Kooperativer Bibliotheksverbund

Language: English

In: BJU international, June 2011, Vol.107(12), pp.1964-6

Description: • To report our experience with a new and simple method of urethral repair with a volar onlay of free labium minus graft. Strictures of the female urethra are rare, and it is well accepted that the therapeutic options of dilation and urethrotomy are not lasting solutions as a result of their high recurrence rates. However, there is no consensus regarding the best way to reconstruct the female urethra in the case of stricture disease. • Four consecutive female patients with a long lasting history of recurrent urethral strictures underwent open urethroplasty with a volar situated free split thickness epidermal graft from the labium minus. • The surgical technique is described and a short-term follow-up is presented. • Operating time was 40-140 min (mean 105 min), and the graft measured between 2 × 1.5 cm and 3 × 2.5 cm. Follow-up time was 11-19 months. Maximum urinary flow rate could be improved from a baseline of 9.4-11.2 mL/s (preoperatively, after intermittent use of dilation) to 19-23 mL/s. • Postvoid residual urine volume was 0-50 mL preoperatively and no postvoid residual urine volume postoperatively. • Urinary catheters were removed after 21 days. Urinary stress incontinence did not occur postoperatively. No complications related to the graft donor site were found. • The reported data concerning a new therapeutic approach for the treatment of recurrent female urethral stricture show that a volar onlay urethroplasty represents a feasible, safe and simple surgical method. • Larger series with long-term follow-up are needed for further evaluation.

Keywords: Urethra -- Surgery ; Urethral Stricture -- Surgery ; Urologic Surgical Procedures -- Methods ; Vulva -- Transplantation

ISSN: 14644096

E-ISSN: 1464-410X

DOI: 10.1111/j.1464-410X.2010.09790.x

URL: View this record in MEDLINE/PubMed

Language: English

In: European Urology, March 2011, Vol.59(3), pp.323-324

Keywords: Medicine

ISSN: 0302-2838

E-ISSN: 1873-7560

DOI: 10.1016/j.eururo.2010.12.003

Source: ScienceDirect Journals (Elsevier)

URL: View record in ScienceDirect (Access to full text may be restricted)

Language: English

In: The Journal of Urology, 2010, Vol.183(4), pp.e426-e426

Keywords: Medicine

ISSN: 0022-5347

E-ISSN: 1527-3792

DOI: 10.1016/j.juro.2010.02.2291

Source: ScienceDirect Journals (Elsevier)

URL: View record in ScienceDirect (Access to full text may be restricted)

Language: German

In: Info Onkologie, 2/2011, Vol.14(1), pp.24-25

ISSN: 1613-3633

E-ISSN: 2196-5692

DOI: 10.1007/BF03362922

Source: Springer (via CrossRef)

Language: German

In: MMW - Fortschritte der Medizin, 5/2010, Vol.152(19), pp.43-44

ISSN: 1438-3276

E-ISSN: 1613-3560

DOI: 10.1007/BF03366556

Source: Springer (via CrossRef)

Language: English

In: European Urology, October 2010, Vol.58(4), pp.514-515

Keywords: Medicine

ISSN: 0302-2838

E-ISSN: 1873-7560

DOI: 10.1016/j.eururo.2010.08.003

Source: ScienceDirect Journals (Elsevier)

URL: View record in ScienceDirect (Access to full text may be restricted)

Language: German

In: MMW Fortschritte der Medizin, 13 May 2010, Vol.152(19), pp.43-4

Keywords: Brachytherapy ; Prostatectomy ; Prostatic Neoplasms -- Therapy

ISSN: 1438-3276

Source: MEDLINE/PubMed (U.S. National Library of Medicine)

URL: View this record in MEDLINE/PubMed

Language: English

In: European Urology, November 2010, Vol.58(5), pp.796-796

Keywords: Medicine

ISSN: 0302-2838

E-ISSN: 1873-7560

DOI: 10.1016/j.eururo.2010.08.022

URL: View record in ScienceDirect (Access to full text may be restricted)

Language: English

In: World Journal of Urology, 2012, Vol.30(5), pp.715-721

Description: Byline: Patrick J. Bastian (1), Margit Mayer (1), Stefan Tritschler (1), Alexander Roosen (1), Philipp Nuhn (1), Ricarda M. Bauer (1), Christian Gozzi (1) Keywords: Urethral stricture; Urethroplasty; Glanular stenosis; Recurrence Abstract: Objective To evaluate the validity of a single-stage dorsal inlay for recurrent peno-glandular stenosis following previous endourological or open urethroplastic surgery. Urethral glanular reconstruction included a deep dorsal incision followed by complete scar excision to create a deep groove presenting well-vascularized recipient bed ensuring appropriate graft healing. Materials and methods Between April 2002 and January 2008, a total of 34 patients (mean age 51.5 years, 14--85 years) were enrolled in the study. Congenital anomalies included hypospadia (n = 19, 53%) and epispadia (n = 2, 6%). Condition of strictures was either iatrogenic (n = 7), due to infection (n = 5), or traumatic (n = 1). Foreskin grafts were used in 13 cases, foreskin and buccal mucosa in one case, penile skin in 6 cases, and inguinal skin/thigh (harvested by electrodermatom) in 14 cases. The combination of meticulous scar excision with a deep incision of the glans was used to provide a well-vascularized grafting bed, thus ensuring excellent graft healing. The outcome analysis included urinary flow, urethral calibration 〉18 ch, voiding cystometry, and patient's satisfaction in a follow-up regime every 3 months. Results The average graft length was 4.7 cm (median 8, range 1.5--14). Mean follow-up was 70 months. In 31 patients (91%), no recurrent glanular stenosis was observed resulting in a post-operative flow of average 26.2 ml/s (11--53). Three post-operative wound infections occurred resulting in stricture recurrence, which was treated with internal urethrotomy, buccal mucosa, or penile skin inlay, respectively. Cosmetic results were satisfactory in all patients. Post-operative voiding parameters were significantly improved (P 〈 0.001). Conclusion The single-stage dorsal inlay for reconstruction of peno-glandular stenosis represents a reliable method even if the urethral plate is severely scarred or has been excised during previous surgery. The good results imply that a well-vascularized graft and the technical approach seem to be more important than the substitute material. Author Affiliation: (1) Urologische Klinik und Poliklinik, Klinikun der Universitat Munchen-Campus Grosshadern, Ludwig-Maximilians-Universitat, Marchioninistr. 15, 81377, Munich, Germany Article History: Registration Date: 20/09/2011 Received Date: 11/10/2010 Accepted Date: 20/09/2011 Online Date: 12/10/2011

Keywords: Urethral stricture ; Urethroplasty ; Glanular stenosis ; Recurrence

ISSN: 0724-4983

E-ISSN: 1433-8726

DOI: 10.1007/s00345-011-0770-4

URL: View full text in Springer (Subscribers only)

In: BJU International, October 2011, Vol.108(8b), pp.E290-E296

Description: Study Type - Prognosis (case series) Level of Evidence4 What's known on the subject? and What does the study add? Epigenetic alterations play an essential role during carcinogenesis. While DNA methylation has been extensively studied in bladder cancer, the relevance of histone modifications remains to be clarified. Earlier studies suggested that global histone modification levels are predictive for patients' outcome in various tumour entities (e.g. prostate, lung, breast and kidney cancer). The possibility to determine global histone modification levels easily and inexpensively using immunohistochemistry increases a potential routine use in the future. Our aim was therefore to investigate the global levels of histone H3K4 and H4K20 mono-, di- and trimethylation. For this purpose we prepared tissue microarrays with non-muscle-invasive bladder cancer (NMIBC), muscle-invasive bladder cancer (MIBC), bladder cancer metastases (METS) and normal urothelium (NU) tissue to compare global H3K4 and H4K20 methylation in these tissues, as well to assess the prognostic value of histone modifications. We show that global histone modification levels (H3K4me1, H3K4me3, H4K20me1, H4K20me2, H4K20me3) are lower in bladder cancer than in NU tissue. Furthermore, there was a decrease of histone modification levels (H3K4me1, H4K20me1, H4K20me2, H4K20me3) from NU over NMIBC and MIBCto METS. Histone modifications are correlated to advanced pathological stage in NMIBC and MIBC. Furthermore, H4K20me3 appeared to be a significant and independent prognostic predictor of bladder cancer-specific survival in patients with MIBC undergoing radical cystectomy. Our findings therefore provide a rationale for further investigation of histone modifications and their manipulation in bladder cancer. times To determine the role of global histone methylation as a prognostic parameter in patients with bladder cancer. times We used a tissue microarray with samples from patients with non-muscle-invasive bladder cancer (NMIBC; n= 161), muscle-invasive bladder cancer (MIBC, n= 127), normal urothelium (NU; n= 31) and bladder cancer metastases (METS; n= 31) to determine global histone methylation (me) levels at histone H3 lysine 4 (H3K4) and H4K20. times Global histone modification levels (H3K4me1, H3K4me3, H4K20me1, H4K20me2, and H4K20me3) were lower in bladder cancersamples than in NU tissue times Global levels of H3K4me1, H4K20me1, H4K20me2 and H4K20me3 were decreasing from NU over NMIBC and MIBC to METS. times H4K20me1 levels were increased in patients with NMIBC with advanced pTstage and less differentiated bladder cancer. times In patients with MIBC, pTstage was negatively correlated with H3K4me1, H4K20me1 and H4K20me2 levels. times H4K20me3 levels were significantly correlated in a univariate and multivariate model with bladder cancer-specific mortality after radical cystectomy in patients with MIBC. times Global histone methylation levels may help to identify patients with bladder cancerwith poor prognosis after radical cystectomy.

Keywords: Histone ; Methylation ; Bladder Cancer ; Survival ; Epigenetics ; H4k20me3

ISSN: 1464-4096

E-ISSN: 1464-410X

DOI: 10.1111/j.1464-410X.2011.10203.x