Sunaho; Ohtakara, Kazuhiro; Deguchi, Takashi; Hoshi, Hiroaki

    2007-01-01

    No studies have yet evaluated the effects of a dosimetric analysis for different urethral volumes. We therefore evaluated the effects of a dosimetric analysis to determine the different urethral volumes. This study was based on computed tomography/magnetic resonance imaging (CT/MRI) combined findings in 30 patients who had undergone prostate brachytherapy. Postimplant CT/MRI scans were performed 30 days after the implant. The urethra was contoured based on its diameter (8, 6, 4, 2, and 0 mm). The total urethral volume-in cubic centimeters [UrV150/200 (cc)] and percent (UrV150%/200%), of the urethra receiving 150% or 200% of the prescribed dose-and the doses (UrD90/30/5) in Grays to 90%, 30%, and 5% of the urethral volume were measured based on the urethral diameters. The UrV150 (cc) and UrD30 were statistically different between the of 8-, 6-, 4-, 2-, and 0-mm diameters, whereas the UrD5 was statistically different only between the 8-, 6-, and 4-mm diameters. Especially for UrD5, there was an approximately 40-Gy difference between the mean values for the 8- and 0-mm diameters. We recommend that the urethra should be contoured as a 4- to 6-mm diameter circle or one side of a triangle of 5-7 mm. By standardizing the urethral diameter, the urethral dose will be less affected by the total urethral volume. (author)

  18. Urethral hydrodistension for management of urethral hypoplasia in prune belly syndrome: long-term results.

    Science.gov (United States)

    Kajbafzadeh, Abdol-Mohammad; Rasouli, Mohammad Reza; Dianat, SeyedSaeid; Nezami, Behtash G; Mahboubi, Amir Hassan; Sina, Alireza

    2010-11-01

    The aim of the study was to evaluate the efficacy and safety of urethral hydrodistension for management of urethral hypoplasia in prune belly syndrome (PBS). During a 10-year period, 7 infants with PBS and urethral hypoplasia presented either with open urachus or surgically created urinary diversion referred to our hospital. Five milliliters of normal saline was pushed via a 22-gauge plastic angiocatheter into the urethra with simultaneous finger pressure on the perineum to occlude the proximal urethra that was repeated with higher volumes of the solution (up to 20 mL). The procedure was continued until a 6F or 8F feeding tube catheter confirmed the urethral patency. Hydrodistension was repeated in 3-month intervals till complete patency was confirmed by imaging. Median age of the infants was 6 (1-8) months. All urethral hydrodistension were successful after 1 to 3 sessions. Follow-up imaging studies showed significant improvement in all patients except one. Natural and surgically created urinary diversions were closed in 6 infants. The hydrodistension create an equal and constant pressure into the urethral wall without any urethral damage. This technique can be considered along with the other available methods for management of urethral hypoplasia in selected cases of PBS. Copyright © 2010 Elsevier Inc. All rights reserved.

  19. Management of severe urethral complications of prostate cancer therapy.

    Science.gov (United States)

    Elliott, Sean P; McAninch, Jack W; Chi, Thomas; Doyle, Sean M; Master, Viraj A

    2006-12-01

    We present our management of urethral stenosis and rectourinary fistula resulting from prostate cancer therapy. We concentrated on cases refractory to minimally invasive treatment, such as dilation, urethrotomy, and urinary and/or fecal diversion. In our prospectively collected urethral reconstruction database we identified patients who underwent reconstruction of urethral stenosis or rectourinary fistula who also received prior treatment for prostate cancer. We documented demographics, prostate cancer pretreatment characteristics, prostate cancer therapy type, urethral reconstruction type and success. A total of 48 patients met the inclusion criteria, including 16 with rectourinary fistula and 32 with urethral stenosis. Urethral complications followed prior radical prostatectomy, brachytherapy, external beam radiotherapy, cryotherapy, thermal ablation and any combination of these procedures. Stenosis repair was successful in 23 of 32 cases (73%) and it differed little between anterior and posterior urethral stenosis. Repair was accomplished by anastomotic urethroplasty in 19 cases, flap urethroplasty in 2, perineal urethrostomy in 2 and a urethral stent in 9. Prior external beam radiotherapy was a risk factor for urethral reconstruction failure. Fistula repair was successful in 14 of 15 patients (93%), excluding 1 who died postoperatively. The complexity of fistula management was dictated by fistula size and the presence or absence of coincident urethral stenosis. Urethral stenosis or rectourethral fistula following prostate cancer therapy can be managed by urethral reconstruction, such that normal voiding via the urethra is maintained, rather than abandoning the urethral outlet and performing heterotopic diversion. This can be accomplished with an acceptable rate of failure, given the complexity of the cases.

  20. Educational series in congenital heart disease:Congenital left-sided heart obstruction

    OpenAIRE

    Carr, Michelle; Curtis, Stephanie; Marek, Jan

    2018-01-01

    Congenital obstruction of the left ventricular outflow tract remains a significant problem and multilevel obstruction can often coexist. Obstruction can take several morphological forms and may involve the subvalvar, valvar or supravalvar portion of the aortic valve complex. Congenital valvar stenosis presenting in the neonatal period represents a spectrum of disorders ranging from the hypoplastic left heart syndrome to almost normal hearts. Treatment options vary dependent on the severity of...

  1. Urethral Cancer Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Urethral cancer occurs in men and women and can spread quickly to lymph nodes near the urethra. Find out about risk factors, symptoms, tests to diagnose, prognosis, staging, and treatment for urethral cancer.

  2. Localized urethral cancer in women

    International Nuclear Information System (INIS)

    Mayer, R.; Fowler, J.E. Jr.; Clayton, M.

    1987-01-01

    The results of treatments for localized carcinoma of the urethra were assessed in 21 consecutive women treated at our institutions over a twenty year period. Only one of the tumors was confined to the distal urethra. Eighty-six percent invaded the periurethral tissues and 24% were known to be associated with regional lymph node metastases. Fifty-seven percent were adenocarcinomas. Five patients refused active therapeutic intervention and expired within one to 30 months following diagnosis. Sixteen patients were treated with extirpative surgery, radiation therapy, or combinations of the two. Four are free of disease at one, four, eleven, and 15 years after treatment. Nine developed pelvic recurrences, two developed pelvic recurrences and distant metastases and one developed distant metastases only from six to 72 months (mean, 19 months) after initial treatment. Eight of these 12 patients died at two to 13 months (mean, 8 months) after secondary treatment, two are alive with residual pelvic tumor, and two are clinically free of disease at 7 and 48 months. Only six patients were known to have distant metastases at the time of death and five of these six had adenocarcinomas. Advanced localized urethral cancer in women is difficult to eradicate and usually fatal

  3. O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2012-01-01

    congenital heart defects, especially as a conduit for the right ventricular outflow tract reconstruction. This article aims to make a comprehensive review on the clinical outcomes of Contegra. Reports of Contegra published since 2002 were comprehensively retrieved, collected and analyzed. There were 1718 Contegra, applied in 1705 patients. The sizes of the conduits were 8-22 mm. The patients aged from newborn to 74.5 years, prevailed by pediatrics. The primary diagnosis was congenital heart defects in all cases, with Tetralogy of Fallot, truncus arteriosus and pulmonary atresia being the first three diagnoses, representing 25.6%, 16.7%, and 13.1%, respectively. Contegra was used as a tube graft in the pulmonary position in 1635 (95.9% patients, as a monocuspid patch in 12 (0.7%, as a graft in the position of the pulmonary valve or a monocusps in 40 (2.3%, and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1% patients, respectively. Conduit reimplantation was performed in 141 (8.3% patients 33.8 ± 37 (8.6-106.8 months after the initial conduit insertion. Conduit plasty was necessary in 6 (0.4%, and reintervention in 83 (4.9% patients. Indications for conduit reimplantation included severe stenosis of the distal anastomosis, pseudoaneurysm of the proximal anastomosis and severe conduit regurgitation. As for the good performance, availability and longevity, Contegra is a biomaterial suitable for the right ventricular outflow tract reconstruction and for patch repair for ventricular septal defect, but not apt for Fontan procedure.

  4. O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas The contegra valved bovine conduit: a biomaterial for the surgical treatment of congenital heart defects

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2012-12-01

    congenital heart defects, especially as a conduit for the right ventricular outflow tract reconstruction. This article aims to make a comprehensive review on the clinical outcomes of Contegra. Reports of Contegra published since 2002 were comprehensively retrieved, collected and analyzed. There were 1718 Contegra, applied in 1705 patients. The sizes of the conduits were 8-22 mm. The patients aged from newborn to 74.5 years, prevailed by pediatrics. The primary diagnosis was congenital heart defects in all cases, with Tetralogy of Fallot, truncus arteriosus and pulmonary atresia being the first three diagnoses, representing 25.6%, 16.7%, and 13.1%, respectively. Contegra was used as a tube graft in the pulmonary position in 1635 (95.9% patients, as a monocuspid patch in 12 (0.7%, as a graft in the position of the pulmonary valve or a monocusps in 40 (2.3%, and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1% patients, respectively. Conduit reimplantation was performed in 141 (8.3% patients 33.8 ± 37 (8.6-106.8 months after the initial conduit insertion. Conduit plasty was necessary in 6 (0.4%, and reintervention in 83 (4.9% patients. Indications for conduit reimplantation included severe stenosis of the distal anastomosis, pseudoaneurysm of the proximal anastomosis and severe conduit regurgitation. As for the good performance, availability and longevity, Contegra is a biomaterial suitable for the right ventricular outflow tract reconstruction and for patch repair for ventricular septal defect, but not apt for Fontan procedure.

  5. Male urethral strictures and their management

    Science.gov (United States)

    Hampson, Lindsay A.; McAninch, Jack W.; Breyer, Benjamin N.

    2014-01-01

    Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques. PMID:24346008

  6. Management of posterior urethral disruption injuries.

    Science.gov (United States)

    Myers, Jeremy B; McAninch, Jack W

    2009-03-01

    Posterior urethral disruption is a traumatic injury to the male urethra, which most often results from pelvic fracture. After trauma, the distraction defect between the two ends of the urethra often scars and becomes fibrotic, blocking the urethra and bladder emptying. Increasing evidence suggests that many posterior urethral disruptions occur at the junction between the membranous urethra and the bulbar urethra, which is distal to the rhabdosphincter. In the acute setting, when a posterior urethral disruption is suspected, retrograde urethrography should be performed. Posterior urethral disruptions can be managed acutely by realignment of the urethra over a urethral catheter or by placement of a suprapubic catheter for bladder drainage only. Once fibrosis has stabilized, the patient can undergo posterior urethroplasty. In most cases, this procedure can be performed via a perineal approach in a single-stage surgery. The results of this single-stage perineal urethroplasty are excellent, and a patent urethra can be re-established in the majority of men who undergo surgery.

  7. Bicuspid aortic valve demonstrated with multislice computed tomography - a case report

    International Nuclear Information System (INIS)

    Marzec, M.; Lasek, W.; Serafin, Z.; Laskowska, K.; Swiatkiewicz, I.; Kubica, J.

    2004-01-01

    Bicuspid aortic valve (BAV) is one of the most common congenital heart defects and often coexists with other congenital abnormalities of the heart and great vessels. A standard diagnostic technique for valve imaging is echocardiography. However, suboptimal images may cause a diagnostic problem, especially in obese patients, women and in case of significant valve calcifications. The paper reports a case of a 27-year-old male patient with recurrent chest pain, appearing regardless of exertion. Routine physical examination, laboratory tests and echocardiography were negative. Multislice computed tomography (MSCT) showed normal coronary arteries and bicuspid aortic valve. The diagnostics of bicuspid aortic valve and the diagnostic value of MSCT are discussed. MSCT seems to be an important point in cardiac diagnostic algorithms, being an alternative modality for MR in BAV imaging. The presented case emphasizes the potential of MSCT for the diagnostics of cardiac valve congenital diseases. (author)

  8. Long-term effect of urethral dilatation and internal urethrotomy for urethral strictures.

    Science.gov (United States)

    Veeratterapillay, Rajan; Pickard, Rob S

    2012-11-01

    Urethral dilatation and direct visual internal urethrotomy (DVIU) are widely used minimally invasive options to manage men with urethral strictures. Advances in open urethroplasty with better long-term cure rates have fuelled the continuing debate as to which treatment is best for primary and recurrent urethral strictures. We reviewed recent literature to identify contemporary practice of urethral dilatation and DVIU and the long-term outcome of these procedures. Systematic literature search for the period January 2010 to December 2011 showed that urethral dilatation and DVIU remain frequently used treatment options as confirmed by surveys of urologists in the USA and the Netherlands. Multiple reports of laser DVIU confirm the safety of this approach but long-term data were lacking. Stricture free rates from urethra dilatation and DVIU vary from 10 to 90% at 12 months, although adjunctive intermittent self-dilatation can reduce time to recurrence. Although quality-of-life benefit appears good in the short term, repeated procedures may harm sexual function in the long-term. Urethral dilatation and DVIU remain widely used in urethral stricture management but high-level comparative evidence of benefit and harms against urethroplasty in the short and long-term is still lacking.

  9. Use of an Absorbable Urethral Stent for the Management of a Urethral Stricture in a Stallion.

    Science.gov (United States)

    Trela, Jan M; Dechant, Julie E; Culp, William T; Whitcomb, Mary B; Palm, Carrie A; Nieto, Jorge E

    2016-11-01

    To describe the successful management of a urethral stricture with an absorbable stent in a stallion. Clinical report. Stallion with a urethral stricture. A 12-year-old Thoroughbred breeding stallion was evaluated for acute onset of colic. Uroperitoneum because of presumptive urinary bladder rupture, with urethral obstruction by a urethrolith, was diagnosed. The uroperitoneum was treated conservatively. The urethrolith was removed through a perineal urethrotomy. Approximately 15 weeks after urethrolith removal, the stallion presented with a urethral stricture. The stricture was unsuccessfully treated with an indwelling urinary catheter and 4 attempts at balloon dilation. Eight weeks after diagnosis of stricture, an absorbable polydioxanone (20 mm × 80 mm) urethral stent was implanted under percutaneous, ultrasound guidance. Urethroscopy was performed at 70, 155, and 230 days after stent placement and the endoscope passed through the affected site without complication. Urethroscopy at 155 days showed the stent had been reabsorbed. Follow-up 20 months after stent placement reports the stallion was able to void a normal urine stream. Absorbable urethral stent placement was a feasible treatment for urethral stricture in this stallion. © Copyright 2016 by The American College of Veterinary Surgeons.

  10. Possibilities of Using Endoscopic Equipment in the Treatment of Post-Traumatic Urethral Strictures in Children

    Directory of Open Access Journals (Sweden)

    D.V. Shevchuk

    2016-10-01

    Full Text Available Background. Damage to the urethra in damaged pelvic bones in children is marked less than in adults (less than 1 % (Tarman G.J. et al., 2002. Post-traumatic urethral stricture in children is a quite rare and complex urologic pathology. Due to anatomical features, treatment for urethral stricture in children is different from its treatment in adults (Onen A. et al., 2005; Nerli R.B. et al., 2008; Ranjan P. et al., 2011. M.M. Koraitim (2012 described the experience of treating 20 patients with complications after transperyneal urethral plasty. The author noted that in the absence of need for reconstruction of the bladder neck, it is quite effective to use endoscopic incision of urethral stricture. T.E. Helmy, A.T. Hafez (2013 also described the results of the successful application of endoscopic equipment (direct visual urethrotomia after open urethroplasty. The important point that leads to finding effective minimally invasive treatments for post-traumatic urethral strictures in children is the development of erectile dysfunction in the future, the incidence of which, according to some authors, (Koraitim M.M., 2014 is up to 47 %. The aim of the study: based on the available published data and own treatment outcomes in children with posterior urethral strictures, to establish the role of endoscopic treatment of this complex pathology as a method of prevention and treatment of neuromuscular dysfunction of the bladder. Materials and methods. At the premises of the surgical departments of Zhytomyr Regional Children’s Clinical Hospital, there were widely implemented invasive endoscopic methods for the diagnosis and treatment of pathologies of the lower urinary tract. Available equipment enables to carry out diagnostic procedures from 1 month old. A variety of endoscopic surge­ries on the lower urinary tract is being performed, namely — the removal of calculi, incision of valves and strictures of the posterior urethra, dissection of urethral cysts

  11. Congenital rubella

    Science.gov (United States)

    ... that usually closes shortly after birth remains open ( patent ductus arteriosus ) Narrowing of the large artery that ... prior to pregnancy can prevent congenital rubella. Pregnant women who have not had the vaccine should avoid ...

  12. Editorial comment on “Etiology of male urethral strictures ...

    African Journals Online (AJOL)

    My colleagues and I are strongly convinced that urethral stricture disease presents different etiologies and pathological characteris- tics in developed compared to developing countries [1]. Recently, we reported the differences in posterior urethral stricture after pelvic fracture urethral distraction defects in developing (India) ...

  13. 21 CFR 876.4590 - Interlocking urethral sound.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Interlocking urethral sound. 876.4590 Section 876...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4590 Interlocking urethral sound. (a) Identification. An interlocking urethral sound is a device that consists of two metal sounds...

  14. Urethral catheterization:The need for adequate undergraduate ...

    African Journals Online (AJOL)

    E.V. Ezenwa

    2016-12-26

    Dec 26, 2016 ... urethral catheterization procedure and precautionary methods taken while carrying out the procedure. Also assessed was the ... Conclusion: Newly recruited interns have poor practical exposure to urethral catheterization. Efforts should .... ska B. Treatment of posterior and anterior urethral trauma. BJU Int.

  15. The detection of microorganisms related to urethritis from the oral cavity of male patients with urethritis.

    Science.gov (United States)

    Le, Phuong Thi; Hamasuna, Ryoichi; Matsumoto, Masahiro; Furubayashi, Keiichi; Hatanaka, Masayuki; Kawai, Shuichi; Yamaguchi, Takamasa; Uehara, Kazutaka; Murakami, Norihiko; Yoshioka, Masaru; Nakayama, Ken; Shiono, Yutaka; Muraoka, Keisuke; Suzuki, Masahiko; Fujimoto, Naohiro; Matsumoto, Tetsuro

    2017-10-01

    To investigate the presence of microorganisms related to urethritis in the oral cavity of male patients with urethritis and the efficacies of antimicrobials for urethritis on microorganisms in the oral cavity. Ninety-two male patients with urethritis and 17 male controls participated to this study at 12 urology clinics in Japan between March 2014 and March 2015. The first voided urine (FVU) and oral wash fluid (OWF) specimens were collected from the participants. The microorganisms in both FVU and OWF specimens were detected by nucleic acid amplification tests at the first and follow-up visit. The efficacies of antimicrobials were evaluated after 1-4 weeks treatment completion. In a total of 92 male patients with urethritis, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ureaplasma parvum, Trichomonas vaginalis and Gardnerella vaginalis were detected from OWF specimens of 12%, 3%, 9%, 0%, 12%, 3%, 3% and 15% patients, respectively. From control males, no microorganism was detected from OWF specimens. Among 46 patients who could be evaluated for antimicrobial efficacies at the follow-up visit, 5 in FVU specimens failed by azithromycin (AZM), and 10 failed in OWF specimens (7 by AZM, 2 by tetracycline, 1 by spectinomycin; p = 0.002). Especially, a high prevalence of G. vaginalis remained positive after treatment for urethritis in the oral cavity. Microorganisms related to urethritis were detected in the oral cavity of male patients with urethritis. Antimicrobials that focused on urethritis, especially AZM regimen seem to be less effective for microorganisms in the oral cavity. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Isotretinoin-induced urethritis versus non-gonococcal urethritis in a man who has sex with men: an open debate.

    Science.gov (United States)

    Ballout, Rami A; Maatouk, Ismael

    2018-01-01

    This is the case of a young man presenting with urethritis despite a negative infectious work-up. Careful history taking elucidated a strong correlation between symptom onset and a recent dose escalation of isotretinoin for treatment of his refractory cystic acne. The urethral symptoms quickly resolved with dose reduction, suggesting urethritis as a rare adverse reaction of isotretinoin.

  17. Piezoelectric valve

    Science.gov (United States)

    Petrenko, Serhiy Fedorovich

    2013-01-15

    A motorized valve has a housing having an inlet and an outlet to be connected to a pipeline, a saddle connected with the housing, a turn plug having a rod, the turn plug cooperating with the saddle, and a drive for turning the valve body and formed as a piezoelectric drive, the piezoelectric drive including a piezoelectric generator of radially directed standing acoustic waves, which is connected with the housing and is connectable with a pulse current source, and a rotor operatively connected with the piezoelectric generator and kinematically connected with the rod of the turn plug so as to turn the turn plug when the rotor is actuated by the piezoelectric generator.

  18. Contemporary Management of Primary Distal Urethral Cancer.

    Science.gov (United States)

    Traboulsi, Samer L; Witjes, Johannes Alfred; Kassouf, Wassim

    2016-11-01

    Primary urethral cancer is one of the rare urologic tumors. Distal urethral tumors are usually less advanced at diagnosis compared with proximal tumors and have a good prognosis if treated appropriately. Low-stage distal tumors can be managed successfully with a surgical approach in men or radiation therapy in women. There are no clear-cut indications for the choice of the most appropriate treatment modality. Organ-preserving modalities have shown effective and should be used whenever they do not compromise the oncological safety to decrease the physical and psychological trauma of dismemberment or loss of sexual/urinary function. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Plastik på trikuspidalklappen (Tricuspid valve annuloplasty. The neglected valve)

    DEFF Research Database (Denmark)

    Pedersen, Thais A L; Wierup, Per; Pedersen, Lia Mendes

    2010-01-01

    INTRODUCTION: Tricuspid valve regurgitation (TVR) is often secondary to left-sided or congenital heart disease (CHD). Surgical correction of TVR is indicated when the primary abnormalities require operation. MATERIAL AND METHODS: Retrospective analysis of all 50 patients (mean age: 65 years (rang...

  20. Deferred endoscopic urethral realignment: Role in management of traumatic posterior urethral disruption

    Directory of Open Access Journals (Sweden)

    M.A. Elgammal

    2014-06-01

    Conclusion: When early realignment is postponed for any reason, deferred endoscopic realignment is considered an adequate substitute because urethral continuity can be achieved in a group of patients without increase incidence of impotence and incontinence.

  1. Parents' perceptions of counselling following prenatal diagnosis of congenital anomalies of the kidney and urinary tract: a qualitative study.

    Science.gov (United States)

    Marokakis, Sarah; Kasparian, Nadine A; Kennedy, Sean E

    2017-03-01

    To explore parents' experiences of counselling after prenatal diagnosis of congenital anomalies of the kidney and urinary tract. Parents of a child born between September 2012 and March 2015 with posterior urethral valves (PUV) or multicystic dysplastic kidney (MCDK) completed a semi-structured telephone interview, demographic survey, and the 21-item self-report Depression, Anxiety and Stress Scales questionnaire. Qualitative data were analysed thematically using NVivo10 software. In all, 17 parents (PUV, eight; MCDK, nine) participated (response rate 40%), and most were offered counselling during pregnancy (14/17). Parents described feelings of shock, fear and uncertainty after diagnosis, and desired early information on all aspects of their child's condition. Most participants were satisfied with the information received; however, unmet information needs relating to treatment and prognosis were identified, particularly amongst fathers and parents in the PUV group. Some parents felt relieved after counselling (12/17); however, emotional distress often persisted long after diagnosis. Parents described a need for written and web-based information resources, specialised psychological services, and parent support groups. While parents valued counselling, many continued to report unmet informational and psychological needs. Early counselling addressing topics important to parents and provision of additional resources and support services may improve parents' adjustment to their baby's diagnosis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  2. Female urethral strictures: successful management with long-term clean intermittent catheterization after urethral dilatation.

    Science.gov (United States)

    Smith, Ariana L; Ferlise, Victor J; Rovner, Eric S

    2006-07-01

    To report our experience in the diagnosis and treatment of urethral stricture in women. A retrospective review of records and video-urodynamics identified women treated for urethral stricture between 1999 and 2004 at one institution by one surgeon. Urethral stricture was defined as a fixed anatomical narrowing between the bladder neck and distal urethra of or = 30 F. After a period of indwelling catheterization, the women were placed on clean intermittent self-catheterization (CISC) at least once daily, and monitored every 3-6 months. At each follow-up, the urethra was catheterized to exclude recurrence. American Urological Association (AUA) symptom scores were obtained at presentation and at the initial 3 month follow-up. Seven women met the criteria for urethral stricture, and were followed for a mean (range) of 21 (6-34) months. All were initially maintained on daily CISC, and some were gradually reduced to weekly CISC for the duration of follow-up. No patient had a recurrent stricture while on CISC, and none has had a urethral reconstruction to manage their condition. AUA symptom scores improved in all of the women by a mean of 10.7 points. No complications related to catheterization were noted. Urethral stricture is rare in women. Long-term CISC in these women is safe and effective, and can avoid the need for major reconstructive surgery.

  3. Early endoscopic realignment in posterior urethral injuries.

    Science.gov (United States)

    Shrestha, B; Baidya, J L

    2013-01-01

    Posterior urethral injury requires meticulous tertiary care and optimum expertise to manage successfully. The aim of our study is to describe our experiences with pelvic injuries involving posterior urethra and their outcome after early endoscopic realignment. A prospective study was carried out in 20 patients with complete posterior urethral rupture, from November 2007 till October 2010. They presented with blunt traumatic pelvic fracture and underwent primary realignment of posterior urethra in our institute. The definitive diagnosis of urethral rupture was made after retrograde urethrography and antegrade urethrography where applicable. The initial management was suprapubic catheter insertion after primary trauma management in casualty. After a week of conservative management with intravenous antibiotics and pain management, patients were subjected to the endoscopic realignment. The follow up period was at least six months. The results were analyzed with SPSS software. After endoscopic realignment, all patients were advised CISC for the initial 3 months. All patients voided well after three months of CISC. However, 12 patients were lost to follow up by the end of 6 postoperative months. Out of eight remaining patients, two had features of restricture and were managed with DVU followed by CISC again. One patient with restricture had some degree of erectile dysfunction who improved significantly after phospodiesterase inhibitors. None of the patients had features of incontinence. Early endoscopic realignment of posterior urethra is a minimally invasive modality in the management of complete posterior urethral injury with low rates of incontinence and impotency.

  4. Male Urethral Diverticulum Having Multiple Stones

    African Journals Online (AJOL)

    muscle fibers in their wall, commonly encountered in adults, and involve the posterior urethra. Differential diagnosis for UD includes syringoceles (cystic dilatation of the Cowper's gland), sequestration cysts, epidermoid and epithelial inclusion cysts. Male Urethral Diverticulum Having Multiple Stones. Mohanty D, Garg PK, ...

  5. [Urethroplasty with transection of urethral orifice and preservation and lengthening of urethral plate: highly applicable to the treatment of hypospadias].

    Science.gov (United States)

    Wang, Wen-Min; Qiu, Wei-Feng; Qian, Chong

    2010-07-01

    To explore the feasibility of urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate in the treatment of hypospadias. Forty-eight patients with hypospadias (18 of the coronal type, 21 the penile type, 8 the penoscrotal type and 1 the perineal type) underwent urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate. The surgical effects were observed by following up the patients for 3-27 months. One-stage surgical success was achieved in 44 of the cases, with satisfactory functional and cosmetic results but no complications. Two cases developed urinary fistula and another 2 urethral stricture, but all cured by the second surgery. Urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate is a simple, safe and effective surgical procedure for the treatment of hypospadias.

  6. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik

    2013-01-01

    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI). ...

  7. Congenital amusias.

    Science.gov (United States)

    Tillmann, B; Albouy, P; Caclin, A

    2015-01-01

    In contrast to the sophisticated music processing reported in the general population, individuals with congenital amusia show deficits in music perception and production. Congenital amusia occurs without brain damage, sensory or cognitive deficits, and has been suggested as a lifelong deficit with genetic origin. Even though recognized for a long time, this disorder has been systematically studied only relatively recently for its behavioral and neural correlates. The currently most investigated hypothesis about the underlying deficits concerns the pitch dimension, notably with impaired pitch discrimination and memory. Anatomic and functional investigations of pitch processing revealed that the amusic brain presents abnormalities in the auditory and inferior frontal cortices, associated with decreased connectivity between these structures. The deficit also impairs processing of pitch in speech material and processing of the time dimension in music for some of the amusic individuals, but does not seem to affect spatial processing. Some studies suggest at least partial dissociation in the disorder between perception and production. Recent studies revealed spared implicit pitch perception in congenital amusia, supporting the power of implicit cognition in the music domain. Current challenges consist in defining different subtypes of congenital amusia as well as developing rehabilitation programs for this "musical handicap." © 2015 Elsevier B.V. All rights reserved.

  8. Microscopy of Stained Urethral Smear in Male Urethritis; Which Cutoff Should be Used?

    Science.gov (United States)

    Moi, Harald; Hartgill, Usha; Skullerud, Kristin Helene; Reponen, Elina J; Syvertsen, Line; Moghaddam, Amir

    2017-03-01

    The microscopical diagnosis of male urethritis was recently questioned by Rietmeijer and Mettenbrink, lowering the diagnostic criteria of the diagnosis to ≥2 polymorphonuclear leucocytes (PMNL) per high power field (HPF), and adopted by Centers for Disease Control and Prevention in their 2015 STD Treatment Guidelines. The European Non-Gonococcal Urethritis Guideline advocates a limit of ≥5 PMNL/HPF. To determine if syndromic treatment of urethritis should be considered with a cutoff value of ≥2 PMNL/HPF in urethral smear. The design was a cross-sectional study investigating the presence and degree of urethritis relative to specific infections in men attending an STI clinic as drop-in patients. The material included 2 cohorts: a retrospective study of 13,295 men and a prospective controlled study including 356 men. We observed a mean chlamydia prevalence of 2.3% in the 0-9 stratum, and a 12-fold higher prevalence (27.3%) in the strata above 9. Of the chlamydia cases, 89.8% were diagnosed in strata above 9. For Mycoplasma genitalium, the prevalence was 1.4% in the 0-9 stratum and 11.2% in the stratum ≥10, and 83.6% were diagnosed in strata above 9. For gonorrhea, a significant increase in the prevalence occurred between the 0-30 strata and >30 strata from 0.2% to 20.7%. The results of the prospective study were similar. Our data do not support lowering the cutoff to ≥2 PMNL/HPF. However, a standardization of urethral smear microscopy seems to be impossible. The cutoff value should discriminate between low and high prevalence of chlamydia, mycoplasma, and gonorrhea to include as many as possible with a specific infection in syndromic treatment, without overtreating those with few PMNL/HPF and high possibility of having nonspecific or no urethritis.

  9. Impact of prior urethral manipulation on outcome of anastomotic urethroplasty for post-traumatic urethral stricture.

    Science.gov (United States)

    Singh, Bhupendra P; Andankar, Mukund G; Swain, Sanjaya K; Das, Krishanu; Dassi, Vimal; Kaswan, Harish K; Agrawal, Vipul; Pathak, Hemant R

    2010-01-01

    To determine the impact of earlier urethral interventions on the outcomes of anastomotic urethroplasty in post-traumatic stricture urethra. From October 1995 to March 2008, a total of 58 patients with post-traumatic posterior urethral stricture underwent anastomotic urethroplasty. Eighteen patients had earlier undergone urethral intervention in the form of urethrotomy (3), endoscopic realignment (7), or open urethroplasty (8). Success was defined as no obstructive urinary symptoms, maximum urine flow rate > or = 15 mL/s, normal urethral imaging and/or urethroscopy, and no need of any intervention in the follow-up period. Patients who met the above objective criteria after needing 1 urethrotomy following urethroplasty were defined to have satisfactory outcome and were included in satisfactory result rate along with patients who had a successful outcome. Results were analyzed using unpaired t test, chi-square test, binary logistic regression, Kaplan-Meier curves, and log rank test. Previous interventions in the form of endoscopic realignment or urethroplasty have significant adverse effect on the success rate of subsequent anastomotic urethroplasty for post-traumatic posterior urethral strictures (P urethrotomies (up to 2 times) did not affect the outcome of subsequent anastomotic urethroplasty. Length of stricture and age of patient did not predict the outcome in traumatic posterior urethral strictures in logistic regression analysis. Previous failed railroading or urethroplasty significantly decrease the success of subsequent anastomotic urethroplasty. Hence, a primary realignment or urethroplasty should be avoided in suboptimal conditions and the cases of post-traumatic urethral stricture should be referred to centers with such expertise. 2010 Elsevier Inc. All rights reserved.

  10. A Case of Urethral Duplication Arising from the Posterior Urethra to the Scrotum with Urinary Stone in a 6-Year-Old Male

    OpenAIRE

    Mori, Kenichi; Shin, Toshitaka; Tobu, Shohei; Noguchi, Mitsuru; Sumino, Yasuhiro; Sato, Fuminoi; Mimata, Hiromitsu

    2014-01-01

    Urethral duplication is a rare congenital anomaly. We report a 6-year-old male with type IIA2 (Y-type) using Effmann’s classification. The accessory urethra, in which a urinary stone existed, arose from the posterior urethra to the scrotum. Because of recurrent urinary tract infection and urinary discharge from the accessory urethra, surgical removal of the accessory urethra through a scrotal incision was performed. At 7-month postoperative follow-up the patient was completely free from urina...

  11. Genetics of Congenital Heart Disease: Past and Present.

    Science.gov (United States)

    Muntean, Iolanda; Togănel, Rodica; Benedek, Theodora

    2017-04-01

    Congenital heart disease is the most common congenital anomaly, representing an important cause of infant morbidity and mortality. Congenital heart disease represents a group of heart anomalies that include septal defects, valve defects, and outflow tract anomalies. The exact genetic, epigenetic, or environmental basis of congenital heart disease remains poorly understood, although the exact mechanism is likely multifactorial. However, the development of new technologies including copy number variants, single-nucleotide polymorphism, next-generation sequencing are accelerating the detection of genetic causes of heart anomalies. Recent studies suggest a role of small non-coding RNAs, micro RNA, in congenital heart disease. The recently described epigenetic factors have also been found to contribute to cardiac morphogenesis. In this review, we present past and recent genetic discoveries in congenital heart disease.

  12. Predictors for success of internal urethrotomy in patients with urethral contracture following perineal repair of pelvic fracture urethral injuries.

    Science.gov (United States)

    Hong, Young-Kwon; Choi, Kyung-Hwa; Lee, Young-Tae; Lee, Seung-Ryeol

    2017-05-01

    Internal urethrotomy (IU) in patients with urethral contracture following perineal repair of pelvic fracture urethral injuries (PRPFUI) is troublesome. We evaluated the clinical factors affecting the surgical outcome of IU for urethral contracture after PRPFUI. We retrospectively reviewed the records of 35 patients who underwent IU for urethral contracture after PRPFUI between March 2004 and June 2013. Ages of patients ranged from 18 to 50, and their follow-up duration was more than 1year after IU. The urethral contracture was confirmed by retrograde urethrogram or cysto-urethroscopy. Success was defined as greater than 15mL/s of peak urinary flow rate at 1year after IU without any clinical evidence of urethral contracture. Success rates were investigated according to the number of IU. Age, body mass index, urethral defect length before PRPFUI, time interval between the original urethral injury and the PRPFUI or between a previous operation and the PRPFUI, time interval between the PRPFUI and the urethral contracture, number of PRPFUI performed, and the type of urethral lengthening procedure were compared between patients with and without success according to the number of IU. Among the 35 patients, the overall success rate of IU was 37% (13/35) during the mean follow-up period of 53 months (range: 17-148 months). There were 8 and 5 patients with success in first and second IU, respectively. However, there was no success after third IU. Urethral defect length before PRPFUI was significantly shorter in patients with success who underwent first and second IU (p<0.05). There were significant differences of success between patients with and without previous repeated failures of PRPFUI in first and second IU (p<0.05). Short urethral defect length and no previous surgical failures before PRPFUI are good prognostic factors for IU following PRPFUI. Only one or two IUs will be helpful in patients with urethral contracture following PRPFUI. Copyright © 2017 Elsevier Ltd

  13. Management of non-gonococcal urethritis.

    Science.gov (United States)

    Moi, Harald; Blee, Karla; Horner, Patrick J

    2015-07-29

    Non-gonococcal urethritis (NGU), or inflammation of the urethra, is the most common treatable sexually transmitted syndrome in men, with approximately 20-50 % of cases being due to infection with Chlamydia trachomatis and 10-30 % Mycoplasma genitalium. Other causes are Ureaplasma urealyticum, Trichomonas vaginalis, anaerobes, Herpes simplex virus (HSV) and adenovirus. Up to half of the cases are non-specific. Urethritis is characterized by discharge, dysuria and/or urethral discomfort but may be asymptomatic. The diagnosis of urethritis is confirmed by demonstrating an excess of polymorpho-nuclear leucocytes (PMNLs) in a stained smear. An excess of mononuclear leucocytes in the smear indicates a viral etiology. In patients presenting with symptoms of urethritis, the diagnosis should be confirmed by microscopy of a stained smear, ruling out gonorrhea. Nucleid acid amplifications tests (NAAT) for Neisseria gonorrhoeae, C. trachomatis and for M. genitalium. If viral or protozoan aetiology is suspected, NAAT for HSV, adenovirus and T. vaginalis, if available. If marked symptoms and urethritis is confirmed, syndromic treatment should be given at the first appointment without waiting for the laboratory results. Treatment options are doxycycline 100 mg x 2 for one week or azithromycin 1 gram single dose or 1,5 gram distributed in five days. However, azithromycin as first line treatment without test of cure for M. genitalium and subsequent Moxifloxacin treatment of macrolide resistant strains will select and increase the macrolide resistant strains in the population. If positive for M. genitalium, test of cure samples should be collected no earlier than three weeks after start of treatment. If positive in test of cure, moxifloxacin 400 mg 7-14 days is indicated. Current partner(s) should be tested and treated with the same regimen. They should abstain from intercourse until both have completed treatment. Persistent or recurrent NGU must be confirmed with microscopy

  14. Defect in mitochondrial functions in damaged human mitral valve

    OpenAIRE

    Shinde, Santosh; Kumar, Pawan; Mishra, Kaushala; Patil, Neela

    2006-01-01

    Mitochondrial diseases are a heterogeneous group of disorders in which a primary mitochondrial dysfunction is proven by morphological, biochemical, and genetic examinations. The mitral valve has important function in the regulation of blood flow from one chamber to another. Often, the mitral valve becomes abnormal with age, in Rheumatic fever or it is abnormal from birth (Congenital) or it can be destroyed by infection i.e. bacterial endocarditis and needs replacement. Myocardial function dep...

  15. Transcatheter aortic valve replacement

    Science.gov (United States)

    ... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

  16. Evaluating the urethral closure mechanism after pelvic organ prolapse surgery

    DEFF Research Database (Denmark)

    Khayyami, Yasmine

    2017-01-01

    . By measuring urethral opening pressure at an abdominal pressure of 50 mmH2O (PO-Abd 50), it is the only method that has succeeded in distinguishing between women with and without SUI. The overall aim of this thesis was to evaluate the urethral closure mechanism before and after anterior and posterior......, the woman has occult SUI. However, only half of all women with occult SUI actually develop de novo SUI postoperatively and therefore, the usefulness of the test has been questioned. Studies investigating how POP reduction and POP surgery affect the urethral closure mechanism have used conventional urethral...... pressure profilometry, a method that has shown wide overlaps in the results of women with and without SUI. Urethral pressure reflectometry (UPR), a method that assesses the urethral closure mechanism by means of acoustic reflectometry, has proven highly reproducible in women with and without SUI...

  17. Urethral pressure reflectometry during intra-abdominal pressure increase—an improved technique to characterize the urethral closure function in continent and stress urinary incontinent women

    DEFF Research Database (Denmark)

    Saaby, Marie-Louise; Klarskov, Niels; Lose, Gunnar

    2013-01-01

    to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women.......to assess the urethral closure function by urethral pressure reflectometry (UPR) during intra-abdominal pressure-increase in SUI and continent women....

  18. Magnetically operated check valve

    Science.gov (United States)

    Morris, Brian G.; Bozeman, Richard J., Jr.

    1994-06-01

    A magnetically operated check valve is disclosed. The valve is comprised of a valve body and a movable poppet disposed therein. A magnet attracts the poppet to hold the valve shut until the force of fluid flow through the valve overcomes the magnetic attraction and moves the poppet to an unseated, open position. The poppet and magnet are configured and disposed to trap a magnetically attracted particulate and prevent it from flowing to a valve seating region.

  19. Recognition and Treatment of Nongonococcal Urethritis in Clinical Practice

    Science.gov (United States)

    Isiadinso, O. O. A.

    1980-01-01

    Nongonococcal urethritis is a relatively common disorder in sexually active individuals. The incidence is almost as high, if not higher, than gonorrhea. This syndrome may present with signs and symptoms indistinguishable from acute gonococcal urethritis. It is essential to differentiate the two diseases, as treatment protocols are different. Early recognition of nongonococcal urethritis and proper therapy will often lead to complete resolution and prevention of annoying complications. PMID:6999164

  20. Distributed pressure sensors for a urethral catheter.

    Science.gov (United States)

    Ahmadi, Mahdi; Rajamani, Rajesh; Timm, Gerald; Sezen, A S

    2015-01-01

    A flexible strip that incorporates multiple pressure sensors and is capable of being fixed to a urethral catheter is developed. The urethral catheter thus instrumented will be useful for measurement of pressure in a human urethra during urodynamic testing in a clinic. This would help diagnose the causes of urinary incontinence in patients. Capacitive pressure sensors are fabricated on a flexible polyimide-copper substrate using surface micromachining processes and alignment/assembly of the top and bottom portions of the sensor strip. The developed sensor strip is experimentally evaluated in an in vitro test rig using a pressure chamber. The sensor strip is shown to have adequate sensitivity and repeatability. While the calibration factors for the sensors on the strip vary from one sensor to another, even the least sensitive sensor has a resolution better than 0.1 psi.

  1. Adenocarcinoma arising in female urethral diverticulum

    International Nuclear Information System (INIS)

    Patanaphan, V.; Prempree, T.; Sewchand, W.; Hafiz, M.A.; Jaiwatana, J.

    1983-01-01

    Cancer arising from a female urethral diverticulum is rare, and because of its rarity, a review of the medical literature reveals significant nonuniformity in its management. We report an additional 2 cases of this disease, one of which has an even rarer feature of being mucin-producing. The management of our 2 cases is presented in detail and in line with the management of female urethral cancer. From our extensive literature search, diverticulectomy alone showed poor results with the highest rate of recurrence (67%). Extensive surgery, either in the form of cystourethrectomy or anterior exenteration, offered results comparable with those of combined therapy (diverticulectomy and full course of irradiation for early cases; preoperative irradiation followed by cystourethrectomy for late cases). Individualization of radiation treatment and cooperative effort between urologist and radiation oncologist are essential if best results are to be achieved

  2. Urethral anatomy and semen flow during ejaculation

    Science.gov (United States)

    Kelly, Diane

    2016-11-01

    Ejaculation is critical for reproductive success in many animals, but little is known about its hydrodynamics. In mammals, ejaculation pushes semen along the length of the penis through the urethra. Although the urethra also carries urine during micturition, the flow dynamics of micturition and ejaculation differ: semen is more viscous than urine, and the pressure that drives its flow is derived primarily from the rhythmic contractions of muscles at the base of the penis, which produce pulsatile rather than steady flow. In contrast, Johnston et al. (2014) describe a steady flow of semen through the crocodilian urethral groove during ejaculation. Anatomical differences of tissues associated with mammalian and crocodilian urethral structures may underlie these differences in flow behavior.

  3. Asymptomatic urethral lymphogranuloma venereum: a case report.

    Science.gov (United States)

    Charest, Louise; Fafard, Judith; Greenwald, Zoë R

    2018-07-01

    Since 2003, there has been a resurgence of lymphogranuloma venereum (LGV), a variant of Chlamydia trachomatis (CT), among men who have sex with men (MSM) in several urban areas of Europe and North America. LGV infection occurs most often at anal sites causing proctitis. Urethral and oropharyngeal infections are rare. In Quebec, LGV incidence has been increasing exponentially in recent years and the current guidelines support systematic LGV genotype testing among anorectal CT-positive samples only. This case report describes a patient with a urethral LGV infection, remarkable due to its prolonged asymptomatic development prior to the manifestation of an inguinal bubo. Physicians should be vigilant of potential cases of LGV and forward CT-positive samples occurring among individuals with LGV risk factors for genotype testing.

  4. What Is Heart Valve Surgery?

    Science.gov (United States)

    ... working correctly. Most valve replacements involve the aortic Tricuspid valve and mitral valves. The aortic valve separates ... where it shouldn’t. This is called incompetence, insufficiency or regurgitation. • Prolapse — mitral valve flaps don’t ...

  5. What Is Heart Valve Disease?

    Science.gov (United States)

    ... and replacing it with a man-made or biological valve. Biological valves are made from pig, cow, or human ... the valve. Man-made valves last longer than biological valves and usually don’t have to be ...

  6. Congenital Hydrocephalus.

    Science.gov (United States)

    Estey, Chelsie M

    2016-03-01

    There are several types of hydrocephalus, which are characterized based on the location of the cerebrospinal fluid (CSF) accumulation. Physical features of animals with congenital hydrocephalus may include a dome-shaped skull, persistent fontanelle, and bilateral ventrolateral strabismus. Medical therapy involves decreasing the production of CSF. The most common surgical treatment is placement of a ventriculoperitoneal shunt. Postoperative complications may include infection, blockage, drainage abnormalities, and mechanical failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Congenital diplopodia

    International Nuclear Information System (INIS)

    Brower, Jason S.; Wootton-Gorges, Sandra L.; Costouros, John G.; Boakes, Jennette; Greenspan, Adam

    2003-01-01

    Diplopodia, or duplicated foot, is a rare congenital anomaly. It differs from polydactyly in that supernumerary metatarsal and tarsal bones are present as well as extra digits. Only a few cases of this anomaly have been reported in the literature to date. We present a newborn male without intrauterine teratogen exposure who was born with a duplicate foot of the left lower extremity and imperforate anus. (orig.)

  8. Calculi in a Female Urethral Diverticulum

    Directory of Open Access Journals (Sweden)

    Ji Sung Shim

    2011-03-01

    Full Text Available Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. The case of a 52-year-old woman presented, who consulted for weak stream associated with repeated urinary infections. The diverticulum was approached via vaginal route and the extraction was successful. The patient has been well, with no dysuria, dyspareunia, incontinence for 3-month follow-ups.

  9. Polypoidal Intestinal Metaplasia and Dysplasia of the External Urethral Meatus

    Directory of Open Access Journals (Sweden)

    Mary Mathew

    2012-01-01

    Full Text Available Urethral mucosa with intestinal metaplasia and dysplasia is a rare occurrence. To date only a single case has been reported in a male with long-standing urethral stricture. We present a 33-year-old female with polypoid intestinal metaplasia and dysplasia of the external urethral meatus in the absence of an inciting factor. Intestinal metaplasia of the urethral mucosa may undergo dysplasia, emphasizing the necessity of a high degree of clinical suspicion and vigilant pathological examination of these lesions.

  10. Congenital toxoplasmosis.

    Science.gov (United States)

    Kieffer, François; Wallon, Martine

    2013-01-01

    Congenital toxoplasmosis results from the transplacental transmission of the parasite Toxoplasma gondii after a maternal infection acquired in pregnancy. Prevalence of congenital infection ranges from 0.1 to 0.3 per 1000 live births. The maternal-fetal transmission rate increases with gestational age at maternal seroconversion, from less than 15% at 13 weeks of gestation to over 70% at 36 weeks. Conversely, the later the maternal infection, the lower the risk of symptomatic congenital infection (infections acquired during the third trimester are most often asymptomatic at birth). Prenatal diagnosis is currently performed by PCR analysis in amniotic fluid. Antenatal management and treatment vary considerably among countries. In some European countries, maternal infections are detected through serological screening allowing a prompt treatment with spiramycin, which is expected to reduce the risk of vertical transmission. If PCR analysis in amniotic fluid is positive or if maternal infection was acquired in the third trimester of pregnancy, a combination with pyrimethamine and sulphonamide is given until delivery. Benefits of antenatal treatments remain controversial. Infected newborns are prescribed pyrimethamine and sulphonamide for 12 months. Despite antenatal and postnatal treatment, chorioretinitis can occur at any age (prevalence>20% at 10 years of age): long-term ophthalmological follow-up remains necessary. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Balloon catheter dilatation of benign urethral strictures

    International Nuclear Information System (INIS)

    Perini, L.; Cavallo, A.; Perin, B.; Bighi, G.

    1988-01-01

    The authors report their experience of benign urethral stricture dilatation by balloon catheter in 11 male patients. Ten posterior and 2 anterior urethral strictures were treated; in 1 patients several narrowings coexisted at various levels. Etiology was inflammatory in 4 cases, iatrogen in 3, post-traumatic in 2, and equivocal in 2. The patients were studied both before and soon after dilatation by means of retrograde and voiding cystourethrogram and uroflowgraphy; the follow-up (2-14 months) was performed by urodynamic alone. In all cases, dilatation was followed by the restoration of urethral gauge, together with prompt functional improvement of urodynamic parameters. The latter result subsisted in time in 9 patients. In 2 cases recurrences were observed demonstrated at once by clinics and urodynamics. Both lesions were successfully re-treated. Neither early not late complication occurred. In spite of the limited material, the valuable results obtained, together with the absence of complications, the peculiar morphology of recurrences, and the chance of repeating it make the procedure advisable as a valid alternative to conventional techniques for these pathologies

  12. Urethral Foreign Body: A Case report

    Directory of Open Access Journals (Sweden)

    Ozgur Enginyurt

    2013-03-01

    Full Text Available Urethral insertion of foreign bodies is not very common. It is often associated with psychological problems and sexual alerts. In men due to the longer urethra this situation remains generally limited to the urethra, in women due to the short urethra foreign body can pass to the bladder. 40 years old, mentally retarded male patient was admitted to the emergency department with a complaint of urethrorrhagia. Physical examination revealed needle like structure in the urethra. The patient was taken into the operating room and under general anestesia by using cysto panendoscopy the foreign body has been identified as an old syringe needle, foreign body was removed with the help of forceps. Endoscopic methods should be utilized for the realization of the diagnosis and treatment of urethral foreign bodies. Foreign body in the urethra is usually encountered in patients with psychiatric disorders. For this reason, a detailed psychiatric evaluation is important in patients with urethral foreign bodies. [J Contemp Med 2013; 3(1.000: 62-65

  13. Concomitant urethral triplication, bladder, and colon duplication.

    Science.gov (United States)

    Tourchi, Ali; Kajbafzadeh, Abdol-Mohammad; Khakpour, Mahshid; Mohammadi Nejad, Payam; Mousavian, Amir-Abbas; Kalantary, Mahdi

    2012-02-01

    The concomitant presence of urethral triplication and caudal duplication is extremely rare with no previous reported cases. We report a case of urethral triplication associated with bladder, sigmoid, and rectum duplication. The patient was initially referred with a history of fecaluria and recurrent urinary tract infection. Physical examination revealed 2 meatal opening on the glans penis. Further investigation revealed three distinct urinary streams, two terminating on the glans penis, and one in the rectum in voiding cystourethrography and retrograde urethrography. Computed tomography demonstrated the bladder divided into two compartments by a complete sagittal septum. The patient was managed by the excision of the rectal ending urethra and removal of the bladder sagittal septum during which, two sigmoidal and rectal segments (the right one filled with fecal) were revealed. The right sigmoid and rectum was resected. The two ventral urethras were kept intact. The postoperative course was uneventful. At his 4 month readmission for colostomy closure, the patient reported good urethral voiding with no complication and recurrence of urinary tract infection and the colostomy was closed with no major complication.

  14. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    OpenAIRE

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-01-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed...

  15. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture.

    Science.gov (United States)

    Fukui, Shinji; Aoki, Katsuya; Kaneko, Yoshiteru; Samma, Shoji; Fujimoto, Kiyohide

    2014-05-01

    A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  16. Ureteral valve masquerading as obstructive megaureter

    Directory of Open Access Journals (Sweden)

    Sushmita Bhatnagar

    2017-05-01

    Full Text Available Primary obstructed megaureter is a common urological condition in the pediatric age group. It is one of the differentials for congenital anomalies of the kidney and urinary tract that include a myriad of structural anomalies of the urinary tract. The obstructive conditions are usually managed conservatively unless there is deterioration in renal function, repeated urinary tract infection, or any other symptom such as abdominal pain on ipsilateral side and hypertension. Presented here is a case of left lower ureteral valve that was diagnosed as primary obstructed megaureter with pain in abdomen and reduced ipsilateral renal function wherein ureteral valve was detected incidentally intraoperatively. Excision of the valve with end to end uretero-ureteral anastomoses over a D-J stent, without resorting to ureteric reimplantation was successful in relieving the obstruction and hydronephrosis

  17. Pulmonary valve endocarditis associated to a septal interventricular defect and infundibular and pulmonary valve Stenosis

    International Nuclear Information System (INIS)

    Echeverri, Juan G; Diaz, Alejandro; Jaramillo, Nicolas; Gonzalez, Sergio

    2004-01-01

    Ventricular septal defects generate 10% of all adult congenital cardiopathies. 4% to 8% of patients to whom the defect has not been corrected are in risk of developing endocarditis. Pulmonary valve endocarditis is a rare event (1.5% to 2% of all endocarditis cases) and its mean etiology is intravenous drug abuse. The most frequently isolated microorganism in these cases is staphylococcus aurous. We report a case of pulmonary valve endocarditis associated with ventricular septal defect and valvular and infundibular pulmonary stenosis caused by streptococcus sp. in a patient without past medical history of drug abuse, alcoholism or previous invasive procedures

  18. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry.

    Science.gov (United States)

    Saaby, Marie-Louise

    2014-02-01

    Stress urinary incontinence (SUI) occurs when the bladder pressure exceeds the urethral pressure in connection with physical effort or exertion or when sneezing or coughing and depends both on the strength of the urethral closure function and the abdominal pressure to which it is subjected. The urethral closure function in continent women and the dysfunction causing SUI are not known in details. The currently accepted view is based on the concept of a sphincteric unit and a support system. Our incomplete knowledge relates to the complexity of the closure apparatus and to inadequate assessment methods which so far have not provided robust urodynamic diagnostic tools, severity measures, or parameters to assess outcome after intervention. Urethral Pressure Reflectometry (UPR) is a novel method that measures the urethral pressure and cross-sectional area (by use of sound waves) simultaneously. The technique involves insertion of only a small, light and flexible polyurethane bag in the urethra and therefore avoids the common artifacts encountered with conventional methods. The UPR parameters can be obtained at a specific site of the urethra, e.g. the high pressure zone, and during various circumstances, i.e. resting and squeezing. During the study period, we advanced the UPR technique to enable faster measurement (within 7 seconds by the continuous technique) which allowed assessment during increased intra-abdominal pressure induced by physical straining. We investigated the urethral closure function in continent and SUI women during resting and straining by the "fast" UPR technique. Thereby new promising urethral parameters were provided that allowed characterization of the closure function based on the permanent closure forces (primarily generated by the sphincteric unit, measured by the Po-rest) and the adjunctive closure forces (primarily generated by the support system, measured by the abdominal to urethral pressure impact ratio (APIR)). The new parameters enabled

  19. Microfluidic sieve valves

    Science.gov (United States)

    Quake, Stephen R; Marcus, Joshua S; Hansen, Carl L

    2015-01-13

    Sieve valves for use in microfluidic device are provided. The valves are useful for impeding the flow of particles, such as chromatography beads or cells, in a microfluidic channel while allowing liquid solution to pass through the valve. The valves find particular use in making microfluidic chromatography modules.

  20. Rotary pneumatic valve

    Science.gov (United States)

    Hardee, Harry C.

    1991-01-01

    A rotary pneumatic valve which is thrust balanced and the pneumatic pressure developed produces only radial loads on the valve cylinder producing negligible resistance and thus minimal torque on the bearings of the valve. The valve is multiplexed such that at least two complete switching cycles occur for each revolution of the cylinder spindle.

  1. Mitral Valve Stenosis

    Science.gov (United States)

    ... the left ventricle from flowing backward. A defective heart valve fails to either open or close fully. Risk factors Mitral valve stenosis is less common today than it once was because the most common cause, ... other heart valve problems, mitral valve stenosis can strain your ...

  2. Aortic Valve Stenosis

    Science.gov (United States)

    ... most cases, doctors don't know why a heart valve fails to develop properly, so it isn't something you could have prevented. Calcium buildup on the valve. With age, heart valves may accumulate deposits of calcium (aortic valve ...

  3. Remote actuated valve implant

    Science.gov (United States)

    McKnight, Timothy E; Johnson, Anthony; Moise, Jr., Kenneth J; Ericson, Milton Nance; Baba, Justin S; Wilgen, John B; Evans, III, Boyd McCutchen

    2014-02-25

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  4. Congenital syphilis

    International Nuclear Information System (INIS)

    Lee, Sang Wook; Kim, Kyung Soo; Hur, Don

    1983-01-01

    In recent years, marked increase in incidence of congenital syphilis has occurred throughout the world due to changes in social norms and development of penicillin-resistant strains. Early diagnosis plays an important role in congenital syphilis as the clinical manifestations may simulate many other conditions in the paediatric age group. The authors analyzed 52 cases of congenital syphilis admitted to the department of paediatrics, Chosun University Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 cases were admitted from OPD, during the period of 8 years from January, 1975 to December, 1982. The results obtained were as follows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Among the 52 cases, a male predominance was observed with a male to female ratio of 2 : 1. 3. The serologic test (VDRL) of the 52 studied cases showed reactive response in 49 cases (94%), and that of syphilitic mothers except 6 cases, reactive in all studied cases. 4. The major manifestations of the 52 cases were bone tenderness (12%) and swelling of the joints (7%) in skeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. The radiological skeletal changes were detected in 45 of 52 cases (87%), and the commonest findings were detected in 45 of 52 cases (87%), and the commonest findings were metaphysitis (83%) and periostitis (81%). The most characteristic type of metaphysitis were transverse trophic line (74%) and zone of rarefaction (65%). 6. The commonest bones to be affected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order of frequency were radius (80%), uina (80%), tibia (77%), femur (69%) and humerus (40%)

  5. Scissor thrust valve actuator

    Science.gov (United States)

    DeWall, Kevin G.; Watkins, John C; Nitzel, Michael E.

    2006-08-29

    Apparatus for actuating a valve includes a support frame and at least one valve driving linkage arm, one end of which is rotatably connected to a valve stem of the valve and the other end of which is rotatably connected to a screw block. A motor connected to the frame is operatively connected to a motor driven shaft which is in threaded screw driving relationship with the screw block. The motor rotates the motor driven shaft which drives translational movement of the screw block which drives rotatable movement of the valve driving linkage arm which drives translational movement of the valve stem. The valve actuator may further include a sensory control element disposed in operative relationship with the valve stem, the sensory control element being adapted to provide control over the position of the valve stem by at least sensing the travel and/or position of the valve stem.

  6. Clinical presentation and treatment of urethral stricture: Experience ...

    African Journals Online (AJOL)

    O.N. Ekeke

    2016-08-23

    Aug 23, 2016 ... demography, aetiology, site, treatment and outcome of treatment of USD were collated and analyzed using. SPSS 20.0. Results: ... Eighty two patients (42.27%) had anterior urethral stricture; while 78 (40.20%) had posterior urethral strictures. ..... to leave a catheter and, if so, for what duration [34,4,35–37] in.

  7. Visual Internal Urethrotomy in the Management of Anterior Urethral ...

    African Journals Online (AJOL)

    Objective: Urethral stricture disease is common in our environment. The aim of this study is to report our experience with visual internal urethrotomy (VIU) in the management of this disease. Patients and Methods: Seventy male patients with a mean age of 30.6 years were treated for anterior urethral stricture by VIU at the Jos ...

  8. A descriptive study of urethral discharge among men in Fiji.

    Science.gov (United States)

    Gaunavinaka, Lavenia; Balak, Dashika; Varman, Sumanthla; Ram, Sharan; Graham, Stephen M

    2014-10-17

    Urethral discharge is a common presentation of sexually transmitted infection (STI) in men and known pathogens include Neisseria gonorrhoeae and Chlamydia trachomatis. There are no published data of the burden of urethral discharge among men in Fiji. To evaluate urethral discharge among men to determine the incidence, the frequency of recurrence and reported at-risk behaviour. We conducted a retrospective, descriptive study of clinical records of all men presenting with urethral discharge to two major reproductive health clinics. Data collected included self-reported at-risk behaviours, results of abnormal syphilis serology and antibiotics prescribed. The frequency of recurrence in the following 1-2 years of initial presentation was determined along with microbiological findings from urethral swab in this group. A total of 748 males presented with urethral discharge to the clinic in one year. This represents an incidence rate of at least 295 per 100,000 adult males per year in the study population. Within the next 1-2 years of the initial presentation, 102 (14%) of these re-presented out of which 42 had urethral swab taken for etiological diagnosis. The commonest isolate was Neisseria gonorrhoeae. Results of syphilis tests were available for 560 (75%) of patients and 29 (5%) were positive. Recurrence was not associated with self-reported at-risk behaviours. The incidence of urethral discharge among males in Fiji is very high and prevention strategies are urgently needed.

  9. Fiber types in the striated urethral and anal sphincters

    DEFF Research Database (Denmark)

    Schrøder, H D; Reske-Nielsen, E

    1983-01-01

    Seven normal human striated urethral and anal sphincters obtained by autopsy were examined using histochemical techniques. In both the urethral sphincter and the subcutaneous (s.c.) and superficial part of the anal sphincter a characteristic pattern with two populations of muscle fibers, abundant...

  10. Female Urethral Anomalies in Pediatric Age Group: Uncovered

    African Journals Online (AJOL)

    Urogenital sinus in females (ectopia of the external urethral opening in the urogenital sinus). All the variants of female hypospadias must be surgically corrected as transposition of the external opening of the urethra from the vagina on the perineum under the clitoris in chronic urethritis. The second case mentioned above.

  11. Urethritis due to corynebacterium striatum: An emerging germ.

    Science.gov (United States)

    Frikh, Mohammed; El Yaagoubi, Imad; Lemnouer, Abdelhay; Elouennass, Mostafa

    2015-01-01

    Corynedbacterium striatum (CS) is a Gram-positive coryneform bacillus that is part of mucous and skin flora. It has been considered as a causative agent of many infections in intensive care, neurology, traumatology and urology, but was never implicated in non-gonococcal urethritis. We report the case of a nosocomial urethritis due to Corynebacterium striatum following resection of an intrameatus condyloma.

  12. Transurethral incision of urethral diverticulum in the female

    DEFF Research Database (Denmark)

    Miskowiak, J; Honnens de Lichtenberg, M

    1989-01-01

    A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time.......A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time....

  13. Gonococcal Conjunctivitis Despite Successful Treatment of Male Urethritis Syndrome.

    Science.gov (United States)

    Peters, Remco P H; Verweij, Stephan P; McIntyre, James A; Schaftenaar, Erik

    2016-02-01

    We report a case of progressive, cephalosporin-susceptible, Neisseria gonorrhoeae conjunctivitis despite successful treatment of male urethritis syndrome. We hypothesize that conjunctival infection progressed due to insufficient penetration of cefixime and azithromycin and point out that extragenital infection and male urethritis may not be cured simultaneously in settings where the syndromic approach is used.

  14. Treatment of Acute Uncomplicated Gonococcal Urethritis in Males by Rosoxacin

    Directory of Open Access Journals (Sweden)

    A N Tiwari

    1986-01-01

    Full Text Available Twenty eight male patients with acute gonococcal, urethritis were treated, with rosoxacin 300 mg capsule, (Eradacil as a single- dose oral therapy. Twenty six patients were cured, while two patients did not improve. Four patients developed post-gonococcal urethritis (PGU.

  15. Original article Urethral Stricture and HIV: Unusual Presentations ...

    African Journals Online (AJOL)

    mn

    cause of urethral stricture in this series was traumatic injury The other important cause was post-inflammatory (after gonococcal urethritis) with HIV co-infection. These patients posed a challenge due to our lack of experience and the absence of literature guidelines on the optimal management. The first unusual feature in the ...

  16. Epidemiology of urethral stricture at Tygerberg Hospital | Steenkamp ...

    African Journals Online (AJOL)

    Over a 12-month period, 120 consecutive male patients with confirmed urethral stricture were prospectively studied with regard to the epidemiology of the disease. Specific urethritis is the main aetiological factor (45%) and internal and external trauma account for an alarming 38,3% of cases. The prevalence is highest ...

  17. Results of surgical excision of urethral prolapse in symptomatic patients.

    Science.gov (United States)

    Hall, Mary E; Oyesanya, Tola; Cameron, Anne P

    2017-11-01

    Here, we present the clinical presentation and surgical outcomes of women with symptomatic urethral prolapse presenting to our institution over 20 years, and seek to provide treatment recommendations for management of symptomatic urethral prolapse and caruncle. A retrospective review of medical records from female patients who underwent surgery for symptomatic urethral prolapse from June 1995 to August 2015 was performed. Surgical technique consisted of a four-quadrant excisional approach for repair of urethral prolapse. A total of 26 patients were identified with a mean age of 38.8 years (range 3-81). The most common presentations were vaginal bleeding, hematuria, pain, and dysuria. All patients underwent surgical excision of urethral prolapse via a standard approach. Follow-up data was available in 24 patients. Six patients experienced temporary postoperative bleeding, and one patient required placement of a Foley catheter for tamponade. One patient experienced temporary postoperative urinary retention requiring Foley catheter placement. Three patients had visible recurrence of urethral prolapse, for which one later underwent re-excision. Surgical excision of urethral prolapse is a reasonable treatment option in patients who have tried conservative management without relief, as well as in those who present with severe symptoms. Possible complications following excision include postoperative bleeding and recurrence, and patients must be counseled accordingly. In this work, we propose a treatment algorithm for symptomatic urethral prolapse. © 2017 Wiley Periodicals, Inc.

  18. Direct vision internal urethrotomy in 459 urethral stricture patients at ...

    African Journals Online (AJOL)

    Four hundred and fifty nine patients seen with simple urethral strictures between 1990 and 1998 underwent direct vision urethrotomy.. The procedure was successful in 441 patients and failed in only 18 patients. Postoperative complications included fever in 31 patients, urethral bleeding in 14 and epididymitis in 17 patients.

  19. Direct vision internal urethrotomy in 459 urethral stricture patients at ...

    African Journals Online (AJOL)

    Keywords: Direct vision, internal, urethrotomy, urethral and stricture.;. Four hundred and fifty nine patients seen with simple urethral strictures between 1990 and 1998 underwent direct vision urethrotomy.. The procedure was successful in 441 patients and failed in only 18 patients. Postoperative complications included fever.

  20. Delayed primary realignment of posterior urethral rupture | Shittu ...

    African Journals Online (AJOL)

    The treatment of acute posterior urethral rupture is controversial. Twelve patients who presented with acute posterior urethral rupture over a five--year period were treated by delayed primary realignment of the injury. The technique of this procedure and the outcome are the subject of this presentation. Eight patients had ...

  1. Urethral Stricture as seen in Dar es Salaam, Tanzania.

    African Journals Online (AJOL)

    dell

    urethritis have increasingly been incriminated as a major etiological factor of inflammatory urethral stricture especially in the developed world. Organisms which fall in this group include. Ureaplasma (T-strain), Mycoplasma, Trichomonas vaginalis, Candida albicans, and Haemophilus vaginalis, Herpes simplex virus type II, ...

  2. Dorsolateral onlay urethroplasty for anterior urethral strictures by a unilateral urethral mobilization approach.

    Science.gov (United States)

    Singh, Bhupendra P; Pathak, Hemant R; Andankar, Mukund G

    2009-04-01

    For management of long segment anterior urethral stricture, dorsal onlay urethroplasty is currently the most favored single-stage procedure. Conventional dorsal onlay urethroplasty requires circumferential mobilization of the urethra, which might cause ischemia of the urethra in addition to chordee. To determine the feasibility and short-term outcomes of applying a dorsolateral free graft to treat anterior urethral stricture by unilateral urethral mobilization through a perineal approach. A prospective study from September 2005 to March 2008 in a tertiary care teaching hospital. Seventeen patients with long or multiple strictures of the anterior urethra were treated by a dorsolateral free buccal mucosa graft. The pendulous urethra was accessed by penile eversion through the perineal wound. The urethra was not separated from the corporal bodies on one side and was only mobilized from the midline on the ventral aspect to beyond the midline on the dorsal aspect. The urethra was opened in the dorsal midline over the stricture. The buccal mucosa graft was secured on the ventral tunica of the corporal bodies. Mean and median. After a follow-up of 12-30 months, one recurrence developed and 1 patient needed an internal urethrotomy. A unilateral urethral mobilization approach for dorsolateral free graft urethroplasty is feasible for panurethral strictures of any length with good short-term success.

  3. Pathogenetic Basis of Aortopathy and Aortic Valve Disease

    Science.gov (United States)

    2018-02-19

    Aortopathies; Thoracic Aortic Aneurysm; Aortic Valve Disease; Thoracic Aortic Disease; Thoracic Aortic Dissection; Thoracic Aortic Rupture; Ascending Aortic Disease; Descending Aortic Disease; Ascending Aortic Aneurysm; Descending Aortic Aneurysm; Marfan Syndrome; Loeys-Dietz Syndrome; Ehlers-Danlos Syndrome; Shprintzen-Goldberg Syndrome; Turner Syndrome; PHACE Syndrome; Autosomal Recessive Cutis Laxa; Congenital Contractural Arachnodactyly; Arterial Tortuosity Syndrome

  4. The effect of penile urethral fat graft application on urethral angiogenesis.

    Science.gov (United States)

    Cakmak, M; Yazıcı, I; Boybeyi, O; Ayva, S; Aslan, M K; Senyucel, M F; Soyer, T

    2015-10-01

    Autologous fat grafts are rich in adipose-derived stem cells, providing optimal soft-tissue replacement and significant quantities of angiogenic growth factor. Although fat grafts (FG) are used in several clinical conditions, the use of FG in urethral repairs and the effects of FG to urethral repairs have not yet been reported. An experimental study was performed to evaluate the effect of FG on urethral angiogenesis and tissue growth factor (GF) levels. Sixteen Wistar albino, adult, male rats were allocated into two groups: the control group (CG) (n = 8) and the experiment group (EG) (n = 8). After anesthetization of all rats, 3-mm vertical incisions were made on the urethras, and then sutured with interrupted 5/0 vicryl sutures. The operations were performed under a stereo dissecting microscope under magnification (×20). In the CG, no additional procedure was performed. In the EG after the same surgical procedure, 1 mm(3) FG was removed from the inguinal region by sharp dissection with a knife. The grafts were trimmed to 1 × 1 mm dimensions on millimeter paper. The FGs were placed on the repaired urethras. The skin was then closed. Samples from urethral and penile skin were taken 21 days after surgery in both groups. Density and intensity of staining with vascular-endothelial GF (VEGF), VEGF-receptor, and endothelial-GF receptor (EGFR) in the endothelial and mesenchymal cells of the penile urethral vessels were immunohistochemically evaluated. Data obtained from immunohistochemical evaluations were analyzed with SPSS 15.0. The P-values lower than 0.05 were considered as significant. Density of VEGF staining was significantly decreased in the vascular endothelium of the EG compared to the CG (P factor levels, which is contrary to the literature data. Fat grafting has an immunohistochemical effect on the growth factor levels that are related to angiogenesis after urethral repair. It is difficult to make a firm conclusion about the role of fat grafting on urethral

  5. Repair of Double Orifice Left AV Valve (DOLAVV with Endocardial Cushion Defect in Adult

    Directory of Open Access Journals (Sweden)

    Vivek Velayudhan Pillai

    Full Text Available Abstract Double orifice left atrioventricular valve (DOLAVV or double orifice mitral valve (DOMV is a rare congenital cardiac anomaly manifesting either as an isolated lesion (mitral stenosis or mitral insufficiency or in association with other congenital cardiac defects. Signs of mitral valve disease are usually present along with the symptoms of associated coexistent congenital heart diseases. Mitral insufficiency due to annular dilatation is seen when DOLAVV is associated with endocardial cushion defects. Surgical intervention like mitral valve repair or replacement is required in 50% of patients and yields good results. We report a case of a 56-year-old lady who successfully underwent surgical correction of DOLAVV with partial atrioventricular canal defect.

  6. In vivo measurement of urethral dose profiles

    International Nuclear Information System (INIS)

    Toye, W.C.; Royal Melbourne Institute of Technology,; Duchesne, G.M.; Das, K.R.; Cee, A.; Mameghan, H.; Johnston, P.N.

    2001-01-01

    Full text: Quality assurance becomes a critical requirement when radiographs are routinely used in planning of treatments. In HDR prostate brachytherapy, the surrounding organs at risk of complications are the bladder and the rectum. However, of particular concern is the urethra that runs centrally through the prostate gland, as an unavoidably high dose can occur in the central region in order to achieve a minimum peripheral dose to a small target volume. Although high urethral doses have previously been related to increased urinary symptoms, some recent studies have not found such a correlation. The aim of this study was firstly, to identify dosimetric indicators of urethral morbidity following HDR prostate brachytherapy (4F x of 5.0 Gy), and secondly, to test the validity of calculated dose values. The in vivo measurements utilised a TLD (LiF:Mg,Ti) train formed by loading eight TLD rods alternating with 1,0 cm brass spacers into a fine plastic flexible tube. The length and diameter of plastic tubing was approximately 45cm and 0.15cm respectively, while the train length was 11.8 cm from the tip of the tube. The TLD train was placed into the central lumen of an 18 F three-way urethral catheter prior to its insertion. Significant urinary morbidity was defined prospectively as a score of a total of 3 or more points for severity from 5 symptoms categories. The five symptoms evaluated were hesitancy, frequency/nocturia, dysuria, haematuria and incontinence. The introduction of in vivo measurements to enhance the existing dosimetric analysis may be required to fully test the quantitative relationships (e.g. dose-volume ratios). Placement of TLDs within the urethra results in measurements whose accuracy is unaffected by internal organ motion as the hollow urethra must move with the prostate. The dose recorded by the TLDs is determined independently of the predictive algorithm used by the treatment planning system, and prostate location errors (e.g. due to image

  7. Large Cluster of Neisseria meningitidis Urethritis in Columbus, Ohio, 2015.

    Science.gov (United States)

    Bazan, Jose A; Turner, Abigail Norris; Kirkcaldy, Robert D; Retchless, Adam C; Kretz, Cecilia B; Briere, Elizabeth; Tzeng, Yih-Ling; Stephens, David S; Maierhofer, Courtney; Del Rio, Carlos; Abrams, A Jeanine; Trees, David L; Ervin, Melissa; Licon, Denisse B; Fields, Karen S; Roberts, Mysheika Williams; Dennison, Amanda; Wang, Xin

    2017-07-01

    Neisseria meningitidis (Nm) is a Gram-negative diplococcus that normally colonizes the nasopharynx and rarely infects the urogenital tract. On Gram stain of urethral exudates, Nm can be misidentified as the more common sexually transmitted pathogen Neisseria gonorrhoeae. In response to a large increase in cases of Nm urethritis identified among men presenting for screening at a sexually transmitted disease clinic in Columbus, Ohio, we investigated the epidemiologic characteristics of men with Nm urethritis and the molecular and phylogenetic characteristics of their Nm isolates. The study was conducted between 1 January and 18 November 2015. Seventy-five Nm urethritis cases were confirmed by biochemical and polymerase chain reaction testing. Men with Nm urethritis were a median age of 31 years (interquartile range [IQR] = 24-38) and had a median of 2 sex partners in the last 3 months (IQR = 1-3). Nm cases were predominantly black (81%) and heterosexual (99%). Most had urethral discharge (91%), reported oral sex with a female in the last 12 months (96%), and were treated with a ceftriaxone-based regimen (95%). A minority (15%) also had urethral chlamydia coinfection. All urethral Nm isolates were nongroupable, ST-11 clonal complex (cc11), ET-15, and clustered together phylogenetically. Urethral Nm isolates were similar by fine typing (PorA P1.5-1,10-8, PorB 2-2, FetA F3-6), except 2, which had different PorB types (2-78 and 2-52). Between January and November 2015, 75 urethritis cases due to a distinct Nm clade occurred among primarily black, heterosexual men in Columbus, Ohio. Future urogenital Nm infection studies should focus on pathogenesis and modes of sexual transmission. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  8. Haemophilus parainfluenzae urethritis among homosexual men.

    Science.gov (United States)

    Hsu, Meng-Shiuan; Wu, Mei-Yu; Lin, Tsui-Hsien; Liao, Chun-Hsing

    2015-08-01

    Haemophilus parainfluenzae is a common inhabitant of the human upper respiratory tract of the normal oral microflora. We report three men who had been having unprotected sex with men (MSM) and subsequently acquired H. parainfluenzae urethritis, which was confirmed by 16S rRNA gene sequencing analysis. Two men were treated with ceftriaxone and doxycycline, and the third man was treated with clarithromycin. All three patients responded to treatment. This case series highlights the potential role of H. parainfluenzae as a sexually transmitted genitourinary pathogen. Copyright © 2012. Published by Elsevier B.V.

  9. Mycoplasmas and Non-gonococcal Urethritis

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1989-01-01

    Full Text Available A total of 692 heterosexual males which included 130 men with non-gonoccal urethritis (NGU and 562 age-matched controls, were studied. Mycoplasmas were cultivated in liquid PPLO medium tubes containing arionine and urea. Mycoplasmas were isolated in 24 (18.59o of the 130 patients and 76 (13.60/o of the 562 controls. Ureaplasma urealyticum was isolated in 18 (13.9% gatients with NGU and in 21 (3.8% controls. Mycoplasma hominiq was isolated in 6 (4.6% patientuft NGU and in 55 (9.8% controls. Ureaplasma urealyticurm has a definite in NGU.

  10. Urethral catheters: can we reduce use?

    Directory of Open Access Journals (Sweden)

    van den Akker-van Marle M Elske

    2011-05-01

    Full Text Available Abstract Background Indwelling urinary catheters are the main cause of healthcare-associated urinary tract infections. It can be expected that reduction of the use of urinary catheters will lead to decreased numbers of urinary tract infection. Methods The efficacy of an intervention programme to improve adherence to recommendations to reduce the use of urethral catheters was studied in a before-after comparison in ten Dutch hospitals. The programme detected barriers and facilitators and each individual facility was supported with developing their own intervention strategy. Outcome was evaluated by the prevalence of catheters, alternatives such as diapers, numbers of urinary tract infections, the percentage of correct indications and the duration of catheterization. The costs of the implementation as well as the catheterization were evaluated. Results Of a population of 16,495 hospitalized patients 3335 patients of whom 2943 were evaluable for the study, had a urethral catheter. The prevalence of urethral catheters decreased insignificantly in neurology (OR 0.93; 95% CI 0.77 - 1.13 and internal medicine wards (OR 0.97; 95% CI 0.83 - 1.13, decreased significantly in surgical wards (OR 0.84; 95% CI 0.75 - 0.96, but increased significantly in intensive care (IC and coronary care (CC units (OR 1.48; 95% CI 1.01 - 2.17. The use of alternatives was limited and remained so after the intervention. Duration of catheterization decreased insignificantly in IC/CC units (ratio after/before 0.95; 95% CI 0.78 - 1.16 and neurology (ratio 0.97; 95% CI 0.80 - 1.18 and significantly in internal medicine (ratio 0.81; 95% CI 0.69 - 0.96 and surgery wards (ratio 0.80; 95% CI 0.71 - 0.90. The percentage of correct indications on the day of inclusion increased from 50 to 67% (p Conclusion Targeted implementation of recommendations from an existing guideline can lead to better adherence and cost savings. Especially, hospitals which use a lot of urethral catheters or

  11. Aetiology of male urethritis in patients recruited from a population with a high HIV prevalence.

    NARCIS (Netherlands)

    Sturm, P.D.J.; Moodley, P.; Khan, N.; Ebrahim, S.; Govender, K.; Connolly, C.E.; Sturm, A.W.

    2004-01-01

    The aetiology of urethritis, the significance of potential pathogens and the relation of urethritis to HIV infection were determined in 335 men (cases) with and 100 men (controls) without urethral symptoms. Urethral swab specimens were tested for different organisms by PCR or by culture for

  12. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments.

    Science.gov (United States)

    Sun, RongRong; Liu, Min; Lu, Lei; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The congenital heart disease includes abnormalities in heart structure that occur before birth. Such defects occur in the fetus while it is developing in the uterus during pregnancy. About 500,000 adults have congenital heart disease in USA (WebMD, Congenital heart defects medications, www.WebMD.com/heart-disease/tc/congenital-heart-defects-medications , 2014). 1 in every 100 children has defects in their heart due to genetic or chromosomal abnormalities, such as Down syndrome. The excessive alcohol consumption during pregnancy and use of medications, maternal viral infection, such as Rubella virus, measles (German), in the first trimester of pregnancy, all these are risk factors for congenital heart disease in children, and the risk increases if parent or sibling has a congenital heart defect. These are heart valves defects, atrial and ventricular septa defects, stenosis, the heart muscle abnormalities, and a hole inside wall of the heart which causes defect in blood circulation, heart failure, and eventual death. There are no particular symptoms of congenital heart disease, but shortness of breath and limited ability to do exercise, fatigue, abnormal sound of heart as heart murmur, which is diagnosed by a physician while listening to the heart beats. The echocardiogram or transesophageal echocardiogram, electrocardiogram, chest X-ray, cardiac catheterization, and MRI methods are used to detect congenital heart disease. Several medications are given depending on the severity of this disease, and catheter method and surgery are required for serious cases to repair heart valves or heart transplantation as in endocarditis. For genetic study, first DNA is extracted from blood followed by DNA sequence analysis and any defect in nucleotide sequence of DNA is determined. For congenital heart disease, genes in chromosome 1 show some defects in nucleotide sequence. In this review the causes, diagnosis, symptoms, and treatments of congenital heart disease are described.

  13. Anaesthesia for the child with congenital heart disease: pointers and ...

    African Journals Online (AJOL)

    Increased pulmonary blood flow (PBF) causes a volume or pressure overload to the ... venous drainage (TAPVD), high left atrial pressure (e.g. hypoplastic left heart ... function. Congenital heart disease (CHD) is the commonest birth defect, with a reported .... Is there valve regurgitation? ... tubing to avoid systemic air emboli.

  14. Long-term outcome of primary endoscopic realignment for bulbous urethral injuries: risk factors of urethral stricture.

    Science.gov (United States)

    Seo, Ill Young; Lee, Jea Whan; Park, Seung Chol; Rim, Joung Sik

    2012-12-01

    Although endoscopic realignment has been accepted as a standard treatment for urethral injuries, the long-term follow-up data on this procedure are not sufficient. We report the long-term outcome of primary endoscopic realignment in bulbous urethral injuries. Patients with bulbous urethral injuries were treated by primary endoscopic realignment between 1991 and 2005. The operative procedure included suprapubic cystostomy and transurethral catheterization using a guide wire, within 72 hours of injury. The study population included 51 patients with a minimum follow-up duration of 5 years. The most common causes of the injuries were straddle injury from falling down (74.5%), and pelvic bone fracture (7.8%). Gross hematuria was the most common complaint (92.2%). Twenty-three patients (45.1%) had complete urethral injuries. The mean time to operation after the injury was 38.8±43.2 hours. The mean operation time and mean indwelling time of a urethral Foley catheter were 55.5±37.6 minutes and 22.0±11.9 days, respectively. Twenty out of 51 patients (39.2%) were diagnosed with urethral stricture in 89.1±36.6 months after surgery. A multivariate analysis revealed that young age and operation time were independent risk factors for strictures as a complication of urethral realignment (hazard ratio [HR], 6.554, P=0.032; HR, 6.206, P=0.035). Urethral stricture commonly developed as a postoperative complication of primary endoscopic urethral realignment for bulbous urethral injury, especially in young age and long operation time.

  15. Congenital amusia.

    Science.gov (United States)

    Williamson, Victoria J; Stewart, Lauren

    2013-01-01

    For most people, music, like language, is acquired effortlessly in early life. But a few percent of the population have lifelong difficulties in the perception and production of music. In this chapter we discuss psycho-acoustic and behavioral studies that have attempted to delineate the nature of the auditory perceptual deficits in this group and consider whether these difficulties extend outside the musical domain. Finally, we review structural imaging studies in this group which point to subtle anomalies in temporal and frontal areas. We suggest that amusia can be considered a disorder of neural development, which has relatively specific consequences at the behavioral level. Studies of congenital amusia provide a unique window on the neurocognitive architecture of music processing. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Patient-specific pediatric silicone heart valve models based on 3D ultrasound

    Science.gov (United States)

    Ilina, Anna; Lasso, Andras; Jolley, Matthew A.; Wohler, Brittany; Nguyen, Alex; Scanlan, Adam; Baum, Zachary; McGowan, Frank; Fichtinger, Gabor

    2017-03-01

    PURPOSE: Patient-specific heart and valve models have shown promise as training and planning tools for heart surgery, but physically realistic valve models remain elusive. Available proprietary, simulation-focused heart valve models are generic adult mitral valves and do not allow for patient-specific modeling as may be needed for rare diseases such as congenitally abnormal valves. We propose creating silicone valve models from a 3D-printed plastic mold as a solution that can be adapted to any individual patient and heart valve at a fraction of the cost of direct 3D-printing using soft materials. METHODS: Leaflets of a pediatric mitral valve, a tricuspid valve in a patient with hypoplastic left heart syndrome, and a complete atrioventricular canal valve were segmented from ultrasound images. A custom software was developed to automatically generate molds for each valve based on the segmentation. These molds were 3D-printed and used to make silicone valve models. The models were designed with cylindrical rims of different sizes surrounding the leaflets, to show the outline of the valve and add rigidity. Pediatric cardiac surgeons practiced suturing on the models and evaluated them for use as surgical planning and training tools. RESULTS: Five out of six surgeons reported that the valve models would be very useful as training tools for cardiac surgery. In this first iteration of valve models, leaflets were felt to be unrealistically thick or stiff compared to real pediatric leaflets. A thin tube rim was preferred for valve flexibility. CONCLUSION: The valve models were well received and considered to be valuable and accessible tools for heart valve surgery training. Further improvements will be made based on surgeons' feedback.

  17. Horseshoe lung with multiple congenital anomalies

    International Nuclear Information System (INIS)

    Hawass, N.D.; Badawi, M.G.; Fatani, J.A.; Meshari, A.A.; Edrees, Y.B.

    1987-01-01

    A detailed radiologic and anatomic study of a 20-week old fetus is presented. In addition to conventional radiography, various contrast medium injection techniques were used. The findings were followed up at autopsy. The fetus showed multiple congenital abnormalities comprising phocomelia, horseshoe lung, horseshoe kidney, urethral stenosis with megacystis, bilateral hydronephrosis, hydroureters, imperforate anus, and a single tracheo-esophageal tube (persistent esophago-trachea). The association of horseshoe lung with persistent esophago-trachea, microurethra, megacystis, bilateral hydroureters, hydronephrosis and phocomelia is, we believe, the first ever to have been recorded in the literature. Twenty-one cases of horseshoe lung have been reported in the literature. These cases were reviewed and a comparison with the present case is presented. The embryologic basis for these anomalies is also briefly discussed. (orig.)

  18. Which valve is which?

    Directory of Open Access Journals (Sweden)

    Pravin Saxena

    2015-01-01

    Full Text Available A 25-year-old man presented with a history of breathlessness for the past 2 years. He had a history of operation for Tetralogy of Fallot at the age of 5 years and history suggestive of Rheumatic fever at the age of 7 years. On echocardiographic examination, all his heart valves were severely regurgitating. Morphologically, all the valves were irreparable. The ejection fraction was 35%. He underwent quadruple valve replacement. The aortic and mitral valves were replaced by metallic valve and the tricuspid and pulmonary by tissue valve.

  19. Adult urethral stricture: practice of Turkish urologists

    Science.gov (United States)

    Akyuz, Mehmet; Sertkaya, Zulfu; Koca, Orhan; Calıskan, Selahattin; Kutluhan, Musab Ali; Karaman, Muhammet Ihsan

    2016-01-01

    ABSTRACT Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US) were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors. PMID:27256189

  20. Adult urethral stricture: practice of Turkish urologists

    Directory of Open Access Journals (Sweden)

    Mehmet Akyuz

    2016-04-01

    Full Text Available ABSTRACT Objectives: To evaluate national practice patterns in the treatment of male anterior urethral strictures among Turkish urologists. Materials and Methods: A survey form including 12 questions prepared to determine active Turkish urologists' approach to diagnosis and treatment of the adult urethral stricture (US were filled out. Based on the survey results, the institutions which 218 urologists work and their years of expertise, methods they used for diagnosis and treatment, whether or not they perform open urethroplasty and timing of open urethroplasty were investigated. Results: Optic internal urethrotomy and dilatation are the most commonly used minimal invasive procedures in treatment of US with the ratios of 93.5% and 63.3% respectively. On the other hand it was seen that urethroplasty was a less commonly used procedure, compared to minimal invasive techniques, with the ratio of 36.7%. Survey results showed us that the number of US cases observed and open urethroplasty procedures performed increases with increasing years of professional experience. Conclusions: As a method demanding special surgical experience and known as a time-consuming and challenging procedure, open urethroplasty will be able to take a greater part in current urological practice with the help of theoretical education and practical courses given by specific centers and experienced authors.

  1. [Neisseria meningitidis urethritis: Two case reports].

    Science.gov (United States)

    Dubois, C; Liegeon, A-L; Fabbro, C; Truchetet, F

    2017-10-01

    Neisseria meningitidis (NM) is a commensal bacteria present in the oropharyngeal flora that causes invasive infections. There have been rarer reports of presence in the genital region. Herein, we present two cases of acute NM urethritis. Two men aged 30 and 31years, one of whom is homosexual and seropositive for HIV infection, presented urethral discharge which was diagnosed as acute urethritis. The unit through samples indicated the presence of NM of serogroups B and C. One of the antibiotic sensitivity tests revealed intermediate susceptibility to penicillin G and to amoxicillin. The clinical presentation of acute NM urethritis is non-specific, because of which urethral samples should be taken wherever acute urethritis is suspected. NM urethritis is infrequent and primarily affects men who have sex with men (MSM). Its current increase is due to unprotected oral-genital sexual practices. Due to the emergence of resistance to NM, antibiotic susceptibility testing should be carried out routinely to ensure appropriate therapy and prophylaxis. Cases of invasive serogroup C meningococcal infections have been recorded within the MSM population with hypothetical sexual port of entry. Thus, the French High Public Health Authority recommends vaccination against meningitis C in this population. Copyright © 2017. Published by Elsevier Masson SAS.

  2. Advances in the Understanding and Treatment of Male Urethritis.

    Science.gov (United States)

    Bachmann, Laura H; Manhart, Lisa E; Martin, David H; Seña, Arlene C; Dimitrakoff, Jordan; Jensen, Jørgen Skov; Gaydos, Charlotte A

    2015-12-15

    Neisseria gonorrhoeae and Chlamydia trachomatis are well-documented urethral pathogens, and the literature supporting Mycoplasma genitalium as an etiology of urethritis is growing. Trichomonas vaginalis and viral pathogens (herpes simplex virus types 1 and 2 and adenovirus) can cause urethritis, particularly in specific subpopulations. New data are emerging regarding the potential role of bacterial vaginosis-associated bacteria in urethritis, although results are inconsistent regarding the pathogenic role of Ureaplasma urealyticum in men. Mycoplasma hominis and Ureaplasma parvum do not appear to be pathogens. Men with suspected urethritis should undergo evaluation to confirm urethral inflammation and etiologic cause. Although nucleic acid amplification testing would detect N. gonorrhoeae and C. trachomatis (or T. vaginalis if utilized), there is no US Food and Drug Administration-approved clinical test for M. genitalium available in the United States at this time. The varied etiologies of urethritis and lack of diagnostic options for some organisms present treatment challenges in the clinical setting. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. [Chlamydia trachomatis and urogenital mycoplasms in nonconococcal urethritis in men].

    Science.gov (United States)

    Vesić, Sonja; Vukićević, Jelica; Gvozdenović, Eleonora; Skiljević, Dusan; Janosević, Slobodanka; Medenica, Ljiljana

    2010-01-01

    Nongonococcal urethritis is the most common sexually transmitted infection in men, with vast majority of the etiological agents such as Chlamydia trachomatis, followed by urogenital mycoplasmas. The aim of this study was to determine the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in nongonococcal urethritis in men, and to examine infections associated with these agents. Material and methods 299 sexually active, heterosexual men with nongonococcal urethritis were included into the study. Urethral samples were taken with a dacron swab placed into the urethra up to 2-3 cm. The Direct immunofluorescence technique was performed for identification of Chlamydia trachomatis. Ureaplasma urealyticum and Mycoplasma hominis were detected with Mycoplasma IST assay. Chlamydia trachomatis was detected in 22.75%, Uraeplasma urealyticum in 21.08% and Mycoplasma hominis in 8.02% cases. We found no significant differences in prevalence between Chlamydia trachomatis and Ureaplasma urealyticym (p > 0.05). Monoinfections were found in 51.85% with significantly higher rate (p urethritis with prevalence of 51.85% in monoinfections and 11.70% in associated infections. In 36.45% of cases the etiology of urethritis was not elucidated. These results suggest that more sensitive diagnostic tool should be applied when searching for the derailed etiology of nongonococcal urethritis.

  4. Bioprosthetic Valve Fracture Improves the Hemodynamic Results of Valve-in-Valve Transcatheter Aortic Valve Replacement.

    Science.gov (United States)

    Chhatriwalla, Adnan K; Allen, Keith B; Saxon, John T; Cohen, David J; Aggarwal, Sanjeev; Hart, Anthony J; Baron, Suzanne J; Dvir, Danny; Borkon, A Michael

    2017-07-01

    Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) may be less effective in small surgical valves because of patient/prosthesis mismatch. Bioprosthetic valve fracture (BVF) using a high-pressure balloon can be performed to facilitate VIV TAVR. We report data from 20 consecutive clinical cases in which BVF was successfully performed before or after VIV TAVR by inflation of a high-pressure balloon positioned across the valve ring during rapid ventricular pacing. Hemodynamic measurements and calculation of the valve effective orifice area were performed at baseline, immediately after VIV TAVR, and after BVF. BVF was successfully performed in 20 patients undergoing VIV TAVR with balloon-expandable (n=8) or self-expanding (n=12) transcatheter valves in Mitroflow, Carpentier-Edwards Perimount, Magna and Magna Ease, Biocor Epic and Biocor Epic Supra, and Mosaic surgical valves. Successful fracture was noted fluoroscopically when the waist of the balloon released and by a sudden drop in inflation pressure, often accompanied by an audible snap. BVF resulted in a reduction in the mean transvalvular gradient (from 20.5±7.4 to 6.7±3.7 mm Hg, P valve effective orifice area (from 1.0±0.4 to 1.8±0.6 cm 2 , P valves to facilitate VIV TAVR with either balloon-expandable or self-expanding transcatheter valves and results in reduced residual transvalvular gradients and increased valve effective orifice area. © 2017 American Heart Association, Inc.

  5. [Efficacy and safety of levofloxacin to non-gonorrheal urethritis].

    Science.gov (United States)

    Onodera, Shoichi; Onoe, Yasuhiko; Hosobe, Takahide; Kato, Tetsuro; Yoshida, Masaki

    2012-12-01

    We investigated the efficacy and safety of levofloxacin (LVFX) 500mg once a day in patients with non-gonorrheal urethritis. Men, aged 20 years or older, with urethritis symptoms, and detection of Chlamydia trachomatis (C. trachomatis) or Mycoplasma genitalium (M. genitalium) by a microbiological examination were eligible for this study. Patients were administered LVFX 500mg, orally, once a day and the dosage period was seven days. We assumed 22 patients for a safety and efficacy analysis. In 22 patients, 17 patients had urethritis with C. trachomatis, 4 patients urethritis with M. genitalium, and one patient mixed infection of C. trachomatis and M. genitalium. In the clinial study, the primary endpoint was set as the bacteriological eradication rate at two to four weeks after completion of treatment. The bacterial eradication rate in the urethritis was 86.4% (19/22). The bacterial eradication rate in the urethritis with C. trachomatis, M. genitalium, and mixed infection of C. trachomatis and M. genitalium were 94.1% (16/17), 50.0% (2/4), 100% (1/1), respectively. A significant difference was not recognized among the three groups. The clinical efficacy at two to four weeks after completion of treatment was 90.9% (20/22). The clinical efficacy rates in the urethritis with C. trachomatis, M. genitalium, and mixed infection of C. trachomatis and M. genitalium were 100% (17/17), 50.0% (2/4), 100% (1/1), respectively. The efficacy rate of urethritis with M. genitalium was significantly low. No adverse drug reactions were observed. These results suggest that once-a-day levofloxacin (500mg) is effective and safe treatment for non-gonorrheal urethritis.

  6. Mitral Valve Prolapse

    Science.gov (United States)

    ... valve syndrome . What happens during MVP? Watch an animation of mitral valve prolapse When the heart pumps ( ... our brochures Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  7. Problem: Mitral Valve Regurgitation

    Science.gov (United States)

    ... each time the left ventricle contracts. Watch an animation of mitral valve regurgitation A leaking mitral valve ... Not Alone Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  8. Problem: Heart Valve Regurgitation

    Science.gov (United States)

    ... should be completely closed For example: Watch an animation of mitral valve regurgitation A leaking mitral valve ... Not Alone Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  9. Aortic valve surgery - open

    Science.gov (United States)

    ... gov/ency/article/007408.htm Aortic valve surgery - open To use the sharing features on this page, ... separates the heart and aorta. The aortic valve opens so blood can flow out. It then closes ...

  10. Corrosion of valve metals

    International Nuclear Information System (INIS)

    Draley, J.E.

    1976-01-01

    A general survey related to the corrosion of valve metals or film-forming metals. The way these metals corrode with some general examples is described. Valve metals form relatively perfect oxide films with little breakdown or leakage when anodized

  11. Mitral valve surgery - open

    Science.gov (United States)

    ... Taking warfarin (Coumadin) References Otto CM, Bonow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ... A.M. Editorial team. Heart Surgery Read more Heart Valve Diseases Read more Mitral Valve Prolapse Read more A. ...

  12. Swing check valve

    International Nuclear Information System (INIS)

    Eminger, H.E.

    1977-01-01

    A swing check valve which includes a valve body having an inlet and outlet is described. A recess in the valve body designed to hold a seal ring and a check valve disc swingable between open and closed positions. The disc is supported by a high strength wire secured at one end in a support spacer pinned through bearing blocks fixed to the valve body and at its other end in a groove formed on the outer peripheral surface of the disc. The parts are designed and chosen such to provide a lightweight valve disc which is held open by minimum velocity of fluid flowing through the valve which thus reduces oscillations and accompanying wear of bearings supporting the valve operating parts. (Auth.)

  13. Comparison of urethral pressure profilometry and contrast radiography in the diagnosis of incompetence of the urethral sphincter mechanism in bitches

    International Nuclear Information System (INIS)

    Gregory, S.P.; Cripps, P.J.; Holt, P.E.

    1996-01-01

    Three diagnostic indicators of urethral sphincter mechanism incompetence were compared in 25 continent and 25 incontinent anaesthetised bitches: the resting urethral pressure profile, the stressed urethral pressure profile and the radiographic position of the bladder neck. Logistic regression indicated that the best predictor of continence status was the stressed urethral pressure profile as assessed by the percentage of negative peaks extending below the resting intravesical pressure; it classified 43 of the 50 dogs correctly. The radiographic position of the bladder neck was a better predictor of continence than either the measurement of functional profile length or the maximum urethral closure pressure from the resting urethral pressure profile, whether alone or in combination. By combining the percentage of negative peaks on the stressed profile with the position of the bladder neck, 46 of the 50 dogs were classified correctly. Cut-off values for the percentage of negative peaks on the stressed urethral pressure profile, and for the radiographic position of the bladder neck are suggested for use in evaluating incontinent bitches in clinical practice

  14. [Congenital hypothyroidism].

    Science.gov (United States)

    Castilla Peón, María Fernanda

    Congenital hypothyroidism (CH) is a cause of preventable mental retardation; therefore, timely diagnosis and treatment by the primary care physician is very important. CH screening must be performed between the second and fifth days of life with capillary blood done with a heel prick and must be confirmed by measurement of thyroid hormones in venous blood. The most common cause of CH is thyroid dysgenesis, which may be identified by a thyroid scan carried out before initiating treatment. Treatment should be with levothyroxine (10-15μg/kg/day) and should not be delayed or suspended during the first 3 years of life due to the deleterious effect on neurodevelopment in case of low thyroid hormones during this time. Preterm or sick infants or those with Down syndrome require special consideration. This article provides diagnostic and therapeutic algorithms for CH. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  15. Mitral Valve Prolapse

    Science.gov (United States)

    Mitral valve prolapse (MVP) occurs when one of your heart's valves doesn't work properly. The flaps of the valve are "floppy" and ... to run in families. Most of the time, MVP doesn't cause any problems. Rarely, blood can ...

  16. Overflow control valve

    International Nuclear Information System (INIS)

    Kessinger, B.A.; Hundal, R.; Parlak, E.A.

    1982-01-01

    An overflow control valve for use in a liquid sodium coolant pump tank which can be remotely engaged with and disengaged from the pump tank wall to thereby permit valve removal. An actuating shaft for controlling the valve also has means for operating a sliding cylinder against a spring to retract the cylinder from sealing contact with the pump tank nozzle. (author)

  17. Fluid control valves

    International Nuclear Information System (INIS)

    Rankin, J.

    1980-01-01

    A fluid control valve is described in which it is not necessary to insert a hand or a tool into the housing to remove the valve seat. Such a valve is particularly suitable for the control of radioactive fluids since maintenance by remote control is possible. (UK)

  18. A remote control valve

    International Nuclear Information System (INIS)

    Cachard, Maurice de; Dumont, Maurice.

    1976-01-01

    This invention concerns a remote control valve for shutting off or distributing a fluid flowing at a high rate and low pressure. Among the different valves at present in use, electric valves are the most recommended for remote control but their reliability is uncertain and they soon become costly when large diameter valves are used. The valve described in this invention does away with this drawback owing to its simplicity and the small number of moving parts, this makes it particularly reliable. It mainly includes: a tubular body fitted with at least one side opening; at least one valve wedge for this opening, coaxial with the body, and mobile; a mobile piston integral with this wedge. Several valves to the specifications of this invention can be fitted in series (a shut-off valve can be used in conjunction with one or more distribution valves). The fitting and maintenance of the valve is very simple owing to its design. It can be fabricated in any material such as metals, alloys, plastics and concrete. The structure of the valve prevents the flowing fluid from coming into contact with the outside environment, thereby making it particularly suitable in the handling of dangerous or corrosive fluids. Finally, the opening and shutting of the valve occurs slowly, thereby doing away with the water hammer effect so frequent in large bore pipes [fr

  19. Heart Valve Diseases

    Science.gov (United States)

    Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

  20. Gerbode defect and multivalvular dysfunction: Complex complications in adult congenital heart disease.

    Science.gov (United States)

    Ruivo, Catarina; Guardado, Joana; Montenegro Sá, Fernando; Saraiva, Fátima; Antunes, Alexandre; Correia, Joana; Morais, João

    2017-07-01

    We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. A true left ventricular-to-right atrial shunt confirmed a direct Gerbode defect. The authors aim to discuss the diagnostic challenge of adult CHD, namely the key role of TEE on septal defects and valve regurgitations description. © 2017, Wiley Periodicals, Inc.

  1. Clinical case of acute chord rupture of the mitral valve posterior leaflet in older patient with comorbidities

    OpenAIRE

    Zhuravlyova, L.; Lopina, N.; Kuznetsov, I.; Lopin, D.; Kramarenko, I.; Sumanova, I.

    2015-01-01

    The article describes the etiologic role of various factors such as chronic rheumatic heart disease, bacterial endocarditis, aortic valve stenosis, hypertension, coronary heart disease, including acute myocardial infarction, degenerative disease of the valves, connective tissue diseases, chest trauma, systemic lupus erythematosus, con-genital heart disease which leading to the mitral valve chords rupture, gives the current classification of the nosology and also features of manifestation and ...

  2. Primary care management of sexually transmitted urethritis in adolescent males.

    Science.gov (United States)

    Lindberg, Claire E

    2003-04-01

    To describe current knowledge about diagnosis, screening, and treatment of sexually transmitted urethritis among adolescent and young adult males. Current research, systematic reviews, consensus guidelines and the author's clinical experience. Urethritis, the most common sexually transmitted syndrome in young males, is most frequently caused by Chlamydia trachomatis and/or Neisseria gonorrhea. Symptoms include dysuria and penile discharge, although up to 50% of males are asymptomatic. Risky sexual behaviors and lack of access to healthcare increase incidence of this infection. Transmission to female partners can lead to pelvic inflammatory disease, infertility, and neonatal infection. Young males with urethritis must be treated as soon as diagnosis is established. Consensus guidelines exist for diagnosis and treatment of gonococcal and non-gonococcal urethritis. Careful patient education is necessary to ensure successful treatment. Prevention of repeat infections requires partner treatment and detailed education about safer sexual practices. Improved access to preventive services for young males should be a healthcare priority.

  3. A novel cannulation technique for difficult urethral catheterization

    Directory of Open Access Journals (Sweden)

    Mehmet Kaynar

    2016-03-01

    Full Text Available Introduction: To propose a novel cannulation technique for difficult urethral catheterization procedures. Technique: The sheath tip of an intravenous catheter is cut off, replaced to the needle tip and pushed through the distal drainage side hole to Foley catheter tip, and finally withdrawn for cannulation. In situations making urethral catheterization difficult, a guide wire is placed under direct vision. The modified Foley catheter is slid successfully over the guide wire from its distal end throughout the urethral passage into the bladder. Results: The modified Foley catheter was used successfully in our clinic in cases requiring difficult urethral catheterization. Conclusions: This easy and rapid modification of a Foley catheter may minimize the potential complications of blind catheter placement in standard catheterization.

  4. Patient knowledge of urethral stricture disease in a state sector ...

    African Journals Online (AJOL)

    M. Barnard

    2018-02-16

    Feb 16, 2018 ... Introduction: The knowledge urethral stricture patients in a developing country Specialist Clinic have ... A systematic review done by DeWalt et al. confirms that low literacy ... The questionnaire was translated into Afrikaans and.

  5. Contralateral Fracture of the Penis with Concomitant Urethral Injury ...

    African Journals Online (AJOL)

    ra

    2009-03-16

    Mar 16, 2009 ... 2, 2009. 103. 103-106. Case Report. Contralateral Fracture of the Penis with Concomitant. Urethral ... Examination revealed ecchymosis and swelling of the proximal shaft and ... of impotence due to infection and cavernosal.

  6. Hinged Transpubic Approach to Delayed Repair of Posterior Urethral

    African Journals Online (AJOL)

    ... to the management of one of the most challenging injuries of the lower urinary tract. ... This patient underwent a successful re-operation with full recovery. ... delayed repair of urethral distraction defects complicating pelvic fracture is feasible.

  7. Heavy gas valves

    Energy Technology Data Exchange (ETDEWEB)

    Steier, L [Vereinigte Armaturen Gesellschaft m.b.H., Mannheim (Germany, F.R.)

    1979-01-01

    Heavy gas valves must comply with special requirements. Apart from absolute safety in operation there are stringent requirements for material, sealing and ease of operation even in the most difficult conditions. Ball valves and single plate pipe gate valves lateral sealing rings have a dual, double sided sealing effect according to the GROVE sealing system. Single plate gate valves with lateral protective plates are suitable preferably for highly contaminated media. Soft sealing gate valves made of cast iron are used for low pressure applications.

  8. THE ROLE OF OPTICAL INTERNAL URETHROTOMY FOR MALE URETHRAL STRICTURE

    Directory of Open Access Journals (Sweden)

    Ekrem Akdeniz

    2016-04-01

    Full Text Available Introduction:Urethral stricture is characterized by decrease in urethral flow severe enough to cause acute urinary retention. Urethral strictures may develop after traumas to urethral epithelium and/or corpus spongiosum. Complication rates due to untreated urethral stricture are very high. Although various treatment methods have been described, the second most common method after urethral dilation in practice is cold-knife internal urethrotomy. The purpose of this study is to evaluate data of patients who were treated with internal urethrotomy in our clinic. Methods:This study included patients who were treated with internal urethrotomy due to internal stricture between January 2011 and May 2015. Demographic, clinical, radiological, uroflowmetric (maximum and mean urine flow rate and operative datas of the patients were retrospectively evaluated and recorded. Results:This study included 155 patients with a mean (±standard deviation age of 71.70 (±13.7. Etiologically the most common reason was urological surgical procedures (67% and the most common stricture was seen at bulbomembranous urethra region (85.2%. Mean length of stricture was 5.4±2.4mm. Mean duration to remove the catheter was 1.8±1.3 days. Regional anesthesia was used in 67.7% of the patients. Our success rate was 78,1%. Comparison of maximum and mean urine flow rates pre and postoperatively revealed significant increases postoperatively. Conclusion:Internal urethrotomy is a first line treatment method for urethral strictures because it is easily applied, has a low complication rate, and can be applied with local aenesthesia in high risk patients who are unable to take general anesthesia. Although recurrence rate is high, repeatability is its greatest advantage and it causes significant relief in patients with urethral strictures, but it must be kept in mind that definitive treatment is urethroplasty.

  9. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men.

    Science.gov (United States)

    Wong, Susan S W; Aboumarzouk, Omar M; Narahari, Radhakrishna; O'Riordan, Anna; Pickard, Robert

    2012-12-12

    Strictures of the urethra are the most common cause of obstructed micturition in younger men and frequently recur after initial treatment. Standard treatment comprises internal widening of the strictured area by simple dilatation or by telescope-guided internal cutting (optical urethrotomy), but these interventions are associated with a high failure rate requiring repeated treatment. The alternative option of open urethroplasty whereby the urethral lumen is permanently widened by removal or grafting of the strictured segment is less likely to fail but requires greater expertise. Findings of Improved choice of graft material and shortened hospital stay suggest that urethroplasty may be under utilised. The extent and quality of evidence guiding treatment choice for this condition are uncertain.   To determine which is the best surgical treatment for male urethral stricture disease taking into account relative efficacy, adverse event rates and cost-effectiveness.   We searched the Cochrane Incontinence Group Specialised Register (searched 21 June 2012), CENTRAL (2012, Issue 6), MEDLINE (January 1946 to week 2 June 2012), EMBASE (January 1980 to week 25 2012), OpenSIGLE (searched 26 June 2012), clinical trials registries and reference lists of relevant articles. We included publications reporting data from randomised or quasi-randomised controlled trials comparing the effectiveness of dilatation, urethrotomy and urethroplasty in the treatment of adult men with urethral stricture disease. Two authors evaluated trials for appropriateness for inclusion and methodological quality. Data extraction was performed using predetermined criteria. Analyses were carried out using the Cochrane Review Manager software (RevMan 5). Two randomised trials were identified. One trial compared the outcomes of surgical urethral dilatation and optical urethrotomy in 210 adult men with urethral stricture disease. No significant difference was found in the proportion of men being

  10. Relief valve testing study

    International Nuclear Information System (INIS)

    BROMM, R.D.

    2001-01-01

    Reclosing pressure-actuated valves, commonly called relief valves, are designed to relieve system pressure once it reaches the set point of the valve. They generally operate either proportional to the differential between their set pressure and the system pressure (gradual lift) or by rapidly opening fully when the set pressure is reached (pop action). A pop action valve allows the maximum fluid flow through the valve when the set pressure is reached. A gradual lift valve allows fluid flow in proportion to how much the system pressure has exceeded the set pressure of the valve (in the case of pressure relief) or has decreased below the set pressure (vacuum relief). These valves are used to protect systems from over and under pressurization. They are used on boilers, pressure vessels, piping systems and vacuum systems to prevent catastrophic failures of these systems, which can happen if they are under or over pressurized beyond the material tolerances. The construction of these valves ranges from extreme precision of less than a psi tolerance and a very short lifetime to extremely robust construction such as those used on historic railroad steam engines that are designed operate many times a day without changing their set pressure when the engines are operating. Relief valves can be designed to be immune to the effects of back pressure or to be vulnerable to it. Which type of valve to use depends upon the design requirements of the system

  11. Congenital platelet function defects

    Science.gov (United States)

    ... pool disorder; Glanzmann's thrombasthenia; Bernard-Soulier syndrome; Platelet function defects - congenital ... Congenital platelet function defects are bleeding disorders that cause reduced platelet function. Most of the time, people with these disorders have ...

  12. Congenital Heart Information Network

    Science.gov (United States)

    ... heart defects. Important Notice The Congenital Heart Information Network website is temporarily out of service. Please join ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright © ...

  13. Congenital heart disease

    Science.gov (United States)

    Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. ... Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... Sabiston Textbook of Surgery: The Biological Basis of Modern ...

  14. Sacral neuromodulation effects on periurethral sensation and urethral sphincter activity.

    Science.gov (United States)

    Gleason, Jonathan L; Kenton, Kimberly; Greer, W Jerod; Ramm, Olga; Szychowski, Jeff M; Wilson, Tracey; Richter, Holly E

    2013-06-01

    To characterize the effect of sacral neuromodulation (SNM) on urethral neuromuscular function. Following IRB approval, women with refractory overactive bladder (OAB) underwent standardized urethral testing prior to and after Stage 1 SNM implantation. Periurethral sensation was measured using current perception thresholds (CPT). Striated urethral sphincter activity was quantified using concentric needle electromyography (CNE) and Multi-Motor Unit Action Potential (MUP) analysis software. Nonparametric analyses were used to characterize pre/post changes with intervention. Baseline CPT and CNE findings were compared between SNM responders and non-responders. Twenty-seven women were enrolled in this pilot study with a mean age of 61 ± 13 years. Twenty of 26 women (76.9%) responded to SNM and went to Stage 2 permanent implantation. Four (14.8%) withdrew after Stage 1 implantation; three of the four withdrawals had not had therapeutic responses to SNM. CPT and CNE parameters did not significantly differ from baseline 2 weeks after SNM. Pre-SNM urethral sensation was not significantly different between responders and non-responders. However, responders had larger amplitude, longer duration and more turns and phases at baseline approaching significance, reflecting more successful urethral reinnervation, than non-responders. SNM does not alter urethral neuromuscular function 2 weeks post Stage 1 implantation. Copyright © 2012 Wiley Periodicals, Inc.

  15. Comparison of radiographic and sonographic urethrography for assessing urethral strictures

    International Nuclear Information System (INIS)

    Babnik Peskar, Darja; Visnar Perovic, Alenka

    2004-01-01

    The aim of this study was to compare radiourethrography (RUG) and sonourethrography (SUG) for assessment of urethral strictures and to evaluate whether RUG underestimates stricture length, as has been reported. Fifty-one men with suspected urethral strictures were evaluated by both methods performed consecutively. Stricture lengths and diameters measured by RUG were significantly greater (mean 22%, 30%) than those measured by SUG because of radiographic magnification. Both methods, however, detected a similar percentage lumen reduction and similarly graded stricture severity. Equally significant non-correlation between both methods for length measurements in the bulbar and penile urethra (p 2 =0.33 and 0.34, respectively) supported radiographic magnification. Previous inaccuracies appear to relate to RUG measurements of the central tight stricture (mean 44% of the entire length in our series), not the full stricture length. Use of sonographic contrast medium intra-urethrally improved the definition of long narrow strictures. The SUG gave information about peri-urethral tissues not provided by RUG. Once radiographic magnification was taken into account, there were no major differences in the assessment of urethral strictures by both methods. With correct measurement methods, RUG does not underestimate stricture length. For full assessment, the combination of RUG and SUG, which gives information about peri-urethral disease, is optimal in many patients. (orig.)

  16. Dorsal onlay vaginal graft urethroplasty for female urethral stricture

    Directory of Open Access Journals (Sweden)

    Manmeet Singh

    2013-01-01

    Full Text Available Introduction: Female urethral stricture is an underdiagnosed and overlooked cause of female bladder outlet obstruction. The possible etiologies may be infection, prior dilation, difficult catheterization with subsequent fibrosis, urethral surgery, trauma, or idiopathic. We present our technique and results of dorsal onlay full thickness vaginal graft urethroplasty for female urethral stricture. Materials and Methods: A retrospective review was performed on 16 female patients with mid-urethral stricture who underwent dorsal onlay vaginal graft urethroplasty from January 2007 to June 2011.Of these, 13 patients had previously undergone multiple Hegar dilatations, three had previous internal urethrotomies. The preoperative work up included detailed voiding history, local examination, uroflowmetry, calibration, and micturating cystourethrogram. Results: All patients had mid-urethral stricture. Mean age was 47.5 years. Mean Q max improved from 6.2 to 27.6 ml/s. Mean residual volume decreased from 160 to 20 ml. Mean duration of follow-up was 24.5 months (6 months to 3 years. Only one patient required self-calibration for 6 months after which her stricture stabilized. None of the patient was incontinent. Conclusion: Dorsal vaginal onlay graft urethroplasty could be considered as an effective way to treat female urethral stricture.

  17. Urethral obstruction from dislodged bladder Diverticulum stones: a case report

    Directory of Open Access Journals (Sweden)

    Okeke Linus I

    2012-11-01

    Full Text Available Abstract Background Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. Case presentation A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. Conclusions Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy.

  18. Effect of fesoterodine on urethral closure function in women with stress urinary incontinence assessed by urethral pressure reflectometry

    DEFF Research Database (Denmark)

    Klarskov, Niels; Darekar, Amanda; Scholfield, David

    2014-01-01

    INTRODUCTION AND HYPOTHESIS: The aim was to evaluate, using urethral pressure reflectometry (UPR), the effect of fesoterodine on urethral function in women with stress urinary incontinence (SUI). METHODS: Women aged 18 to 65 years were eligible for this randomised, double-blind, placebo...... significant differences were seen between fesoterodine 4 mg or fesoterodine 8 mg and placebo in opening urethral pressure (primary endpoint) or other UPR endpoints. No statistically significant differences were seen between either fesoterodine dose and placebo in the change from baseline in the bladder diary...... variables (total urinary incontinence, SUI, or urgency urinary incontinence episodes per 24 h). Adverse events were reported by 8 participants taking fesoterodine 4 mg, 17 taking fesoterodine 8 mg, and 8 taking placebo. CONCLUSIONS: Fesoterodine did not affect urethral pressure or significantly decrease...

  19. The Efficacy of Bulbar Urethral Mobilization for Anastomotic Anterior Urethroplasty in a Case With Recurrent Anterior Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Shinji Fukui

    2014-05-01

    Full Text Available A 2-month-old boy was diagnosed with febrile urinary tract infection. Voiding cystourethrography showed bulbar and anterior urethral strictures, and endoscopic internal urethrotomy was performed. He developed febrile urinary tract infection again and revealed the recurrence of the anterior urethral stricture. Consequently, endoscopic internal urethrotomy was performed 4 times. Because the anterior urethral stricture had not improved, he was referred to us. Anterior urethroplasty was performed when he was 5 years. After excision of the scarred portions of the urethra, the defect of the urethra was 20 mm. Transperineal bulbar urethral mobilization was performed, and a single-stage end-to-end anterior urethroplasty without tension could be performed simultaneously.

  20. A misleading urethral smear with polymorphonuclear leucocytes and intracellular diplococci; case report of urethritis caused by Neisseria meningitidis.

    Science.gov (United States)

    Genders, R E; Spitaels, D; Jansen, C L; van den Akker, Th W; Quint, K D

    2013-12-01

    The primary pathogens found in men with urethritis are Chlamydia trachomatis and Neisseria gonorrhoeae. Rapid diagnosis of N. gonorrhoeae infection can be made based on a Gram- or methylene blue-stained urethral smear. We describe a case of a man with purulent penile discharge, in which microscopic examination led to the presumptive diagnosis of gonorrhoea. A nucleic acid amplification test was negative for N. gonorrhoeae but positive for C. trachomatis. Culture showed Gram-negative diplococci which were identified as Neisseria meningitidis. N. meningitidis can be sporadically pathogenic in the genito-urinary tract and mimicks gonococcal urethritis, and appears identical by microscopy. When a gonococcal urethritis is suspected based on clinical signs and microscopic examination, but investigatory tests cannot confirm the diagnosis, a N. meningitidis infection should be considered.

  1. [Reoperative valve replacement in patients undergoing cardiac reoperation: a report of 104 cases].

    Science.gov (United States)

    Zou, Liang-jian; Xu, Zhi-yun; Wang, Zhi-nong; Lang, Xi-long; Han, Lin; Lu, Fang-lin; Xu, Ji-bin; Tang, Hao; Ji, Guang-yu; Wang, Er-song; Wang, Jun; Qu, Yi

    2010-08-15

    To review the experience of reoperative valve replacement for 104 patients. From January 2002 to December 2009, 104 patients underwent heart valve replacement in reoperations, accounting for 2.92% of the total patient population (3557 cases) who had valve replacement during this period. In this group, 53 male and 51 female patients were included with a median age of 46 years (ranged from 13 to 72 years). The reasons of reoperation included 28 cases suffered from another valve lesion after valve replacement, 10 cases suffered from valve lesion after mitral valvuloplasty, 19 cases suffered from perivalvular leakage after valve replacement, 18 cases suffered from valve lesion after previous correction of congenital heart defect, 7 cases suffered from bioprosthetic valve decline, 10 cases suffered from prosthetic valve endocarditis, 9 cases suffered from dysfunction of machine valve, and 3 cases suffered from other causes. The re-operations were mitral and aortic valve replacement in 2 cases, mitral valve replacement in 59 cases, aortic valve replacement in 24 cases, tricuspid valve replacement in 16 cases, and Bentall's operation in 3 cases. The interval from first operation to next operation was 1 month-19 years. There were 8 early deaths from heart failure, renal failure and multiple organ failure (early mortality 7.69%). Major complications were intraoperative hemorrhage in 2 cases, re-exploration for mediastinal bleeding in 2 cases and sternotomy surgical site infection in 1 case. Complete follow-up (3 months-7 years and 2 months) was available for all patients. Two patients died, one patient died of intracranial hemorrhage, and another cause was unknown. Satisfactory short-term and long-term results can be obtained in reoperative valve replacement with appropriate timing of operation control, satisfactory myocardial protection, accurate surgical procedure and suitable perioperative treatment.

  2. Endoscopic removal of a proximal urethral stent using a holmium laser: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Francisco Botelho

    2012-01-01

    Full Text Available Urethral stents were initially developed for the management of urethral strictures and obstructive voiding disorders in select patients. Urethral stent complications are common and may require stent explantation, which is often quite challenging. We present our experience with endoscopic removal of an encrusted UroLume proximal urethral stent in a 72-year-old male using a holmium laser. The literature on various management options and outcomes for urethral stent removal is reviewed. Endoscopic removal of proximal urethral stents is feasible and safe and should be considered as the primary treatment option in patients requiring stent extraction.

  3. Partial hammock valve: surgical repair in adulthood.

    Science.gov (United States)

    Aramendi, José I; Rodríguez, Miguel A; Voces, Roberto; Pérez, Pedro; Rodrigo, David

    2006-09-01

    We describe a forme frustrée of hammock valve involving only the posterior mitral leaflet. Three adult patients were referred to surgery with the diagnosis of severe mitral regurgitation due to fibrosis of the posterior mitral leaflet. The final diagnosis was done intraoperatively. In all of them the posterior leaflet was attached to some accessory papillary muscles arranged en palisade, with three to four fused muscle heads producing restrictive leaflet motion in systole. Repair consisted in division of the papillary muscles, patch augmentation, and ring annuloplasty. This previously unreported lesion is congenital but manifests itself in adulthood.

  4. Congenital Intrahepatic Portosystemic Shunts

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woong Hee; Kim, Young Tong; Jou, Sung Shick; Shin, Hyeong Cheol [Soonchunhyang University, Asan (Korea, Republic of)

    2008-12-15

    Intrahepatic portosystemic shunts are an anomalous connection between the portal vein and hepatic vein/IVC, which may be either congenital or acquired secondary to liver cirrhosis or portal hypertension. Cases of congenital intrahepatic shunts are usually encountered in children and may spontaneously resolve. We report 5 cases of congenital intrahepatic portosystemic shunts in neonates and an adult

  5. Transurethral resection of fibrotic scar tissue combined with temporary urethral stent placement for patients with in anterior urethral stricture

    Directory of Open Access Journals (Sweden)

    Cheol Yong Yoon

    2014-08-01

    Full Text Available Introduction Fibrotic scar formation is a main cause of recurrent urethral stricture after initial management with direct vision internal urethrotomy (DVIU. In the present study, we devised a new technique of combined the transurethral resection of fibrotic scar tissue and temporary urethral stenting, using a thermo-expandable urethral stent (MemokathTM 044TW in patients with anterior urethral stricture. Materials and Methods As a first step, multiple incisions were made around stricture site with cold-cutting knife and Collins knife electrode to release a stricture band. Fibrotic tissue was then resected with a 13Fr pediatric resectoscope before deployment of a MemokathTM 044TW stent (40 – 60mm on a pre-mounted sheath using 0° cystoscopy. Stents were removed within 12 months after initial placement. Results We performed this technique on 11 consecutive patients with initial (n = 4 and recurrent (n = 7 anterior urethral stricture (April 2009 – February 2013. At 18.9 months of mean follow-up (12-34 months, mean Qmax (7.8±3.9ml/sec vs 16.8 ± 4.8ml/sec, p < 0.001, IPSS (20.7 vs 12.5, p = 0.001 , and QoL score (4.7 vs 2.2, p < 0.001 were significantly improved. There were no significant procedure-related complications except two cases of tissue ingrowth at the edge of stent, which were amenable by transurethral resection. In 7 patients, an average 1.4 times (1-5 times of palliative urethral dilatation was carried out and no patients underwent open surgical urethroplasty during the follow-up period. Conclusion Combined transurethral resection and temporary urethral stenting is a effective therapeutic option for anterior urethral stricture. Further investigations to determine the long-term effects, and safety profile of this new technique are warranted.

  6. New Technologies for Surgery of the Congenital Cardiac Defect

    Directory of Open Access Journals (Sweden)

    David Kalfa

    2013-07-01

    Full Text Available The surgical repair of complex congenital heart defects frequently requires additional tissue in various forms, such as patches, conduits, and valves. These devices often require replacement over a patient’s lifetime because of degeneration, calcification, or lack of growth. The main new technologies in congenital cardiac surgery aim at, on the one hand, avoiding such reoperations and, on the other hand, improving long-term outcomes of devices used to repair or replace diseased structural malformations. These technologies are: 1 new patches: CorMatrix® patches made of decellularized porcine small intestinal submucosa extracellular matrix; 2 new devices: the Melody® valve (for percutaneous pulmonary valve implantation and tissue-engineered valved conduits (either decellularized scaffolds or polymeric scaffolds; and 3 new emerging fields, such as antenatal corrective cardiac surgery or robotically assisted congenital cardiac surgical procedures. These new technologies for structural malformation surgery are still in their infancy but certainly present great promise for the future. But the translation of these emerging technologies to routine health care and public health policy will also largely depend on economic considerations, value judgments, and political factors.

  7. Transcatheter Pulmonary Valve Replacement: Current State of Art.

    Science.gov (United States)

    Alkashkari, Wail; Alsubei, Amani; Hijazi, Ziyad M

    2018-03-15

    The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. This review aims to summarize (1) the current state of the art for tPVR, (2) the expanding indications, and (3) the technological obstacles to optimizing tPVR. Since its introduction in 2000, more than ten thousands tPVR procedures have been performed worldwide. Although the indications for tPVR have been adapted earlier from those accepted for surgical intervention, they remain incompletely defined. The new imaging modalities give better assessment of cardiac anatomy and function and determine candidacy for the procedure. The procedure has been shown to be feasible and safe when performed in patients who received pulmonary conduit and or bioprosthetic valves between the right ventricle and the pulmonary artery. Fewer selected patients post trans-annular patch repair for tetralogy of Fallot may also be candidates for this technology. Size restrictions of the currently available valves limit deployment in the majority of patients post trans-annular patch repair. Newer valves and techniques are being developed that may help such patients. Refinements and further developments of this procedure hold promise for the extension of this technology to other patient populations.

  8. Anatomic, histopathologic, and echocardiographic features in a dog with an atypical pulmonary valve stenosis with a fibrous band of tissue and a patent ductus arteriosus.

    Science.gov (United States)

    Yoon, Hakyoung; Kim, Jaehwan; Nahm, Sang-Soep; Eom, Kidong

    2017-07-11

    Congenital pulmonary valve stenosis and patent ductus arteriosus are common congenital heart defects in dogs. However, concurrence of atypical pulmonary valve stenosis and patent ductus arteriosus is uncommon. This report describes the anatomic, histopathologic, and echocardiographic features in a dog with concomitant pulmonary valve stenosis and patent ductus arteriosus with atypical pulmonary valve dysplasia that included a fibrous band of tissue. A 1.5-year-old intact female Chihuahua dog weighing 3.3 kg presented with a continuous grade VI cardiac murmur, poor exercise tolerance, and an intermittent cough. Echocardiography indicated pulmonary valve stenosis, a thickened dysplastic valve without annular hypoplasia, and a type IIA patent ductus arteriosus. The pulmonary valve was thick line-shaped in systole and dome-shaped towards the right ventricular outflow tract in diastole. The dog suffered a fatal cardiac arrest during an attempted balloon pulmonary valvuloplasty. Necropsy revealed pulmonary valve dysplasia, commissural fusion, and incomplete opening and closing of the pulmonary valve because of a fibrous band of tissue causing adhesion between the right ventricular outflow tract and the dysplastic intermediate cusp of the valve. A fibrous band of tissue between the right ventricular outflow track and the pulmonary valve should be considered as a cause of pulmonary valve stenosis. Pulmonary valve stenosis and patent ductus arteriosus can have conflicting effects on diastolic and systolic dysfunction, respectively. Therefore, beta-blockers should always be used carefully, particularly in patients with a heart defect where there is concern about left ventricular systolic function.

  9. A Systematic Review of Infective Endocarditis in Patients With Bovine Jugular Vein Valves Compared With Other Valve Types.

    Science.gov (United States)

    Sharma, Ashutosh; Cote, Anita T; Hosking, Martin C K; Harris, Kevin C

    2017-07-24

    The aim of this study was to systematically evaluate the incidence of infective endocarditis (IE) in right ventricle-to-pulmonary artery conduits and valves, comparing bovine jugular vein (BJV) valves with all others. Recent evidence suggests that the incidence of IE is higher in patients with congenital heart disease who have undergone implantation of BJV valves in the pulmonary position compared with other valves. Systematic searches of published research were conducted using electronic databases (MEDLINE, Embase, and CINAHL) and citations cross-referenced current to April 2016. Included studies met the following criteria: patients had undergone right ventricle-to-pulmonary artery conduit or percutaneous pulmonary valve implantation, and investigators reported on the type of conduit or valve implanted, method of intervention (surgery or catheter based), IE incidence, and follow-up time. Fifty studies (Levels of Evidence: 2 to 4) were identified involving 7,063 patients. The median cumulative incidence of IE was higher for BJV compared with other valves (5.4% vs. 1.2%; p endocarditis with BJV valves than other types of right ventricle-to-pulmonary artery conduits. There was no difference in the incidence of endocarditis between catheter-based bovine valves and surgically implanted bovine valves, suggesting that the substrate for future infection is related to the tissue rather than the method of implantation. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Trends in the prevalence of pathogens causing urethritis in Asturias, Spain, 1989-2000.

    Science.gov (United States)

    Varela, José A; Otero, Luis; García, María José; Palacio, Virgilo; Carreño, Francisco; Cuesta, Mar; Sánchez, Carmen; Vázquez, Fernando

    2003-04-01

    There are few studies of recent trends in the etiology and epidemiologic characteristics of specific microorganisms causing urethritis in men. The objective of the current study was to show the clinical experience in our country and to evaluate the trends in the prevalence of the pathogens in male urethritis, as well as the epidemiologic patterns in a series of 2101 patients. This was a descriptive study of the etiological agents causing urethritis in our sexually transmitted disease clinics in a period of 12 years (1989-2000), with a comparison of two periods of time. There were 97 cases of gonococcal urethritis (4.6%), 2004 of nongonococcal urethritis (95.4%), and 82 of mixed urethritis (3.9%). An association was found between gonococcal urethritis and heterosexual men; between chlamydial urethritis and homosexual/bisexual men; Ureaplasma urealyticum urethritis and heterosexual men and patients younger than 30 years of age; and between trichomonal urethritis and patients more than 30 years of age and the presence of HIV antibodies. During the period of research there was a significant decrease in cases of Neisseria gonorrhoeae and Chlamydia trachomatis urethritis and an increase in those of U urealyticum urethritis. In conclusion, this report describes changes in the etiology and epidemiologic patterns of urethritis in our country in recent years.

  11. Echocardiography in the adult's congenital cardiopaties

    International Nuclear Information System (INIS)

    Escobar Q, Carlos I; Jaramillo U, Mario; Tenorio, Luis F; Molina V, Claudia; Saldarriaga A, Marcela; Arango, Angela M

    2003-01-01

    The number of adults with congenital heart disease is steadily increasing in the course of time. We ignore the prevalence and the most frequent diagnoses in our environment. A descriptive prospective study is presented. Between November 1 1999 and July 31 2001, 8871 Tran-thoracic and Tran-esophageal echocardiographies were performed in the Clinica Cardiovascular Santa Maria's echocardiography service. We found 143 congenital cardiopathies (1.6%) in 74 men and 69 women with a mean age of 37.7 +/- 18.4 years. the most frequent diagnoses were bicuspid aortic valve, atrial septal defect, ventricular septal defect, patent ductus arteriosus and Ebstein's anomaly. these findings agree with world wide data

  12. Guide to prosthetic cardiac valves

    International Nuclear Information System (INIS)

    Morse, D.; Steiner, R.M.; Fernandez, J.

    1985-01-01

    This book contains 10 chapters. Some of the chapter titles are: The development of artificial heart valves: Introduction and historical perspective; The radiology of prosthetic heart valves; The evaluation of patients for prosthetic valve implantation; Pathology of cardiac valve replacement; and Bioengineering of mechanical and biological heart valve substitutes

  13. A case of urethral duplication arising from the posterior urethra to the scrotum with urinary stone in a 6-year-old male.

    Science.gov (United States)

    Mori, Kenichi; Shin, Toshitaka; Tobu, Shohei; Noguchi, Mitsuru; Sumino, Yasuhiro; Sato, Fuminoi; Mimata, Hiromitsu

    2014-01-01

    Urethral duplication is a rare congenital anomaly. We report a 6-year-old male with type IIA2 (Y-type) using Effmann's classification. The accessory urethra, in which a urinary stone existed, arose from the posterior urethra to the scrotum. Because of recurrent urinary tract infection and urinary discharge from the accessory urethra, surgical removal of the accessory urethra through a scrotal incision was performed. At 7-month postoperative follow-up the patient was completely free from urinary incontinence and urinary tract infection.

  14. A Case of Urethral Duplication Arising from the Posterior Urethra to the Scrotum with Urinary Stone in a 6-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Kenichi Mori

    2014-01-01

    Full Text Available Urethral duplication is a rare congenital anomaly. We report a 6-year-old male with type IIA2 (Y-type using Effmann’s classification. The accessory urethra, in which a urinary stone existed, arose from the posterior urethra to the scrotum. Because of recurrent urinary tract infection and urinary discharge from the accessory urethra, surgical removal of the accessory urethra through a scrotal incision was performed. At 7-month postoperative follow-up the patient was completely free from urinary incontinence and urinary tract infection.

  15. Interventional Cardiology for Congenital Heart Disease.

    Science.gov (United States)

    Kenny, Damien

    2018-05-01

    Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth. Increasing parental and physician expectancy has inevitably lead to higher risk interventions on smaller infants and appreciation of the consequences of these interventions on departmental outcome data needs to be considered. Registry data evaluating congenital heart interventions remain less robust than surgical registries, leading to a lack of insight into the longer-term consequences of our interventions. Increasing collaboration with surgical colleagues has not been met with necessary development of dedicated equipment for hybrid interventions aimed at minimizing the longer-term consequences of scar to the heart. Therefore, great challenges remain to ensure children and adults with congenital heart disease continue to benefit from an exponential growth in minimally invasive interventions and technology. This can only be achieved through a concerted collaborative approach from physicians, industry, academia and regulatory bodies supporting great innovators to continue the philosophy of thinking beyond the limits that has been the foundation of our specialty for the past 50 years. Copyright © 2018. The Korean Society of Cardiology.

  16. Mycoplasma genitalium in male urethritis: diagnosis and treatment in Japan.

    Science.gov (United States)

    Hamasuna, Ryoichi

    2013-07-01

    Male urethritis is a common disease for urologists, with the most common pathogens being, Chlamydia trachomatis and Neisseria gonorrhoeae. When the tests fail to detect these pathogens, the presented urethritis is called non-chlamydial non-gonococcal urethritis. Mycoplasma genitalium is one of the pathogens for non-chlamydial non-gonococcal urethritis. The test for detecting M. genitalium, which is commercially available in Japan, is not accepted by the Japanese insurance system now. The detection rate of M. genitalium from patients with non-gonococcal urethritis is 10-20% in Japan. Antimicrobial susceptibility testing for M. genitalium showed that macrolide has the strongest activity and the minimum inhibitory concentrations of tetracyclines were not substantially lower. Some kinds of fluoroquinolones, such as sitafloxacin and moxifloxacin, have stronger activities against M. genitalium. For non-gonococcal urethritis, macrolides and tetracycline are recommended in some guidelines. In clinical studies, tetracyclines are less effective against M. genitalium than azithromycin, and azithromycin regimens including 1 g stat or 2 g stat are now recommended for urethritis with M. genitalium. However, macrolide-resistant M. genitalium strains have recently emerged and are spreading worldwide. This macrolide-resistance is closely related to mutations on the 23S rRNA gene. Sitafloxacin and moxifloxacin have shown good efficacies for M. genitalium in some clinical studies. If the azithromycin regimens fail, we must consider the use of fluoroquinolones, such as sitafloxacin, in Japan. The most important issues include the acceptance of M. genitalium examinations by the national insurance system and the individual treatment of C. trachomatis and M. genitalium in the not-too-distant future. © 2013 The Japanese Urological Association.

  17. Intelligent Flow Control Valve

    Science.gov (United States)

    Kelley, Anthony R (Inventor)

    2015-01-01

    The present invention is an intelligent flow control valve which may be inserted into the flow coming out of a pipe and activated to provide a method to stop, measure, and meter flow coming from the open or possibly broken pipe. The intelligent flow control valve may be used to stop the flow while repairs are made. Once repairs have been made, the valve may be removed or used as a control valve to meter the amount of flow from inside the pipe. With the addition of instrumentation, the valve may also be used as a variable area flow meter and flow controller programmed based upon flowing conditions. With robotic additions, the valve may be configured to crawl into a desired pipe location, anchor itself, and activate flow control or metering remotely.

  18. Nuclear valves latest development

    International Nuclear Information System (INIS)

    Isaac, F.; Monier, M.

    1993-01-01

    In the frame of Nuclear Power Plant upgrade (Emergency Power Supply and Emergency Core Cooling), Westinghouse had to face a new valve design philosophy specially for motor operated valves. The valves have to been designed to resist any operating conditions, postulated accident or loss of control. The requirements for motor operated valves are listed and the selected model and related upgrading explained. As part of plant upgrade and valves replacement, Westinghouse has sponsored alternative hardfacing research programme. Two types of materials have been investigated: nickel base alloys and iron base alloys. Programme requirements and test results are given. A new globe valve model (On-Off or regulating) is described developed by Alsthom Velan permitting the seat replacement in less than 10 min. (Z.S.) 2 figs

  19. Cryogenic Cam Butterfly Valve

    Science.gov (United States)

    McCormack, Kenneth J. (Inventor)

    2016-01-01

    A cryogenic cam butterfly valve has a body that includes an axially extending fluid conduit formed there through. A disc lug is connected to a back side of a valve disc and has a circular bore that receives and is larger than a cam of a cam shaft. The valve disc is rotatable for a quarter turn within the body about a lug axis that is offset from the shaft axis. Actuating the cam shaft in the closing rotational direction first causes the camming side of the cam of the cam shaft to rotate the disc lug and the valve disc a quarter turn from the open position to the closed position. Further actuating causes the camming side of the cam shaft to translate the valve disc into sealed contact with the valve seat. Opening rotational direction of the cam shaft reverses these motions.

  20. Low noise control valve

    International Nuclear Information System (INIS)

    Christie, R.S.

    1975-01-01

    Noise is one of the problems associated with the use of any type of control valve in systems involving the flow of fluids. The advent of OSHA standards has prompted control valve manufacturers to design valves with special trim to lower the sound pressure level to meet these standards. However, these levels are in some cases too high, particularly when a valve must be located in or near an area where people are working at tasks requiring a high degree of concentration. Such locations are found around and near research devices and in laboratory-office areas. This paper describes a type of fluid control device presently being used at PPL as a bypass control valve in deionized water systems and designed to reduce sound pressure levels considerably below OSHA standards. Details of the design and construction of this constant pressure drop variable flow control valve are contained in the text and are shown in photographs and drawings. Test data taken are included

  1. Long anterior urethral stricture: Reconstruction by dorsally quilted penile skin flap

    Directory of Open Access Journals (Sweden)

    Mohammad Sayed Abdel-Kader

    2013-01-01

    Conclusion: Free penile skin flaps offer good results (functional and cosmetic in long anterior urethral stricture. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.

  2. Tissue Engineering for Human Urethral Reconstruction : Systematic Review of Recent Literature

    NARCIS (Netherlands)

    de Kemp, Vincent; de Graaf, Petra; Fledderus, Joost O.; Bosch, JLHR; de Kort, Laetitia

    2015-01-01

    Background Techniques to treat urethral stricture and hypospadias are restricted, as substitution of the unhealthy urethra with tissue from other origins (skin, bladder or buccal mucosa) has some limitations. Therefore, alternative sources of tissue for use in urethral reconstructions are

  3. Aortic or Mitral Valve Replacement With the Biocor and Biocor Supra

    Science.gov (United States)

    2017-04-26

    Aortic Valve Insufficiency; Aortic Valve Regurgitation; Aortic Valve Stenosis; Aortic Valve Incompetence; Mitral Valve Insufficiency; Mitral Valve Regurgitation; Mitral Valve Stenosis; Mitral Valve Incompetence

  4. Magnetic Check Valve

    Science.gov (United States)

    Morris, Brian G.; Bozeman, Richard J., Jr.

    1994-01-01

    Poppet in proposed check valve restored to closed condition by magnetic attraction instead of spring force. Oscillations suppressed, with consequent reduction of wear. Stationary magnetic disk mounted just upstream of poppet, also containing magnet. Valve body nonmagnetic. Forward pressure or flow would push poppet away from stationary magnetic disk so fluid flows easily around poppet. Stop in valve body prevents poppet from being swept away. When flow stopped or started to reverse, magnetic attraction draws poppet back to disk. Poppet then engages floating O-ring, thereby closing valve and preventing reverse flow. Floating O-ring facilitates sealing at low loads.

  5. Butterfly valves for seawater

    International Nuclear Information System (INIS)

    Yamanaka, Katsuto

    1991-01-01

    Recently in thermal and nuclear power stations and chemical plants which have become large capacity, large quantity of cooling water is required, and mostly seawater is utilized. In these cooling water systems, considering thermal efficiency and economy, the pipings become complex, and various control functions are demanded. For the purpose, the installation of shut-off valves and control valves for pipings is necessary. The various types of valves have been employed, and in particular, butterfly valves have many merits in their function, size, structure, operation, maintenance, usable period, price and so on. The corrosion behavior of seawater is complicated due to the pollution of seawater, therefore, the environment of the valves used for seawater became severe. The structure and the features of the butterfly valves for seawater, the change of the structure of the butterfly valves for seawater and the checkup of the butterfly valves for seawater are reported. The corrosion of metallic materials is complicatedly different due to the locating condition of plants, the state of pipings and the condition of use. The corrosion countermeasures for butterfly valves must be examined from the synthetic viewpoints. (K.I.)

  6. Redo mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Redoy Ranjan

    2018-03-01

    Full Text Available This study is based on the findings of a single surgeon’s practice of mitral valve replacement of 167 patients from April 2005 to June 2017 who developed symptomatic mitral restenosis after closed or open mitral commisurotomy. Both clinical and color doppler echocardiographic data of peri-operative and six months follow-up period were evaluated and compared to assess the early outcome of the redo mitral valve surgery. With male-female ratio of 1: 2.2 and after a duration of 6 to 22 years symptom free interval between the redo procedures, the selected patients with mitral valve restenosis undergone valve replacement with either mechanical valve in 62% cases and also tissue valve in 38% cases. Particular emphasis was given to separate the adhered pericardium from the heart completely to ameliorate base to apex and global contraction of the heart. Besides favorable post-operative clinical outcome, the echocardiographic findings were also encouraging as there was statistically significant increase in the mitral valve area and ejection fraction with significant decrease in the left atrial diameter, pressure gradient across the mitral valve and pulmonary artery systolic pressure. Therefore, in case of inevitable mitral restenosis after closed or open commisurotomy, mitral valve replacement is a promising treatment modality.

  7. Nitric Oxide-Sensitive Pulmonary Hypertension in Congenital Rubella Syndrome

    Directory of Open Access Journals (Sweden)

    Francesco Raimondi

    2015-01-01

    Full Text Available Persistent pulmonary hypertension is a very rare presentation of congenital virus infection. We discuss the case of complete congenital rubella syndrome presenting at echocardiography with pulmonary hypertension that worsened after ductus ligation. Cardiac catheterization showed a normal pulmonary valve and vascular tree but a PAP=40 mmHg. The infant promptly responded to inhaled nitric oxide while on mechanical ventilation and was later shifted to oral sildenafil. It is not clear whether our observation may be due to direct viral damage to the endothelium or to the rubella virus increasing the vascular tone via a metabolic derangement.

  8. Necrotizing Urethritis due to Aerococcus urinae

    Directory of Open Access Journals (Sweden)

    Abdulrahman A. Babaeer

    2015-01-01

    Full Text Available A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft of the penis and the scrotum were swollen and tender. No skin necrosis was observed and no crepitus was palpable. Serum white count (WBC was 29.5 × 103/μL. A CT scan showed gas in the corpus spongiosum. Antibiotics were started with IV metronidazole, vancomycin, and piperacillin/tazobactam. Metronidazole was then replaced by clindamycin. Exploration was performed but no necrotic tissue was identified. Cystourethroscopy revealed dusky looking urethra. A suprapubic tube and a urethral catheter were placed in the bladder. WBC trended down to 13.9 × 103/μL on the fourth postoperative day. Urine culture grew Aerococcus urinae and blood cultures grew Alpha Hemolytic Streptococcus. On the sixth day, the patient was feeling worse and WBC increased. MRI revealed absent blood flow to the corpus spongiosum. Urethroscopy revealed necrosis of the urethra. Urethrectomy was performed via perineal approach. The patient immediately improved. The patient was discharged on the sixth postoperative day to continue ampicillin/sulbactam IV every 6 hours for a total of 4 weeks from the day of urethrectomy.

  9. Necrotizing Urethritis due to Aerococcus urinae.

    Science.gov (United States)

    Babaeer, Abdulrahman A; Nader, Claudia; Iacoviello, Vito; Tomera, Kevin

    2015-01-01

    A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft of the penis and the scrotum were swollen and tender. No skin necrosis was observed and no crepitus was palpable. Serum white count (WBC) was 29.5 × 10(3)/μL. A CT scan showed gas in the corpus spongiosum. Antibiotics were started with IV metronidazole, vancomycin, and piperacillin/tazobactam. Metronidazole was then replaced by clindamycin. Exploration was performed but no necrotic tissue was identified. Cystourethroscopy revealed dusky looking urethra. A suprapubic tube and a urethral catheter were placed in the bladder. WBC trended down to 13.9 × 10(3)/μL on the fourth postoperative day. Urine culture grew Aerococcus urinae and blood cultures grew Alpha Hemolytic Streptococcus. On the sixth day, the patient was feeling worse and WBC increased. MRI revealed absent blood flow to the corpus spongiosum. Urethroscopy revealed necrosis of the urethra. Urethrectomy was performed via perineal approach. The patient immediately improved. The patient was discharged on the sixth postoperative day to continue ampicillin/sulbactam IV every 6 hours for a total of 4 weeks from the day of urethrectomy.

  10. Diseases of the Tricuspid Valve

    Science.gov (United States)

    ... stenosis. Tricuspid Regurgitation Tricuspid regurgitation is also called tricuspid insufficiency or tricuspid incompetence. It means there is a ... require valve surgery. Tags: heart valves , tricuspid incompetence , ... tricuspid regurgitation , tricuspid stenosis , valve disease Related Links ...

  11. Enterovesical Fistula: A Rare Complication of Urethral Catheterization

    Directory of Open Access Journals (Sweden)

    Amr Hawary

    2009-01-01

    Full Text Available This report describes the case of an eighty-two-year old lady with an indwelling urethral catheter inserted eight years prior to her presentation to manage her urinary incontinence. She underwent radiotherapy for muscle-invasive bladder cancer (stage T2b in 1991 and had a laparotomy and drainage of an appendicular abscess in her early twenties. She presented with a short history of fecaluria, pneumaturia, and passage of urine per rectum. On laparotomy she was found to have an inflated catheter balloon that has eroded through the bladder wall into the lumen of a terminal ileal segment. To our knowledge this is the first reported case in literature of a patient developing an enterovesical fistula as a result of a urethral catheter eroding through the bladder wall into the bowel lumen. There are numerous known complications of long-term urethral catheterization. They include recurrent urinary tract infections, recurrent pyelonephritis, sepsis, urethral stricture, blocked and retained catheters, among many other reported complications. This case describes an unusual presentation secondary to an even more unusual complication. This should be considered when handling patients with indwelling urethral catheters inserted in unhealthy bladders.

  12. [Urethral pain syndrome: fact or fiction--an update].

    Science.gov (United States)

    Dreger, N M; Degener, S; Roth, S; Brandt, A S; Lazica, D A

    2015-09-01

    Urethral pain syndrome is a symptom complex including dysuria, urinary urgency and frequency, nocturia and persistent or intermittent urethral and/or pelvic pain in the absence of proven infection. These symptoms overlap with several other conditions, such as interstitial cystitis bladder pain syndrome and overactive bladder. Urethral pain syndrome may occur in men but is more frequent in women. The exact etiology is unknown but infectious and psychogenic factors, urethral spasms, early interstitial cystitis, hypoestrogenism, squamous metaplasia as well as gynecological risk factors are discussed. These aspects should be ruled out or confirmed in the diagnostic approach. Despite the assumption of a multifactorial etiology, pathophysiologically there is a common pathway: dysfunctional epithelium of the urethra becomes leaky which leads to bacterial and abacterial inflammation and ends in fibrosis due to the chronic impairment. The therapeutic approach should be multimodal using a trial and error concept: general treatment includes analgesia, antibiotics, alpha receptor blockers and muscle relaxants, antimuscarinic therapy, topical vaginal estrogen, psychological support and physical therapy. In cases of nonresponding patients intravesical and/or surgical therapy should be considered. The aim of this review is to summarize the preliminary findings on urethral pain syndrome and to elucidate the diagnostic and therapeutic options.

  13. Urethral triplication with meatuses terminating on the penis: a rare case presenting with bifid urinary stream

    International Nuclear Information System (INIS)

    Hirselj, Daniel A.; Jayanthi, Venkata R.; Lowe, Gregory K.

    2009-01-01

    Urethral duplication is an uncommon clinical finding, and classification systems have been described to explain the clinical findings. Urethral triplication is an extremely uncommon diagnosis, with few published case reports. We present the rare case of an infant noted to have a bifid urinary stream and found to have urethral triplication on voiding cystourethrography. (orig.)

  14. Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015-2016.

    Science.gov (United States)

    Toh, Evelyn; Gangaiah, Dharanesh; Batteiger, Byron E; Williams, James A; Arno, Janet N; Tai, Albert; Batteiger, Teresa A; Nelson, David E

    2017-02-01

    At a clinic in Indianapolis, Indiana, USA, we observed an increase in Neisseria gonorrhoeae-negative men with suspected gonococcal urethritis who had urethral cultures positive for N. meningitidis. We describe genomes of 2 of these N. meningitidis sequence type 11 complex urethritis isolates. Clinical evidence suggests these isolates may represent an emerging urethrotropic clade.

  15. Soap induced urethral pain in boys | Okeke | West African Journal of ...

    African Journals Online (AJOL)

    Results: The symptoms started suddenly while bathing with soap. Penile erections at onset occurred in 14(78%). Two (11%) had purulent urethral discharge and 1(5.5%) had meatal stenosis. Application of bland petroleum jelly to the external urethral meatus before each soap bath satisfactorily controlled the urethral pains.

  16. Urethral triplication with meatuses terminating on the penis: a rare case presenting with bifid urinary stream

    Energy Technology Data Exchange (ETDEWEB)

    Hirselj, Daniel A.; Jayanthi, Venkata R. [Nationwide Children' s Hospital, Department of Pediatric Urology, Columbus, OH (United States); Lowe, Gregory K. [The Ohio State University Medical Center, Department of Urology, Columbus, OH (United States)

    2009-11-15

    Urethral duplication is an uncommon clinical finding, and classification systems have been described to explain the clinical findings. Urethral triplication is an extremely uncommon diagnosis, with few published case reports. We present the rare case of an infant noted to have a bifid urinary stream and found to have urethral triplication on voiding cystourethrography. (orig.)

  17. Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015–2016

    Science.gov (United States)

    Toh, Evelyn; Gangaiah, Dharanesh; Batteiger, Byron E.; Williams, James A.; Arno, Janet N.; Tai, Albert; Batteiger, Teresa A.

    2017-01-01

    At a clinic in Indianapolis, Indiana, USA, we observed an increase in Neisseria gonorrhoeae–negative men with suspected gonococcal urethritis who had urethral cultures positive for N. meningitidis. We describe genomes of 2 of these N. meningitidis sequence type 11 complex urethritis isolates. Clinical evidence suggests these isolates may represent an emerging urethrotropic clade. PMID:28098538

  18. Neonatal screening to detect critical congenital cardiac disease. A revolution in pediatrics

    Directory of Open Access Journals (Sweden)

    Vela Amieva Marcela

    2014-07-01

    Full Text Available There is solid evidence that demonstrate the usefulness of routine oxygen saturation testing in every apparently healthy newborn after 24 hours of life and before 48 hours. This procedure is known as “newborn screening for critical congenital heart disease” and serves to detect timely those congenital structural cardiac malformations with hypoxema, such as heart syndrome, pulmonary valve atresia, truncus arteriosus, total anomalous pulmonary vein connection, complete transposition of the great arteries, tetralogy of Fallot and tricuspid valve atresia. This test has been included in the mandatory neonatal screening panel of many countries and its generalization all over the world, seems imminent.

  19. Unicuspid aortic valve disease: a magnetic resonance imaging study

    International Nuclear Information System (INIS)

    Debl, K.; Buchner, S.; Heinicke, N.; Riegger, G.; Luchner, A.; Djavidani, B.; Poschenrieder, F.; Feuerbach, S.; Schmid, C.; Kobuch, R.

    2008-01-01

    Purpose: congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and methods/results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 ± 4.7 cm 2 vs. 8.7 ± 2.3 cm 2 , p < 0.01 and 4.6 ± 0.7 cm vs. 3.6 ± 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 ± 0.6 cm vs. 2.3 ± 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 ± 0.5 cm vs. 2.6 ± 0.3 cm, p < 0.05). (orig.)

  20. Unicuspid aortic valve disease: a magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Debl, K.; Buchner, S.; Heinicke, N.; Riegger, G.; Luchner, A. [Klinik und Poliklinik fuer Innere Medizin II, Universitaetsklinikum Regensburg (Germany); Djavidani, B.; Poschenrieder, F.; Feuerbach, S. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany); Schmid, C.; Kobuch, R. [Klinik und Poliklinik fuer Herz-, Thorax- und herznahe Gefaesschirurgie, Universitaetsklinikum Regensburg (Germany)

    2008-11-15

    Purpose: congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and methods/results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 {+-} 4.7 cm{sup 2} vs. 8.7 {+-} 2.3 cm{sup 2}, p < 0.01 and 4.6 {+-} 0.7 cm vs. 3.6 {+-} 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 {+-} 0.6 cm vs. 2.3 {+-} 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 {+-} 0.5 cm vs. 2.6 {+-} 0.3 cm, p < 0.05). (orig.)

  1. Genomic Characterization of Urethritis-Associated Neisseria meningitidis Shows that a Wide Range of N. meningitidis Strains Can Cause Urethritis.

    Science.gov (United States)

    Ma, Kevin C; Unemo, Magnus; Jeverica, Samo; Kirkcaldy, Robert D; Takahashi, Hideyuki; Ohnishi, Makoto; Grad, Yonatan H

    2017-12-01

    Neisseria meningitidis , typically a resident of the oro- or nasopharynx and the causative agent of meningococcal meningitis and meningococcemia, is capable of invading and colonizing the urogenital tract. This can result in urethritis, akin to the syndrome caused by its sister species, N. gonorrhoeae , the etiologic agent of gonorrhea. Recently, meningococcal strains associated with outbreaks of urethritis were reported to share genetic characteristics with the gonococcus, raising the question of the extent to which these strains contain features that promote adaptation to the genitourinary niche, making them gonococcus-like and distinguishing them from other N. meningitidis strains. Here, we analyzed the genomes of 39 diverse N. meningitidis isolates associated with urethritis, collected independently over a decade and across three continents. In particular, we characterized the diversity of the nitrite reductase gene ( aniA ), the factor H-binding protein gene ( fHbp ), and the capsule biosynthetic locus, all of which are loci previously suggested to be associated with urogenital colonization. We observed notable diversity, including frameshift variants, in aniA and fHbp and the presence of intact, disrupted, and absent capsule biosynthetic genes, indicating that urogenital colonization and urethritis caused by N. meningitidis are possible across a range of meningococcal genotypes. Previously identified allelic patterns in urethritis-associated N. meningitidis strains may reflect genetic diversity in the underlying meningococcal population rather than novel adaptation to the urogenital tract. Copyright © 2017 American Society for Microbiology.

  2. Correlation between prostate brachytherapy-related urethral stricture and peri-apical urethral dosimetry: A matched case–control study

    International Nuclear Information System (INIS)

    Earley, James J.; Abdelbaky, Ather M.; Cunningham, Melanie J.; Chadwick, Eliot; Langley, Stephen E.M.; Laing, Robert W.

    2012-01-01

    Background and purpose: Radiation dose to the bulbomembranous urethra has been shown to correlate with urethral stricture formation. This retrospective case–control study was designed to explore the relationship between dose to the apical/peri-apical regions of the urethra and development of brachytherapy (BXT)-related urethral stricture. Materials and methods: Cases were patients who developed urethral stricture after treatment with BXT as monotherapy and who had urethral dosimetry post-implant. Each case was matched with a control that had not developed urethral stricture. Dosimetry was compared between cases and controls. Results: Twenty-three cases were pair matched with 23 controls. There were no significant differences between the two groups in terms of age, presenting Prostate Specific Antigen (PSA), International Prostate Symptom Score (IPSS) or Gleason score. The dose delivered to the peri-apical and apical urethra was significantly higher for cases when compared with controls (peri-apical urethra: mean V 150 1.1 Vs 0.8 cc [p = 0.02]; apical urethra: mean dose 200 Vs 174 Gy [p = 0.01]). The distance from the prostate apex to isodose lines was also found to be significant in predicting stricture formation. Conclusion: There was evidence to suggest that the development of BXT-related stricture was associated with radiation dose at the apical and peri-apical urethra. Attention to the dose delivered to those areas may minimise the risk of developing such morbidity.

  3. Vaginal Swab Test Compared With the Urethral Q-tip Test for Urethral Mobility Measurement: A Randomized Controlled Trial.

    Science.gov (United States)

    Meyer, Isuzu; Szychowski, Jeff M; Illston, Jana D; Parden, Alison M; Richter, Holly E

    2016-02-01

    To assess whether use of a vaginal cotton-tipped swab is equivalent to the standard Q-tip test regarding urethral mobility. Secondarily, to examine whether both tests agree in hypermobility diagnosis, discomfort level, and patients' preference. In this randomized crossover trial, women with stress urinary incontinence without prolapse beyond the hymen were randomized to undergo either a vaginal or urethral mobility test first followed by the alternate approach. The primary outcome was the difference in rotation angle, from resting to maximum strain, between tests. The equivalence margin was ±10°. The secondary outcome was agreement in hypermobility diagnosis using two definitions: 1) maximum straining angle of 30° or greater from the horizontal plane; and 2) rotation angle 30° or greater. Discomfort was assessed using a 0-10 visual analog scale. Using 90% power assuming a standard deviation of 20°, 36 and 139 patients were needed for 10° and 5° equivalence margins, respectively. From January 2014 to March 2015, 140 women were randomized. The mean difference between the two tests was 5.1° (95% confidence interval 3.2-6.9°), meeting the predefined equivalence criteria. In the hypermobility diagnosis, the urethral and vaginal tests had no disagreement using definition 1 (P=.23), whereas the two tests disagreed using definition 2 (P=.03). The urethral approach had a higher discomfort level (Pstandard Q-tip test in measuring urethral mobility with less discomfort and is preferred by patients.

  4. Treatment of male urethral strictures - possible reasons for the use of repeated dilatation or internal urethrotomy rather than urethroplasty.

    Science.gov (United States)

    Heyns, C F; van der Merwe, J; Basson, J; van der Merwe, A

    2012-07-16

    To investigate the possible reasons for repeated urethral dilatation or optical internal urethrotomy rather than urethroplasty in the treatment of male urethral strictures. Men referred to the stricture clinic of our institution during the period April 2007 - March 2008 were reviewed and the operative urological procedures performed in the same period were analysed. Statistical analysis was performed using Student's t-test and Fisher's exact test (purethrotomy in 26%, 15% and 28%, and urethroplasty in 4%, 9% and 0, respectively. The group with 5 - 6 compared with 1 - 2 previous treatments was significantly older (mean age 60.2 v. 46.6 years) and had a significantly greater proportion with underlying co-morbidities (80% v. 52%). The group that had undergone urethroplasty compared with 5 - 6 repeated dilatations or urethrotomies was significantly younger (mean age 48.2 v. 60.2 years) with a lower prevalence of co-morbidities (47% v. 80%). During the study period urethroplasty was performed in 16 (2%) of 821 inpatients, whereas 55 men were seen who had undergone ≥3 previous procedures, indicating that urethroplasty was performed in less than one-third of cases in which it would have been the optimal treatment. Owing to limited theatre time, procedures indicated for malignancy, urolithiasis, renal failure and congenital anomalies were performed more often than urethroplasty. Factors that possibly influenced the decision to perform repeated urethrotomy or dilatation instead of urethroplasty were limited theatre time, increased patient age and the presence of underlying co-morbidities.

  5. [Non-gonococcal infectious urethritis : pathogen spectrum and management].

    Science.gov (United States)

    Lautenschlager, S

    2015-01-01

    For many years an increase in cases of urethritis has been observed in western Europe. In order to be able to combat this continuous rise, the perception of sexually transmitted diseases must be promoted, the clarification and screening must be intensified and therapy must be rapidly and correctly carried out. In addition to the commonest pathogens causing urethritis, namely chlamydia and gonococci, many other pathogenic microbes must be taken into consideration in the diagnostics. With respect to therapy, apart from the increasing resistance formation of Mycoplasma genitalium, the decreasing effectiveness of standard forms of treatment of other microbes must be emphasized. For chronic and recurrent urethritis in particular a broad clarification of the pathogen should be carried out to enable targeted treatment and also partner treatment. Priority must again be given to primary prevention.

  6. Sonourethrography in the evaluation of anterior urethral strictures

    International Nuclear Information System (INIS)

    Kim, Jong Chul; Kwag, Jin Geun

    1994-01-01

    To determine the reliability of sonourethrography (SUG) in the evaluation of male anterior urethral strictures. Both SUG with retrograde saline infusion and retrograde urethrography (RUG) were performed in 5 young normal volunteers and 20 patients with symptoms of impaired urine flow. Those findings were compared with urethroscopic and operative findings in all patients. SUG was more accurate in the evaluation of the stricture length and degree than RUG in 7 patients with anterior urethral strictures, when compared with their subsequent open urethroplasty findings. Only SUG could classify the degree of spongiofibrosis surrounding the strictures in 15 patients. So, SUG was diagnostically as efficacious as or, superior to, RUG in all 20 patients. SUG can be used as one of complementary and reliable tools for diagnosis, evaluation and follow-up of anterior urethral strictures

  7. Adult congenital cardiopathy: percutaneous treatment of a complex case

    International Nuclear Information System (INIS)

    Suarez N, Alberto; Carvajal, Andres; Bustillo, Sabas

    2008-01-01

    Adult congenital cardiopathy is a clinical entity difficult to treat and diagnose. Since 1982 endovascular therapy changed its approach radically (1) and in the last years the design of new appliances and better balloon catheters facilitated the implementation of therapy to a greater number of patients (2). It is the election treatment for entities such as pulmonary valve stenosis (3), atrial septal defect (4) and persistent ductus arteriosus. We present the case of complex adult congenital cardiopathy that consisted of wide atrial septal defect,pulmonary valve stenosis with severe repercussion on the right ventricle, persistent PDA with severe calcification and pulmonary arterial hypertension and systemic essential arterial hypertension that were successfully treated through interventionist endovascular therapy in the Hospital Militar Central, in Bogota.

  8. Danfos: Thermostatic Radiator Valves

    DEFF Research Database (Denmark)

    Gregersen, Niels; Oliver, James; Hjorth, Poul G.

    2000-01-01

    This problem deals with modelling the flow through a typical Danfoss thermostatic radiator valve.Danfoss is able to employ Computational Fluid Dynamics (CFD) in calculations of the capacity of valves, but an experienced engineer can often by rules of thumb "guess" the capacity, with a precision...

  9. Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts. Part Five-transcatheter intervention for the treatment of compound congenital cardiac anomalies

    International Nuclear Information System (INIS)

    Committee on Congenital Heart Diseases, Internal Medicine Branch of Cadiovascular Diseases of China Physicians' Association

    2011-01-01

    Compound congenital cardiac anomalies refer to two or more congenital cardiovascular defects coexisting in the same patient. Transcatheter intervention for compound congenital cardiac anomalies has got satisfactory results in recent years. However, the percutaneous closure procedure used for compound congenital cardiac defects does not mean the simple addition of single interventional technique. Clinically, it needs more specialist expertise to deal with such complex defects. This chapter will briefly describe the pathophysiology and clinical features of the following compound congenital cardiac anomalies: the ventricular septal defect (VSD) with coexistence of atrial septal defect (ASD), patent ductus arteriosus (PDA) or pulmonary valve stenosis (PS), the ASD coexistence of PDA, PS or mitral stenosis (Lutembacher's syndrome), and coarctation of aorta compound with PDA. The indications and contraindications, the therapeutic principles, the matters needing attention, the postoperative management, the judgment of curative effect, etc. of using transcatheter for the treatment of such compound anomalies will also be discussed. (authors)

  10. Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts. Part Five-transcatheter intervention for the treatment of compound congenital cardiac anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Committee on Congenital Heart Diseases, Internal Medicine Branch of Cadiovascular Diseases of China Physicians' Association

    2011-05-15

    Compound congenital cardiac anomalies refer to two or more congenital cardiovascular defects coexisting in the same patient. Transcatheter intervention for compound congenital cardiac anomalies has got satisfactory results in recent years. However, the percutaneous closure procedure used for compound congenital cardiac defects does not mean the simple addition of single interventional technique. Clinically, it needs more specialist expertise to deal with such complex defects. This chapter will briefly describe the pathophysiology and clinical features of the following compound congenital cardiac anomalies: the ventricular septal defect (VSD) with coexistence of atrial septal defect (ASD), patent ductus arteriosus (PDA) or pulmonary valve stenosis (PS), the ASD coexistence of PDA, PS or mitral stenosis (Lutembacher's syndrome), and coarctation of aorta compound with PDA. The indications and contraindications, the therapeutic principles, the matters needing attention, the postoperative management, the judgment of curative effect, etc. of using transcatheter for the treatment of such compound anomalies will also be discussed. (authors)

  11. Congenital orbital teratoma

    OpenAIRE

    Aiyub, Shereen; Chan, Weng Onn; Szetu, John; Sullivan, Laurence J; Pater, John; Cooper, Peter; Selva, Dinesh

    2013-01-01

    We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The p...

  12. Where do patients go for treatment of urethritis?

    Science.gov (United States)

    Hoscan, Mustafa Burak; Tunckiran, Ahmet; Oksay, Taylan; Ozorak, Alper; Ozkardes, Hakan

    2014-05-01

    Urethritis is characterized by urethral inflammation, and it can result from both infectious and noninfectious conditions. Physicians and other health care providers play a critical role in preventing and treating urethritis. The aim of this study was to describe and identify predictors of health care seeking behavior among men with urethritis. In total, 98 male patients aged between 16 to 52 years-of-age (mean 30.9 ± 8.0 years), who attended our clinic with symptoms of urethritis, were included in the study. We conducted face-to-face interviews with the patients using a 9-item survey questionnaire. Patients were divided into three groups according to their level of education as follows: group I (n = 44), elementary school; group II (n = 38), high school; and group III (n = 16), university. Among the 98 patients evaluated, the source of treatment was physicians in 44 patients (44.9%), drugstores in 38 cases (38.77%), and friends in 16 patients (16.32%). There was a statistically significant difference found between the groups according to the source of treatment (P < 0.001). The most common factors associated with seeking care from other sources, rather than physicians, were economic reasons in 19 patients (35.18%), confidentiality concerns in 24 (44.4%), and ease of access in 11 patients (20.37%). A substantial proportion of patients with urethritis sought help from other sources, rather than physicians. The results of our study show that the patients with higher levels of education were more likely to seek help from health care services. It is important to promote the public's knowledge through informative studies and educational materials in order to encourage patients to seek rapid and effective treatment from proper sources.

  13. Urethral stricture following high dose rate brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Sullivan, Lisa; Williams, Scott G.; Tai, Keen Hun; Foroudi, Farshad; Cleeve, L.; Duchesne, Gillian M.

    2009-01-01

    Purpose: To evaluate the incidence, timing, nature and outcome of urethral strictures following high dose rate brachytherapy (HDRB) for prostate carcinoma. Methods and materials: Data from 474 patients with clinically localised prostate cancer treated with HDRB were analysed. Ninety percent received HDRB as a boost to external beam radiotherapy (HDRBB) and the remainder as monotherapy (HDRBM). Urethral strictures were graded according to the Common Terminology Criteria for Adverse Events v3.0. Results: At a median follow-up of 41 months, 38 patients (8%) were diagnosed with a urethral stricture (6-year actuarial risk 12%). Stricture location was bulbo-membranous (BM) urethra in 92.1%. The overall actuarial rate of grade 2 or more BM urethral stricture was estimated at 10.8% (95% CI 7.0-14.9%), with a median time to diagnosis of 22 months (range 10-68 months). All strictures were initially managed with either dilatation (n = 15) or optical urethrotomy (n = 20). Second line therapy was required in 17 cases (49%), third line in three cases (9%) and 1 patient open urethroplasty (grade 3 toxicity). Predictive factors on multivariate analysis were prior trans-urethral resection of prostate (hazard ratio (HR) 2.81, 95% CI 1.15-6.85, p = 0.023); hypertension (HR 2.83, 95% CI 1.37-5.85, p = 0.005); and dose per fraction used in HDR (HR for 1 Gy increase per fraction 1.33, 95% CI 1.08-1.64, p = 0.008). Conclusions: BM urethral strictures are the most common late grade 2 or more urinary toxicity following HDR brachytherapy for prostate cancer. Most are manageable with minimally invasive procedures. Both clinical and dosimetric factors appear to influence the risk of stricture formation.

  14. Bioprinting a cardiac valve.

    Science.gov (United States)

    Jana, Soumen; Lerman, Amir

    2015-12-01

    Heart valve tissue engineering could be a possible solution for the limitations of mechanical and biological prostheses, which are commonly used for heart valve replacement. In tissue engineering, cells are seeded into a 3-dimensional platform, termed the scaffold, to make the engineered tissue construct. However, mimicking the mechanical and spatial heterogeneity of a heart valve structure in a fabricated scaffold with uniform cell distribution is daunting when approached conventionally. Bioprinting is an emerging technique that can produce biological products containing matrix and cells, together or separately with morphological, structural and mechanical diversity. This advance increases the possibility of fabricating the structure of a heart valve in vitro and using it as a functional tissue construct for implantation. This review describes the use of bioprinting technology in heart valve tissue engineering. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Space Vehicle Valve System

    Science.gov (United States)

    Kelley, Anthony R. (Inventor); Lindner, Jeffrey L. (Inventor)

    2014-01-01

    The present invention is a space vehicle valve system which controls the internal pressure of a space vehicle and the flow rate of purged gases at a given internal pressure and aperture site. A plurality of quasi-unique variable dimension peaked valve structures cover the purge apertures on a space vehicle. Interchangeable sheet guards configured to cover valve apertures on the peaked valve structure contain a pressure-activated surface on the inner surface. Sheet guards move outwardly from the peaked valve structure when in structural contact with a purge gas stream flowing through the apertures on the space vehicle. Changing the properties of the sheet guards changes the response of the sheet guards at a given internal pressure, providing control of the flow rate at a given aperture site.

  16. Multiple-port valve

    International Nuclear Information System (INIS)

    Doody, T.J.

    1978-01-01

    A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

  17. Male non-gonococcal urethritis: From microbiological etiologies to demographic and clinical features.

    Science.gov (United States)

    Ito, Shin; Hanaoka, Nozomu; Shimuta, Ken; Seike, Kensaku; Tsuchiya, Tomohiro; Yasuda, Mitsuru; Yokoi, Shigeaki; Nakano, Masahiro; Ohnishi, Makoto; Deguchi, Takashi

    2016-04-01

    To detect microorganisms responsible for male acute urethritis and to define the microbiology of non-gonococcal urethritis. The present study comprised 424 men with symptoms and signs compatible with acute urethritis. Their urethral swabs and first-voided urine underwent detection of the microorganisms. Demographic characteristics and clinical features of Mycoplasma genitalium-, Ureaplasma urealyticum-, Haemophilus influenza-, adenovirus- or Herpes simplex virus-positive monomicrobial non-gonococcal urethritis, or all-examined microorganism-negative urethritis in heterosexual men were compared with urethritis positive only for Chlamydia trachomatis. Neisseria gonorrhoeae was detected in 127 men (30.0%). In 297 men with non-gonococcal urethritis, C. trachomatis was detected in 143 (48.1%). In 154 men with non-chlamydial non-gonococcal urethritis, M. genitalium (22.7%), M. hominis (5.8%), Ureaplasma parvum (9.1%), U. urealyticum (19.5%), H. influenzae (14.3%), Neisseria meningitidis (3.9%), Trichomonas vaginalis (1.3%), human adenovirus (16.2%), and Herpes simplex virus types 1 (7.1%) and 2 (2.6%) were detected. Although some features of monomicrobial non-chlamydial non-gonococcal urethritis or all-examined microorganism-negative urethritis were significantly different from those of monomicrobial chlamydial non-gonococcal urethritis, most features were superimposed. Predicting causative microorganisms in men with non-gonococcal urethritis based on demographic and clinical features is difficult. However, the present study provides useful information to better understand the microbiological diversity in non-gonococcal urethritis, and to manage patients with non-gonococcal urethritis appropriately. © 2016 The Japanese Urological Association.

  18. Mechanical valve at pulmonary site in adult TOF & absent pulmonary valve

    Directory of Open Access Journals (Sweden)

    Aayush Goyal

    2017-09-01

    Full Text Available Absent pulmonary valve syndrome (APVS is a rare congenital heart disease. Tetralogy of Fallot (TOF with APVS is a rare variation of TOF. These patients are commonly cyanotic at birth. Respiratory complaints predominate due to airway compression by dilated pulmonary arteries. Commonest age of presentation is infancy with anecdotal adult case-reports. Surgical treatment requires establishing unobstructed competent right ventricular outflow tract (RVOT often with monocusp or conduits. We present a novel technique of rendering RVOT competent by implanting a tilting disc mechanical prosthesis in a rare adult TOF with APVS.

  19. Cytomegalovirus Congenital Cataract

    Directory of Open Access Journals (Sweden)

    Ridha Wahyutomo

    2011-06-01

    Full Text Available Cytomegalovirus congenital infection is an infection caused by the the subfamily â Herpesviridae, during pregnancy. The incidence of infections among newborn infants is 1 %. One of the effects of congenitally acquired infection is the congenital cataract. A 6-year-old child complained to have a blurred vision diagnosed with cytomegalovirus congenital cataract. The diagnosis was confirmed by a positive serology testing for Ig M and Ig G CMV. The laboratory test using Giemsa staining to find inclusion bodies and a faster PCR could not be carried out (Sains Medika, 3(1:84-88.

  20. Urethral Lymphogranuloma Venereum Infections in Men With Anorectal Lymphogranuloma Venereum and Their Partners: The Missing Link in the Current Epidemic?

    NARCIS (Netherlands)

    de Vrieze, Nynke Hesselina Neeltje; van Rooijen, Martijn; Speksnijder, Arjen Gerard Cornelis Lambertus; de Vries, Henry John C.

    2013-01-01

    Urethral lymphogranuloma venereum (LGV) is not screened routinely. We found that in 341 men having sex with men with anorectal LGV, 7 (2.1%) had concurrent urethral LGV. Among 59 partners, 4 (6.8%) had urethral LGV infections. Urethral LGV is common, probably key in transmission, and missed in

  1. Urethral lymphogranuloma venereum infections in men with anorectal lymphogranuloma venereum and their partners: the missing link in the current epidemic?

    Science.gov (United States)

    de Vrieze, Nynke Hesselina Neeltje; van Rooijen, Martijn; Speksnijder, Arjen Gerard Cornelis Lambertus; de Vries, Henry John C

    2013-08-01

    Urethral lymphogranuloma venereum (LGV) is not screened routinely. We found that in 341 men having sex with men with anorectal LGV, 7 (2.1%) had concurrent urethral LGV. Among 59 partners, 4 (6.8%) had urethral LGV infections. Urethral LGV is common, probably key in transmission, and missed in current routine LGV screening algorithms.

  2. Genetics Home Reference: congenital hypothyroidism

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions Congenital hypothyroidism Congenital hypothyroidism Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Congenital hypothyroidism is a partial or complete loss of function ...

  3. Bleomycin induced urethral stricture in Hodgkin′s disease

    Directory of Open Access Journals (Sweden)

    Ritesh Tapkire

    2009-01-01

    Full Text Available Bleomycin is a glycoprotein that is extensively used in combination with other anti-cancer agents because of its relative lack of hematological and gastrointestinal toxicity. However, pulmonary toxicity is common with bleomycin and limits its therapeutic utility. Urethral stricture as a result of bleomycin toxicity has not been reported in literature. In this case report, a young male patient who developed urethral stricture after bleomycin-based chemotherapy is described and the possible effects of bleomycin on the urethra are discussed.

  4. A bulbar artery pseudoaneurysm following traumatic urethral catheterization.

    Science.gov (United States)

    Bettez, Mathieu; Aubé, Melanie; Sherbiny, Mohamed El; Cabrera, Tatiana; Jednak, Roman

    2017-01-01

    Traumatic urethral catheterization may result in a number of serious complications. A rare occurrence is the development of a urethral pseudoaneurysm. We report the case of a 13-year-old male who required placement of a Foley catheter for an orthopedic surgical procedure. The Foley was misplaced in the bulbourethra, resulting in the development of a bulbar artery pseudoaneurysm. Profuse bleeding via the urethra was noted after removal of the catheter, and the patient experienced severe intermittent hematuria during the postoperative period. Cystoscopy revealed a pulsatile mass within the bulbourethra. Angiography confirmed a bulbar artery pseudoaneurysm, which was successfully embolized with resolution of bleeding.

  5. Incomplete urethral duplication with cyst formation in a dog

    International Nuclear Information System (INIS)

    Duffey, M.H.; Barnhart, M.D.; Barthez, P.Y.; Smeak, D.D.

    1998-01-01

    Incomplete urethral duplication with cyst formation was diagnosed in a dog that had soft, fluctuant, subcutaneous swellings in the ventral perineal and penile areas and a history of nocturia and incontinence during recumbency that were unresponsive to treatment with antibiotics. Retrograde urethrocystography, voiding urethrography, double-contrast cystography, radiography after direct administration of contrast medium into cystic structures, and excretory urography were performed to evaluate the urinary tract. Communication between the cysts and the urethra was demonstrated radiographically only after intralesional injection of contrast medium. Nocturia and incontinence resolved after surgical removal of the urethral duplication and cysts. The dog was clinically normal 1 year after surgery

  6. A bulbar artery pseudoaneurysm following traumatic urethral catheterization

    Science.gov (United States)

    Bettez, Mathieu; Aubé, Melanie; Sherbiny, Mohamed El; Cabrera, Tatiana; Jednak, Roman

    2017-01-01

    Traumatic urethral catheterization may result in a number of serious complications. A rare occurrence is the development of a urethral pseudoaneurysm. We report the case of a 13-year-old male who required placement of a Foley catheter for an orthopedic surgical procedure. The Foley was misplaced in the bulbourethra, resulting in the development of a bulbar artery pseudoaneurysm. Profuse bleeding via the urethra was noted after removal of the catheter, and the patient experienced severe intermittent hematuria during the postoperative period. Cystoscopy revealed a pulsatile mass within the bulbourethra. Angiography confirmed a bulbar artery pseudoaneurysm, which was successfully embolized with resolution of bleeding. PMID:28163815

  7. Impacted calculus within a urethral stent: A rare cause of urinary retention

    Directory of Open Access Journals (Sweden)

    Shanmugasundaram Rajaian

    2011-01-01

    Full Text Available An elderly male presented to the emergency department with acute urinary retention. He had poor flow of urine associated with serosanguinous discharge per urethra for 3 days duration. Earlier he underwent permanent metallic urethral stenting for post TURP bulbar urethral stricture. Plain X-ray of Pelvis showed an impacted calculus within the urethral stent in bulbar urethra. Urethrolitholapaxy was done with semirigid ureteroscope. Urethral stent was patent and well covered. Subsequently he had an uneventful recovery. We describe a unique case of acute urinary retention due to calculus impaction within a urethral stent.

  8. Measurement of urethral closure function in women with stress urinary incontinence

    DEFF Research Database (Denmark)

    Klarskov, N; Scholfield, D; Soma, K

    2009-01-01

    , double-blind, placebo controlled, crossover study 17 women with stress urinary incontinence or mixed urinary incontinence received 4 mg esreboxetine or placebo for 7 to 9 days followed by a washout period before crossing over treatments. Urethral pressure reflectometry and urethral pressure profilometry......, and had a positive and clinically relevant effect on urethral closure function and symptoms of stress urinary incontinence....... esreboxetine patients had significantly fewer incontinence episodes and reported a treatment benefit (global impression of change) compared to placebo. CONCLUSIONS: The opening pressure measured with urethral pressure reflectometry was less variable compared to the parameters measured with urethral pressure...

  9. Mitochondrial disorders in congenital myopathies

    Directory of Open Access Journals (Sweden)

    D. A. Kharlamov

    2014-01-01

    Full Text Available The literature review gives data on the role of mitochondrial disorders in the pathogenesis of congenital myopathies: congenital muscular dystrophies and congenital structural myopathies. It describes changes in congenital muscular dystrophies with type VI collagen, in myodystrophy with giant mitochondria, in congenital central core myopathies, myotubular myopathy, etc. Clinical and experimental findings are presented. Approaches to therapy for energy disorders in congenital myopathies are depicted.

  10. The dosimetry of prostate brachytherapy-induced urethral strictures

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Tollenaar, Bryan G.; Galbreath, Robert W.; Lief, Jonathan H.

    2002-01-01

    Purpose: There is a paucity of data regarding the incidence of urethral strictures after prostate brachytherapy. In this study, we evaluate multiple clinical, treatment, and dosimetric parameters to identify factors associated with the development of brachytherapy-induced urethral strictures. Methods and Materials: 425 patients underwent transperineal ultrasound-guided prostate brachytherapy using either 103 Pd or 125 I for clinical T1b/T3a NxM0 (1997, American Joint Committee on Cancer) adenocarcinoma of the prostate gland from April 1995 to October 1999. No patient was lost to follow-up. 221 patients were implanted with 103 Pd and 204 patients with 125 I. The median patient age was 68 years (range 48-81 years). The median follow-up was 35.2 months (range 15-72 months). Follow-up was calculated from the day of implantation. Thirteen patients developed brachytherapy-induced strictures, and all strictures involved the membranous urethra. A control group of 35 patients was rigorously matched to the stricture patients in terms of treatment approach; i.e., choice of isotope, plus or minus radiation therapy, and plus or minus hormonal manipulation. Nine of the 13 stricture patients had detailed Day 0 urethral dosimetry available for review. The apex of the prostate gland and the membranous urethra were defined by CT evaluation. Urethral dosimetry was reported for the prostatic urethra, the apical slice of the prostate gland, and the membranous urethra which was defined as extending 20 mm in length. Results: The 5-year actuarial risk of a urethral stricture was 5.3%, with a median time to development of 26.6 months (range 7.8-44.1 months). Of multiple clinical and treatment parameters evaluated, only the duration of hormonal manipulation (>4 months, p=0.011) was predictive for the development of a urethral stricture. The radiation dose to the membranous urethra was significantly greater in patients with strictures than those without: 97.6%±20.8% vs. 81.0%±19.8% of

  11. Dorsolateral onlay urethroplasty for anterior urethral strictures by a unilateral urethral mobilization approach

    Directory of Open Access Journals (Sweden)

    Bhupendra P Singh

    2009-01-01

    Settings and Design: A prospective study from September 2005 to March 2008 in a tertiary care teaching hospital. Materials and Methods: Seventeen patients with long or multiple strictures of the anterior urethra were treated by a dorsolateral free buccal mucosa graft. The pendulous urethra was accessed by penile eversion through the perineal wound. The urethra was not separated from the corporal bodies on one side and was only mobilized from the midline on the ventral aspect to beyond the midline on the dorsal aspect. The urethra was opened in the dorsal midline over the stricture. The buccal mucosa graft was secured on the ventral tunica of the corporal bodies. Statistical Analysis Used: Mean and median. Results: After a follow-up of 12-30 months, one recurrence developed and 1 patient needed an internal urethrotomy. Conclusions: A unilateral urethral mobilization approach for dorsolateral free graft urethroplasty is feasible for panurethral strictures of any length with good short-term success.

  12. The urethral closure function in continent and stress urinary incontinent women assessed by urethral pressure reflectometry

    DEFF Research Database (Denmark)

    Saaby, Marie-Louise

    2014-01-01

    , the parameters showed highly significant negative correlation with ICIQ-SF, pad test and the number of incontinence episodes per week and are therefore valid as urodynamic severity measures. UPR in SUI women before and after TVT demonstrated a more efficient urethral closure function after the operation. The Po......-rest was unchanged suggesting that the sphincteric unit was virtually unaltered and hence the permanent closure forces unchanged. However, the resting opening elastance increased by 18% indicating that at the resting state the TVT somewhat improves the closure function by providing increased resistance against...... the dilation of the urethra, which probably explains the decreased maximum urine flow rate found after TVT in this and previous studies. The APIR increased in all patients after TVT suggesting that the support system was re-established and thus the adjunctive closure forces improved, regardless of the type...

  13. Potential implications of the helical heart in congenital heart defects.

    Science.gov (United States)

    Corno, Antonio F; Kocica, Mladen J

    2007-01-01

    The anatomic and functional observations made by Francisco Torrent-Guasp, in particular his discovery of the helical ventricular myocardial band (HVMB), have challenged what has been taught to cardiologists and cardiac surgeons over centuries. A literature debate is ongoing, with interdependent articles and comments from supporters and critics. Adequate understanding of heart structure and function is obviously indispensable for the decision-making process in congenital heart defects. The HVMB described by Torrent-Guasp and the potential impact on the understanding and treatment of congenital heart defects has been analyzed in the following settings: embryology, ventriculo-arterial discordance (transposition of great arteries), Ebstein's anomaly, pulmonary valve regurgitation after repair of tetralogy of Fallot, Ross operation, and other congenital heart defects. The common structural spiral feature is only one of the elements responsible for the functional interaction of right and left ventricles, and understanding the form/function relationship in congenital heart defects is more difficult than for acquired heart disease because of the variety and complexity of congenital heart defects. Individuals involved in the care of patients with congenital heart defects have to be stimulated to consider further investigations and alternative surgical strategies.

  14. Gate valve performance prediction

    International Nuclear Information System (INIS)

    Harrison, D.H.; Damerell, P.S.; Wang, J.K.; Kalsi, M.S.; Wolfe, K.J.

    1994-01-01

    The Electric Power Research Institute is carrying out a program to improve the performance prediction methods for motor-operated valves. As part of this program, an analytical method to predict the stem thrust required to stroke a gate valve has been developed and has been assessed against data from gate valve tests. The method accounts for the loads applied to the disc by fluid flow and for the detailed mechanical interaction of the stem, disc, guides, and seats. To support development of the method, two separate-effects test programs were carried out. One test program determined friction coefficients for contacts between gate valve parts by using material specimens in controlled environments. The other test program investigated the interaction of the stem, disc, guides, and seat using a special fixture with full-sized gate valve parts. The method has been assessed against flow-loop and in-plant test data. These tests include valve sizes from 3 to 18 in. and cover a considerable range of flow, temperature, and differential pressure. Stem thrust predictions for the method bound measured results. In some cases, the bounding predictions are substantially higher than the stem loads required for valve operation, as a result of the bounding nature of the friction coefficients in the method

  15. Modeling valve leakage

    International Nuclear Information System (INIS)

    Bell, S.R.; Rohrscheib, R.

    1994-01-01

    The American Society of Mechanical Engineers (ASME) Code requires individual valve leakage testing for Category A valves. Although the U.S. Nuclear Regulatory Commission (USNRC) has recognized that it is more appropriate to test containment isolation valves in groups, as allowed by 10 CFR 50, Appendix J, a utility seeking relief from these Code requirements must provide technical justification for the relief and establish a conservative alternate acceptance criteria. In order to provide technical justification for group testing of containment isolation valves, Illinois Power developed a calculation (model) for determining the size of a leakage pathway in a valve disc or seat for a given leakage rate. The model was verified experimentally by machining leakage pathways of known size and then measuring the leakage and comparing this value to the calculated value. For the range of values typical of leakage rate testing, the correlation between the experimental values and calculated values was quote good. Based upon these results, Illinois Power established a conservative acceptance criteria for all valves in the inservice testing (IST) program and was granted relief by the USNRC from the individual leakage testing requirements of the ASME Code. This paper presents the results of Illinois Power's work in the area of valve leakage rate testing

  16. Face-Sealing Butterfly Valve

    Science.gov (United States)

    Tervo, John N.

    1992-01-01

    Valve plate made to translate as well as rotate. Valve opened and closed by turning shaft and lever. Interactions among lever, spring, valve plate, and face seal cause plate to undergo combination of translation and rotation so valve plate clears seal during parts of opening and closing motions.

  17. Congenital heat disease

    International Nuclear Information System (INIS)

    Higgins, C.B.; Silverman, N.H.; Kersting-Somerhoff, B.A.

    1990-01-01

    The book covers the tomographic anatomy of the normal and congenitally malformed heart and tomographic imaging of the normal heat. It then compares echocardiographic evaluation and the use of MR imaging in the diagnosis and evaluation of individual congenital cardiac malformations

  18. GIANT PROSTHETIC VALVE THROMBUS

    Directory of Open Access Journals (Sweden)

    Prashanth Kumar

    2015-04-01

    Full Text Available Mechanical prosthetic valves are predisposed to bleeding, thrombosis & thromboembolic complications. Overall incidence of thromboembolic complications is 1% per year who are on oral anticoagulants, whereas bleeding complications incidence is 0.5% to 6.6% per year. 1, 2 Minimization of Scylla of thromboembolic & Charybdis of bleeding complication needs a balancing act of optimal antithrombotic therapy. We are reporting a case of middle aged male patient with prosthetic mitral valve presenting in heart failure. Patient had discontinued anticoagulants, as he had subdural hematoma in the past. He presented to our institute with a giant prosthetic valve thrombus.

  19. Key aspects congenital infection

    Directory of Open Access Journals (Sweden)

    Yu. V. Lobzin

    2014-01-01

    Full Text Available The key questions to solve the problem of congenital infection in the Russian Federation are: using in national practice over world accepted terminology adapted to the recommendations of the World Health Organization; representation of the modern concepts of an infectious process in the classification of congenital infections; scientific development and introducing in clinical practice the «standard case definitions», applied to different congenital infections; optimization of protocols and clinical guidelines for diagnosis, treatment and prevention of congenital infections; improvement a knowledge in the infectious disease for all  pecialists involved in the risk assessment of congenital infections, manage pregnancy and children. Based on our experience and analysis of publications, the authors suggest possible solutions.

  20. Rosoxacin in the treatment of uncomplicated acute gonococcal urethritis.

    Directory of Open Access Journals (Sweden)

    Vagaskar S

    1990-10-01

    Full Text Available A total of 112 male patients presenting with acute gonococcal urethritis were admitted to the hospital. The diagnosis was confirmed by smear, culture, oxidase reaction and sugar fermentation tests. The patients were treated with a single 300 mg capsule of rosoxacin. All patients except one showed adequate response to rosoxacin.

  1. current concepts in the management of anterior urethral strictures

    African Journals Online (AJOL)

    iam

    such as calculi, urethral hair and stent encrustation which may be useful in ... and 7 o'clock to the prostatic urethra, 3 and 9 o'clock ... anterior urethra the use of stents is limited to but ... take such as radiotherapy, peripheral vascular disease.

  2. Oral mucosa grafts for urethral reconstruction | Mungadi | Annals of ...

    African Journals Online (AJOL)

    Background: Urethral reconstruction has continued to present formidable and enormous challenges for urologic, paediatric and plastic surgeons as diverse opinions have been expressed on the quality and type of ideal substitution material. This literature review is aimed at drawing attention of surgeons to the versatile ...

  3. Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty.

    Science.gov (United States)

    Tinaut-Ranera, Javier; Arrabal-Polo, Miguel Ángel; Merino-Salas, Sergio; Nogueras-Ocaña, Mercedes; López-León, Víctor Manuel; Palao-Yago, Francisco; Arrabal-Martín, Miguel; Lahoz-García, Clara; Alaminos, Miguel; Zuluaga-Gomez, Armando

    2014-01-01

    We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years. This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both. In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success. In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.

  4. Treatment of urethral strictures with balloon dilation: A forgotten tale

    Directory of Open Access Journals (Sweden)

    Konstantinos Stamatiou

    2015-09-01

    Full Text Available Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization and dilation, urethroplasty and endoscopic internal urethrotomy as well. Although treatment option depends on the type, length and aetiology of stricture, the choice can be influenced to varying degrees by the simplicity of the method, the preferences of the patient the available accoutrements and the patient health condition. Both urethroplasty and endoscopic internal urethrotomy require anaesthesia and thus are not suitable for many elder and unfit for surgical treatment patients. On the other hand, dilations are easy to perform in every day clinical practice however they have been associated with iatrogenic urethral trauma. In contrast, balloon dilation under vision dilates by radial application of forces against the stricture, avoiding the potentially shearing forces associated with sequential rigid dilation. Since it reduces the possibility of an iatrogenic urethral trauma and the subsequent spongiofibrosis may lead into improved therapeutic outcomes. In this report we describe a technique for the treatment of urethral strictures with balloon dilation in elder and unfit for surgical treatment patients.

  5. Urethroplasty for male urethral strictures: Experience from a national ...

    African Journals Online (AJOL)

    B. Fall

    The success of urethroplasty was more frequent for urethral strictures between 1 and 5 cm (46/69) than in ... advent, endoscopic internal urethrotomy (EIU) raised great hopes because it is a .... The comparative analysis of the variables was performed with .... thral stricture are neither clinically effective nor cost-effective.

  6. Pelvic fracture urethral injuries revisited: A systematic review ...

    African Journals Online (AJOL)

    In children, the urethra and bladder neck may be directly torn by the sharp edge of bone fragments. Retrograde urethrography remains the cornerstone for the diagnostic appraisal of posterior urethral injury. Of the three conventional treatment methods primary suturing has the greatest complication rates of incontinence and ...

  7. Review: Management of anterior urethral strictures with buccal ...

    African Journals Online (AJOL)

    Urethral stricture management is a challenging surgery. Multiplicity of techniques means that none of them is ideal. No single technique is appropriate for all situations and the successful surgeon should have a store of operations to choose from according to each specific case. This review aims to provide an update on the ...

  8. The Treatment of Complex Urethral Strictures Using Ventral Onlay ...

    African Journals Online (AJOL)

    Objectives: To compare the outcome of free onlay Buccal Mucosa Graft (BMG) with onlay penile Skin Island Flap (SIF) urethroplasty in the treatment of complex urethral strictures. Patients and Methods: A prospective comparative study was conducted at the Universitas Academic Hospital in Bloemfontein, South Africa.

  9. Prostatic urethral lift vs transurethral resection of the prostate

    DEFF Research Database (Denmark)

    Gratzke, Christian; Barber, Neil; Speakman, Mark J

    2017-01-01

    OBJECTIVES: To compare prostatic urethral lift (PUL) with transurethral resection of the prostate (TURP) with regard to symptoms, recovery experience, sexual function, continence, safety, quality of life, sleep and overall patient perception. PATIENTS AND METHODS: A total of 80 patients with lower...

  10. Semen-like urethral discharge during the use of mazindol

    NARCIS (Netherlands)

    van Puijenbroek, E P; Meyboom, R H

    Two case reports are described of male patients experiencing a semen-like urethral discharge during micturition, suspected to be induced by mazindol. Mazindol has an indirect sympathomimetic action and is known to cause urogenital side effects such as urinary retention and testicular pain. It is

  11. Congenital heart defects in Williams syndrome.

    Science.gov (United States)

    Yuan, Shi-Min

    2017-01-01

    Yuan SM. Congenital heart defects in Williams syndrome. Turk J Pediatr 2017; 59: 225-232. Williams syndrome (WS), also known as Williams-Beuren syndrome, is a rare genetic disorder involving multiple systems including the circulatory system. However, the etiologies of the associated congenital heart defects in WS patients have not been sufficiently elucidated and represent therapeutic challenges. The typical congenital heart defects in WS were supravalvar aortic stenosis, pulmonary stenosis (both valvular and peripheral), aortic coarctation and mitral valvar prolapse. The atypical cardiovascular anomalies include tetralogy of Fallot, atrial septal defects, aortic and mitral valvular insufficiencies, bicuspid aortic valves, ventricular septal defects, total anomalous pulmonary venous return, double chambered right ventricle, Ebstein anomaly and arterial anomalies. Deletion of the elastin gene on chromosome 7q11.23 leads to deficiency or abnormal deposition of elastin during cardiovascular development, thereby leading to widespread cardiovascular abnormalities in WS. In this article, the distribution, treatment and surgical outcomes of typical and atypical cardiac defects in WS are discussed.

  12. Nyre- og urinvejsabnormiteter hos småbørn

    DEFF Research Database (Denmark)

    Cortes, D; Lee, K; Thorup, J M

    1999-01-01

    abnormalities after presentry with their first urinary tract infection. The obstructive urological diagnoses: congenital hydronephrosis, congenital megaureter and posterior urethral valves made up to 57% (20/35) of the abnormalities. Nine boys were operated upon; three for unilateral hydronephrosis, two...... for posterior urethral valves, one for unilateral megaureter and three for phimosis. Two girls were treated with oestrogen for labial fusion. Urological abnormalities which were treated were found among the ultrasonographically diagnosed abnormalities, apart from phimosis and labial fusion. The frequency...

  13. Valve monitoring ITI-MOVATS

    International Nuclear Information System (INIS)

    Moureau, S.

    1993-01-01

    ITI-MOVATS provides a wide range of test devices to monitor the performance of valves: motor operated gate or globe valve, butterfly valve, air operated valve, and check valve. The ITI-MOVATS testing equipment is used in the following three areas: actuator setup/baseline testing, periodic/post-maintenance testing, and differential pressure testing. The parameters typically measured with the MOVATS diagnostic system as well as the devices used to measure them are described. (Z.S.)

  14. Bioprosthetic Valve Fracture to Facilitate Transcatheter Valve-in-Valve Implantation.

    Science.gov (United States)

    Allen, Keith B; Chhatriwalla, Adnan K; Cohen, David J; Saxon, John T; Aggarwal, Sanjeev; Hart, Anthony; Baron, Suzanne; Davis, J Russell; Pak, Alex F; Dvir, Danny; Borkon, A Michael

    2017-11-01

    Valve-in-valve transcatheter aortic valve replacement is less effective in small surgical bioprostheses. We evaluated the feasibility of bioprosthetic valve fracture with a high-pressure balloon to facilitate valve-in-valve transcatheter aortic valve replacement. In vitro bench testing on aortic tissue valves was performed on 19-mm and 21-mm Mitroflow (Sorin, Milan, Italy), Magna and Magna Ease (Edwards Lifesciences, Irvine, CA), Trifecta and Biocor Epic (St. Jude Medical, Minneapolis, MN), and Hancock II and Mosaic (Medtronic, Minneapolis, MN). High-pressure balloons Tru Dilation, Atlas Gold, and Dorado (C.R. Bard, Murray Hill, NJ) were used to determine which valves could be fractured and at what pressure fracture occurred. Mitroflow, Magna, Magna Ease, Mosaic, and Biocor Epic surgical valves were successfully fractured using high-pressures balloon 1 mm larger than the labeled valve size whereas Trifecta and Hancock II surgical valves could not be fractured. Only the internal valve frame was fractured, and the sewing cuff was never disrupted. Manufacturer's rated burst pressures for balloons were exceeded, with fracture pressures ranging from 8 to 24 atmospheres depending on the surgical valve. Testing further demonstrated that fracture facilitated the expansion of previously constrained, underexpanded transcatheter valves (both balloon and self-expanding) to the manufacturer's recommended size. Bench testing demonstrates that the frame of most, but not all, bioprosthetic surgical aortic valves can be fractured using high-pressure balloons. The safety of bioprosthetic valve fracture to optimize valve-in-valve transcatheter aortic valve replacement in small surgical valves requires further clinical investigation. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. A Method for Recording Urethral Pressure Profiles in Female Rats.

    Directory of Open Access Journals (Sweden)

    Shengfei Xu

    Full Text Available Urethral pressure profile (UPP and leak-point pressure (LPP measurements as well as external urethral sphincter (EUS electromyography (EMG and videourodynamic analyses are the primary methods for evaluating urethral function in humans. However, UPP recording in female rats, a widely used animal model, is challenging due to their small body sizes. This study reports a novel method for recording UPP in female rats.Seventeen anesthetized female rats were studied. LPP data for 14 rats were included. The other 3 rats were excluded because of death or abnormal urogenital organs. UPP curves were recorded using a modified water-perfusion catheter system, with the lateral hole facing the 3-, 6-, 9-, and 12-o'clock positions in a randomized sequence. LPP, functional urethral length (FUL and maximum urethral closure pressure (MUCP were analyzed.The mean LPP was 64.39 ± 20.29 cm H2O. The mean FUL and MUCP values at the 3-, 6-, 9-, and 12-o'clock positions were 12.90 ± 1.20, 16.70 ± 1.95, 13.90 ± 2.42, and 11.60 ± 0.97 mm, respectively, and 38.70 ± 11.85, 33.90 ± 11.82, 37.40 ± 11.95, and 71.90 ± 23.01 cm H2O, respectively. The FUL at the 6-o'clock position and MUCP at the 12-o'clock position were significantly greater than those at the other 3 positions. The FUL and MUCP of repeated UPP recordings were not significantly different than those of the first recordings.UPP recording using a modified method based on a water-perfusion catheter system is feasible and replicable in female rats. It produces UPP curves that sensitively and appreciably reflect detailed pressure changes at different points within the urethra and thus provides opportunity to evaluate urethral structures, especially the urethral sphincter, in detail. These results may enhance the utility of female rat models in research of urinary sphincter mechanisms.

  16. Pulmonary valve stenosis

    Science.gov (United States)

    ... surgery - discharge Images Heart valves References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil ... Saunders; 2016:chap 69. Otto CM, Bownow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ...

  17. Aortic Valve Disease

    Science.gov (United States)

    ... team will discuss with you the advantages and disadvantages of both valve types. Regardless of which type ... Diagnosis and Treatment Options Recovery Questions for Your Doctor Will my condition ever get better without treatment? ...

  18. Dry product valve

    International Nuclear Information System (INIS)

    Greaves, James D.

    1984-01-01

    This invention provides a system for delivering particulate radioactive or other toxic wastes to a container in which they can be solidified. The system includes a set of valves that prevent the escape of dusty materials to the atmosphere

  19. Ball check valve

    International Nuclear Information System (INIS)

    Bevilacqua, F.

    1978-01-01

    A pressurized nuclear reactor having an instrument assembly sheathed in a metallic tube which is extended vertically upward into the reactor core by traversing a metallic guide tube which is welded to the wall of the vessel is described. Sensors in each instrument assembly are connected to instruments outside the vessel to manifest the conditions within the core. Each instrument assembly probe is moved into position within a metallic guide channel. The guide channel penetrates the wall of the vessel and forms part of the barrier to the environment within the pressure vessel. Each channel includes a ball check valve which is opened by the instrument assembly probe when the probe passes through the valve. A ball valve element is moved from its seat by the probe to a position lateral of the bore of the channel and is guided to its seat along a sloped path within the valve body when the probe is removed. 5 claims, 3 figures

  20. Urethroplasty after Urethral Urolume Stent: an International Multicenter Experience.

    Science.gov (United States)

    Angulo, Javier C; Kulkarni, Sanjay; Pankaj, Joshi; Nikolavsky, Dmitriy; Suarez, Pedro; Belinky, Javier; Virasoro, Ramón; DeLong, Jessica; Martins, Francisco E; Lumen, Nicolaas; Giudice, Carlos; Suárez, Oscar A; Menéndez, Nicolás; Capiel, Leandro; López-Alvarado, Damian; Ramirez, Erick A; Venkatesan, Krishnan; Husainat, Maha M; Esquinas, Cristina; Arance, Ignacio; Gómez, Reynaldo; Santucci, Richard

    2018-05-08

    To evaluate the outcomes and factors affecting success of urethroplasty in patients with stricture recurrence after Urolume® urethral stent. Retrospective international multicenter study on patients treated with urethral reconstruction after Urolume® stent. Stricture and stent length, time between urethral stent insertion and urethroplasty, age, mode of stent retrieval, type of urethroplasty, complications and baseline and post-urethroplasty voiding parameters were analyzed. Successful outcome was defined as standard voiding, without need of any postoperative adjunctive procedure. Sixty-three patients were included. Stent was removed at urethroplasty in 61 patients. Reconstruction technique was excision and primary anastomosis in 14(22.2%), dorsal onlay buccal mucosa graft (BMG) 9(14.3%), ventral onlay BMG 6(9.5%), dorso-lateral onlay BMG 9(14.3%), ventral onlay plus dorsal inlay BMG 3(4.8%), augmented anastomosis 5(7.9%), pedicled flap urethroplasty 6(9.5%), 2-stage procedure 4(6.4%) and perineal urethrostomy 7(11.1%). Success rate was 81% at a mean 59.7+63.4months. Dilatation and/or internal urethrotomy was performed in 10(15.9%), redo-urethroplasty in 5(7.9%). Total IPSS, QoL, Qmax and PVR significantly improved (pUrethroplasty in patients with Urolume® urethral stents is a viable option of reconstruction with a high success rate and very acceptable complication rate. Numerous techniques are viable, however, urethral preservation, tine-by-tine stent extraction and use of BMG augmentation produced significantly better outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Thulium laser urethrotomy for urethral stricture: a preliminary report.

    Science.gov (United States)

    Wang, Linhui; Wang, Zhixiang; Yang, Bo; Yang, Qing; Sun, Yinghao

    2010-09-01

    The outcome of thulium laser urethrotomy for patients with urethral stricture had not been reported. The purpose of this study was to evaluate outcome of endourethrotomy with the thulium laser as a minimally invasive treatment for urethral stricture. Twenty-one consecutive patients with urethral stricture were evaluated by retrograde uroflowmetry, International Prostate Symptom Score (IPSS), and quality of life preoperatively at a single academic center. All patients were treated with thulium laser urethrotomy. All patients were followed up for 12-24 months postoperatively by uroflowmetry and by retrograde with voiding cystourethrogram every 3 months. And all patients were followed up by mailed questionnaire, including IPSS and quality of life. Retrograde endoscopic thulium laser urethrotomy was performed in all 21 patients. Most patients (N = 16; 76.2%) did not need any reintervention. Five patients developed recurrent strictures, of them two patients were treated by another laser urethrotomy, one patient was treated by open urethroplasty with buccal mucosa and the other two patients' reintervention were treated by urethral dilation. No intraoperative complications were encountered, although in 9.5% (N = 2) of patients, a urinary tract infection was diagnosed postoperatively. No gross hematuria occurred. Including two patients treated with repeat laser urethrotomy, 17(81.0%) showed good flow of urine (Q(ave)>16.0 ml/second) and adequate caliber urethra in retrograde urethrogram (RGU) 12 months after operation. Three (14.3%) patients showed narrow stream of urine (Q(ave)urethrotomy. The thulium laser urethrotomy was a safe and effective minimally invasive therapeutic modality for urethral stricture. 2010 Wiley-Liss, Inc.

  2. [Oral mucosa graft urethroplasty for complicated urethral strictures].

    Science.gov (United States)

    Horiguchi, Akio; Sumitomo, Makoto; Kanbara, Taiki; Tsujita, Yujiro; Yoshii, Takahiko; Yoshii, Hidehiko; Satoh, Akinori; Asakuma, Junichi; Ito, Keiichi; Hayakawa, Masamichi; Asano, Tomohiko

    2010-03-01

    We evaluated the efficacy and outcome of one-stage oral mucosa graft urethroplasty, which is currently the procedure of choice for treating lengthy and complicated urethral strictures not amenable to excision and primary end-to-end anastomosis. Seven patients 33 to 74 years old (mean age = 53.7) underwent one-stage oral mucosa graft urethroplasty for a stricture in either the bulbar urethra (four patients), penile urethra (two patients), or pan-anterior urethra (one patient). Three of the strictures were due to trauma, one was due to inflammation, and one was due to a failed hypospadia repair. The other two were iatrogenic. All patients had previously undergone either internal urethrotomy or repeated urethral dilation. Three patients received a tube graft, three received a ventral onlay, and one received a dorsal onlay. A free graft of oral mucosa was harvested from the inside of each patient's left cheek, and if necessary to obtain a sufficient length, the harvest was extended to include mucosa from the lower lip and the right cheek. The graft lengths ranged from 2.5 to 12 cm (mean = 4.6 cm). A urethral catheter was left in place for 3 weeks postoperatively. While no severe complications at the donor site were observed during follow-up periods ranging from 3 to 55 months (mean = 14 months), two patients who had received a tube graft developed distal anastomotic ring strictures that were managed by internal urethrotomy. The other five required no postoperative urological procedure even though one who had received a ventral onlay developed a penoscrotal fistula. Oral mucosa is an ideal urethral graft, and oral mucosa graft urethroplasty is an effective procedure for repairing complicated urethral strictures involving long portions of the urethra.

  3. Valve for gas centrifuges

    Science.gov (United States)

    Hahs, Charles A.; Burbage, Charles H.

    1984-01-01

    The invention is a pneumatically operated valve assembly for simultaneously (1) closing gas-transfer lines connected to a gas centrifuge or the like and (2) establishing a recycle path between two of the lines so closed. The valve assembly is especially designed to be compact, fast-acting, reliable, and comparatively inexpensive. It provides large reductions in capital costs for gas-centrifuge cascades.

  4. Coanda effect in valves

    Directory of Open Access Journals (Sweden)

    Uruba Václav

    2017-01-01

    Full Text Available Coanda effect takes place in flow within valves diffuser for certain conditions. The valve plug in half-closed position forms wall-jet, which could be stable or instable, depending on geometry and other conditions. This phenomenon was subject of experimental study using time-resolved PIV technique. For the acquired data analysis the special spatio-temporal methods have been used.

  5. Three-dimensional translabial ultrasound assessment of urethral supports and the urethral sphincter complex in stress urinary incontinence.

    Science.gov (United States)

    Cassadó Garriga, Jordi; Pessarrodona Isern, Antoni; Rodríguez Carballeira, Monica; Pallarols Badia, Mar; Moya Del Corral, Manuela; Valls Esteve, Marta; Huguet Galofré, Eva

    2017-09-01

    The pathophysiological mechanism of incontinence is multifactorial. We evaluated the role of 3D-4D ultrasound in the assessment of the fascial supports of the urethra and the urethral sphincter complex (USC) for diagnosing stress urinary incontinence. Observational case-control study in women with and without stress urinary incontinence attending a urogynecology service and a general gynecology service. All women were interviewed, examined, and classified according to the Pelvic Organ Prolapse Quantification (POP-Q) and underwent a 3D-4D translabial ultrasound. Fascial supports of the urethra were assessed by tomographic ultrasound and were considered to be intact or absent if it was possible to identify them at eight levels on each side, urethral mobility was assessed on maximal Valsalva in sagittal section and the length and volume of the USC at rest and on maximal Valsalva were determined using the Virtual Organ Computer-aided Analysis (VOCAL) program. Variables were compared between continent and incontinent women. A total of 173 women were examined, 78 continent and 95 incontinent. There was a significant difference in urethral mobility between continent and incontinent women (12.82 mm vs. 21.85 mm, P rest was significantly shorter (P continent and incontinent women. However, the length of the USC at rest was shorter and urethral mobility was higher in incontinent women. Neurourol. Urodynam. 9999:XX-XX, 2016. © 2016 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. EFFECTIVENESS OF TRANSPU B IC URETHROPLASTY FOR RECURRENT URETHRAL STR U CTURE IN PELVIC FRACTURE URETHRAL DISTRACTION DEFECT

    Directory of Open Access Journals (Sweden)

    Mudegowdar

    2015-08-01

    Full Text Available AIM OF THE STUDY: Effectiveness of Transpubic urethroplasty in recurrent (failed urethral strictures due to pelvic fracture urethral distraction defects. INTRODUCTION: Urethral distraction injuries occur upto 10% of pelvic fracture cases. The principle indication of Transpubic urethroplasty is length >3 c ms, recur rent (failed repairs of posterior urethral stricture. Though other procedures like primary anastomotic urethroplasty, rerouting of the urethra under the corporal body, urethral substitution with tubularised flaps, two stage urethroplasty are described, Tr anspubic urethroplasty is said to produce the best results especially when repeat procedures are required. MATERIALS & METHODS: This is a prospective study from 2004 to 2014 consisting of 17 patients having recurrent stricture urethra secondary to pelvic f racture urethral distraction defects (PFUDD. All the patients were males and their age ranged from 15year to 45 years. Pre - op evaluation included X - ray KUB, Ultrasound abdomen & pelvis, retrograde urethrogram (RGU, micturating cystourethrogram (MCU, up and down Cystoscopy, urine culture and renal biochemical parameters. Urethra was approched through progressive perineal and abdominal approach with total pubectomy, followed by excising fibrosed stricture and tension free end to end anastomosis. Post opera tively pericatheteral RGU was carried out after 4 weeks and Catheter removed if there was no leak. RGU, MCU uroflowmetry and PVR were done one month after removal of catheter. Subsequently UFR, PVR and obstructive symptoms were assessed periodically. RESUL TS: All 17 Cases were followed up for a period of 3 - 11 years. Out of 17patients, 14(80% patients maintained good uroflow (UFR and insignificant PVR and procedure was considered successful. In 3 patients procedure failed, of which 2 patients had pericathe ter leak and reduced urinary flow with significant PVR and were followed up with CIC and 1 patient remained on permanent

  7. Effects of rosuvastatin on progression of stenosis in adult patients with congenital aortic stenosis (PROCAS Trial)

    NARCIS (Netherlands)

    Linde, D. van der; Yap, S.C.; Dijk, A.P. van; Budts, W.; Pieper, P.G.; Burgh, P.H. van der; Mulder, B.J.; Witsenburg, M.; Cuypers, J.A.; Lindemans, J.; Takkenberg, J.J.; Roos-Hesselink, J.W.

    2011-01-01

    Recent trials have failed to show that statin therapy halts the progression of calcific aortic stenosis (AS). We hypothesized that statin therapy in younger patients with congenital AS would be more beneficial, because the valve is less calcified. In the present double-blind, placebo-controlled

  8. Symptoms of non-gonococcal urethritis in heterosexual men: a case control study.

    Science.gov (United States)

    Iser, P; Read, Tr H; Tabrizi, S; Bradshaw, C; Lee, D; Horvarth, L; Garland, S; Denham, I; Fairley, C K

    2005-04-01

    To determine microbial and behavioural factors contributing to non-gonococcal urethral symptoms in men. Case-control study of heterosexual men with non-gonococcal urethral symptoms (cases) and without urethral symptoms (controls) attending Melbourne Sexual Health Centre, Australia. Sexual behaviour and condom use were measured by questionnaire. First stream urine was tested for potential pathogens: Chlamydia trachomatis (ligase chain reaction), Mycoplasma genitalium (polymerase chain reaction, PCR), Ureaplasma urealyticum (culture and PCR), and Streptococcus spp, Gardnerella vaginalis, and Haemophilus species (culture). Urethral smears from cases were examined for polymorphonuclear leucocytes. 80 cases and 79 controls were recruited over 4 months in 2002-3. 49 cases (61%) had urethritis by microscopic criteria, 17 (21%) had Chlamydia trachomatis (adjusted odds ratio (OR) 27 (95% confidence interval (CI): 3.4 to 222)), five (6%) had Mycoplasma genitalium (OR 6.1 (95% CI: 0.6 to 61)), and 11 (14%) had Gardnerella vaginalis (OR 9.0 (95% CI: 1.6 to 52)). Other organisms were not significantly associated with urethral symptoms. The presence of urethritis on urethral smear did not predict the presence of Chlamydia trachomatis (OR 1.7 (95% CI: 0.5 to 5.4)). Urethral symptoms were significantly associated with unprotected vaginal sex with more than one casual partner (OR 9.3 (95% CI: 1.3 to 65)) and unprotected anal sex with a regular partner in the past month (OR 3.5 (95% CI: 1.0 to 13)). Gardnerella vaginalis and unprotected anal sex may cause symptoms of non-gonococcal urethritis. Microscopy of the urethral smear to diagnose urethritis in this population does not help to identify which men with urethral symptoms require treatment for chlamydia.

  9. Congenital symmastia revisited

    DEFF Research Database (Denmark)

    Sillesen, Nanna H; Hölmich, Lisbeth R; Siersen, Hans Erik

    2012-01-01

    Symmastia is defined as medial confluence of the breast. The term 'symmastia' is modified from Greek (syn meaning 'together', and mastos meaning 'breast') and was first presented by Spence et al. in 1983. Two forms of symmastia exist: an iatrogenic and a congenital version. Congenital symmastia...... is a rare condition in which web-like soft tissue traverses the sternum to connect the breasts medially. The literature on congenital symmastia is limited, few cases have been published, and knowledge about ideal treatment is still insufficient....

  10. The effect of single oral doses of duloxetine, reboxetine, and midodrine on the urethral pressure in healthy female subjects, using urethral pressure reflectometry

    DEFF Research Database (Denmark)

    Klarskov, Niels; Cerneus, Dirk; Sawyer, William

    2018-01-01

    AIMS: To evaluate the effect on urethral pressure of reference drugs known to reduce stress urinary incontinence symptoms by different effect size and mechanisms of action on urethral musculature under four test conditions in healthy female subjects using urethral pressure reflectometry. METHODS......: Healthy females aged 18-55 years were recruited by advertising for this phase 1, single site, placebo-controlled, randomized, four-period, crossover study. The interventions were single oral doses of 10 mg Midodrine, 80 mg Duloxetine, 12 mg Reboxetine, and placebo. The endpoints were the opening urethral...... pressure measured in each period at four time points (predose and 2, 5.5, and 9 h after dosing). RESULTS: Twenty-nine females were enrolled; 25 randomized and 24 completed the study. The opening urethral pressure was higher in all measurements with filled bladder compared with empty bladder, and during...

  11. Embryological origin of the endocardium and derived valve progenitor cells: from developmental biology to stem cell-based valve repair.

    Science.gov (United States)

    Pucéat, Michel

    2013-04-01

    The cardiac valves are targets of both congenital and acquired diseases. The formation of valves during embryogenesis (i.e., valvulogenesis) originates from endocardial cells lining the myocardium. These cells undergo an endothelial-mesenchymal transition, proliferate and migrate within an extracellular matrix. This leads to the formation of bilateral cardiac cushions in both the atrioventricular canal and the outflow tract. The embryonic origin of both the endocardium and prospective valve cells is still elusive. Endocardial and myocardial lineages are segregated early during embryogenesis and such a cell fate decision can be recapitulated in vitro by embryonic stem cells (ESC). Besides genetically modified mice and ex vivo heart explants, ESCs provide a cellular model to study the early steps of valve development and might constitute a human therapeutic cell source for decellularized tissue-engineered valves. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Cardiac Pathways of Differentiation, Metabolism and Contraction. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life.

    Science.gov (United States)

    Almobarak, F; Al-Mobarak, F; Khan, A O

    2009-06-01

    To report complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life. Retrospective institutional case series. Forty-two eyes of 36 patients with Ahmed valve implantation (without prior drainage device surgery) during the first 2 years of life and 2 years' postsurgical follow-up were identified. Most eyes had primary congenital glaucoma (28/42, 66.7%), aphakic glaucoma (5/42, 11.9%) or Peters anomaly (5/42, 11.9%). All but three eyes had prior ocular surgery. Surgery was at a mean age of 11.83 months (m) (SD 5.63). The most common significant postoperative complications were tube malpositioning requiring intervention (11/42, 26.2%), endophthalmitis (3/42, 7.1%; one with tube exposure) and retinal detachment (3/42, 7.1%). Thirty-six eyes (85.8%) required resumption of antiglaucoma medications to maintain intraocular pressure (IOP) valve survival (IOPendophthalmitis and retinal detachment are known potential complications following any incisional surgery for advanced buphthalmos; however, tube exposure is a unique potential problem following aqueous shunt implantation that can lead to intraocular infection. Cumulative valve survival 2 years following implantation was 63.3%.

  13. Congenital orbital teratoma.

    Science.gov (United States)

    Aiyub, Shereen; Chan, Wengonn; Szetu, John; Sullivan, Laurence J; Pater, John; Cooper, Peter; Selva, Dinesh

    2013-12-01

    We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

  14. Congenital orbital teratoma

    Directory of Open Access Journals (Sweden)

    Shereen Aiyub

    2013-01-01

    Full Text Available We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

  15. Congenital Constriction Band Syndrome

    OpenAIRE

    Rajesh Gupta, Fareed Malik, Rishabh Gupta, M.A.Basit, Dara Singh

    2008-01-01

    Congenital constriction bands are anomalous bands that encircle a digit or an extremity. Congenitalconstriction band syndrome is rare condition and is mostly associated with other musculoskeletaldisorders.We report such a rare experience.

  16. SIU/ICUD Consultation on Urethral Strictures: Posterior urethral stenosis after treatment of prostate cancer.

    Science.gov (United States)

    Herschorn, Sender; Elliott, Sean; Coburn, Michael; Wessells, Hunter; Zinman, Leonard

    2014-03-01

    Posterior urethral stenosis can result from radical prostatectomy in approximately 5%-10% of patients (range 1.4%-29%). Similarly, 4%-9% of men after brachytherapy and 1%-13% after external beam radiotherapy will develop stenosis. The rate will be greater after combination therapy and can exceed 40% after salvage radical prostatectomy. Although postradical prostatectomy stenoses mostly develop within 2 years, postradiotherapy stenoses take longer to appear. Many result in storage and voiding symptoms and can be associated with incontinence. The evaluation consists of a workup similar to that for lower urinary tract symptoms, with additional testing to rule out recurrent or persistent prostate cancer. Treatment is usually initiated with an endoscopic approach commonly involving dilation, visual urethrotomy with or without laser treatment, and, possibly, UroLume stent placement. Open surgical urethroplasty has been reported, as well as urinary diversion for recalcitrant stenosis. A proposed algorithm illustrating a graded approach has been provided. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves

    DEFF Research Database (Denmark)

    Dvir, Danny; Webb, John; Brecker, Stephen

    2012-01-01

    Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry....

  18. NRC valve performance test program - check valve testing

    International Nuclear Information System (INIS)

    Jeanmougin, N.M.

    1987-01-01

    The Valve Performance Test Program addresses the current requirements for testing of pressure isolation valves (PIVs) in light water reactors. Leak rate monitoring is the current method used by operating commercial power plants to survey the condition of their PIVs. ETEC testing of three check valves (4-inch, 6-inch, and 12-inch nominal diameters) indicates that leak rate testing is not a reliable method for detecting impending valve failure. Acoustic emission monitoring of check valves shows promise as a method of detecting loosened internals damage. Future efforts will focus on evaluation of acoustic emission monitoring as a technique for determining check valve condition. Three gate valves also will be tested to evaluate whether the check valve results are applicable to gate type PIVs

  19. [Urethral stent to treat a refractory traumatic urethra stricture in a male hunting dog].

    Science.gov (United States)

    Vogt, S; Schneider, M; Peppler, C; Günther, C; Kramer, M

    2014-01-01

    In a 1.5-year-old male hunting dog, a urethral defect distal to the pelvic flexure and the resulting urethral fistula were treated with a mucosal graft and a transurethral catheter. Six months postoperatively a stricture of the urethra occurred. Following balloon dilatation, urination was normal. One month after dilatation, urethral narrowing relapsed and was treated using a combination of balloon dilatation and urethral stent implantation. Ten months following stent implantation the dog continued to show normal urination, although a deformation of the proximal part of the stent was diagnosed radiographically. During the 1-year follow-up no additional complications were observed. In the future, urethral stents may replace surgical resection of the narrowed urethral region and re-anastomosis of the urethra.

  20. Acquired urethral diverticulum in a man with paraplegia presenting with a scrotal mass: a case report

    Directory of Open Access Journals (Sweden)

    El Ammari Jalal Eddine

    2012-11-01

    Full Text Available Abstract Introduction Male urethral diverticula are rare. Patients with paraplegia may present with acquired diverticula as a result of prolonged catheterization. Diverticula may be asymptomatic or lead to lower urinary tract symptoms. Rarely, the diverticulum may initially present as a scrotal mass. Case presentation We report the case of a male 45-year-old Arab with paraplegia who presented with a mass in the peno-scrotal junction. He had in his medical history iterative prolonged urethral catheterizations associated with urine leakage through the urethral meatus upon applying compression. Diagnosis confirmation of urethral diverticula is obtained by retrograde urethrography. The patient underwent a diverticulectomy with urethroplasty. Conclusion Male acquired urethral diverticula can be found in patients who have a spinal cord injury because of prolonged urethral catheterization. Clinical presentations are different and sometimes can be misleading. Retrograde urethrography is the key to diagnosis and open surgery is the treatment of reference.

  1. Congenital chylous ascites

    International Nuclear Information System (INIS)

    Romanska-Kita, J.; Borszewska-Kornacka, M. K.; Rudzinska, I.; Wawrzoniak, T.; Dobrzanska, A.; Czech-Kowalska, J.

    2011-01-01

    Congenital chylous ascites is a rare entity, conditioned by numerous factors and with changing dynamics of the disease. Because of the lack of therapeutic and diagnostic standards, this disease constitutes to be a medical challenge. This article presents current knowledge on pathogenesis, diagnostics and management of this disease, as well as a case of a newborn with primary congenital chylous ascites in the abdominal cavity. (authors)

  2. Multifocal Congenital Hemangiopericytoma.

    Science.gov (United States)

    Robl, Renata; Carvalho, Vânia Oliveira; Abagge, Kerstin Taniguchi; Uber, Marjorie; Lichtvan, Leniza Costa Lima; Werner, Betina; Mehrdad Nadji, Mehrdad

    2017-01-01

    Congenital hemangiopericytoma (HPC) is a rare mesenchymal tumor with less aggressive behavior and a more favorable prognosis than similar tumors in adults. Multifocal presentation is even less common than isolated HPC and hence its clinical and histologic recognition may be challenging. A newborn infant with multifocal congenital HPC causing severe deformity but with a favorable outcome after chemotherapy and surgical removal is reported. © 2016 Wiley Periodicals, Inc.

  3. Check valves aging assessment

    International Nuclear Information System (INIS)

    Haynes, H.D.

    1991-01-01

    In support of the NRC Nuclear Plant Aging Research (NPAR) program, the Oak Ridge National Laboratory (ORNL) has carried out an assessment of several check value diagnostic monitoring methods, in particular, those based on measurements of acoustic emission, ultrasonics, and magnetic flux. The evaluations have focussed on the capabilities of each method to provide information useful in determining check valve aging and service wear effects, check valve failures, and undesirable operating modes. This paper describes the benefits and limitations associated with each method and includes recent laboratory and field test data, including data obtained from the vendors who recently participated in a comprehensive series of tests directed by a nuclear industry users group. In addition, as part of the ORNL Advanced Diagnostic Engineering Research and Development Center (ADEC), two novel nonintrusive monitoring methods were developed that provide several unique capabilities. These methods, based on external ac- an dc-magnetic monitoring are also described. None of the examined methods could, by themselves, monitor both the instantaneous position and motion of check valve internals and valve leakage; however, the combination of acoustic emission monitoring with one of the other methods provides the means to determine vital check valve operational information

  4. [Current approaches to the treatment of non-gonococcal urethritis in men].

    Science.gov (United States)

    Kondrat'eva, Iu S; Neĭmark, A I

    2011-01-01

    The study was made of 50 men suffering from non-gonococcal urethritis caused by mixed pathogenic and opportunistic urogenital infection. Clinical characteristics of urethritis in relation to infection pathogen are shown. The results of clinical and laboratory examinations were considered in choice of antibacterial therapy. Safocid, a combined antibacterial medicine, demonstrated its clinical and microbiological efficacy in the treatment of patients with non-gonococcal urethritis of mixed etiology.

  5. Aortic valve replacement and the stentless Freedom SOLO valve

    NARCIS (Netherlands)

    Wollersheim, L.W.L.M.

    2016-01-01

    Aortic valve stenosis has become the most prevalent valvular heart disease in Europe and North America, and is generally caused by age-related calcification of the aortic valve. For most patients, severe symptomatic aortic stenosis needs effective mechanical relief in the form of valve replacement

  6. Comparative Efficacy of Penicillin and Doxycycline in Gonococcal Urethritis

    Directory of Open Access Journals (Sweden)

    Vinod K Sharma

    1987-01-01

    Full Text Available Ninety two episodes of gonococcal urethritis treated with one of the following regimens viz: (A 3 m. u. of fortified procaine penicillin made by adding 1 m.u. of crystalline penicillin to 2 m.u. of fortified procaine penicillin intramuscularly with one gram of probenecid orally, (B 3 m.u. of above fortified procaine penicillin intramuscularly alone, and (C 400 mg single oral dose of doxycycline produced success rates of 95,76.2 and 66.7% respectively. Post gonococcal urethritis was detected in 37% patients. Thirty four (45.94% of the 74 isolates of N. gonorrhoeae were relatively resistant (MIC 0. 12 units ml to penicillin. None of the 74 Neisseria gonorrhoeac strains was beta lactamase producing.

  7. The Structure of Urethral Epithelium in Merinos Lambs

    Directory of Open Access Journals (Sweden)

    Vasile RUS

    2018-05-01

    Full Text Available The aim of this study was to investigate by histological techniques the structure of urethral epithelium in lambs. In this study, we harvested several fragments (prostatic, membranous and cavernous from urethra from 5 merino’s lambs of 3 months old. The first anatomical segment, the prostatic urethra, is lined by a urinary epithelium. The intermediary layer of this epithelium is formed of 5-6 rows of oval cells. The second segment of urethra has the same type of epithelium but the intermediary layer is formed of 6-7 rows of oval cells. In the last anatomical segment, the penile urethra, the epithelium is the same, but the intermediary layer has 3-4 rows of oval cells. In lambs, the urethra is lined by urinary epithelium. The urethral epithelium does not have the same thickness in all segments. The thinner epithelium it is in the cavernous urethra, the ticker is the membranous urethra.

  8. Urethral pressure reflectometry in women with pelvic organ prolapse

    DEFF Research Database (Denmark)

    Khayyami, Yasmine; Lose, Gunnar; Klarskov, Niels

    2017-01-01

    at an abdominal pressure of 50 cmH2O (PO-Abd 50). UPR can help identify women with POP at risk of postoperative de novo SUI. The aim of this study was to investigate the reproducibility of UPR in women with POP. METHODS: Women with anterior or posterior vaginal wall prolapse were recruited for this prospective......INTRODUCTION AND HYPOTHESIS: The mechanism of continence in women with pelvic organ prolapse (POP) before and after surgery remains unknown. Urethral pressure reflectometry (UPR) separates women with stress urinary incontinence (SUI) from continent women by measuring urethral opening pressure...... studies to help reveal urodynamic features predictive of postoperative de novo SUI in women with POP....

  9. Comparative study of Butterfly valves

    International Nuclear Information System (INIS)

    Galmes Belmonte, F.B.

    1998-01-01

    This work tries to justify the hydrodynamic butterfly valves performance, using the EPRI tests, results carried out in laboratory and in situ. This justification will be possible if: - The valves to study are similar - Their performance is calculated using EPRI's methodology Looking for this objective, the elements of the present work are: 1. Brief EPRI butterfly valve description it wild provide the factors which are necessary to define the butterfly valves similarity. 2. EPRI tests description and range of validation against test data definition. 3. Description of the spanish butterfly analyzed valves, and comparison with the EPRI performance results, to prove that this valves are similar to the EPRI test valves. In this way, it will not be necessary to carry out particular dynamic tests on the spanish valves to describe their hydrodynamic performance. (Author)

  10. A symmetric safety valve

    International Nuclear Information System (INIS)

    Burtraw, Dallas; Palmer, Karen; Kahn, Danny

    2010-01-01

    How to set policy in the presence of uncertainty has been central in debates over climate policy. Concern about costs has motivated the proposal for a cap-and-trade program for carbon dioxide, with a 'safety valve' that would mitigate against spikes in the cost of emission reductions by introducing additional emission allowances into the market when marginal costs rise above the specified allowance price level. We find two significant problems, both stemming from the asymmetry of an instrument that mitigates only against a price increase. One is that most important examples of price volatility in cap-and-trade programs have occurred not when prices spiked, but instead when allowance prices collapsed. Second, a single-sided safety valve may have unintended consequences for investment. We illustrate that a symmetric safety valve provides environmental and welfare improvements relative to the conventional one-sided approach.

  11. Idiopathic urethritis in children: Classification and treatment with steroids.

    Science.gov (United States)

    Jayakumar, Sivasankar; Pringle, Kirsty; Ninan, George K

    2014-07-01

    Idiopathic urethritis [IU] in children is of unknown etiology and treatment options are limited. We propose a classification for IU based on cystourethroscopy findings and symptoms (Grade 1 - 4) and report our experience with use of topical and oral steroids in IU. Retrospective data collection of all male children (0-16 years) diagnosed with IU over a period of 8 years between 2005 and 2012 at our institution. Data was collected on patient demographics, laboratory and radiological investigations, cystourethroscopy findings, management and outcomes. A total of 19 male children were diagnosed with IU. The median age of the patients was 13(7-16) years. Presenting symptoms included dysuria in 12; hematuria in 9; loin pain in 6; and scrotal pain in 2 patients. Both patients with scrotal pain had previous left scrotal exploration that revealed epididymitis. Serum C-reactive protein and Full blood count was tested in 15 patients and was within normal limits in all of them. Cystourethroscopy revealed urethritis of grade-I in 2; grade-II in 11; and grade-III in 3 patients. There were 3 patients with systemic symptoms from extra-urethral extension of inflammation (grade-IV). Mean follow up was 18.9(1-74) months. All patients had steroid instillation at the time of cystourethroscopy. Three patients with IU grade IV required oral steroids (prednisolone) in view of exacerbation of symptoms and signs despite steroid instillation. Complete resolution of symptoms and signs occurred in 18(94.7%) patients. Significant improvement in symptoms and signs was noted in 1(5.3%) patient who is still undergoing treatment. IU in male children can be successfully managed with steroid instillation, especially in grade I and II. Grade III, will need steroid instillation but treatment of scarring and stricture will necessitate longer duration of treatment. In children with IU and extra-urethral symptoms (grade IV), oral steroids may be required.

  12. A young man with oligoarthritis preceded by urethritis and diarrhea

    Directory of Open Access Journals (Sweden)

    Ahmed Zedan

    2014-09-01

    Full Text Available Reactive arthritis is a form of seronegative spondyloarthritis temporally triggered by an apparent infection, usually gastroenteritis or urethritis. This arthritis typically starts within a few weeks of the inciting infection. It commonly affects young adults and is strongly associated with the MHC class I antigen HLA-B27. Here we present an interesting case of young man with HLA-B27 positive reactive arthritis in whom the presumptive diagnosis was reached early in the course of his illness.

  13. [Results of anastomotic urethroplasty for male urethral stricture disease].

    Science.gov (United States)

    Fall, B; Zeondo, C; Sow, Y; Sarr, A; Sine, B; Thiam, A; Faye, S T; Sow, O; Traoré, A; Diao, B; Fall, P A; Ndoye, A K; Ba, M

    2018-04-04

    To report our experience with anastomotic uretroplasty (AU) due to male urethral stricture disease (USD) and to identify factors affecting the results. We conducted a retrospective study over a period of 4 years and 6 months (July 2012 to December 2016). Any subsequent use of endoscopic urethrotomy or new urethroplasty was considered a failure. Forty-eight cases were included. The mean age of patients was 53.5±17.3 years (23-87 years). Urinary retention was the reason for consultation in 42 cases (87.5%). The most common localization of USD was the bulbar urethra (n=45). The mean length of USD was 1.23±0.62cm (0.5-3cm) with a median length of 1cm. The etiology was post-infectious in 56.3% of cases. More than half (58.3%) of patients had already undergone at least one urethral manipulation. After an average follow-up of 21.1±12.6 months (1 to 52 months), the overall success rate was 77.1%. In univariate analysis, length, cause and location of the stricture, age of patient, the presenting symptoms of the stricture, previous urethral manipulation and surgeon experience did not significantly impact on the success rate of anastomotic urethroplasty at one and two years follow-up. The AU had provided good results in our practice. The infectious origin of the stricture and previous urethral manipulation did not significantly impact the result of this surgical technique. 4. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  14. Idiopathic urethritis in children: Classification and treatment with steroids

    Directory of Open Access Journals (Sweden)

    Sivasankar Jayakumar

    2014-01-01

    Full Text Available Background: Idiopathic urethritis [IU] in children is of unknown etiology and treatment options are limited. We propose a classification for IU based on cystourethroscopy findings and symptoms (Grade 1 - 4 and report our experience with use of topical and oral steroids in IU. Materials and Methods: Retrospective data collection of all male children (0-16 years diagnosed with IU over a period of 8 years between 2005 and 2012 at our institution. Data was collected on patient demographics, laboratory and radiological investigations, cystourethroscopy findings, management and outcomes. Results: A total of 19 male children were diagnosed with IU. The median age of the patients was 13(7-16 years. Presenting symptoms included dysuria in 12; hematuria in 9; loin pain in 6; and scrotal pain in 2 patients. Both patients with scrotal pain had previous left scrotal exploration that revealed epididymitis. Serum C-reactive protein and Full blood count was tested in 15 patients and was within normal limits in all of them. Cystourethroscopy revealed urethritis of grade-I in 2; grade-II in 11; and grade-III in 3 patients. There were 3 patients with systemic symptoms from extra-urethral extension of inflammation (grade-IV. Mean follow up was 18.9(1-74 months. All patients had steroid instillation at the time of cystourethroscopy. Three patients with IU grade IV required oral steroids (prednisolone in view of exacerbation of symptoms and signs despite steroid instillation. Complete resolution of symptoms and signs occurred in 18(94.7% patients. Significant improvement in symptoms and signs was noted in 1(5.3% patient who is still undergoing treatment. Conclusions: IU in male children can be successfully managed with steroid instillation, especially in grade I and II. Grade III, will need steroid instillation but treatment of scarring and stricture will necessitate longer duration of treatment. In children with IU and extra-urethral symptoms (grade IV, oral

  15. Neisseria gonorrhoeae DNA bacterial load in men with symptomatic and asymptomatic gonococcal urethritis.

    Science.gov (United States)

    Priest, David; Ong, Jason J; Chow, Eric P F; Tabrizi, Sepehr; Phillips, Sam; Bissessor, Melanie; Fairley, Christopher K; Bradshaw, Catriona S; Read, Tim R H; Garland, Suzanne; Chen, Marcus

    2017-11-01

    Previous studies have quantified bacterial loads of Neisseria gonorrhoeae in the pharynx and rectum of men but not the urethra. We quantified the bacterial load of N. gonorrhoeae in men with symptomatic and asymptomatic urethral gonorrhoea infections. Consecutive men diagnosed with urethral gonorrhoea by Aptima Combo 2 testing of urine at the Melbourne Sexual Health Centre between March and July 2016 were eligible for the study: symptomatic men with purulent urethral discharge and asymptomatic men with no urethral symptoms. The gonococcal bacterial load in both groups was measured by urethral swab using a standardised collection method and real-time quantitative PCR targeting the opa gene. Twenty men were recruited into the study: 16 had purulent urethral discharge and 4 had asymptomatic urethral gonorrhoea. The median gonococcal bacterial load was significantly higher among symptomatic men (3.7×10 6 copies per swab, IQR 2.5×10 6 -4.7×10 6 ) compared with asymptomatic men (2.0×10 5 copies per swab, IQR 2.7×10 4 -4.5×10 5 ) (p=0.002). Gonococcal loads in men with urethral discharge were higher than loads seen with asymptomatic urethral gonorrhoea and loads seen in asymptomatic pharyngeal and rectal gonorrhoea infections in previous studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Female urethral diverticulum presenting with acute urinary retention: Reporting the largest diverticulum with review of literature

    Directory of Open Access Journals (Sweden)

    Manas Ranjan Pradhan

    2012-01-01

    Full Text Available Female urethral diverticulum is a rare entity with diverse spectrum of clinical manifestations. It is a very rare cause of bladder outlet obstruction and should be considered as a differential diagnosis in females presenting with acute urinary retention associated with a vaginal mass. Strong clinical suspicion combined with thorough physical examination and focused radiological investigations are vital for its diagnosis. Herein we report a case of giant urethral diverticulum presenting with acute urinary retention in a young female. It was managed by excision and urethral closure, and is the largest urethral diverticulum reported till date in the literature.

  17. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

    Science.gov (United States)

    Anele, Uzoma A; Le, Brian V; Burnett, Arthur L

    2014-12-01

    Urethral injury is an uncommon surgical complication of penile prosthesis (PP) surgery. Conventional dogma requires abortion of the procedure if the adjacent corporal body is involved or delayed implantation to avert device infection associated with urinary extravasation. Besides the setback of the aborted surgery, this management approach also presents the possible difficulty of encountering corporal fibrosis at the time of reoperation. We report an approach using primary urethral repair and temporary suprapubic cystostomy for the management of incidental urethral injuries in a cohort of patients allowing for successful completion of unaborted PP implantation. We performed a retrospective analysis of all patients receiving PPs from 1990 to 2014 in which incidental urethral injuries were repaired and PP implantation was completed with suprapubic cystostomy (suprapubic tube [SPT] insertion). After allowing for urethral healing and urinary diversion via SPT for 4-8 weeks, the PP was activated. Successful management was determined by the absence of perioperative complications within 6 months of implantation. We identified four cases, all receiving inflatable PPs, managed with temporary suprapubic cystostomy. These patients sustained urethral injuries during corporal dissection (one patient), corporal dilation (one patient), and penile straightening (two patients). All patients were managed safely and successfully. Primary urethral repair followed by temporary suprapubic cystostomy offers a surgical approach to complete PP implantation successfully in patients who sustain urethral injury complications, particularly for complex PP surgeries. Anele UA, Le BV, and Burnett AL. Suprapubic cystostomy for the management of urethral injuries during penile prosthesis implantation.

  18. Spectrum of Congenital Heart Diseases in Eastern Nepal: A tertiary care hospital experience

    Directory of Open Access Journals (Sweden)

    Prashant Shah

    2017-01-01

    Full Text Available Background & Objectives: Congenital heart diseases are neglected especially in world’s poorest nations and appear to be ignored and unexplored dimension of health. The exact prevalence and spectrum of congenital heart diseases in Nepal is largely unknown. The aim of this study was to describe the local experience on the magnitude and the pattern of congenital heart disease in order to increase the awareness of the public and health policy makers on its burden in Nepal.Materials & Methods: This is an observational hospital based study carried out in a tertiary care hospital in Eastern Nepal. The duration of this study was from April 2015 to July 2016. The echocardiography reports of all patients clinically suspected of having congenital heart disease were retrieved, and their diagnostic details were extracted. Only patients of day one of life to 14 years of age were included. Congenital heart diseases like bicuspid aortic valve, mitral valve prolapse and various inherited cardiomyopathies were excluded.Results: A total of 330 echocardiograms were performed for clinically suspected congenital heart disease.  The mean age of study population was 22.31±34.08 months with male to female ratio of 1.2:1. 23% of clinically suspected congenital heart disease cases turned out to have normal echocardiography. Acyanotic congenital heart disease was most common (81.5% followed by cyanotic congenital heart disease (14.2% and obstructive congenital heart disease (4.3%. Atrial septal defect was found to be the most common form of acyanotic congenital heart disease (52% which was followed by ventricular septal defect (28.8% and patent ductus arteriosus (14.8%. Tetralogy of Fallot and double outlet right ventricle were the most common form of cyanotic CHD representing 44.4% of all cyanotic patients. Pulmonary stenosis was the most common obstructive congenital heart disease observed in this study population (63.6%. Rarer entities, like d-transposition of great

  19. Long QT in children with congenital deafness: a brief report

    Directory of Open Access Journals (Sweden)

    Naseraldin Akbari Asbagh

    2013-08-01

    Full Text Available Background: Long QT syndromes (LQT are genetic abnormalities of ventricular repo-larization, with an estimated incidence of about one per 10000 births. It is characterized by prolongation of the QT interval in electrocardiogram (EKG and associated with a high risk for syncope and sudden death in patients. Type of this syndrome is association with congenital deafness. Our objective was to evaluate QT interval in children with congenital deafness.Methods: For 219 patients referred to Imam Khomeini Hospital audiometric clinic in 2011, questionnaire were completed. A total of 23 congenitally deaf children were incl-uded. All patients’ examinations were done by a pediatric cardiologist. Electrocardio-gram is conducted in all children (23 patients with sever and deep congenital deafness. Then the QT interval was measured based on Bazett’s formula. Echocardiography was also performed in these children to assess left ventricular function and the presence of mitral valve prolapse.Results: The overall patients were two hundred and nineteen children. A total of twenty three congenitally deaf children were included and electrocardiogram was obtained. Three children had obviously prolonged QTc (0.48±0.02 second. The median age of them was 6.1±5 year, the median weight was 18±11.3 kilogram and the median of QT interval was 0.48±0.02 second.Conclusion: The QT interval obtained 0.48±0.02 second. In the present study we found prolonged QT in congenital deafness, thus we recommend to evaluate the electrocardio-gram of children with congenital deafness.

  20. Nuclear reactor steam depressurization valve

    International Nuclear Information System (INIS)

    Moore, G.L.

    1991-01-01

    This patent describes improvement in a nuclear reactor plant, an improved steam depressurization valve positioned intermediate along a steam discharge pipe for controlling the venting of steam pressure from the reactor through the pipe. The improvement comprises: a housing including a domed cover forming a chamber and having a partition plate dividing the chamber into a fluid pressure activation compartment and a steam flow control compartment, the valve housing being provided with an inlet connection and an outlet connection in the steam flow control compartment, and a fluid duct in communication with a source of fluid pressure for operating the valve; a valve set mounted within the fluid flow control compartment comprising a cylindrical section surrounding the inlet connection with one end adjoining the connection and having a radially projecting flange at the other end with a contoured extended valve sealing flange provided with an annular valve sealing member, and a valve cylinder traversing the partition plate and reciprocally movable within an opening in the partition plate with one terminal and extending into the fluid pressure activation compartment and the other terminal end extending into the steam flow control compartment coaxially aligned with the valve seat surrounding the inlet connection, the valve cylinder being surrounded by two bellow fluid seals and provided with guides to inhibit lateral movement, an end of the valve cylinder extending into the fluid flow control compartment having a radially projecting flange substantially conterminous with the valve seat flange and having a contoured surface facing and complimentary to the contoured valve seating surface whereby the two contoured valve surfaces can meet in matching relationship, thus providing a pressure actuated reciprocatable valve member for making closing contact with the valve seat and withdrawing therefrom for opening fluid flow through the valve