Urology JournalPub Date : 2024-06-09DOI: 10.22037/uj.v20i.8140
Farzad Allameh, Amir Hossein Eslami
{"title":"Extra-peritoneal vs. Trans-peritoneal Radical Cystectomy pros and cons.","authors":"Farzad Allameh, Amir Hossein Eslami","doi":"10.22037/uj.v20i.8140","DOIUrl":"10.22037/uj.v20i.8140","url":null,"abstract":"<p><p>One of the most common cancers of the urinary tract is bladder tumors. Bladder cancers are divided into two groups: non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer. (1) Trans-Peritoneal Radical Cystectomy (RC) with pelvic lymphadenectomy is the standard technique in muscle invasive and high risk non-muscle invasive bladder cancer (2). and Urologist around the world are more familiar with trans-peritoneal technique. In some articles extra-peritoneal Radical Cystectomy (RC) implied as an decreased postoperative complications techniques. In this letter we want to compare these two techniques and find out the pros and cons of these techniques.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"271"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predicting the Efficacy of Repeated Shockwave Lithotripsy for Treating Patients with Upper Urinary Tract Calculi Using an Artificial Neural Network Model.","authors":"Zhongfan Peng, Mingjun Wen, Yunfei Li, Tao He, Jiao Wang, Taotao Zhang","doi":"10.22037/uj.v20i.8006","DOIUrl":"10.22037/uj.v20i.8006","url":null,"abstract":"<p><strong>Purpose: </strong>To establish a prediction model for repeated shockwave lithotripsy (SWL) efficacy to help choose an appropriate treatment plan for patients with a single failed lithotripsy, reducing their treatment burden.</p><p><strong>Patients and methods: </strong>The clinical records and imaging data of 304 patients who underwent repeat SWL for upper urinary tract calculi (UUTC) at the Urology Centre of Shiyan People's Hospital between April 2019 and April 2023 were retrospectively collected. This dataset was divided into training (N = 217; 146 males [67.3%] and 71 females [32.7%]) and validation (N = 87; 66 males [75.9%] and 21 females [24.1%]) sets. The overall predictive accuracy of the models was calculated separately for the training and validation. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was calculated. The normalized importance of each independent variable (derived from the one-way analyses) in the input layer of the artificial neural network (ANN) model for the dependent variable (success or failure in repeat SWL) in the output layer was plotted as a bar chart.</p><p><strong>Results: </strong>This study included 304 patients, of whom 154 (50.7%) underwent successful repeat SWL. Predictive models were constructed in the training set and assessed in the validation set. Fourteen influencing factors were selected as input variables to build an ANN model: age, alcohol, body mass index, sex, hydronephrosis, hematuria, mean stone density (MSD), skin-to-stone distance (SSD), stone heterogeneity index (SHI), stone volume (SV), stone retention time, smoking, stone location, and urinary irritation symptom. The model's AUC was 0.852 (95% confidence interval (CI): 0.8-0.9), and its predictive accuracy for stone clearance in the validation group was 83.3%. The order of importance of the independent variables was MSD > SV > SSD > stone retention time > SHI.</p><p><strong>Conclusion: </strong>Establishing an ANN model for repeated SWL of UUTC is crucial for optimizing patient care. This model will be pivotal in providing accurate treatment plans for patients with an initial unsuccessful SWL treatment. Moreover, it can significantly enhance the success rate of subsequent SWL treatments, ultimately alleviating patients' treatment burden.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"234-241"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urology JournalPub Date : 2024-06-09DOI: 10.22037/uj.v20i.7703
Oktay Özman
{"title":"Why Discovery of PSA was not Granted a Nobel Prize?","authors":"Oktay Özman","doi":"10.22037/uj.v20i.7703","DOIUrl":"10.22037/uj.v20i.7703","url":null,"abstract":"<p><p>This essay draws attention to the prostate-specific antigen (PSA) discovery's lack of Nobel Prize acknowledgement despite its significance for prostate cancer (PCa) clinical practice. The Nobel Prize committee gives more weight to discoveries in basic research than to applications in medicine, which may account for PSA's lack of recognition. The prize has been dominated by the identification of cancer-causing viruses. Considering the subject from our -urologists- side, numerous pioneer researchers have uncovered PSA's presence and function, and its overuse in PCa screening has sparked debates about issues like overdiagnosis and overtreatment. We must concur that the factors contributing to PSA's underappreciation include the lack of a clear pioneer in its discovery and the contradictory opinions around its use. As a conclusion, PSA may have to wait for a better application before it receives recognition in the Nobel Prize.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"265-266"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9672983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urology JournalPub Date : 2024-06-09DOI: 10.22037/uj.v20i.8044
Hamed Akhavizadegan
{"title":"Male Genetic Evaluation in Infertility, Recurrent Abortion and Recurrent in Vitro Fertilization Failure; A Clinical Approach.","authors":"Hamed Akhavizadegan","doi":"10.22037/uj.v20i.8044","DOIUrl":"10.22037/uj.v20i.8044","url":null,"abstract":"<p><strong>Purpose: </strong>This review presents a clinical approach to genetic issues in male infertility. Unlike other related reviews that discuss different types of genetic diseases (such as Klinefelter and Down syndrome), this review focuses on the clinical features that result from these genetic problems (such as azoospermia and oligospermia).</p><p><strong>Methods: </strong>A narrative review of the clinical literature in PubMed was conducted using keywords related to male infertility, recurrent pregnancy loss, recurrent in vitro fertilization failure, and genetics. The search included articles with English reviews published online after 2020. Headlines were defined based on the available literature, and after a critical review of each manuscript, clinical facts were classified under the corresponding headlines, and a primary draft was written.</p><p><strong>Results: </strong>29 relevant articles were selected from the search. According to the literature, there are clinical genetic approaches for azoospermia, severe oligospermia, severe teratospermia, severe asthenospermia, recurrent miscarriage, and recurrent in vitro fertilization failure.</p><p><strong>Conclusion: </strong>Although many mutations that can affect male fertility and spermogram have been identified, only a few have clinical predictive value.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"221-225"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Step-by-Step Guide to Double-Puncture Technique for Endoscopic Management of Ureterocele.","authors":"Behnam Nabavizadeh, Reza Nabavizadeh, Abdol-Mohammad Kajbafzadeh","doi":"10.22037/uj.v16i7.6028","DOIUrl":"10.22037/uj.v16i7.6028","url":null,"abstract":"<p><p>To date, the optimal surgical technique for treatment of ureterocele remains unclear and the available options are variable. The endoscopic techniques that are gaining popularity mostly share major drawbacks including low success rate, high probability of mandatory secondary surgery and de novo vesicoureteral reflux to the ureterocele moiety. The Double-Puncture technique is shown to have promising outcomes in terms of long-term success and low rate of complications. In this video, a step-by-step guide to this technique is presented.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"273"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38471413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urology JournalPub Date : 2024-06-09DOI: 10.22037/uj.v20i.8008
Hamid Kalantari, Marjan Sabbaghian, Paraskevi Vogiatzi, Giovanni M Colpi, Mohammad Ali Sadighi Gilani
{"title":"New Insights beyond Established Norms: A Scoping Review of Genetic Testing for Infertile Men.","authors":"Hamid Kalantari, Marjan Sabbaghian, Paraskevi Vogiatzi, Giovanni M Colpi, Mohammad Ali Sadighi Gilani","doi":"10.22037/uj.v20i.8008","DOIUrl":"10.22037/uj.v20i.8008","url":null,"abstract":"<p><strong>Purpose: </strong>From a diagnostic standpoint, certain approaches to genetic screening in clinical practice remain ambiguous in the era of assisted reproduction. Even the most current guidelines do not provide definite guidance on testing protocols, leaving clinicians to carefully determine which tests best serve patients struggling with infertility. The lack of uniformity in the current practice of male fertility evaluation can prove to be quite costly, thus necessitating healthcare practitioners to carefully appraise the necessity and weigh the advantages against potential economic and psychological detriments. The objective of this review is to map the existing literature on the general topic of the clinical indications of routine karyotyping and/or AZF screening in infertile men, identify key concepts, determine where the gaps are, and lastly, provide an overview of the conclusions drawn from a body of knowledge that varies widely in terms of methodologies or disciplines.</p><p><strong>Materials and methods: </strong>A thorough search was conducted for the published findings up until July 2023, utilizing PubMed (MEDLINE). This comprehensive search involved the use of specific search keywords, either individually or in combination. The search terms employed were as follows: \"Karyotype\", \"Klinefelter\" or \"KS\" or \"47,XXY\", \"AZF\" or \"Azoospermi*\" and/or \"microdeletion*\" in the title or abstract. Once the titles and abstracts of selected articles were obtained, the complete texts of linked papers were meticulously scrutinized.</p><p><strong>Results: </strong>A total of 191 records were identified from PubMed. During screening, 161 records (84.3%) were eliminated. Finally, 30 papers were included in this scoping review, which was conducted in 18 countries. The number of sequence tag sites (STSs) used in the studies varied from 5 to 59. The rate of AZF deletions among patients with NOA ranged from 1.3% to 53%. The mean frequency was estimated to be 5.6%. The rate of YCM among patients with XXY karyotype was nil in 19 out of 30 studies (63%), whilst, in the remaining studies, the rate varied from 0.8% to 67%.</p><p><strong>Conclusion: </strong>This review provides insights into managing male infertility. The presence of spermatozoa in ejaculation and successful surgical retrieval cannot be excluded for individuals with AZFb/AZFbc microdeletions. Screening for Y chromosome microdeletions is not needed for mosaic or classic KS. Only 1% of individuals with sperm concentration exceeding 1×106 sperm/mL and less than 5×106 sperm/mL exhibit AZF microdeletions; therefore, testing referral for such populations may need reassessment. Individuals with mosaic monosomy X karyotype and certain chromosomal anomalies should be referred for AZF deletion screening. These findings have implications for male infertility management and future research.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"200-207"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urology JournalPub Date : 2024-06-09DOI: 10.22037/uj.v20i.7886
Jalil Hosseini, Samin Khannejad, Armin Attar, Ali Goudarzikarim
{"title":"Management of Anterior Urethral Stricture: A Survey of Contemporary Practice of Iranian Urologists.","authors":"Jalil Hosseini, Samin Khannejad, Armin Attar, Ali Goudarzikarim","doi":"10.22037/uj.v20i.7886","DOIUrl":"10.22037/uj.v20i.7886","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate Iranian urologists' approach to urethral stricture and assess how often they select open urethroplasty over minimally invasive procedures.</p><p><strong>Material and methods: </strong>This cross-sectional observational study was conducted via www.</p><p><strong>Survey: </strong>porsline.ir among members of the Iranian urologists' community. The urologists were contacted via email and social media applications (e.g., WhatsApp, Telegram), and data, including their demographic information and years of practice, as well as questions related to their attitude towards the management of urethral stricture, were collected.</p><p><strong>Results: </strong>A total number of 376 patients were included in the current survey. The specialty of reconstructive urology was selected by less than 2% (n=5) as their field of interest. Only 6.64% (n=25) of the urologists stated that they received adequate training for management of urethral stricture. Only about 5% (n=19), believed that according to scientific resources, chose open urethroplasty as the initial management. Almost 94% (n=353) did not perform any urethroplasties during the past year and about 0.2% (n=2) performed more than 20 open urethroplasties. For diagnosing urethral stricture, almost 99% of them chose RUG+VCUG, 72% chose urethrocystoscopy, and 69% chose uroflowmetry in the third place. For evaluation of urethroplasty postoperative outcomes, 76% (n=269) used RUG+VCUG, 15% (n=56) used Rigid Cystoscopy, and 8% (n=29) used Flexible Cystoscopy, Conclusion: Iranian urologists prefer minimally invasive procedures for treating urethral stricture, similar to other countries. This lack of urologists' interest in open urethroplasty is greatly due to poor training during the residency years and little experience with urethral strictures. Therefore, further considerations in order to improve urologists' knowledge and expertise for management of urethral stricture is recommended.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"269-270"},"PeriodicalIF":1.5,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urology JournalPub Date : 2024-05-06DOI: 10.22037/uj.v21i03.7937
Cengiz Çanakcı, Orkunt Özkaptan, Erdinç Dinçer, Osman Murat Ipek, Gürkan Dalgıç, Ahmet Sahan
{"title":"Perioperative Outcomes of Open Extra-peritoneal Versus Laparoscopic Radical Cystoprostatectomy: A single Center Comparative Study.","authors":"Cengiz Çanakcı, Orkunt Özkaptan, Erdinç Dinçer, Osman Murat Ipek, Gürkan Dalgıç, Ahmet Sahan","doi":"10.22037/uj.v21i03.7937","DOIUrl":"10.22037/uj.v21i03.7937","url":null,"abstract":"<p><strong>Purpose: </strong>To compare 90-day perioperative complications and pathological outcomes between laparoscopic radical cystectomy (LRC) and extraperitoneal radical cystectomy (EORC) approaches.</p><p><strong>Materials and methods: </strong>All operations were performed in a single high-volume tertiary referee center by the same surgical team.Males ≥ 18 years with pre-cystectomy clinical T1-T3 disease and having undergone an ileal conduit were included. Exclusion criteria included patients with inflammatory bowel disease, previous pelvic and/or abdominal irradiation, neo-adjuvant chemotherapy, and/or clinical T4 disease. Perioperative outcomes such as operative time, estimated blood loss, transfusion rate, hospital stay, and 90-day complications were evaluated. The recovery duration of regular bowel activity, mean stool passage,and ileus rates were recorded.</p><p><strong>Results: </strong>A total of 221 patients met the inclusion criteria(81 LRC and 130 EORC). Demographics and preoperative parameters were comparable. Intraoperative estimated blood lossfavored LRC by a median of 450 mL (200-900) P=.021) vs. a median of 700 mL (300-2900) for EORC. The transfusion rate did not differ between the two groups; %14.8 (N=12) for the LRC and %20.8 (N=27) for EORC (P=.37). The median hospital stay was 9 (4-49) days for EORC and 8 (4-29) days for LRC (P=.011). The need for analgesics to control pain through an epidural catheter was higher for EORC (P=.042). There was no difference in overall complication rates (P=.47).</p><p><strong>Conclusion: </strong> Although LRC appears to have a slight advantage over EORC, both techniques yield satisfactory results in regard to ileus rates and 90-day perioperative complications.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"175-181"},"PeriodicalIF":1.5,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Urology JournalPub Date : 2024-05-06DOI: 10.22037/uj.v20i.7854
Yaşar Pazır, Abdullah Esmeray, Mucahit Gelmis, Ufuk Caglar, Faruk Ozgor, Omer Sarılar, Fatih Akbulut
{"title":"Performance of the EORTC and CUETO Models to Predict Recurrence and Progression in High-risk Non-muscle-invasive Bladder Cancer Patients.","authors":"Yaşar Pazır, Abdullah Esmeray, Mucahit Gelmis, Ufuk Caglar, Faruk Ozgor, Omer Sarılar, Fatih Akbulut","doi":"10.22037/uj.v20i.7854","DOIUrl":"10.22037/uj.v20i.7854","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) risk scoring models in non-muscle-invasive bladder cancer (NMIBC) patients defined as high risk according to European Association of Urology guidelines and managed based on current recommendations.</p><p><strong>Material and methods: </strong>Data from 187 high-risk NMIBC patients treated at a tertiary center between July 2010 and November 2021 were analyzed retrospectively. One- and five-year recurrence- and progression-free survival were assessed for each patient using the EORTC and CUETO risk scores. The patients were divided into four risk groups according to their risk scores as low, medium-low, medium-high and high risk, as indicated in the models. Discriminative ability was evaluated with the Harrell's concordance index (c-index).</p><p><strong>Results: </strong>Both risk scoring models overestimated the risk of recurrence and progression at one and five years. Only the prediction of recurrence at five years in the high risk group according to the CUETO model was compatible with our cohort. CUETO (c-indices for recurrence and progression were 0.802 and 0.834, respectively) exhibited better discrimination than EORTC (0.722 for recurrence and 0.752 for progression) in the prediction of disease recurrence and progression.</p><p><strong>Conclusion: </strong>The CUETO model was superior to the EORTC model in predicting recurrence and progression and stratifying patients with different prognoses in our high-risk NMIBC patient population treated according to current guideline recommendations. However, both models overestimated the probability of disease recurrence and progression. Only the probability of recurrence at five years in the high-risk group of the CUETO model was compatible with our cohort.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"169-174"},"PeriodicalIF":1.5,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Necessity of Incorporating an Interposition Flap During Vesicovaginal Fistula Repair: Can Modifying the Method of Vaginal Repair Serve as a Substitute? A Randomized Clinical Trial.","authors":"Mohammad Hatef Khorami, Mahtab Zargham, Pegah Taheri, Farshad Gholipoor, Maede Safari","doi":"10.22037/uj.v20i.7950","DOIUrl":"10.22037/uj.v20i.7950","url":null,"abstract":"<p><strong>Purpose: </strong>Traditionally, an omental flap is employed to reduce the risk of recurrence of vesicovaginal fistula (VVF) repair. In this study, we employed a modified surgical technique wherein the vaginal defect was closed using Connell sutures, without incorporation of an omental flap, aiming to mitigate potential complications.</p><p><strong>Material and method: </strong>Between 2010 to 2018, the current randomized clinical trial was conducted on 52 women who were candidates for open fistula repair. The patients were randomly allocated into two groups. In one group, the conventional method of fistula repair was performed involving an omental flap, while in the other group, we used a modified approach with a variation in the vaginal wall closure technique. In-hospital variables, including the length of surgery, hospital stay, and occurrences of ileus, were recorded. Patient follow-up extended for one year, with assessments conducted one, six, and twelve months postoperatively. These evaluations encompassed pad test to ascertain success rates and identify any potential complications.</p><p><strong>Results: </strong>The final analysis comprised 49 patients, with an average age of 46.5 years. Baseline characteristics were comparable between the two groups (P-values > 0.05). The modified technique was associated with significantly reduced surgical duration (P = ˂ 0.001), and shorter hospital stays (P < 0.001). Ileus occurrence was reduced, but it was not significant(P = 0.856). However, the success rate showed no significant difference between the groups, with a success rate of 100% for the modified technique compared to 91.6% for the classic O'Conner method (P = 0.288).</p><p><strong>Conclusion: </strong>Based on the findings of this study, vaginal wall closure using Connell sutures during VVF repair demonstrates a success rate equivalent to the classic approach involving an omental flap. Moreover, this technique presents a reduced incidence of adverse effects, along with decreased surgical duration, hospital stay, and postoperative ileus.</p>","PeriodicalId":23416,"journal":{"name":"Urology Journal","volume":" ","pages":"189-194"},"PeriodicalIF":1.5,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}