The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Shinichi Ohshima - One of the best experts on this subject based on the ideXlab platform.
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The efficacy of endopyeloureterotomy via a transpelvic extraureteral approach
The Japanese Journal of Urology, 1995Co-Authors: Shinichi Ohshima, Tsuneo Kinukawa, Masafumi Sahashi, Norio Katoh, Osamu Matsuura, Norihisa Takeuchi, Ryohei Hattori, Masaya Itoh, Shin YamadaAbstract:: To evaluate the efficacy of endopyeloureterotomy via a transpelvic extraureteral approach for the treatment of ureteropelvic junction obstruction or upper ureteric stenosis, we analysed the results of 85 patients treated with this procedure between Aug. 1988 and June 1993. Eighty-five patients underwent 87 procedures. Each patient has been followed-up more than 6 months postoperatively. Of 87 procedures, 71 were performed in patients with ureteropelvic junction obstruction and 16 were in patients with stenosis of the upper third ureter. Primary disease was 59 and secondary disease was 28. Twenty-one procedures were performed in patients with the stenotic segment over 2 cm. The operative procedure was performed by first incising with a 22 Fr. Urethrotome (ACMI Co.); the dilated renal pelvic or ureteral wall posterolaterally as long as 1-1.5 cm junction from the stenotic segment toward ureteropelvic junction, then bringing the Urethrotome out retroperitoneally through the incision and finally incising the stenotic segment with the cold knife under direct vision. A 12-16 Fr. PTCS tube (Sumitomo Behkuraito Co.) was left in place for 3 weeks as a stent. Mean operative time was 101 min and average length of incised segment was 3.7 cm. Complication included pneumothorax (1 case), pseudo ureter (1 case) and renal arterial anexryma (1 case). Followed-up period ranged from 6 to 64 months with the average being 26 months. Of 87 procedures, 80 (92%) achieved a disappearance or improvement of the obstructive change and 7 failed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Endopyeloureterotomy via transpelvic extraureteral approach
The Japanese Journal of Urology, 1992Co-Authors: Tsuneo Kinukawa, Shinichi OhshimaAbstract:: Endopyelotomy has been established as a valuable procedure to relieve the obstruction of ureteropelvic junction or upper ureteral stenosis. However, in a case with a long stenotic segment and in a case with high insertion type of ureteropelvic junction obstruction, we had often poor results by the conventional technique. To resolve these problems, we developed a new technique of endopyeloureterotomy via transpelvic extraureteral approach. We made an auxiliary incision in renal pelvis or dilated ureter involved with stricture to pass a 22 Fr. Urethrotome equipped with a cold knife into the retroperitoneal space. Then we incised a stenotic segment by the knife through the Urethrotome until the normal caliber of ureteric lumen was found. A 10-16 Fr. stent was left in place in the incised segment for 3 weeks. We treated 38 patients with ureteropelvic junction stenosis or upper ureteral stenosis by this procedure between August 1988 and June 1990. A total of 39 procedures were performed on 39 ureteropelvic junctions or upper ureters. Original disease were congenital anomalies in 23 patients, strictures secondary to urinary calculi in 12 and postoperative strictures in 4. The length of incision was 2 to 6 cm with the average being 3.2 cm. Postoperative follow-up period ranged 4 to 32 months with the average being 19 months. Obstructive changes disappeared or improved in 37 procedures (95%). In two procedures we failed. Thus this new technique of endopyeloureterotomy might be an useful procedure to relieve ureteropelvic junction stenosis or upper ureteral stenosis with a long stenotic segment or high insertion type of ureteropelvic junction stenosis.
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Endopyeloureterotomy via a transpelvic extraureteral approach.
The Journal of Urology, 1992Co-Authors: Shinichi Ohshima, Tsuneo Kinukawa, Masafumi Sahashi, Shin YamadaAbstract:AbstractEndopyeloureterotomy has been accepted as a procedure to relieve obstruction of the ureteropelvic junction and upper ureteral stenosis. However, in patients with a long stenotic segment poor results are often obtained with the conventional technique. To resolve this problem we developed a new technique using a 22F Urethrotome and a transpelvic extraureteral approach. In this technique the renal pelvis was incised for 1 to 1.5cm. from the ureteropelvic junction in the direction of the parenchyma using the cold knife of the Urethrotome under direct vision. For upper ureteral stenosis the dilated pelvic and ureteral posterolateral walls were incised 1 to 1.5cm. from the stenotic segment toward the ureteropelvic junction. Then, the stenotic segment was treated with the Urethrotome after it was advanced into the retroperitoneal space through the incision in the renal pelvis. We treated 21 patients with the new technique between August 1988 and August 1990. Our series included 3 patients with the high i...
Shin Yamada - One of the best experts on this subject based on the ideXlab platform.
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The efficacy of endopyeloureterotomy via a transpelvic extraureteral approach
The Japanese Journal of Urology, 1995Co-Authors: Shinichi Ohshima, Tsuneo Kinukawa, Masafumi Sahashi, Norio Katoh, Osamu Matsuura, Norihisa Takeuchi, Ryohei Hattori, Masaya Itoh, Shin YamadaAbstract:: To evaluate the efficacy of endopyeloureterotomy via a transpelvic extraureteral approach for the treatment of ureteropelvic junction obstruction or upper ureteric stenosis, we analysed the results of 85 patients treated with this procedure between Aug. 1988 and June 1993. Eighty-five patients underwent 87 procedures. Each patient has been followed-up more than 6 months postoperatively. Of 87 procedures, 71 were performed in patients with ureteropelvic junction obstruction and 16 were in patients with stenosis of the upper third ureter. Primary disease was 59 and secondary disease was 28. Twenty-one procedures were performed in patients with the stenotic segment over 2 cm. The operative procedure was performed by first incising with a 22 Fr. Urethrotome (ACMI Co.); the dilated renal pelvic or ureteral wall posterolaterally as long as 1-1.5 cm junction from the stenotic segment toward ureteropelvic junction, then bringing the Urethrotome out retroperitoneally through the incision and finally incising the stenotic segment with the cold knife under direct vision. A 12-16 Fr. PTCS tube (Sumitomo Behkuraito Co.) was left in place for 3 weeks as a stent. Mean operative time was 101 min and average length of incised segment was 3.7 cm. Complication included pneumothorax (1 case), pseudo ureter (1 case) and renal arterial anexryma (1 case). Followed-up period ranged from 6 to 64 months with the average being 26 months. Of 87 procedures, 80 (92%) achieved a disappearance or improvement of the obstructive change and 7 failed.(ABSTRACT TRUNCATED AT 250 WORDS)
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Endopyeloureterotomy via a transpelvic extraureteral approach.
The Journal of Urology, 1992Co-Authors: Shinichi Ohshima, Tsuneo Kinukawa, Masafumi Sahashi, Shin YamadaAbstract:AbstractEndopyeloureterotomy has been accepted as a procedure to relieve obstruction of the ureteropelvic junction and upper ureteral stenosis. However, in patients with a long stenotic segment poor results are often obtained with the conventional technique. To resolve this problem we developed a new technique using a 22F Urethrotome and a transpelvic extraureteral approach. In this technique the renal pelvis was incised for 1 to 1.5cm. from the ureteropelvic junction in the direction of the parenchyma using the cold knife of the Urethrotome under direct vision. For upper ureteral stenosis the dilated pelvic and ureteral posterolateral walls were incised 1 to 1.5cm. from the stenotic segment toward the ureteropelvic junction. Then, the stenotic segment was treated with the Urethrotome after it was advanced into the retroperitoneal space through the incision in the renal pelvis. We treated 21 patients with the new technique between August 1988 and August 1990. Our series included 3 patients with the high i...
Gordon Mclorie - One of the best experts on this subject based on the ideXlab platform.
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cold knife valvulotomy for posterior urethral valves using novel optical Urethrotome
Urology, 2009Co-Authors: Theodore Barber, Osama Alomar, Gordon MclorieAbstract:Objectives To present our results after valve ablation using a novel cold knife Urethrotome. Methods Eleven consecutive male patients with posterior urethral valves underwent cold knife valvulotomy using a modified optical pediatric Urethrotome. Patients were assessed both pre- and postoperatively using serum creatinine, voiding cystourethrography, and renal/bladder ultrasonography. Results From August 2003 to August 2005, 11 patients underwent cold knife valvulotomy, of whom 7 returned for postoperative follow-up (mean follow-up 17.4 months). At surgery, the patients ranged in age from 5 days to 9 years. At presentation, 5 of the 7 patients had an elevated serum creatinine (mean 2.5 mg/dL, range 0.3-6.5), all had bilateral hydronephrosis of at least grade 3, and 6 of 7 had at least grade 3 reflux on 1 side. Intraoperatively, 1 complication (minor urethral laceration) occurred. Postoperatively, all 6 patients with serum creatinine levels measured showed improvement in renal function (mean creatinine 0.47 mg/dL, range 0.2-0.9). For the 6 patients who underwent postoperative ultrasonography, 4 had either complete resolution or significant improvement in their hydronephrosis, and none showed worsening. Six patients underwent postoperative voiding cystourethrography, with 5 showing either marked improvement or complete resolution of their reflux and 1 showing stable, unilateral reflux. Conclusions Valvulotomy using our modified Urethrotome is a safe and effective technique for valve ablation.
Benjamin N Breyer - One of the best experts on this subject based on the ideXlab platform.
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Male urethral strictures and their management
Nature Reviews Urology, 2014Co-Authors: Lindsay A. Hampson, Jack W Mcaninch, Benjamin N BreyerAbstract:Hampson et al . discuss the epidemiology, pathogenesis, aetiology, and evaluation of anterior male urethral strictures. They also consider some current controversies in urethroplasty, such as the management of failed hypospadias repair and long or complex strictures, as well as the use of dorsal versus ventral onlay grafting. 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. Male urethral strictures are common and have a significant impact on a patient's quality of life and health-care costs Studies such as retrograde urethrography, voiding cystourethrography, and intraoperative ultrasonography can be helpful for determining the best operative approach and management plan Urethral dilation and internal urethrotomy have similar rates of success, with long-term success rates of 20–30% Repeated internal urethrotomy is not clinically effective or cost-effective Long-term success rates are high for urethroplasty, generally ranging from 85–90%
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Male urethral strictures and their management
Nature Reviews Urology, 2013Co-Authors: Lindsay A. Hampson, Jack W Mcaninch, Benjamin N BreyerAbstract: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.
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management for prostate cancer treatment related posterior urethral and bladder neck stenosis with stents
The Journal of Urology, 2011Co-Authors: Bradley A Erickson, Jack W Mcaninch, Michael L Eisenberg, Samuel L Washington, Benjamin N BreyerAbstract:Purpose: Prostate cancer treatment has the potential to lead to posterior urethral stricture. These strictures are sometimes recalcitrant to dilation and urethrotomy alone. We present our experience with the Urolume® stent for prostate cancer treatment related stricture.Materials and Methods: A total of 38 men with posterior urethral stricture secondary to prostate cancer treatment were treated with Urolume stenting. Stents were placed in all men after aggressive urethrotomy over the entire stricture. A successfully managed stricture was defined as open and stable for greater than 6 months after any necessary secondary procedures.Results: The initial success rate was 47%. After a total of 31 secondary procedures in 19 men, including additional stent placement in 8 (18%), the final success rate was 89% at a mean ± SD followup of 2.3 ± 2.5 years. Four cases (11%) in which treatment failed ultimately requiring urinary diversion (3) or salvage prostatectomy (1). Incontinence was noted in 30 men (82%), of whom...
Jack W Mcaninch - One of the best experts on this subject based on the ideXlab platform.
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Male urethral strictures and their management
Nature Reviews Urology, 2014Co-Authors: Lindsay A. Hampson, Jack W Mcaninch, Benjamin N BreyerAbstract:Hampson et al . discuss the epidemiology, pathogenesis, aetiology, and evaluation of anterior male urethral strictures. They also consider some current controversies in urethroplasty, such as the management of failed hypospadias repair and long or complex strictures, as well as the use of dorsal versus ventral onlay grafting. 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. Male urethral strictures are common and have a significant impact on a patient's quality of life and health-care costs Studies such as retrograde urethrography, voiding cystourethrography, and intraoperative ultrasonography can be helpful for determining the best operative approach and management plan Urethral dilation and internal urethrotomy have similar rates of success, with long-term success rates of 20–30% Repeated internal urethrotomy is not clinically effective or cost-effective Long-term success rates are high for urethroplasty, generally ranging from 85–90%
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Male urethral strictures and their management
Nature Reviews Urology, 2013Co-Authors: Lindsay A. Hampson, Jack W Mcaninch, Benjamin N BreyerAbstract: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.
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effect of a temporary thermo expandable stent on urethral patency after dilation or internal urethrotomy for recurrent bulbar urethral stricture results from a 1 year randomized trial
The Journal of Urology, 2013Co-Authors: Gerald H Jordan, Jack W Mcaninch, Hunter Wessells, Charles L Secrest, James F Squadrito, Lawrence Levine, Michael Van Der BurghtAbstract:Purpose: The long-term success rate of dilation and/or internal urethrotomy is low in cases of recurrent urethral stricture. We investigated the ability of the Memokath™ 044TW stent to maintain urethral patency after dilation or internal urethrotomy for recurrent urethral stricture.Materials and Methods: A total of 92 patients with recurrent bulbar urethral strictures (mean length 2.7 cm) were treated with dilation or internal urethrotomy and randomized to short-term urethral catheter diversion (29) or insertion of a Memokath 044TW stent (63). The primary end point was urethral patency, as assessed by passage of a calibrated endoscope. Secondary end points included urinary symptoms and uroflowmetry parameters. Stents were scheduled to remain in situ for 12 months.Results: The rate of successful stent insertion was 93.6% (59 of 63 patients). In stented patients patency was maintained significantly longer than controls (median 292 vs 84 days, p <0.001). Patency was reflected in significantly improved uroflo...
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management for prostate cancer treatment related posterior urethral and bladder neck stenosis with stents
The Journal of Urology, 2011Co-Authors: Bradley A Erickson, Jack W Mcaninch, Michael L Eisenberg, Samuel L Washington, Benjamin N BreyerAbstract:Purpose: Prostate cancer treatment has the potential to lead to posterior urethral stricture. These strictures are sometimes recalcitrant to dilation and urethrotomy alone. We present our experience with the Urolume® stent for prostate cancer treatment related stricture.Materials and Methods: A total of 38 men with posterior urethral stricture secondary to prostate cancer treatment were treated with Urolume stenting. Stents were placed in all men after aggressive urethrotomy over the entire stricture. A successfully managed stricture was defined as open and stable for greater than 6 months after any necessary secondary procedures.Results: The initial success rate was 47%. After a total of 31 secondary procedures in 19 men, including additional stent placement in 8 (18%), the final success rate was 89% at a mean ± SD followup of 2.3 ± 2.5 years. Four cases (11%) in which treatment failed ultimately requiring urinary diversion (3) or salvage prostatectomy (1). Incontinence was noted in 30 men (82%), of whom...
