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Objective: The urethral gap in pelvic fracture urethral injury (PFUI) is traditionally assessed using voiding cystourethrogram (VCUG) and retrograde urethrogram (RGU). Magnetic resonance imaging (MRI) is performed in complex cases. We assessed the refined "Joshi" MRI protocol to evaluate complex urethral defects after PFUI. Material and methods: A prospective study was conducted at our center from January 2018 to January 2020, involving patients aged >18 years with PFUI, suitable for MRI, and those who gave consent to perform standard RGU, VCUG, and MRI using standard and "Joshi" protocol. Forty men were included in the study. Distance between urethral/prostatic stumps was measured. Image quality was scored by four radiologists and four urologists. The surgical approach and type of PFUI repair were noted. We also established the need for inferior pubectomy by assessing the position of the posterior urethra (membranous) in relation to a horizontal line drawn from the lower edge of the pubic bone anteriorly to the rectum posteriorly in a sagittal image. Results: The mean age was 30 years (SD, 5.25; range, 21--43), and the time from injury to imaging was 4 months (3--10 months); 40% of the men underwent crural separation, 57.5%, inferior pubectomy, and 2.5%, crural rerouting. There was a difference of 0.3 to 1.1 cm in the urethral gap measurements between MR images using the standard versus "Joshi" technique. MRI identified complex injuries such as rectourethral fistula, the need for inferior pubectomy, and the orientation of the posterior urethra. Urologists' and radiologists' satisfaction scores for the MR images were satisfactory to excellent. If the posterior urethra was over the defined mark, there was a 100% likelihood of inferior pubectomy (23/40 patients). Objective: The urethral gap in pelvic fracture urethral injury (PFUI) is traditionally assessed using voiding cystourethrogram (VCUG) and retrograde urethrogram (RGU). Magnetic resonance imaging (MRI) is performed in complex cases. We assessed the refined "Joshi" MRI protocol to evaluate complex urethral defects after PFUI. Material and methods: A prospective study was conducted at our center from January 2018 to January 2020, involving patients aged >18 years with PFUI, suitable for MRI, and those who gave consent to perform standard RGU, VCUG, and MRI using standard and "Joshi" protocol. Forty men were included in the study. Distance between urethral/prostatic stumps was measured. Image quality was scored by four radiologists and four urologists. The surgical approach and type of PFUI repair were noted. We also established the need for inferior pubectomy by assessing the position of the posterior urethra (membranous) in relation to a horizontal line drawn from the lower edge of the pubic bone anteriorly to the rectum posteriorly in a sagittal image. Results: The mean age was 30 years (SD, 5.25; range, 21--43), and the time from injury to imaging was 4 months (3--10 months); 40% of the men underwent crural separation, 57.5%, inferior pubectomy, and 2.5%, crural rerouting. There was a difference of 0.3 to 1.1 cm in the urethral gap measurements between MR images using the standard versus "Joshi" technique. MRI identified complex injuries such as rectourethral fistula, the need for inferior pubectomy, and the orientation of the posterior urethra. Urologists' and radiologists' satisfaction scores for the MR images were satisfactory to excellent. If the posterior urethra was over the defined mark, there was a 100% likelihood of inferior pubectomy (23/40 patients). [ABSTRACT FROM AUTHOR]

Objective: Hypospadias is a congenital anomaly of the male urethra that is becoming increasingly prevalent. In this paper, we share the results of our series of 45 distal hypospadias cases treated with tubularized incised plate urethroplasty (TIPU) at a single center in Şanlıurfa, Turkiye. Materials and Methods: Hypospadias repairs were made by two urologists who had completed their urology residencies at the same clinic in a state hospital. The TIPU technique was used for all 45 patients. To prevent bladder contractions and reduce anal itching during hospitalization, the patients were administered low-dose oxybutynin and 2 mg/mL hydroxyzine hydrochloride; they were also followed up postoperatively for a mean duration of 9.3 (6-12) months. Results: The average age of the patients was 9.5±0.5 (2-24) years. Ten patients had been circumcised previously, preoperative skin chordee was observed in 35, and none experienced preoperative complications. Postoperative catheterization lasted seven days. Postoperatively, one patient developed a fistula and two developed meatal strictures. No other complications were observed in the other patients. Conclusion: Hypospadias is an anomaly frequently seen in pediatric urology practice and requires considerable attention and experience. TIPU is an ideal technique for correcting hypospadias, especially distal hypospadias, due to its low complication rate and favorable cosmetic results. Although hypospadias surgery requires experience, it can be done quite easily in peripheral hospitals by surgeons who have trained in clinics experienced in this field, provided that they follow the rules pertaining to surgery. [ABSTRACT FROM AUTHOR]