Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures

Abstract

The treatment of long urethral strictures is based on the use of buccal mucosa graft (BMG). Postoperative failures commonly occur in patients with the obliterative strictures, and the long augmented part of the urethra which is prone to fibrotic changes.Combined approach with the resection of the obliterative part of the urethral plate located in the bulbar urethra, together with the ventral placement of BMG was performed in 36 patients. Etiology of the stricture was: idiopathic in 19/36 (52.7%), iatrogenic in 14/36 (38.8%), and other causes in 3/36 (8.3%). Mean length of the stricture was 7.2±1.6 cm, and the length of the augmented graft 4.5±1.2 cm (due to resected urethral plate) so, the single BMG was enough in 25/36 (69.4%) patients. The medium postoperative follow up was 24 months (20–28 months) months. Success of the surgery was defined as no need for additional surgery neither dilatation. Cystoscopy was performed 4–6 months after the surgery and additional follow up with IPSS and uroflowmetry.Overall success was achieved in 31/36 (86.1%) patients. Mean postoperative IPSS was 9.5±2.1 in these patients. Complications were according to Clavien Dindo scale: grade II in 11/36 (30.5%-infection, orchialgia, scrotal pain), grade III in 4/36 (11.1%-fistula) and grade IV in 5/36 (14.5% - restenosis). Postoperative Qmax= 13.2±1.2 ml/s. Bell shaped curve was present in 14/36(38.8%).Our results suggest that overall success rate is similar to the expected values for BMG surgery, and the number of the grafts used is lower due to reduced stricture length.

Thermodynamics of a food macromolecular assembly: the case of okra mucilage

“…methane) is eluted as to allow for the calculation of the column's dead time/volume. 12,18,31,32 The parameter of interest in IGC experiments is the net retention volume, V N . For a given probe, this is the volume of the carrier gas required to sweep the injected probe out of the column, and is calculated by eqn (1): 32,33…”

“…Inverse gas chromatography (IGC) is a useful and quite versatile technique for materials' characterization over a wide temperature range. It has been used for the characterization of a variety of organic materials such as homopolymers and copolymers, [12][13][14] hyperbranched polymers, 15,16 polymer blends, 17 pharmaceutical materials, 18 powders, 19,20 nanomaterials, 21 bers, 22 crude oils, 23 and some non-food carbohydrates. [24][25][26] IGC can contribute to the estimation of two principal groups of properties, namely, (i) a material's (polymer's) surface energy parameters, typically its surface free energy and its acid-base character; (ii) its bulk thermodynamic properties, such as the polymer's solubility parameters and/or the Flory-Huggins interaction parameters.…”