Bulbomembranous Urethral Strictures Repair After Surgical Treatment of Benign Prostatic Hyperplasia. Experience From a Latin American Referral Centre.

OBJECTIVE: To evaluate stricture recurrence and urinary incontinence (UI) rates in patients who underwent bulbomembranous anastomosis for management of short (≤ 2cm) bulbomembranous urethral stricture (BMS) after benign prostatic hyperplasia (BPH) surgical treatment. In addition, we studied if there was any relation between post urethroplasty UI and the method employed for BPH surgical treatment. MATERIALS AND METHODS: A retrospective study was conducted between January 2011 and October 2019. We included all patients who developed BMS after undergoing Transurethral Resection of the Prostate, Holmium Laser Enucleation of the Prostate or Open Simple Prostatectomy (OSP). We excluded patients with UI after BPH surgical treatment as well as patients who underwent a dorsal or ventral onlay oral graft urethroplasty for longer proximal bulbar strictures, and also patients with associated bladder neck contracture or other strictures locations. We defined failure as the need for any intervention to restore the urethral caliber. RESULTS: Overall, 77 patients were included in the study with mean age 70 years (sd 8). Median BMS length was 1.5 cm (IQR 1-2). Median follow-up was 53 months (IQR 24 to 82). Of the patients, 74/77 (96.1%) were classified as success and 3/77 (3.9%), as failure. Out of the 6/77 (7.8%) patients who had postoperative UI, 5 of them had been treated for their BPH with OSP (p 0.001). CONCLUSIONS: Bulbomembranous anastomosis is a suitable reconstructive option for short proximal bulbar urethral strictures after BPH surgical treatment. OSP was associated with postoperative UI more frequently than endoscopic treatments modalities.

[Study on most common overnight urological service consultations.] / Principales consultas urológicas a la guardia de un hospital de alta complejidad.

INTRODUCTION: In Argentina, our institutionhas a urology resident on call who handles requests to the single radio during nighttime. Few studies address this important issue that provides useful information to promote education and optimize hospital dynamics. OBJECTIVE: To describe the characteristics of the calls received in the urology radio during night shifts. MATERIALS AND METHODS: During the night shifts, all calls to the radio were recorded during the period between June and July 2019. We determined: time, source, sex, and age of the patient, reason for the call and classified the calls according to: calls for immediate resolution (which required urological instrumental intervention, bladder catheterization or lavage, etc.), unnecessary calls (wrong number), and the number of emergencies that require calling a superior for immediate surgical resolution. RESULTS: We registered a total of 325 calls, most of them male patients. The main reason for calling was for placement, replacement, or washing of the urinary catheter or suprapubic catheter. We obtained 139 calls that required urological intervention. The highest number of calls was from the emergency department (119), followed by the Internal Medicine staff (47). Most of them (242) did not require patient admission. The total of unnecessary calls was three, corresponding to wrong number. CONCLUSION: This study helped us to characterize the calls to the Urology radio from other services and emergency department, allowing us to identify the most common problems and educate based on this.

INTRODUCCIÓN: En Argentina nuestra institución cuenta con un residente de guardia activa de urología que se ocupa de las llamadas al radio único durante la noche. Existen pocos trabajos que tratan este tema que resulta importante, ya que brinda información útil para promover educación y optimizar la dinámica hospitalaria.OBJETIVO: Describir las características de las llamadas al radio de urología durante la guardia.MATERIALES Y MÉTODOS: Durante la guardia activa, se registraron llamadas al radio durante el período comprendido en junio y julio de 2019. Determinamos:  hora, fuente, sexo y edad del paciente, motivo de la llamada y los clasificamos según: llamadas para guardia inmediata (que necesitó intervención instrumental urológica como sonda, talla o lavado vesical, etc.), llamadas innecesarias (número equivocado) y número de urgencias que requieren llamar a médico urólogo de pasiva para guardia quirúrgica inmediata.RESULTADOS: Se recopilaron un total de 325 llamadas, la mayoría de pacientes de sexo masculino. El principal motivo de la llamada fue para colocación, recambio o lavado de sonda vesical y/o talla vesical. Obtuvimos 139 llamadas que requirieron intervención urológica. El mayor número de llamadas fue de la Guardia externa (119), seguidos de Clínica Médica (47). La mayoría de las llamadas (242) no fueron ingresos. El total de llamadas innecesarias fueron 3 que corresponden al número equivocado.CONCLUSIÓN: Este trabajo permitió detallar las llamadas al radio de Urología provenientes de otros servicios y guardia externa, pudiendo identificar las problemáticas más comunes y educar en base a esto.