Central European Journal of Urology最新文献

{"title":"Nitroxoline: treatment and prevention of urinary tract infections from the urologist's perspective.","authors":"Wojciech Krajewski, Jan Łaszkiewicz, Wojciech Tomczak, Łukasz Nowak, Joanna Chorbińska, Aleksandra Sójka, Bartosz Małkiewicz, Tomasz Szydełko","doi":"10.5173/ceju.2024.17","DOIUrl":"https://doi.org/10.5173/ceju.2024.17","url":null,"abstract":"<p><strong>Introduction: </strong>Nitroxoline is an old antimicrobial agent with a broad spectrum of pharmacological applications and a unique mechanism of action. However, its use in the treatment and prevention of urinary tract infections (UTIs) has not been popular in the recent past. Recently, nitroxoline is gaining interest, due to frequent drug-resistance in uropathogens. Unfortunately, there are few modern clinical trials assessing this antibiotic. Also, older researchers often do not meet current scientific standards. This review seeks to provide a comprehensive overview of nitroxoline as a viable option in treating uncomplicated lower UTIs.</p><p><strong>Material and methods: </strong>A comprehensive literature search regarding the use of nitroxoline in UTIs was conducted using Pubmed, Cochrane Library and Embase databases. A cross-reference search was also performed. Case reports, editorials and non-peer-reviewed literature were excluded from further analysis. As a result, 21 publications were included in this review.</p><p><strong>Results: </strong>The available literature on nitroxoline's mechanism of action, pharmacokinetics, minimum inhibitory concentrations, <i>in vitro</i> activity and resistance rates strongly suggests that nitroxoline is a potent broad-spectrum antimicrobial agent. Moreover, clinical efficacy of the drug was analyzed - 2 articles proved high eradication rates in women with uncomplicated lower UTIs and 1 reported unsuccessful treatment in geriatric patients with lower complicated and uncomplicated UTIs. Finally, the present data on adverse effects indicate that nitroxoline is well-tolerated.</p><p><strong>Conclusions: </strong>Nitroxoline is an obscure, yet potentially effective and safe antimicrobial agent in uncomplicated lower UTIs. Unfortunately, it is available only in a few countries. Nonetheless, nitroxoline can be useful in urological practice.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"339-343"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detrusor underactivity and complicated stress urinary incontinence: a cross-data study.","authors":"Emanuele Rubilotta, Francesco Ditonno, Marilena Gubbiotti, Alessandro Antonelli, Matteo Balzarro","doi":"10.5173/ceju.2023.147","DOIUrl":"https://doi.org/10.5173/ceju.2023.147","url":null,"abstract":"<p><strong>Introduction: </strong>It is still uncertain whether detrusor underactivity (DUA) influences the outcomes of women undergoing surgery for stress urinary incontinence (SUI). Even less evidence is available about women with complicated stress urinary incontinence (C-SUI). The aim of the study was to assess outcomes of middle urethral sling (MUS) placement according to the type of SUI, and the impact of DUA on uncomplicated SUI (U-SUI) and C-SUI functional and surgical results.</p><p><strong>Material and methods: </strong>The study was conducted among patients undergoing MUS. The population was divided into 4 groups: 1: C-SUI with DUA; 2: C-SUI without DUA; 3: U-SUI with DUA; and 4: U-SUI without DUA. Women were qualified for the DUA group if they met one of the Jeong, Abarbanel and Marcus, BVE, and PIP1 Griffiths criteria. Post-operative functional outcomes and differences in POUR rate, de novo overactive bladder syndrome (OAB), and SUI recurrence were examined.</p><p><strong>Results: </strong>142 women took part in the study, of whom 97 completed the 2-year follow-up. DUA was found in 54.6% (53/97) of patients. C-SUI was prevalent also in the no-DUA group (59.1%). Post-operative ICIQ-FLUTS improved more in the no-DUA patients compared to the DUA women. Post-operative Qmax was statistically significant higher the in no-DUA than in the DUA population. After surgery, neither the PVR nor the PVR ratio differed in the DUA and the no-DUA patients. C-SUI and U-SUI patients showed a POUR rate of 15.6%-12.1%, de novo OAB 12.5%-3%, tape incision 3.1%-3%, and SUI recurrence 4.6%-3%, respectively.</p><p><strong>Conclusions: </strong>The impact of pre-operative DUA on the outcomes of patients undergoing MUS was negligible, even in C-SUI cases. DUA women with SUI, even if complicated, should not be excluded from this kind of surgery.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"58-63"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The presence of cribriform pattern in prostate biopsy and radical prostatectomy is associated with negative postoperative pathological features.","authors":"Rafal Osiecki, Mieszko Kozikowski, Łukasz Białek, Michał Pyzlak, Jakub Dobruch","doi":"10.5173/ceju.2023.215","DOIUrl":"https://doi.org/10.5173/ceju.2023.215","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer is the second most common male cancer worldwide. Its rising incidence and high overtreatment rate drive the search for new prognostic factors. Histopathological variants, such as cribriform pattern (CP), are associated with poorer oncologic outcome. The aim of this study was to assess the correlation between CP in prostate biopsy and radical prostatectomy (RP) and postoperative pathological features.</p><p><strong>Material and methods: </strong>In this retrospective, single-centre study we analysed the reviewed medical records of 100 men who underwent minimally invasive RP in the years 2017-2019. RP histopathological examination was performed by a single expert pathologist, and preoperative biopsies were assessed by various professionals from different referral centres.</p><p><strong>Results: </strong>48% of men underwent endoscopic RP with limited lymphadenectomy, whereas 52% underwent laparoscopic RP with extended lymphadenectomy. CP in biopsy was present in 6 patients: 3 in each of both groups (6.3% and 5.8%, respectively). Lymph node metastases were present in 50% and 10% of patients with and without CP in biopsy, respectively (p = 0.028). Postoperative histopathological examination revealed CP in 65%. CP in RP was associated with higher International Society of Urological Pathology (ISUP) (p < 0.001), extraprostatic extension (EPE) (p = 0.001), seminal vesicle invasion (SVI) (p = 0.001), and positive surgical margin (PSM) (p = 0.004). Thirteen (20%) of the patients with CP in the RP specimen had lymph node metastasis, and none of the patients without CP in the RP specimen had regional LN metastasis.</p><p><strong>Conclusions: </strong>The presence of CP in a biopsy specimen and RP is associated with negative postoperative features. Therefore, efforts should be made to increase CP reporting in biopsies because its identification could trigger a more radical surgical approach with extended lymphadenectomy.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 1","pages":"22-29"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11032032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and predictors of clinically significant prostate cancer detection by transperineal computer fusion biopsy during active surveillance.","authors":"Tomasz Milecki, Wojciech Malewski, Anna Barnaś, Omar Tayara, Andrzej Antczak, Piotr Kryst, Łukasz Nyk","doi":"10.5173/ceju.2024.95.R1","DOIUrl":"10.5173/ceju.2024.95.R1","url":null,"abstract":"<p><strong>Introduction: </strong>Active surveillance (AS) is an option for management of low-risk and selected intermediate prostate cancer (PC) patients. Pathological progression confirmed on prostate biopsy (PB) is the most common reason for transitioning to radical treatment. The role and timing of repeat PB during AS is a topic of ongoing debate.The aim of the study was to determine the detection rate of clinically significant PC (csPC) during AS protocol by transperineal computer fusion PB in low-risk PC patients enrolled based on results of transrectal systematic PB, and to identify predictors that may impact csPC detection.</p><p><strong>Material and methods: </strong>The study involved 95 patients with low-risk PC enrolled in AS, who underwent confirmatory or follow-up PB, proceeded by mpMRI.</p><p><strong>Results: </strong>The reclassification rate to csPC was 38.9% and 43.9% for confirmatory and follow-up biopsies, respectively. Patients with csPC differed significantly from those without csPC in the following parameters: prostate-specific antigen (PSA) 10.5 ng/ml vs 7.3 ng/ml (p = 0.029), PSA density (PSAD) 0.27 ng/ml² vs 0.18 ng/ml² (p = 0.006), age - 68 years vs 66.5 years (p = 0.024), lesion size 16 mm vs 14 mm (p = 0.042), and PIRADS score (p = 0.004). Multivariable regression models showed that PIRADS score each one-category increase hazard ratio (HR) - 3.615 (1.599-8.172), PSAD >0.20 ng/ml²; HR - 2.760 (1.065-7.149) and age; HR - 1.085 (1.011-1.164) were independent factors increasing the probability of csPC detection in PB.</p><p><strong>Conclusions: </strong>Confirmatory and repeat transperineal PB detect a significant rate of csPC in low-risk PC patients on AS. Higher PIRADS score and PSAD >0.20 ng/ml² increase the csPC detection rates during AS and should prompt immediate PB.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"418-423"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over 48,000 baseline prostate-specific antigen measurements in young men: a 16-year time-analysis.","authors":"Diego M Capibaribe, Natalia D Avilez, Natássia C C Truzzi, José C C I Truzzi, Mehrsa Jalalizadeh, Leonardo O Reis","doi":"10.5173/ceju.2024.62.R2","DOIUrl":"10.5173/ceju.2024.62.R2","url":null,"abstract":"<p><strong>Introduction: </strong>To broaden our understanding of baseline PSA variations over the last decades in men under 40 years old.</p><p><strong>Material and methods: </strong>We analysed the baseline total PSA of 48,896 men below the age of 40 years, grouped into 3 age groups: <30 (n = 6,123), 30-35 (n = 16,118), and >35 (n = 25,351) years old. Multiple linear regression model predicted the average LogPSA per month as a function of time, age, and testing rate during the 16-year period of the data (2003-2018).</p><p><strong>Results: </strong>The average age and standard deviation were 34.5 ±4.6 years, and the median PSA ± interquartile range was 0.63 ±0.46 ng/dl with a leftward skew towards zero (81% of results below 1 ng/dl) in all years. The average LogPSA was steadily rising over time, independent of age and testing rate in all 3 age groups: multiple R² = 0.40, estimate = 1.211e-05, p <0.0001. Mean/median PSA and age were 0.69/0.57 ng/dl and 35.6/37.2 years in 2003 and 1.04/0.66 ng/dl and 33.6/35.8 years in 2018.</p><p><strong>Conclusions: </strong>The average baseline PSA is rising in young men. Changes in medical routine practice (e.g. reserving the test for those with higher suspicion) and a true rise in benign or pathological prostate conditions are possible reasons.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"411-417"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and burden of disease associated with kidney stone disease in children and young persons (<20 years): Trends in Europe between 1990-2019 according to the Global Burden of Disease database.","authors":"Patrick Juliebø-Jones, Lazaros Tzelves, Øyvind Ulvik, Mathias Sørstrand Æsøy, Christian Beisland, Bhaskar K Somani","doi":"10.5173/ceju.2024.03.R1","DOIUrl":"10.5173/ceju.2024.03.R1","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of urolithiasis in children has increased. However, research regarding the associated mortality burden group is lacking. Our objective was to evaluate trends across Europe.s.</p><p><strong>Material and methods: </strong>Data on mortalities associated with urolithiasis in persons under 20 years was obtained from the Global Burden of Disease database for the period 1990-2019. Data included demographic information such as gender and age as well mortality rate, crude number of deaths and disability adjusted life years (DALYs). Data was collected from the European region as defined by the World Health Organization.</p><p><strong>Results: </strong>Over 30-year period and across 53 countries, there were 184 deaths (106 males, 78 females) recorded in persons <20 years. The highest crude number of deaths occurred in the 10-14-year-old group (n = 54), followed by 5-9 years (n = 53), 15-19 years (n = 52) and <5 years (n = 25). The distribution in the total number of deaths according to these age groups, did not change over time. Overall, there was a 73% decrease when comparing the number of deaths in 1990 with 2019. Between these two time points, the overall death rate also decreased from 0.006 to 0.002 per 100,000. Over time the gender gap narrowed in terms of the number of deaths and by 2019, the male to female ratio was at its lowest to date (1.2 : 1).</p><p><strong>Conclusions: </strong>Mortality associated with kidney stone disease in children and young persons has improved in recent decades. More deaths have occurred among males, but this gender gap is narrowing.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 3","pages":"483-485"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of tissue fibrosis genes in congenitally obstructed pyeloureteral junction and biomarkers of renal damage.","authors":"Vytis Kazlauskas, Ramune Zilinskaite-Tamasauske, Povilas Barasa, Natalija Krestnikova, Darius Dasevicius, Vytautas Bilius, Gilvydas Verkauskas","doi":"10.5173/ceju.2023.218R","DOIUrl":"https://doi.org/10.5173/ceju.2023.218R","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the expression of fibrosis-related genes in obstructed ureteral tissue and determine its relationship with biomarkers of renal damage and preoperative renal scan findings.</p><p><strong>Material and methods: </strong>In all cases, bladder urine and blood samples were collected preoperatively. They were analysed for serum cystatin C, urinary albumin, urinary beta 2 microglobulin, and urinary neutrophil gelatinase-associated lipocalin concentrations, as well as their concentrations standardised by urine creatinine. Pyeloureteral junction obstruction tissue specimens were frozen in liquid nitrogen upon harvesting. RNA was extracted from the samples using TRIzol reagent. qPCR was performed, and the relative expressions of TGFβ1, MMP1, TIMP1, PAI1, CTGF, and VEGFA in stenotic ureteral tissue were calculated. Spearman's rank correlation test was used to calculate the correlation between the relative expression of investigated genes, urine, and blood biomarkers of renal damage and preoperative renal scan findings.</p><p><strong>Results: </strong>A total of 20 pyeloureteral junctions of 20 patients were harvested at the time of dismembered pyeloplasty. The median age of the patients at the time of the operation was 15.2 [9.07, 66.2] months. There was a significant negative correlation between urinary albumin concentration and relative TGFβ1 expression in pyeloureteral junction tissue (rho = -0.45, p = 0.047), as well as between uAlb and relative VEGFA expression (rho = -0.575, p = 0.008). No correlation with other urine biomarkers of renal damage or renal scan findings was found.</p><p><strong>Conclusions: </strong>Expression of fibrosis-related genes in the obstructive tissue of the pyeloureteral junction have no direct correlation with biomarkers of renal damage.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"326-333"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hiatal expansion and pelvic organ prolapse - the association is not causation.","authors":"Peter Petros","doi":"10.5173/ceju.2023.272","DOIUrl":"https://doi.org/10.5173/ceju.2023.272","url":null,"abstract":"","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"203-205"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic vs open transcapsular adenomectomy (Millin): a comparative study of perioperative outcomes and complications.","authors":"Gonçalo Mendes, Alexandra Rocha, Bernardo Lobão Teixeira, Mariana Madanelo, Sofia Mesquita, Miguel Monteiro, Avelino Fraga, Diogo Nunes-Carneiro, João Cabral, Frederico Teves","doi":"10.5173/ceju.2023.223","DOIUrl":"https://doi.org/10.5173/ceju.2023.223","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic adenomectomy for prostates larger than 80 mL is still a topic of debate. The purpose of this study is to evaluate the perioperative outcomes and complications between open Millin (OM) and laparoscopic Millin (LM) adenomectomy.</p><p><strong>Material and methods: </strong>Perioperative data and complications were retrospectively collected from patients submitted to Millin procedure from August 2019 to August 2022 in a tertiary centre, and OM and LM were compared. Complications were classified according to Clavien-Dindo classification.</p><p><strong>Results: </strong>A total of 205 patients were identified, 125 in the OM group and 80 in the LM group. Baseline characteristics were similar between the groups. Mean total blood loss (194 ±210 vs 477 ±389 mL, p <0.001), mean haemoglobin drop (1.40 ±1.16 vs 2.62 ±1.42 g/dL, p <0.001), duration of catheterisation (4.63 ±1.39 vs 5.37 ±1.99 days, p = 0.004), and hospital stay (4.59 ±1.72 vs 5.82 ±3.36 days, p = 0.003) were significantly lower in the laparoscopic group. The mean operative time was longer in the laparoscopic group (109.9 ±33.4 vs 68.7 ±18.0 min, p <0.001). The overall complication rate was significantly lower in the laparoscopic group (18.8% vs 36.8%; p = 0.012), and this difference was maintained only in Clavien-Dindo groups I (3.8% vs 13.6%; p = 0.018) and II (12.5% vs 21.6%; p = 0.049). Regarding individual complications, patients in the LM group had significantly less haematuria (1.3% vs 8.8%, p = 0.031), wound infections (0% vs 4.8%, p = 0.047), and blood transfusions (0% vs 6.4%, p = 0.024).</p><p><strong>Conclusions: </strong>Laparoscopic Miilin adenometomy is a safe technique, with less intraoperative blood loss, shorter length of hospital stay and catheterisation time, and fewer complications, including a lower transfusion rate, than its open counterpart.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"256-261"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of urethral complications after total phallic reconstruction: a single center experience.","authors":"Mohammed Abdel-Rassoul, Galal El Shorbagy, Sameh Kotb, Ahmed Alagha, Samih Zamel, Ahmed M Rammah","doi":"10.5173/ceju.2023.160","DOIUrl":"https://doi.org/10.5173/ceju.2023.160","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the outcomes of different urethroplasty procedures as well as two novel techniques, invented in our center, in management of urethral complications after total phallic reconstruction.</p><p><strong>Material and methods: </strong>Different urethroplasty procedures were conducted according to the urethral pathology for 36 cis-male patients with urethral complications after total phallic reconstruction including meatoplasty, visual internal urethrotomy, staged Johanson urethroplasty utilizing either buccal mucosal graft or skin graft (Tiersche-Duplay principle), non-transecting urethroplasty (Hieneke-Miiklulicz principle), excision and primary anastomosis, as well as two novel techniques: urethral closure under a suprapubic tunnel and abdominal pedicled skin flap urethroplasty. Each patient was routinely evaluated one month after surgery and every 3 months for 12 months, with clinical evaluation, uroflowmetry and post-void residual urine.</p><p><strong>Results: </strong>With a total of 41 procedures for the 36 patients, 32 patients (88.8 %) could eventually void while standing. The success rate was highest for staged Johanson urethroplasty using split thickness skin graft, staged abdominal pedicled skin flap and excision and primary anastomosis, respectively, while it was lowest for visual internal urethrotomy (0% success) and non-transecting anastomotic urethroplasty (50% success). For staged versus one-stage procedures prospective analysis, 17 out of 26 one-stage procedures (65.4%) succeeded while 13 out of 15 staged procedures (86.6%) succeeded.</p><p><strong>Conclusions: </strong>Urethral complications following phalloplasty require complex procedures demanding a high level of surgical expertise. Abdominal pedicled skin flap urethroplasty is a viable option for long and recalcitrant urethral strictures.</p>","PeriodicalId":9744,"journal":{"name":"Central European Journal of Urology","volume":"77 2","pages":"310-319"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}