Surgical and Quality of Life Outcomes Following Robotic-Assisted (da Vinci) Laparoscopic Repair of Vesicovaginal Fistula: A Case Report and Video Demonstration.

This report presents the case of a 63-year-old woman who developed a vesicovaginal fistula as a complication of a previous total hysterectomy. The fistula was treated with the use of the da Vinci X surgical system by a multi-disciplinary operating team, including senior Robotic Urological and Gynecological Surgeons at St. Luke's Hospital in Thessaloniki, Greece. The patient was monitored up to 12 months post-op at the time of writing and she was asked to evaluate post-op quality of life using the SF-36 and ICIQ-SF-UI questionnaires. The robotic surgical procedure was completed successfully. The total operation duration was 105 minutes, without any intra-operative complications. The patient was hospitalized for two days and made a swift, uneventful recovery. Regarding the quality of life, the patient reported satisfactory improvement in almost every domain assessed compared to her pre-op assessment; an improvement that was maintained throughout the reported follow-up period. At the time of writing, the patient reports no long-term complications and satisfactory urinary continence. Robotic-assisted laparoscopic vesicovaginal fistula repair is an effective and safe treatment option for this rare complication, as indicated by both post-operative data and the patient's own self-evaluation in this report. Further research is warranted, focusing on refining the surgical technique and comparing this to other alternative methods aiming to further improve patient outcomes.

Recommendations for Mechanical Thrombectomy in Patients with Acute Ischemic Stroke : A Clinical Guide by the Hellenic Stroke Organization.

This document presents the consensus recommendations of the Hellenic Stroke Organization which can be of assistance to the treating stroke physicians.

[Congenital valves of the posterior urethra in puberty with primary enuresis as the only symptom]. / Válvulas congénitas de uretra posterior en pubertad con el único síntoma la enuresis primaria.

OBJECTIVE: To present a case of a 16-year-old male patient with primary enuresis refractory to conservative treatment. METHODS/RESULTS: Radiologic and urodynamic tests revealed posterior urethral valves that were treated by transurethral fulguration. The patient was cured of both enuresis and infravesical obstruction and remains disease-free 3 years after the operation with no impact on his sexual function. CONCLUSIONS: Posterior urethral valves are very rarely diagnosed in adolescents and adults. Very few cases have been published in the literature. To our knowledge, the case described herein is the first case presenting with persistent primary enuresis.

Válvulas congénitas de uretra posterior en pubertad con el único síntoma la enuresis primaria / Posterior urethral valves in an adolescent presenting with primary eneuresis

Objetivo: Presentar un caso clínico de un varón de 16 años de edad cuyo único síntoma era la enuresis nocturna primaria, resistente al tratamiento farmacológico. Método/resultados: Tras la exploración radiológica y el estudio urodinámico se llegó a la conclusión de la existencia de válvulas congénitas de uretra posterior. El tratamiento consistió en resecar las válvulas por vía transuretral con recuperación tanto de la enuresis, como de la obstrucción infravesical. Conclusión: El diagnóstico de válvulas de uretra posterior es excepcional en jóvenes así como en adultos. En la bibliografía internacional se han publicado muy pocos casos, siendo éste el primero que se presenta con enuresis nocturna como síntoma único (AU)