Effect of KTP laser on surgically resected adenomas of prostate

Transurethral resection of prostate [TURP] is the most common urological operation performed. Regarding the complications of this surgery, studies are looking for alternative endoscopic techniques in order to reduce risk of complications. Use of high energy lasers is the most promising method for managing patients with benign prostate hyperplasia [BPH]. In this study, we evaluated the effect of homemade KTP laser on resected prostate adenoma after open prostatectomy. A total of forty resected prostate adenoma by open prostatectomy, assigned in to the study groups. One part of specimens without any intervention was sent to the pathology department and the rests divided to four KTP dose response groups [10 patients in each group]. The prostate specimens were ablated by KTP laser in one, two, three, and four sessions according to their number of subgroups. Prostate tissue was irradiated by 5-watt KTP laser for 15 seconds in each stage. All prostate specimens ablated with laser were sent to pathology for evaluation of tissue ablation capacity and tissue penetration depth. Mean age of the participants was 73.25 +/- 6.8 years with mean serum level PSA of 3.65 +/- 2.1 ng/dl. 1 to 2 mm of the tissue was ablated at each session of laser administration. In pathologic examination, 0 to 2 mm of tissue destruction with disappearance of nuclei of the cells, basophilia of the stroma, and damaged tissue [cutter like effect] were witnessed. Findings were compatible with burn effect. KTP laser prostatectomy is a safe and effective procedure with low risk of complications in which bladder outlet obstruction symptoms will relieve. According to our study, extra penetration of prostate tissue during laser irradiation is rare. This finding could be suggestive this theory that KTP laser has little risk of capsule perforation

Fistula repair after hypospadias surgery using buccal mucosal graft

The aim of this study was to evaluate the success rate of urethrocutaneous fistula repair using buccal mucosal graft in patients with a previous hyposadias repair. We reviewed records of our patients with urethrocutaneous fistula developed after hypspadias repair in whom buccal mucosal graft fistula repair had been performed. All of the patients had been followed up for 24 postoperative months. A successful surgical operation was defined as no fistula recurrence or urethral stricture. Retrograde urethrography and urethrocystoscopy would be performed in patients who had any history of decreased force and caliber of urine or any difficulty in urination. Fistula repair using buccal mucosa patch graft had been done in 14 children with urethrocutaneous fistula developing after hypospadias reconstruction. The mean age of the children was 8.70 +/- 1.00 years old [range, 4 to 11 years]. Seven fistulas were in the midshaft, 4 were in the penoscortal region, and 3 were in the coronal region. Repair of the fistulas was successful in 11 of 14 patients [78.6%]. In the remaining children, the diameter of the fistula was smaller than that before the operation, offering a good opportunity for subsequent closure. Our findings showed that fistula repair using buccal mucosal graft can be on the acceptable techniques for repairing fistulas developed after hypopadias repair

Supracrural rerouting as a technique urology for resolution of posterior urethral disruption defects

Selection of an acceptable method for the treatment of posterior urethral disruption defects would be highly desirable. We determined the efficacy and success rate of some techniques including supracrural rerouting for removing of these defects among our patients. Records of 200 consecutive men treated with anastomotic urethroplasty for traumatic posterior urethral strictures were reviewed at our teaching hospital. Prior treatment, surgical approach, and ancillary techniques required during reconstruction were evaluated. Success rate due to posterior urethral reconstruction was achieved in 78.0% of cases. Supracrural urethral rerouting was performed in 11 patients [5.5%], of whom 7 sustained recurrent stricture requiring intervention. The highest success rate of defect resolving was reported by urethral mobilization [92.4%]. Supracrural rerouting is not an acceptable technique and can result in postoperative complications such as recurrent stricture in most of the patients with posterior urethral disruption defects