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Visualization of the surgically operated tissues is vital to improve surgical model animals including mouse. Urological surgeries for urethra include series of fine manipulations to treat the increasing number of birth defects such as hypospadias. Hence visualization of the urethral status is vital. Inappropriate urethral surgical procedure often leads to the incomplete wound healing and subsequent formation of urethro-cutaneous fistula or urethral stricture. Application of indocyanine green mediated visualization of the urethra was first performed in the current study. Indocyanine green revealed the bladder but not the urethral status in mouse. Antegrade injection of contrast agent into the bladder enabled to detect the urethral status in vivo. The visualization of the leakage of contrast agent from the operated region was shown as the state of urethral fistula in the current hypospadias mouse model and urethral stricture was also revealed. A second trial for contrast agent was performed after the initial operation and a tendency of accelerated urethral stricture was observed. Thus, assessment of post-surgical conditions of urogenital tissues can be improved by the current analyses on the urethral status.

Objective: To determine the rate and the distribution of the structural defects in the urinary bladder complicating urethral stricture in men, and to compare the complications observed in the younger patients to those observed in the older patients., Methods: Retrospectively, case files of patients diagnosed of urethral stricture using retrograde urethrogram (RUG) and voiding cysto-urethrogram (VCUG) from February 2009 to August 2018 were analyzed. Stricture characteristics were outlined. In addition, complicating structural defects in the lower urinary tract proximal to the stricture site were documented. The complicating defects identified in the patients were segregated according to age for any observable associations. Logistic regression analysis was used to define the nature of the association of patient age, stricture site, number and length, with distribution of complicating structural defects. Analyses were done using SPSS® version 20., Results: Within the 10-year review period, 257 of 421 suspected cases of urethral stricture were confirmed. Patients are between 1 and 104 years of age (mean: 50.1 ± 19.1 years; median: 51.0 years IQR 35.0-65.0). Bulbar (34.2%); short segment (62.6%); partial (73.9%) strictures are prevalent. Forty-seven (18.3%) of 257 patients presented with 1 or more complications. Bladder diverticulum (8.6%) and urethra-cutaneous fistula (6.6%) are prevalent complications. The distribution of complications does not vary with age, or with stricture characteristics., Conclusion: Presentation with complications is not uncommon. The distribution of these complications does not vary with age or with stricture characteristics.

Voiding cystourethrogram (VCUG) is needed to ascertain the upper end of urethral stricture. Occasionally, a patient is unable to open the bladder neck with resultant failure of the test. Realizing the strong and prompt alpha antagonistic action of silodosin, we evaluated single 8 mg dose as a pharmacological adjunct prior to VCUG to overcome this problem.

This article presents an overview of reconstruction of lower urinary tract injury caused by radiation therapy for prostate cancer. Discussions include cause, patient evaluation, reconstructive techniques, and outcomes following repair., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: Stricture of the vesico-urethral anastomosis is a well-known complication after radical prostatectomy. Dilatation, stricture incision or resection have been proposed for endoscopic treatment., Methods: In a retrospective study of 340 patients with prostatic cancer who underwent a radical retropubic prostatectomy from 1988 until 1996, we looked at the incidence of anastomotic strictures., Results: An anastomotic stricture was found in 24 cases (7%) requiring endoscopic treatment. Based on prospective X-ray studies, we were able to show that the site of stricture is located below the bladder neck musculature in most cases well above the distal urethral sphincter and pelvic floor. No continence problems were encountered following structure resection in a follow-up of 12-72 months determined by a questionnaire and pad test., Conclusion: The transurethral resection of anastomotic stricture allows for a rather generous tissue resection, which is preferable to incision or dilatation in our hands.

In cases of missed preoperative diagnosis of prostatic cancer and benign hyperplasia, the recovery of unassisted urination in patients who previously have undergone transvesicular adenomectomy is often accompanied by traumatic removal of the tissues. This leads to severe anatomical changes of the cervicourethral segment in the form of postoperative strictures with occasional complete obliteration of the posterior urethra. If endoscopic correction of the posterior urethra fails to produce a persistent therapeutic effect, it is valid to perform urethral invagination into the bladder cervix according to Solovov for restoration of the bladder reservoir function, prevention of its fusion and progression of chronic interstitial cystitis. The case demonstrates successful recovery of the patency of the vesicourethral segment and capacity of the bladder in complete obliteration of the posterior urethra and small urinary bladder.

To correct urination the authors used retrograde infusion urethrocystography (RIU) in 102 males. 57 of them had an urethral stricture. A novel urethrocystography device is proposed which facilitates the procedure and is more safe in relation to complication danger. The advantages of the modified RIU over routine one are demonstrated.

Using a newly devised chair for transperineal sonography we performed ultrasonic voiding cystourethrography in a total of 219 male patients and volunteers. The study produced adequate images in more than 80% of the people examined. Valsalva's maneuver during urination elicited an intermittent depression of the bladder dome toward the bladder base. In patients with benign prostatic hyperplasia or bladder neck contracture the bladder neck did not open well. Urethral stricture was associated with a marked opening of the bladder neck and posterior urethra. In patients with detrusor-sphincter dyssynergia an involuntary contraction of the external sphincter was observed. These results indicate that this method is useful for screening male patients for diseases causing voiding disturbance and for making differential diagnosis of such diseases.

A retrospective analysis of 51 women presenting with stress urinary incontinence was performed. Preoperative assessment protocol consisted of a careful history and physical examination, urinalysis and culture, cystoscopy, urodynamic study, beaded-chain cystogram, and intravenous pyelogram (IVP). All patients in the study were subjected to the Marshall-Marchetti-Krantz vesicourethral suspension procedure. The overall incidence of detrusor instability was 38.8 per cent. Surgical success rate was 92.5 per cent. Identification of detrusor instability was considered not to be a deterrent to surgery, nor a prognosticator of surgical failure. The chain cystogram was believed to be of little value in cases that had undergone previous surgical corrective attempts. Urodynamic studies were felt helpful in patients presenting with mixed symptom patterns, as well as in patients previously operated on for stress urinary incontinence. The preoperative IVP was not found to be a cost-effective study.

A case report of a child is presented in which double sectioing of the lower ureter was required to close simultaneously low cutaneous loop ureterostomies and to excise congenital ureterovesical junction strictures. One ureteroneocystostomy required revision. The vasculature of the ureteral segments was preserved by not mobilizing the ureter.

The addition of pressure and flow rate recordings to conventional cystourethrography is relatively inexpensive in terms of cost and of radiologist's time, each investigation requiring approximately half an hour.The value of this investigation in males lies in assessing the severity and site of outlet obstruction, particularly when the prostate is not clinically enlarged. Its value in demonstrating detrusor instability in cases of obstruction and in patients with post-prostatectomy problems is discussed. It is essential to the adequate assessment of sphincter mechanisms in both males and females. The particular importance of this in the female lies in the poor results of routine surgery for incontinence where this is due to detrusor instability.Finally the importance in neurological patients of a urodynamic evaluation of continence mechanisms and voiding dysfunction, both as a preliminary assessment and as a guide to the efficacy of treatment, is outlined.Various criticisms of the technique are reviewed and appropriate rebuttals provided.

The aim of the investigation was to classify urethral variability as seen on micturating cystograms of 193 young girls and to study the physiological and pathological significance of the various shapes. It was shown that significant abnormalities were associated with all types of urethral configuration. Comparison of urethral shapes and clinical symptoms (dysuria, enuresis) did not show any particular appearance. Differentiation of urethral shapes into those that were dilated, and therefore suggested a stenosis, and those that were not dilated, showed no significant correlation between clinical and radiological findings.

Distal urethral stenosis in girls as well as meatal and bulbar narrowed urethral segments in boys are still subjects of discussion about their pathologic value in the literature. The urodynamic findings in enuretic children by urethral pressure profile and cystometry frequently point to a outflow resistance. Calibration with bougies à boule, urethroscopy and permictional cysturethrography disclose such urethral narrowing. The survey of our own 107 enuritic children shows that urethrotomy has given good results relative to urodynamic data. The effect of methantheline medications consists in suppressing the hyperactivity of the detrusor.

We report the use of micturating cystourethrography to demonstrate complications of the urethra in hypospadias. We recommend MCU to evaluate hypospadias, both before and after the surgical repair.