Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.477
Filtrar
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(4): 641-645, 2019 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-31420615

RESUMO

OBJECTIVE: To evaluate the clinical effect of single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap. METHODS: We retrospectively reviewed the clinical database of 22 male patients with penile urethral stricture who received single-stage repair using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap from November 2015 to October 2018. All the cases had no complications, such as skin fistula. The causes of stricture included iatrogenic (14/22, 63.6%), inflammation (2/22, 9.1%) and idiopathic (6/22, 27.3%). A ventral urethrotomy was made in the segment of stricture and extended proximally and distally until the normal calibre urethra was encountered. The oral mucosa graft was secured to the corpus spongiosum in dorsal onlay fashion or underlying corpora cavernosum after resection of the severe scarred urethra. Then the prepared Orandi fasciocutaneous penile skin flap was secured to edges of corpus spongiosum or oral mucosa graft. A 16 F or 14 F Foley catheter was left in situ for a minimum of 3 weeks, at which time a urethrogram was performed to look for extravasation, and the urethroscopy was performed if necessary. Success was defined as an open urethra with Qmax≥15 mL/s and no need for further surgical intervention. RESULTS: all the 22 patients with a mean age of 52.6 (18-73) years underwent the combined tissue-transfer technique. The mean length of the penile urethral stricture was 5.3 (2.5-10.0) cm and the mean preoperative Qmax was 6.7 mL/s. the mean length of oral mucosa grafts and fasciocutaneous skin flaps were 5.5 (3.2-10.5) cm and 6.0 (3.5-11.0) cm, respectively. The mean operation time was 225 (150-420) minutes and the mean evaluated blood loss was 53 (20.0-110.0) mL. The grafts included buccal mucosa (19/22, 86.4%) and lingual mucosa (3/22, 13.6%). The mean postoperative Q max was 21.2 (15-32) mL/s. A case of skin fistula and 2 cases of recurrent stricture were found, so the technique success rate was 81.8% (18/22) at a mean follow-up of 20.5 (5-51) months. The perioperative complications included 2 cases of infection and skin necrosis, which healed well after conservative treatment. CONCLUSION: Single-stage repair of penile urethral stricture using combined dorsal onlay oral mucosa grafting with ventral onlay penile skin flap appears to be an excellent option to repair penile urethral stricture with unsalvageable urethral plate and the penile skin is available. The present clinical series showed a successful rate of 81.8% (18/22).


Assuntos
Estreitamento Uretral , Idoso , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal , Estudos Retrospectivos , Resultado do Tratamento , Uretra , Procedimentos Cirúrgicos Urológicos Masculinos
4.
Medicina (Ribeiräo Preto) ; 52(3)jul.-set. 2019.
Artigo em Português | LILACS | ID: biblio-1025786

RESUMO

A mucosa vesical, na presença de agentes agressores, sofre alterações inicialmente benignas, mas com a cronicidade pode sofrer modificações potencialmente metaplásicas. A cistite glandular apresenta um quadro sintomático inespecífico, sendo necessária a realização de biópsia para seu diagnóstico e diferenciação histológica, podendo dividir-se em subtipos clássico e intestinal. Após análise de prontuário médico pertencente ao Hospital Santa Rita de Maringá, objetiva-se relatar o caso de um paciente masculino, de 32 anos, com disúria e dor em hipogástrico, apresentando em ultrassonografia lesão cística de 3,8 cm de diâmetro na bexiga. Após a retirada da lesão por ressecção transuretral, a análise histopatológica revelou presença de ninhos de Von Brunn, áreas de epitélio mucossecretor e mucina extracelular na mucosa vesical, propondo a existência de lesão glandular com metaplasia intestinal. Foi realizado estudo imunohistoquímico para diagnóstico diferencial de adenocarcinoma mucossecretor bem diferenciado. A cistite glandular, quando manifestada macroscopicamente, assemelha-se a uma neoplasia por apresentar um aspecto irregular, difuso e algumas vezes ulceroso. Seu diagnóstico e tratamento podem ser simultâneos, porém, nos casos mais graves, as opções terapêuticas são restritas. O diagnóstico diferencial é extremamente importante para afastar a possibilidade de adenocarcinoma vesical, portanto, é imprescindível o acompanhamento periódico dos pacientes após o tratamento com a realização de exames específicos. O uso de marcadores imunohistoquímicos tem se tornado relevante para o correto diagnóstico, pois genes relacionados ao ciclo celular, como o fator de transcrição homebox 2 do tipo caudal (CDX2), podem representar um vínculo entre o surgimento de metaplasia e sua possível progressão a adenocarcinoma. (AU)


The bladder's mucosa, in the presence of aggressive agents, undergoes initially benign changes, but with chronicity may undergo potentially metaplastic modifications. Glandular cystitis presents nonspecific symptoms and biopsy is necessary for diagnosis and histological differentiation, subdividing it into classic and intestinal subtypes. After analyzing a medical record belonging to the Santa Rita Hospital from Maringá, the objective of this study is to report the case of a 32-year-old male patient with dysuria and pain in the hypogastric region, presenting on ultrasonography cystic lesion of 3.8 cm of diameter in the bladder. After removal of the lesion by transurethral resection, the histopathological analysis revealed the presence of Von Brunn nests, areas of mucosecretory epithelium and extracellular mucin in the bladder's mucosa, suggesting the existence of a glandular lesion with intestinal metaplasia. It was performed an immunohistochemical study for differential diagnosis of well-differentiated mucosecretory adenocarcinoma. Glandular cystitis, when manifest-ed macroscopically, resembles a neoplasm, since it can present an irregular aspect, diffuse and sometimes ulcerous. The diagnosis and treatment can be simultaneous, but in severe cases, the therapeutic options are restricted. Differential diagnosis is extremely important to rule out the possibility of bladder adenocarcinoma, therefore it is essential to follow up patients after treatment with specific tests periodically. The use of immunohistochemical markers has become rele-vant for the correct diagnosis, since genes related to the cell cycle, such as caudal type homeobox transcription factor 2 (CDX2), may represent a link between the onset of metaplasia and its possible progression to adenocarcinoma (AU)


Assuntos
Humanos , Masculino , Adulto , Procedimentos Cirúrgicos Urológicos Masculinos , Cistite , Metaplasia
5.
Curr Urol Rep ; 20(8): 45, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31218458

RESUMO

PURPOSE OF REVIEW: To provide an economic context within which to consider treatment options for benign prostatic hyperplasia (BPH). To this end, this review provides a comparison of the costs of combination medical therapy, operative treatment, and office-based therapies for BPH from a payer perspective. RECENT FINDINGS: Analysis of Medicare charges from the authors' institution, as well as local retail costs of medication, demonstrated a wide range in costs of commonly used BPH treatments. In this study, interventions for BPH reached cost equivalence with combination medical therapy within 6 months to 8 years. A myriad of options for managing men with symptomatic BPH exist. It is prudent not only to consider surgeon preference and patient-specific factors when selecting a treatment but also to understand the economic impact different BPH therapies confer.


Assuntos
Hiperplasia Prostática/economia , Hiperplasia Prostática/terapia , Terapia Combinada/economia , Custos e Análise de Custo , Humanos , Masculino , Medicare/economia , Estados Unidos , Procedimentos Cirúrgicos Urológicos Masculinos/economia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Agentes Urológicos/economia , Agentes Urológicos/uso terapêutico
8.
Arch Esp Urol ; 72(5): 443-450, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31223122

RESUMO

OBJECTIVE: The objective of this study is to perform an analysis of the patients who underwent middle and distal penile hypospadias repair using the two most widely used techniques in our Pediatric Urology Unit. MATERIAL AND METHODS: We perform a retrospective analysis of patients with a diagnosis of middle penile and distal penile hypospadias and operated by the Snodgrass or Mathieu technique, between 2011 and 2016 ensuring minimal follow-up of one year. We will analyze the use of each one, the results obtained, and the possible factors that could influence their success rate. RESULTS: A total of 80 patients were included in the study, with a median age of 28 months at surgery (Range: 11 to 151). There were 34 patients (42.5%) with Snodgrass technique and there were 46 patients (57.5%) with Mathieu technique. We have not identified statistically significant differences in complications between both surgical techniques. The percentage of fistulas is higher in Snodgrass urethroplasty (12.1% vs 8.9%), decreasing in the last years of the series, at the same time meatal stenosis is higher in Snodgrass technique (3% vs 2.2%) while the meatal retraction is higher in the urethroplasty of Mathieu (20% vs 15.2%). CONCLUSIONS: The exhaustive selection of patients seems the key in the succesful correction of these types of hypospadias. Despite both techniques are comparable in terms of the type of patient in which they could be applied and both techniques present similar rates in terms of fistulas and stenosis/retractions of the neomeatus (most frequent complications in this type of repairs), we consider that the characteristics of the patient should be prioritized before the preference of the surgeon to reach higher success rates.


Assuntos
Fístula , Hipospadia , Criança , Pré-Escolar , Humanos , Hipospadia/cirurgia , Lactente , Masculino , Pênis , Estudos Retrospectivos , Resultado do Tratamento , Uretra , Procedimentos Cirúrgicos Urológicos Masculinos
10.
Urologe A ; 58(6): 640-650, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31089755

RESUMO

The differentiated surgical treatment of male urinary incontinence is a very interesting and sometimes also emotional topic, in which evidence is increasingly maturing. Nowadays, the most common surgical procedures are fixed sling and adjustable incontinence systems as well as the artificial urinary sphincter. The evidence for the procedures varies and there is currently a lack of prospective, comparative studies. The challenging question is: Which operation is the best for which patient? The following article is intended to give an overview of the surgical options and a constructive attempt to differentiate the indication.


Assuntos
Próteses e Implantes , Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial , Procedimentos Cirúrgicos Urológicos/métodos , Humanos , Intenção , Masculino , Complicações Pós-Operatórias/cirurgia , Prostatectomia , Resultado do Tratamento , Incontinência Urinária por Estresse/diagnóstico , Incontinência Urinária por Estresse/etiologia , Procedimentos Cirúrgicos Urológicos Masculinos
11.
Urologe A ; 58(6): 651-657, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31098652

RESUMO

Defects in ureteral continuity and function can originate from various etiologies such as stricture, radiotherapy, tuberculosis, tumor, trauma or perforation due to iatrogenic injury. The surgical options for the management of ureteral defects are complex and depend on the location of the defect. The aim of the surgical management of ureteral stricture is the reconstruction of an anti-refluxive and nonobstructive flow of urine to preserve kidney function. There are numerous possibilities for the reconstruction of ureteral defects ranging from ureteroneocystostomy with or without psoas-hitch- or Boari-flap to ileal ureteral replacement. Nearly all these techniques can either be done in open surgery or in a laparoscopically or robotic-assisted manner. The technique of robotic-assisted reconstruction of ureteral defects is challenging but offers a great opportunity. The aim of this article is to provide an overview of current surgical procedures in ureteric reconstruction.


Assuntos
Cistostomia/métodos , Íleo/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Reimplante/métodos , Retalhos Cirúrgicos , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Feminino , Humanos , Laparoscopia , Estudos Retrospectivos , Resultado do Tratamento , Ureter/anormalidades , Ureter/lesões , Obstrução Ureteral/etiologia
12.
Curr Urol Rep ; 20(6): 31, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31041616

RESUMO

PURPOSE OF REVIEW: Gender-affirming surgery has become a more common procedure in the last 5 years. Feminizing genitoplasty typically involves inversion of penile skin as a neovagina, urethral shortening, and glans reduction to create a neoclitoris. Masculinizing genitoplasty is more complex, typically is performed in multiple stages, and has more inherent urologic risks. RECENT FINDINGS: The most common urologic complications involve voiding dysfunction, specifically meatal stenosis or fistula to the urinary tract. Urethral stricture, fistula, urinary retention, and voiding dysfunction are very common and require early recognition and intervention. This includes placement of catheter drainage, if necessary with the appropriate urologic instrumentation. Genital risks relating to phallus health are rare, but risks associated with placement of penile prosthesis for sexual function are common and require immediate attention. Urological complications after gender-affirming surgery are common, and the general urologist and urogynecologist should be able to identify and treat problems in this population after review of this chapter.


Assuntos
Transtornos do Desenvolvimento Sexual/cirurgia , Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Uretra/cirurgia , Estreitamento Uretral/etiologia , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Humanos , Masculino , Prótese de Pênis , Reoperação , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
14.
J Urol ; 202(3): 592-598, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31059668

RESUMO

PURPOSE: Male lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is common in men and can have negative effects on quality of life (QoL). It is the hope that this Guideline becomes a reference for effective evidence-based surgical management of LUTS/BPH. MATERIALS AND METHODS: The evidence team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality database to identify studies indexed between January 2007-September 2017. Following initial publication, this guideline was amended in 2019 and reflects relevant literature published through January 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table 1 in supplementary unabridged guideline, https://www.jurology.com). RESULTS: This Guideline provides evidence-based recommendations regarding management of LUTS/BPH utilizing surgery and minimally invasive surgical therapies (MIST). Additional statements are made regarding diagnostic and pre-operative tests. Clinical statements are made in comparison to what is generally accepted as the gold standard (i.e. transurethral resection of the prostate [TURP] monopolar and/or bipolar). This guideline is designed to be used in conjunction with the associated treatment algorithm (see figure).[Figure: see text]Conclusions:The prevalence and the severity of LUTS increases as men age and is an important diagnosis in the healthcare of patients and the welfare of society. This document will undergo updating as knowledge regarding treatments and future surgical options continues to expand.


Assuntos
Sintomas do Trato Urinário Inferior/cirurgia , Hiperplasia Prostática/complicações , Sociedades Médicas/normas , Procedimentos Cirúrgicos Urológicos Masculinos/normas , Urologia/normas , Idoso , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/psicologia , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Cuidados Pré-Operatórios/normas , Próstata/cirurgia , Hiperplasia Prostática/cirurgia , Qualidade de Vida , Estados Unidos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Urologia/métodos
15.
Pediatr Surg Int ; 35(7): 823-827, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31049665

RESUMO

PURPOSE: To evaluate the intermediate outcomes of our institution's experience with staged TPIF urethroplasty for proximal hypospadias repair. METHODS: We retrospectively evaluated the medical records of patients who underwent repair of proximal hypospadias using staged TPIF urethroplasty at our hospital from 2011 to 2017. RESULTS: One hundred and two patients were included in the present study. The mean follow-up was 52.4 months (range 13-74 months). The mean age at the time of the first surgery was 13.5 months (range 11-65 months). There were two main types of initial complications including meatal stenosis in four (3.9%) and urethrocutaneous fistula in three (2.9%) patients after the first stage. Surgical complications were seen in 15 patients after second stage, including urethrocutaneous fistulas in 8 (7.8%), urethral strictures in 5 (4.9%), urethral diverticula in 2 (1.9%). Overall complication rates after second stage were 14.7%. The incidence of fistulas was lower in patients who underwent repair with a tunica vaginalis flap (1/29, 3.4%) than with the dartos fascia (7/73, 9.6%; p = 0.435). CONCLUSIONS: Our results show that staged TPIF urethroplasty is a viable and durable technique for primary severe proximal hypospadias. This procedure was associated with a 14.7% complication rate in the present study. Staged TPIF urethroplasty can reduce the incidence of urethral strictures and diverticula associated with the second stage.


Assuntos
Prepúcio do Pênis/cirurgia , Hipospadia/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos , Uretra/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Pré-Escolar , Seguimentos , Humanos , Lactente , Masculino , Estudos Retrospectivos , Resultado do Tratamento
16.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936333

RESUMO

We present a case of intractable acute ischaemic priapism occurring secondary to newly commenced olanzapine. It demonstrates rapid intervention in a stepwise approach aiming to restore penile flaccidity in order to prevent chronic damage to the corpora cavernosa. After an unsuccessful conservative approach, our patient underwent two formal distal penile shunt procedures with no effective penile detumescence. Subsequently, bilateral proximal penile shunts were performed comprising a right corpus cavernosum to corpus spongiosum anastomosis and a left saphenous vein to left corpus cavernosum anastomosis. The patient remained an inpatient for observation, and detumescence was gradually achieved over several days after this procedure. However, follow-up revealed erectile dysfunction, and it was explained to the patient that he was unlikely to achieve further erections and that a penile implant was the only realistic option.


Assuntos
Antipsicóticos/efeitos adversos , Olanzapina/efeitos adversos , Pênis/cirurgia , Priapismo/induzido quimicamente , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Antipsicóticos/administração & dosagem , Humanos , Masculino , Olanzapina/administração & dosagem , Pênis/irrigação sanguínea , Pênis/efeitos dos fármacos , Priapismo/fisiopatologia , Priapismo/cirurgia , Prisioneiros , Resultado do Tratamento
17.
Curr Urol Rep ; 20(6): 30, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31020487

RESUMO

PURPOSE OF REVIEW: Fossa navicularis strictures represent a surgically challenging disease process that requires detailed preoperative planning and an understanding of each patient's goals in order to achieve a satisfactory long-term outcome. This review summarizes the various approaches used in the management of fossa navicularis strictures over the past several decades. RECENT FINDINGS: In addition to existing evidence to support open flap- and graft-based reconstruction, recent studies suggest a potential role for limited open repair via a transurethral approach. Open repair of fossa navicularis strictures has become the standard of care with high success rates using local skin flaps or tissue grafts. There remains a very limited role for minimally invasive techniques in definitive management of this disease.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos/história , Estreitamento Uretral/história , Procedimentos Cirúrgicos Urológicos Masculinos/história , História do Século XXI , Humanos , Masculino , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estreitamento Uretral/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
18.
Arch Ital Urol Androl ; 91(1): 25-29, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30932426

RESUMO

OBJECTIVE: The purpose of this study was to provide a detailed analysis of surgical and functional outcomes after correction of acquired buried penis in the adult. MATERIALS AND METHODS: From 2006 to 2016, we retrospectively reviewed 47 patients undergoing surgical treatment for the correction of buried penis. Functional and surgical outcomes, as well as patients' satisfaction were the main endpoints. RESULTS: The most common complains at presentation were recurrent uro-genital infections, sexual dysfunction, voiding dysfunction and Lichen Sclerosus (LS). Surgical management steps included: circumcision (27.66%), scrotoplasty (19.14%), V-Y skin plasty (4.25%), split thickness skin graft (STSG) 12.76%, full thickness skin graft (FTSG) 36.17%, suprapubic fat pad excision (57.44%), abdominoplasty (25.53%), division of the suspensory ligament (36.17%). Postoperative complications were recorded in 15% of patients. Vaginal penetration and erectile function ended up being more effective in 97.87% (46/47) and 42.55% (20/47) of patients. Improvement in penile erogenous sensation was in 6.38% (3/47). Aesthetic appearance of genitalia fully satisfied 36.17% of patients (17/47). Overall patients' satisfaction rate resulted 76.59% (36/47). CONCLUSION: Management of adult acquired buried penis still remains a challenging task to achieve, however excellent cosmetic results can be obtained by surgical reconstruction.


Assuntos
Satisfação do Paciente , Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adulto , Idoso , Circuncisão Masculina/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/anormalidades , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Escroto/cirurgia , Transplante de Pele/métodos , Resultado do Tratamento
20.
J Urol ; 202(3): 552-557, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30840543

RESUMO

PURPOSE: We evaluated the role of magnetic resonance imaging of the penis in the diagnosis of penile fracture and/or concomitant urethral lesions in real-life emergency settings compared with intraoperative findings. MATERIALS AND METHODS: A total of 43 patients presented with suspicion of penile fracture between January 2006 and December 2016. Magnetic resonance imaging was performed in 28 patients prior to surgical treatment in the emergency setting. Surgery was done in all patients via a subcoronal, circumferential degloving approach. We calculated sensitivity, specificity, and positive and negative predictive values as well as likelihood ratios of the positive and negative results of the agreement between magnetic resonance imaging and intraoperative findings. RESULTS: Intraoperatively penile fracture was confirmed in 19 of 28 patients (67.9%) and a concomitant urethral lesion was observed in 5 of 28 (17.9%). Magnetic resonance imaging findings were highly associated with intraoperative findings of tunical rupture, including 100% sensitivity (95% CI 98.5-100), 77.8% specificity (95% CI 50.6-100), 90.5% positive predictive value (95% CI 78-100), 100% negative predictive value (95% CI 97.6-100) and a positive result likelihood ratio of 4.5. Magnetic resonance imaging had lower accuracy for urethral lesions with 60% sensitivity (95% CI 17.1-100), 78.3% specificity (95% CI 61.5-95.1), 37.5% positive predictive value (95% CI 4-71), 90% negative predictive value (95% CI 76.9-100) and a positive result likelihood ratio of 2.76. CONCLUSIONS: Magnetic resonance imaging may be applicable in the emergency setting if the goal is to treat all men who warrant intervention. It has high sensitivity and negative predictive value for tunical rupture and concomitant urethral lesions. Therefore, it could help avoid unnecessary surgery by excluding the diagnosis. However, solitary magnetic resonance imaging is not sufficient for diagnosis and it should not replace clinical assessment or delay surgical exploration.


Assuntos
Imagem por Ressonância Magnética , Pênis/lesões , Ruptura/diagnóstico por imagem , Uretra/lesões , Adulto , Idoso , Emergências , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/diagnóstico por imagem , Pênis/cirurgia , Valor Preditivo dos Testes , Ruptura/cirurgia , Sensibilidade e Especificidade , Uretra/diagnóstico por imagem , Uretra/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA