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Fulltext Hypospadias from the perspective of a single-surgeon practice in Malaysia

Yeap BH, Mohan N

Med J Malaysia, 2008 Dec;63(5):388-90.
PMID: 19803297 MyJurnal

The last decade has witnessed an alarming increase in the worldwide incidence of hypospadias. For non-hypospadiologists, the surgical correction of hypospadias will be increasingly demanding. This paper aims to evaluate the effectiveness of a treatment strategy devised by a single-surgeon practice in Malaysia to tackle this anticipated surge of caseload. Over a period exceeding eight years, 254 boys underwent corrective hypospadias surgery by a single paediatric surgeon at Alor Star Hospital, Malaysia. Patient demographics, racial distribution and meatal location were among the data collected retrospectively. The various types of corrective procedure employed, their outcome as well as complications were evaluated. Distal type of hypospadias dominated this series. There was an explainable peculiarity in the age distribution of hypospadias. For all types of repair, the complication rate was 33% consisting mainly of urethrocutaneous fistula (18%) and meatal stenosis (9%). Complication rate for tubularised incised plate (TIP) urethroplasty, the commonest technique of repair, was 30%, mainly from meatal stenosis (15%) and urethrocutaneous fistula (13%). Univariate analysis revealed that proximal hypospadias, repairs done during the initial four years of study and utilisation of repair other than TIP to be adverse risk factors. Tubularised incised plate urethroplasty was appropriate for almost all types of hypospadias. For the remainder, the two stage repair is satisfactorily employed. This study from a primary referral centre also dispelled the notion that proximal hypospadias predominate in this region. The versatility and reliability of TIP urethroplasty lends itself readily in tackling primary and repeat hypospadias surgery within a single-surgeon practice.

Matched MeSH terms: Urogenital Surgical Procedures/adverse effects; Urogenital Surgical Procedures/methods*
Robotic repair of vesicovaginal fistula: case series of five patients

Sundaram BM, Kalidasan G, Hemal AK

Urology, 2006 May;67(5):970-3.
PMID: 16698357

To describe a technique of robotic repair of vesicovaginal fistula (VVF) and present our experience with 5 such patients.

Matched MeSH terms: Urogenital Surgical Procedures*
Association of urodynamics and lower urogenital tract nerve growth factor after synthetic vaginal mesh implantation on a rat model

Lo TS, Lin YH, Chu HC, Cortes EF, Pue LB, Tan YL, et al.

J Obstet Gynaecol Res, 2017 Jan;43(1):173-178.
PMID: 27762470 DOI: 10.1111/jog.13158

AIM: By investigating the association of urodynamics and urogenital nerve growth factor (NGF) levels in vaginal mesh surgery, we may be able to associate the likelihood of postoperative lower urinary tract symptoms developing as a result of synthetic mesh implanted for pelvic floor reconstructive surgery.
METHODS: Thirty-eight female Sprague-Dawley rats were divided into three groups: mesh, sham (no mesh), and control. Urodynamic study and NGF analysis of the urogenital tissues were done and results were compared among all groups. The urodynamic studies of the mesh and sham groups were further divided into the 4th and 10th days. A P-value

Matched MeSH terms: Urogenital Surgical Procedures/methods*
Fulltext The prevalence and risk factors of occult stress urinary incontinence in women undergoing genitourinary prolapse surgery

Jibril AH, Norlelawati Ab Latip, Ng, PY, Jegasothy, R

Journal of Surgical Academia, 2016;6(1):10-17.
MyJurnal

De novo stress urinary incontinence (SUI) may occur in up to 80% of clinically continent women following genitourinary prolapse surgery. This had resulted in an increase in the rate of concurrent continence surgery during prolapse repair from 38% in 2001 to 47% in 2009 in the United States. To date, there is no local data available to estimate the prevalence of occult SUI (OSUI) among Malaysian women awaiting surgery. Therefore, this study was conducted to elicit the prevalence of occult SUI and its associated risks factors in patients awaiting prolapse surgery. We retrospectively studied the records of 296 consecutive women with significant pelvic organ prolapse awaiting reconstructive repair. All patients attended the Urogynaecology Unit in Hospital Kuala Lumpur Malaysia between October 2007 and September 2011. They had undergone standardized interviews, clinical examinations and urodynamic studies. During the urodynamic testings, all prolapses were reduced using ring pessaries to elicit OSUI. Primary outcome was the prevalence of OSUI with prolapse reduction to predict possibility of developing de novo SUI following prolapse surgery. Secondary outcome was the assessment of potential risk factors for OSUI. Among the 296 women studied, 121 (40.9%) were found to have OSUI. The risk factors associated with OSUI included age, BMI, numbers of SVD, recurrent UTI, reduction of urinary flow symptoms and grade 2 to 4 central compartment prolapses. We concluded that preoperative urodynamic testing with reduction of prolapse is useful to identify women with OSUI. This is important for preoperative counselling as well as planning for one step approach of prophylactic concomitant anti-incontinence procedures during prolapse surgery in order to avoid postoperative de novo SUI.

Matched MeSH terms: Urogenital Surgical Procedures