Sir Denis Browne: Contributions to Pediatric Urology

Patel, Sutchin R.; Caldamone, Anthony A.

doi:10.1016/j.jpurol.2009.10.017

Cited by 11 publications

(2 citation statements)

References 11 publications

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“…This technique, which involves only sewing 1 edge of the graft to the urethral margin, relies on the Duplay-Denis Brown principle of epithelization to increase the diameter of the urethral lumen beyond the width provided by the graft and as a result, potentially improve patency outcomes and confounding our result. 23,41 Whether recurrence risk is mitigated by avoiding penile skin incisions or by utilizing 1-sided urethral dissection warrants substantial further investigation, as it could challenge the rationale of performing staged urethroplasty in patients with LS, which involves significant incision and violation of the penile skin.…”

Section: Discussionmentioning

confidence: 99%

One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus-Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-Analysis

2021

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Performing 1-stage urethroplasty in patients with urethral strictures caused by lichen sclerosus (LS) is hotly debated among reconstructive urologists due to conflicting reports of success. Therefore, the objective of this study was to determine the pooled incidence of stricture recurrence following 1-stage buccal mucosal graft (BMG) urethroplasty in patients with LS, to determine the impact of surgical technique on recurrence and to compare recurrence risk between patients with and without LS after 1-stage repairs. Materials and Methods: A systematic review was conducted in accordance with PRISMA criteria. The primary outcome was pooled incidence of recurrence, which was calculated using a Der-Simonian-Laird binary random effects model with a Freeman-Tukey arcsine transformation. A total of 21 studies were included, of which 15 provided data for comparative analyses. Results: Pooled data from 625 LS patients revealed a stricture recurrence rate of 10% (95% CI 6e14). Among studies with longer followup (!24 months), this increased to 18%. Among patients with penile urethral involvement, studies utilizing a penile skin incision had significantly higher pooled recurrence rates than those utilizing penile invagination (p[0.004). Across all studies, there was no evidence to suggest a difference in pooled recurrence rate between patients with and without LS (p[0.36). However, across only long-term studies, recurrence risk was significantly higher for patients with LS (OR 1.83, p[0.05). Conclusions: One-stage BMG urethroplasty is likely a viable surgical option for patients with LS-related strictures; however, high-quality data are limited. Future multi-institutional, long-term prospective studies are needed to assess durability of 1-stage repair.

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Section: Discussionmentioning

confidence: 99%

One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus-Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-Analysis

2021

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“…Children operated after this have a memory of the surgery which could lead to psychological problems. 3 2. The interaction of the surgeon and the guardians is extremely important in the post operative course.…”

Section: The Ten Commandments Of Hypospadius Surgerymentioning

confidence: 99%

Discussions on hypospadius repair

Mehta¹,

Mehta²,

Bajaj³

et al. 2021

JSAS

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Surgery for Hypospadius is fraught with complications. The very fact that there are more than a hundred techniques described for this problem is evidence enough to confirm that no single technique is the perfect answer to our efforts. The presenting author is a student of Dr.H.S.Asopa and an advocate of the perpucial island flap technique, though not dogmatic in its propagation. He has also had the opportunity to train with Mr. Aviar Bracka and uses different techniques judiciously. This presentation is about the details no author stresses upon for Hypospadius and surgery. Pre and post operative pictures are not the only teaching aids. Ten Commandments for Hypospadius surgeons. These are in themselves self explanatory for the students of Hypospadius as well as the senior specialist. We have been achieving consistant results even though we have not struck to any one technique. We have been using the modified Asopa-I technique (for almost half the cases) and Bracka technique as the two main methods for surgery. This step by step on pitfalls in hypospadius surgery is not to highlight surgical techniques but to discuss about steps which have their own importance to produce acceptable results.In spite of so many methods to perform surgery for patients of hypospadius, some general principles on tissue handling, suture management, prevention of edema, general method of dissection, dressing techniques etc go a long way in giving consistant results whatever the method used for the repair.

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Surgical Anatomy: Orchiectomy and Fertility Preservation Options

Owyong

Ramasamy

2021

Urological Care for the Transgender Patient

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Sir Denis Browne: Contributions to Pediatric Urology

Cited by 11 publications

References 11 publications

One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus-Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-Analysis

One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus-Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-Analysis

Discussions on hypospadius repair

Surgical Anatomy: Orchiectomy and Fertility Preservation Options

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