Humans ; Infant, Newborn ; Male ; Sepsis ; diagnosis ; microbiology ; Urethral Stricture ; complications ; microbiology ; Urinary Tract Infections ; complications ; microbiology

PURPOSE: Penoscrotal transposition is found in cases with severe form of hypospadias. In those cases, severe chordee generally coexists and a long length of urethra may be necessary for its correction. We evaluated the clinical outcome of surgical repairs for 12 patients of proximal hypospadias with penoscrotal transposition. MATERIALS AND METHODS: Out of 12 cases, there were 2 with penoscrotal type, 7 with scrotal type and 3 with perineal type hypospadias. All cases had moderate to severe chordee. Five cases were treated with one-stage repair and seven cases with multi-stage repair. We analysed operative methods, postoperative complications and those managements between the cases of one-stage and multi-stage repairs. RESULTS: For one-stage repair, we used transverse preputial island flap method in 3 cases and urethroplasty using scrotal skin flap in 2 cases. For multi-stage repair, we performed Thiersh-Duplay urethroplasty in 2 cases, bladder mucosal graft in 2 cases and Belt-Fugua urethroplasty in 3 cases. Correction of penoscrotal transposition was performed successfully in all cases. In all cases, a paucity of skin was the most difficult problem. The overall complication rate was 50.0%. In cases treated with one-stage repair, there were two cases with urethrocutaneous fistulas. However, in cases treated with multi-stage repair, there were four cases with complications such as urethral strictures, urethrocutaneous fistulas with or without large skin defect. Overall the complications in cases with multi-stage repair were more severe than those in cases with one-stage repair. CONCLUSIONS: Our experience suggests that multi-stage operation may be not superior to one-stage operation in cases with proximal hypospadias associated with penoscrotal transposition. Thus we recommand one-stage repair in those cases despite a paucity of foreskin.
Female ; Fistula ; Foreskin ; Humans ; Hypospadias* ; Male ; Postoperative Complications ; Skin ; Transplants ; Urethra ; Urethral Stricture ; Urinary Bladder

A retrospective analysis of 108 patients who had undergone transurethral prostatectomy for benign prostatic hyperplasia between January 1988 and December 1992 was performed to evaluate risk factors influencing intraoperative and postoperative morbidity and mortality. Of 108 patients complications occurred in 32 cases, with the morbidity rate of 29.6% but no death occurred. The most common postoperative complication was bleeding in 9 cases(8.3%) followed by incontinence in 7 cases(6.5%), capsular perforation in 4 cases(3.7%), failure to void in 4 cases(3.7%) and urethral stricture in 4 cases(3.7%). Risk factors which increased the morbidity of transurethral prostatectomy were age greater than 75 years and the presence of associated medical disease(p<0.05) but a resection time of more than 90 minutes, weight of resected tissue more than 30 gram and amounts of irrigating solution of more than 20 L did not increase the postoperative morbidity significantly. In conclusion, meticulous preoperative and postoperative cares are necessary because poor general condition increase the postoperative complications and long-term, prospective randomized studies are required to evaluate risk factors influencing postoperative morbidity after transurethral prostatectomy.
Hemorrhage ; Humans ; Mortality ; Postoperative Complications ; Prostatic Hyperplasia* ; Retrospective Studies ; Risk Factors* ; Transurethral Resection of Prostate* ; Urethral Stricture

A clinical observation for operative, postoperative complications were made from 61 case of TURP from June 1985 to April 1989. The following results were obtained. 1. Mean operative time was 81.5 minutes and mean weight of resected prostatic tissue was 13. 6gm. Therefore, it had taken average 6.97 minutes to resect 1gm of prostatic tissue. 2. Perioperative blood replacement was performed in only 16 cases except one case of death and the mean amount was 0.66 pint (210ml). The remaining 45 cases (73.8 %) were not necessary to transfuse blood. 3. Postoperative serum sodium concentration was decreased in 38 of 60 cases and not changed in 8 cases and increased in 14 cases. These changes in serum sodium concentration showed no significant correlation with operative, amount of irrigating fluid. 4. Nineteen of 61 cases of TURP showed several types of non-fatal complications and one case of these expired and the rest of people showed' no complication. 5. The most common complication was transient urinary incontinence (11.4%), the remainders were in order of urethral stricture (6.6%), late bleeding (4.9%), re-TURP due to inadequate resection (3.3%), death (severe bleeding) (1.6%).
Hemorrhage ; Operative Time ; Postoperative Complications ; Prostatic Hyperplasia* ; Sodium ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Incontinence

Under the direct endoscopic manipulation, 15 internal urethrotomies in 14 cases with urethral stricture were applied at our department from March to August, 1983. Following results were obtained: 1. The cause of 14 cases hospitalized, were injury in 13 cases and tuberculosis in one. The sites of urethral stricture were anterior urethra in 8 cases and posterior urethra in 6. The managements before applying direct visual internal urethrotomy were dilatation in 1 case having tuberculous urethral stricture and initial cystostomy just after in 13 cases. In 3 cases of them, Otis internal urethrotomy and urethroplasty had performed in one previously. 2. The length of urethral stricture estimate on preoperative retrograde urethrogram was less than 0.5cm in 3 cases, 0.6 to 1.0 cm in 5, 1.1 to 2.0 cm in 2, and 2.1 to 3.0 cm in 4, all of them were less than 3.0 cm. 3. The periods of catheter indwelling postoperatively were less than 3 days in 6 cases, 4 to 7 days in 7 and more than 8 days in only one, predominantly less than 7 days in 13. 4. The maximum flow rates were excellent or improved postoperatively. Voiding cystourethrogram was more valuable than retrograde urethrogram in urethral stricture. 5. Epididymitis in 1 case and urethral bleeding in 2 as postoperative complications were present. These results implied that the visual internal urethrotomy was a valuable method as the management before deciding to perform urethroplasty.
Catheters ; Cystostomy ; Dilatation ; Epididymitis ; Hemorrhage ; Male ; Postoperative Complications ; Tuberculosis ; Urethra ; Urethral Stricture*

Fifteen patients with urethral stricture were treated with Otis urethrotome at our hospital during the period from November 1982 to August 1983. The results were as follows: 1. The age distribution ranges from 13 to 48years old, the mean of 15 cases was 34.7 years old, The causes of urethral stricture were traumatic in 13 cases and iatrogenic in 2. The sites of urethral stricture were anterior urethra in 8 cases and posterior in 7. The preliminary managements before internal urethrotomy were cystostomy in 11 cases, urethroplasty in 3 and internal urethrotomy with Maisonneuve urethrotome in 1. 2. The length of urethral stricture measured on preoperative retrograde urethrogram and < or =0.5 cm in 2 cases, 0.6-1.0 cm in 6, 1.1-2.0 cm in 3 and 2.1-3.0 cm. in 4, All of them revealed < or =3.0 cm. 3. The foley catheter was indwelled for the period from 2 to 6 weeks and mean duration of the indwelling catheter was 19.3 days; < or =3 weeks in 8 cases and >3 weeks in 7. 4. Satisfactory (> or =20 ml/sec) and improved maximum flow (15 to 19 ml/sec) were in 10 cases and unsatisfactory (< or =14 ml/sec) in 5, three of them followed visual internal urethrotomy and satisfactory results were obtained. The retrograde urethrograms were slightly improved postoperatively. 5. Postoperative complications noticed in 3 cases (20%); false way in 2 cases, urethral bleeding associated with fever in one. From above experience, we believe that internal urethrotomy is a valuable method for nearly all types of patent urethral stricture.
Age Distribution ; Catheters ; Catheters, Indwelling ; Cystostomy ; Fever ; Hemorrhage ; Humans ; Postoperative Complications ; Urethra ; Urethral Stricture*

A comparative analysis was made in 115 cases of TUR and 38 cases of open surgery in benign prostatic hyperplasia from March 1982 to December 1988.The results were as follows: The mean duration of operation was 84 min in TUR and 112 min in open surgery. The mean weight of resected tissues was 15.9em in TUR and 34.8gm in open surgery. The number of patients who needed transfusion were 74 of 115 in TUR(64%) and 35 of 38 in open surgery. Mean periods of postoperative hopitalization wee 9.1 days in TUR and 15.3 days in open surgery. Intraoperative complications were massive bleeding(5.2%), perforation of prostatic capsule(2.6%), hyponatremia(0.9%) in TUR and massive bleeding( 10.5%) in open surgery. Postoperative complications were unable to void, bleeding, incontinence, epididymitis, pyelonephritis and urethral stricture in TUR and bleeding. incontinence, epididymitis, pyelonephritis, vesicocutaneous fistula and wound infection in open surgery. Total complication rate was 26.1% in TUR and 28.9% in open surgery.
Epididymitis ; Fistula ; Hemorrhage ; Humans ; Intraoperative Complications ; Male ; Postoperative Complications ; Prostatic Hyperplasia* ; Pyelonephritis ; Transurethral Resection of Prostate ; Urethral Stricture ; Wound Infection

The use of artificial urinary sphincter (AUS) for the treatment of stress urinary incontinence has become more prevalent, especially in the "prostate-specific antigen (PSA)-era", when more patients are treated for localized prostate cancer. The first widely accepted device was the AMS 800, but since then, other devices have also entered the market. While efficacy has increased with improvements in technology and technique, and patient satisfaction is high, AUS implantation still has inherent risks and complications of any implant surgery, in addition to the unique challenges of urethral complications that may be associated with the cuff. Furthermore, the unique nature of the AUS, with a control pump, reservoir, balloon cuff, and connecting tubing, means that mechanical complications can also arise from these individual parts. This article aims to present and summarize the current literature on the management of complications of AUS, especially urethral atrophy. We conducted a literature search on PubMed from January 1990 to December 2018 on AUS complications and their management. We review the various potential complications and their management. AUS complications are either mechanical or nonmechanical complications. Mechanical complications usually involve malfunction of the AUS. Nonmechanical complications include infection, urethral atrophy, cuff erosion, and stricture. Challenges exist especially in the management of urethral atrophy, with both tandem implants, transcorporal cuffs, and cuff downsizing all postulated as potential remedies. Although complications from AUS implants are not common, knowledge of the management of these issues are crucial to ensure care for patients with these implants. Further studies are needed to further evaluate these techniques.
Atrophy ; Humans ; Postoperative Complications/therapy* ; Prosthesis Failure ; Prosthesis Implantation ; Prosthesis-Related Infections/therapy* ; Urethra/pathology* ; Urethral Diseases/therapy* ; Urethral Stricture/surgery* ; Urinary Incontinence, Stress/surgery* ; Urinary Sphincter, Artificial

A clinical observation was made on twenty cases of retropubic prostatectomy from June, 30 1978 to June 30, 1981. The results were summerized as follows. 1. The mean operation time was 92 minutes in retropubic prostatectomy. 2. The mean amount of blood transfusion was 1.2 pint. Transfusion was done in 75% of retropubic prostatectomy. 3. The mean duration of the urethral catheter indwelling was 8.85 days. 4. The mean duration of hospitalization was 9.6 days. 5. The weight of adenomatous tissue enucleated ranged from 20 to 52gm. 6. Postoperative complications were urinary infections in 12 cases, temporary incontinence in 5 cases, urethral strictures, wound abscesses and pyrexia. The mortality rate was 0%.
Abscess ; Blood Transfusion ; Fever ; Hospitalization ; Mortality ; Postoperative Complications ; Prostatectomy* ; Prostatic Hyperplasia* ; Urethral Stricture ; Urinary Catheters ; Wounds and Injuries

PURPOSE: The twenty-six F sized continuous running irrigation transurethral resection (TUR) system has showed a relatively high risk for inducing postoperative urethral stricture in Korean men. We evaluated the efficacy and safety of recently available 22F continuous running irrigation TUR system for treating benign prostatic hyperplasia (BPH) patients. MATERIALS AND METHODS: A total of seventy patients with severe symptomatic BPH underwent transurethral prostatectomy (TURP). The 26F system was used in 31 cases and the 22F system was used in 39 patients. The total resection weight, the resection rate, and the intraoperative and immediate postoperative complication rates were compared between the 2 groups. The patients were followed for 2 weeks, 4 weeks and 3 months postoperatively to check for the development of urethral stricture. RESULTS: The total resection weight was 14.8+/-9.5gm in the 22F group and 11.2+/-10.2gm in the 26F group (p>0.05). The resection rates were 0.24+/-0.10gm/min and 0.19+/-0.11gm/min, respectively. The rate of urethral stricture requiring any type of management was 15.4% (6/39) in the 22F group and 38.7% (12/31) in the 26F group (p<0.05). Visual internal urethrotomy was performed in 2.6% (1/39) and 9.7% (3/31) of the patients, respectively. Other complications were 1 capsular perforation, 1 TUR syndrome, 1 epididymitis and 1 delayed bleeding in the 22F group, and 1 intraoperative fever and 1 epididymitis in the 26F group. CONCLUSIONS: TURP using the 22F continuous running irrigation system enabled the surgeon to resect prostate adenoma with a similar speed and effectiveness as compared with the 26F system, and it significantly reduced the risk of urethral stricture. Performing TURP with using this system can be considered as a first line therapy for the BPH patients who require surgery.
Adenoma ; Epididymitis ; Fever ; Hemorrhage ; Humans ; Male ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Running* ; Transurethral Resection of Prostate* ; Urethral Stricture