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Global Surgery pp 397–441Cite as

Essential Urology

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Abstract

Urological cases represent about 20% of cases performed in hospitals in low- and middle-income countries. For urethral strictures, open urethroplasty has much better long-term patency rates than urethral dilation or internal urethrotome. Buccal mucosal flaps have equal patency rates to penile skin flaps and are easier to perform. In a low-resource setting, vesicovaginal fistulas are either obstetrical or postsurgical in etiology. Obstetrical VVFs are ischemic in origin and many can be repaired vaginally with a Martius or gracilis flap. Post-hysterectomy VVFs can be approached abdominally or vaginally, and omental flaps may be useful in their closure. Liberal use of flaps will improve the success rate of VVF repair. BPH with obstruction is a common condition in aging men. Prostate size impacts the optimal selection of BPH surgical approach. TURP is easier to perform in cases of mild to moderate BPH with a prostate size of less than 60 cc. Open prostatectomy for BPH is most appropriate and easiest to perform for prostate gland sizes above 70 cc. Urinary stones cause significant morbidity and mortality in low- and middle-income countries. Open stone surgery is the mainstay of treatment. Urinary stone location, size, and knowledge of urinary tract and renal anatomy will help the surgeon to select the best operative approach in combination with judicious use of central cooling with ice which will improve stone-free rates and renal functional outcomes.

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References

  1. Jordan GH, McCammon KA. Surgery of the penis and urethra (Chapter 36, Pages 956–1000). In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology, 10th ed. Philadelphia, PA: Elsevier Saunders; 2011; p. 4320, 10:1416069119, 13:978–1416069119.

    Google Scholar 

  2. Pansadoro V, Emliozzi P. Internal Urethrotomy in the management of anterior urethral strictures: long-term follow-up. J Urol. 1996;156:73–5.

    Article  CAS  PubMed  Google Scholar 

  3. Culty T, Boccon-Gibod. Anastomotic urethroplasty for posttraumatic urethral stricture: previous urethral manipulation has a negative impact on the final outcome. J Urol. 2007;177:1374–7.

    Article  PubMed  Google Scholar 

  4. Breyer BN, McAninch JW, Whitson JM, et al. Multivariate analysis of risk factors for long-term urethroplasty outcome. J Urol. 2010;183:613–7.

    Article  PubMed  Google Scholar 

  5. Richter S, Kotliroff O, Nissenkorn I. Single preoperative bladder instillation of povidone-iodine for the prevention of postprostatectomy bacteriuria and wound infection. Infect Control Hosp Epidemiol. 1991;12(10):579–82.

    Article  CAS  PubMed  Google Scholar 

  6. Heyns CF, Marais DC. Prospective evaluation of the American Urological Association symptom index and peak urinary flow rate for the follow-up of men with known urethral stricture disease. J Urol. 2002;168:2051.

    Article  CAS  PubMed  Google Scholar 

  7. Dubey D, Vijjan V, Kapoor R, Srivastava A, Mandhani A, Kumar A, Ansari MS. Dorsal onlay buccal mucosa versus penile skin flap urethroplasty for anterior urethral strictures: results from a randomized prospective trial. J Urol. 2007;178(6):2466–9.

    Article  PubMed  Google Scholar 

  8. Rourke K, McKinney S, St. Martin B. Effect of wound closure on buccal mucosal graft harvest site morbidity: results of a randomized prospective trial. Urology. 2012;79:443–8.

    Article  PubMed  Google Scholar 

  9. Muruganandam K, Dubey D, Gulia AK, et al. Closure versus non-closure of buccal mucosal graft harvest site morbidity: results of a randomized prospective trial. Indian J Urol. 2009;25:72–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Simonato A, Gregori A, Ambrusosi C, et al. Lingual mucosal graft urethroplasty for anterior urethral reconstruction. Eur Urol. 2008;54:79.

    Article  PubMed  Google Scholar 

  11. Xu YM, Xu QK, Fu Q, et al. Oral complications after lingual mucosal graft harvesting for urethroplasty in 110 cases. BJU Int. 2011;108:140.

    Article  PubMed  Google Scholar 

  12. Wang K, Miao X, Wang L, et al. Dorsal onlay versus ventral onlay urethroplasty for anterior urethral stricture; a meta-analysis. Urol Int. 2009;83:342.

    Article  PubMed  Google Scholar 

  13. Mangera A, Patterson JM, Chapple CR. A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures. Eur Urol. 2011;59:797.

    Article  PubMed  Google Scholar 

  14. Barbagli G, Selli C, Tosto A, et al. Dorsal free graft urethroplasty. J Urol. 1996;155:123.

    Article  CAS  PubMed  Google Scholar 

  15. Quartey JKM. Microcirculation of penile and scrotal skin. In: Jordan GH, editor. Reconstruction for urethral stricture: atlas of the urologic clinics of North America, vol 5, issue 1. Philadelphia: W.B. Saunders; 1997.

    Google Scholar 

  16. Okorie CO, Salia M, Liu P, Pisters LL. Modified suprapubic prostatectomy without irrigation is safe. Urology. 2010;75:701–6.

    Article  PubMed  Google Scholar 

  17. Okorie CO, Pisters LL. Effect of modified suprapubic prostatectomy for benign prostatic hyperplasia on postoperative hemoglobin levels. Can J Urol. 2010;17(4):5255–8.

    PubMed  Google Scholar 

  18. Evans DH, Madjar S, Politano VA, et al. Interposition flaps in transabdominal vesicovaginal fistula repairs: are they really necessary? Urology. 2001;57(4):670–4.

    Article  CAS  PubMed  Google Scholar 

  19. Eilber KS, Kavaler E, Rodriguez LV, et al. Ten year experience with transvaginal vesicovaginal fistula repair using tissue interposition. J Urol. 2003;169:1033–6.

    Article  PubMed  Google Scholar 

  20. Rovner ES. Urinary tract fistulae (Chapter 77, Pages 2223–2261). In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology, 10th ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 4320, 10:1416069119, 13:978–1416069119.

    Google Scholar 

  21. Benson MC, McKiernan JM, Olsson CA. Cutaneous continent urinary diversion (Chapter 81, Pages 2579–2612). In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology, 10th ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 4320, ISBN 0–7216–0798-5; 13–78–0-7216-0798-6.

    Google Scholar 

  22. Okorie CO, Pisters LL. Monti reconstruction in patients with complex vesicovaginal fistula. Can J Urol. 2010;17(2):5124–6.

    PubMed  Google Scholar 

  23. Spirnak JP, Resnick MI. Kidney stone surgery (Chapter 17, Pages 555–578). In: Gillenwater JY, editor. Adult and pediatric urology. Philadelphia, PA: Mosby; 1987. p. 1800, ISBN – 0-8151-3476-2, 9780815134763.

    Google Scholar 

  24. Marshall FF, Smith NA, Murphy JB, et al. A comparison of ultrasonography and radiography in the localization of renal calculi: Experimental and operative experience. J Urol. 1981;126:576.

    CAS  PubMed  Google Scholar 

  25. Harvey RB. Effect of temperature on function of isolated dog kidney. Am J Phys. 1959;197:181.

    CAS  Google Scholar 

  26. Gil-Vernet JM. Pyelolithotomy. In: Roth RA, Finlayson B, editors. Stones clinical management of urolithiasis. Williams & Wilkins Co: Balitmore; 1983. p. 297–331.

    Google Scholar 

  27. Resnick MI. Surgery of renal calculi. AUA Update Series 1983, Volume 2, Lesson 29.

    Google Scholar 

  28. Blandy JP, Singh M. The case for a more aggressive approach to Staghorn stones. J Urol. 1976;115:505.

    CAS  PubMed  Google Scholar 

  29. Boyce WH, Elkins IB. Reconstructive renal surgery following anatrophic nephrolithotomy: follow-up of 100 consecutive cases. J Urol. 1974;111:307.

    CAS  PubMed  Google Scholar 

  30. Sutherland JW. Residual postoperative upper urinary tract stone. J Urol. 1981;126:573.

    CAS  PubMed  Google Scholar 

  31. McCallum RW. The adult male urethra. Radiol Clin N Am. 1979;17:227–44.

    CAS  PubMed  Google Scholar 

  32. Jordan GH. Management of anterior urethral stricture disease. Probl Urol. 1987;1:199–225.

    Google Scholar 

  33. Jordan GH. Principles of plastic surgery. In: Droller MJ, editor. Surgical management of urologic diseases: an anatomic approach. Philadelphia: Mosby-Year Book; 1992. p. 1218–37.

    Google Scholar 

  34. Jordan GH. Management of anterior or urethral stricture disease. In: Webster GD, editor. Problems in urology. Philadelphia: JB Lippincott; 1987. p. 214.

    Google Scholar 

  35. Raz S. Vesicovaginal fistulae. In: Raz S, editor. Atlas of transvaginal surgery. Philadelphia: WB Saunders; 1992. p. 138.

    Google Scholar 

  36. Ganabathi K, Sirls L, Zimmern P, Leach CE. Vesicovaginal fistulae: reconstructive techniques. In: McAninch J, editor. Traumatic and reconstructive urology. Philadelphia: WB Saunders; 1996. p. 315.

    Google Scholar 

  37. Monti PR, Lara RC, Dutra MA, et al. New techniques for construction of efferent conduits based on the Mitrofanoff principle. Urology. 1997;49:112–5.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1373, Houston, TX, 77030, USA

    Louis L. Pisters MD

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  1. Louis L. Pisters MD
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Correspondence to Louis L. Pisters MD .

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Editors and Affiliations

  1. Department of Surgery, Anne Arundel Health System, Johns Hopkins University School of Medicine, Annapolis, Maryland, USA

    Adrian Park

  2. Department of Surgery, Center for Global Surgery, Department of Family and Preventative Medicine, Division of Public Health, University of Utah, Salt Lake City, Utah, USA

    Raymond Price

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Pisters, L.L. (2017). Essential Urology. In: Park, A., Price, R. (eds) Global Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-49482-1_18

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  • DOI: https://doi.org/10.1007/978-3-319-49482-1_18

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