1
|
Farzamfar S, Richer M, Rahmani M, Naji M, Aleahmad M, Chabaud S, Bolduc S. Biological Macromolecule-Based Scaffolds for Urethra Reconstruction. Biomolecules 2023; 13:1167. [PMID: 37627232 PMCID: PMC10452429 DOI: 10.3390/biom13081167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 08/27/2023] Open
Abstract
Urethral reconstruction strategies are limited with many associated drawbacks. In this context, the main challenge is the unavailability of a suitable tissue that can endure urine exposure. However, most of the used tissues in clinical practices are non-specialized grafts that finally fail to prevent urine leakage. Tissue engineering has offered novel solutions to address this dilemma. In this technology, scaffolding biomaterials characteristics are of prime importance. Biological macromolecules are naturally derived polymers that have been extensively studied for various tissue engineering applications. This review discusses the recent advances, applications, and challenges of biological macromolecule-based scaffolds in urethral reconstruction.
Collapse
Affiliation(s)
- Saeed Farzamfar
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada; (S.F.); (M.R.); (S.C.)
| | - Megan Richer
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada; (S.F.); (M.R.); (S.C.)
| | - Mahya Rahmani
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran;
| | - Mohammad Naji
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran;
| | - Mehdi Aleahmad
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613151, Iran;
| | - Stéphane Chabaud
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada; (S.F.); (M.R.); (S.C.)
| | - Stéphane Bolduc
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Quebec, QC G1V 4G2, Canada; (S.F.); (M.R.); (S.C.)
- Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC G1V 0A6, Canada
| |
Collapse
|
2
|
Welsh PJ, McDaniel K, Goldsmith EW, Ramsay JD, Conley A, Owen TJ, Ambrosini YM, Ciccarelli M. Case report: Persistent Müllerian duct syndrome and enlarged prostatic utricle in a male dog. Front Vet Sci 2023; 10:1185621. [PMID: 37470070 PMCID: PMC10352618 DOI: 10.3389/fvets.2023.1185621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 07/21/2023] Open
Abstract
A 1-year-old male intact Miniature Schnauzer mix was presented for chronic intermittent hematuria. Abdominal ultrasonography revealed a large, fluid-filled cystic structure extending cranially and dorsally to the prostate. Computed tomography scan images revealed that the fluid-filled cavity resembled a uterus, with both horns entering the scrotum through the inguinal canal adjacent to the testes. On cytogenetic analysis, the dog was found to have a homozygote mutation on AMHRII consistent with persistent Müllerian duct syndrome (PMDS). A gonadohysterectomy was performed, and surgical and histologic findings confirmed the presence of a uterus, oviducts, vagina, and testes in this dog. Additionally, an intraoperative fluoroscopy exam revealed a communication between the uterus and the bladder via an enlarged utricle, explaining the hematuria and urine in the reproductive tract (urometra). To our knowledge, this is the first clinical report of a phenotypically intact male dog with PMDS and urometra due to an enlarged prostatic utricle. This case illustrates a combination of a disorder of sex and urogenital sinus development.
Collapse
Affiliation(s)
- Peter J. Welsh
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, United States
| | - Kaylyn McDaniel
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, United States
| | - Elizabeth W. Goldsmith
- Department of Veterinary Microbiology and Pathology, Washington State University, Pullman, WA, United States
- Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, WA, United States
| | - Joshua D. Ramsay
- Pathology Services, North American Science Associates, Minneapolis, MN, United States
| | - Alan Conley
- School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Tina Jo Owen
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, United States
| | - Yoko M. Ambrosini
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, United States
| | - Michela Ciccarelli
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA, United States
| |
Collapse
|
3
|
Jain A, Lone YA. Urethral Duplication Associated with Ectopic Scrotum: A Case Study. J Indian Assoc Pediatr Surg 2023; 28:348-351. [PMID: 37635880 PMCID: PMC10455700 DOI: 10.4103/jiaps.jiaps_8_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/09/2023] [Accepted: 04/07/2023] [Indexed: 08/29/2023] Open
Abstract
Urethral duplication is a rare anomaly with varying clinical manifestations. About 300 cases have been reported till date and are often associated with genitourinary (GU) and gastrointestinal (GI) tract anomalies. A 6-day-old neonate presented with an absent anal opening and a tiny perineal fistula having slight meconium staining. He did well after anoplasty. Low anorectal malformation (ARM) has been reported as the GI anomaly associated with urethral duplication. However, an ectopic scrotum as the principal GU tract anomaly associated with urethral duplication is being reported for the first time in literature with probable embryologic explanation. The GU tract anomalies were successfully repaired surgically later in infancy.
Collapse
Affiliation(s)
- Ankit Jain
- Department of General Surgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Yasir Ahmad Lone
- Department of Pediatric Surgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| |
Collapse
|
4
|
Sabra TA, Abdelmohsen SM, Ali AK. Surgical correction of epispadias associated with buried penis. Int J Surg Case Rep 2023; 108:108406. [PMID: 37336177 PMCID: PMC10382747 DOI: 10.1016/j.ijscr.2023.108406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Isolated male epispadias is a rare entity with incidence of approximately 1 in 120,000 live births. Epispadias usually presents with a phimotic preputial orifice where glans is not visible and hence is also known as concealed epispadias. Buried penis in children is defined as a congenital insufficient penile skin with an unretractable foreskin that keeps the penis deep inside the pre-pubic fat. This congenital malformation of the penile envelopes is usually isolated. However, in some cases the concealed penis hides an underlying penile anomaly. We present surgical repair of a very rare case with concealed epispadias. CASE PRESENTATION A nine-month-old infant had buried his penis, and his mother was seeking his circumcision. Local examination revealed concealed penopubic epispadias. A pediatric surgeon operated on this patient using the modified partial penile disassembly technique. The patient was doing well at follow-up visits at one, three, and six months. There were no urethral stricture or obstructive urinary symptoms. The parents were satisfied with the cosmetic outcome. CLINICAL DISCUSSION The embryogenesis and development of the urethra and the prepuce are linked. Urethral development defects (as in hypospadias or epispadias) are frequently coupled with faulty prepuce on the same side. The goal of surgical management for epispadias is to correct the dorsal chordee and reconstruct the epispadiac urethra and glans. Based on the cosmesis of the penis reconstruction, preservation of erectile function, and achieving urine continence, the outcome is evaluated. CONCLUSION Concealed epispadias is frequently ignored because patients appear with buried penis, non-retractile prepuce, and a normal urine stream. Preoperative diagnosis and parent counseling are critical for the effective treatment of this uncommon entity. The modified partial penile disassembly procedure, in which the tunica albuginea is stitched to the pubic periosteum at 3 and 9 o'clock, can be used to correct buried epispadias.
Collapse
|
5
|
Ren J, Ma T, Huang S, Chen G, Dietrich CF, Peng Y, Cui X. A narrative review on the applications of intracavitary contrast-enhanced ultrasonography in pediatric lower genitourinary anomalies. Front Pediatr 2023; 11:984643. [PMID: 37274817 PMCID: PMC10236366 DOI: 10.3389/fped.2023.984643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 04/13/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose We mainly aimed to perform a narrative review of clinical applications of the three intracavitary contrast-enhanced ultrasonography (CEUS) including contrast-enhanced voiding urosonography (ceVUS), contrast-enhanced retrograde urethrosonography (ceRUG), and contrast-enhanced genitosonography (ceGS) in pediatric lower genitourinary anomalies. Method A literature search in the PubMed and Web of Science databases was conducted up to 1 July 2022 on all studies published in English using the search terms "contrast-enhanced voiding urosonography", "contrast-enhanced retrograde urethrosonography", and "contrast-enhanced genitosonography". Trials were limited to pediatric subjects (ages ≤18 years) with no time restrictions. The inclusion criteria were studies on ceVUS, ceRUG, and ceGS to evaluate pediatric lower genitourinary anomalies. Two independent authors summarized the included articles. Results Finally, a total of 48 original articles and 6 case reports or case series were included, of which 50 (93%) were only relevant to ceVUS, 3 (5%) articles involved ceGS, while only one (2%) article involved ceRUG, and 87% of the applications of ceVUS were focused on vesicoureteral reflux (VUR). We also searched 24 related reviews, of which 20 involved ceVUS in diagnosing VUR and 4 involved ceRUG and ceGS for other lower genitourinary anomalies. Conclusion Intracavitary CEUS including ceVUS, ceRUG, and ceGS in pediatrics has many advantages over other radiological examinations in diagnosing lower genitourinary anomalies. Although ceVUS is widely used in detecting VUR, ceRUG and ceGS have also become promising techniques for evaluating the urethral pathologies and urogenital sinus.
Collapse
Affiliation(s)
- Jiayu Ren
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Ma
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuyan Huang
- Department of Ultrasound, The First People’s Hospital of Huaihua, Huaihua, China
| | - Gongquan Chen
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Bern, Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Bern, Beau Site, Salem und Permanence, Bern, Switzerland
| | - Yuexiang Peng
- Department of Ultrasound, The Third Hospital of Wuhan, Wuhan, China
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
6
|
Ikhuoriah T, Oboh D, Abramowitz C, Musheyev Y, Shamsian E. Posterior urethral valve: A case report in an older Nigerian child. Radiol Case Rep 2023; 18:1715-1720. [PMID: 36895892 PMCID: PMC9989312 DOI: 10.1016/j.radcr.2023.01.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 03/03/2023] Open
Abstract
Posterior urethral valve (PUV) is an anomaly of the urinary tract in male children and is the leading cause of urinary tract obstruction in the pediatric population. PUV is diagnosed radiologically by ultrasonography, both pre- and postnatally, and using micturating cystourethrography. Its prevalence and age of diagnosis may vary by demographic and ethnic background. This case highlights an older Nigerian child that presented with recurrent urinary tract symptoms and was subsequently diagnosed with PUV. The study further explores the key radiographic findings and analyzes the radiographic imaging features of PUV in various populations.
Collapse
Affiliation(s)
- Teddy Ikhuoriah
- New York Institute of Technology College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, Old Westbury, NY 11545 USA
| | - David Oboh
- Medical Imaging Department, Prince Faisal Bin Khalid Cardiac Center (PFKCC), Abha, Aseer, Saudi Arabia
| | - Chiya Abramowitz
- New York Institute of Technology College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, Old Westbury, NY 11545 USA
| | - Yakubmiyer Musheyev
- New York Institute of Technology College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, Old Westbury, NY 11545 USA
| | - Ethan Shamsian
- New York Institute of Technology College of Osteopathic Medicine, 101 Northern Blvd, Glen Head, Old Westbury, NY 11545 USA
| |
Collapse
|
7
|
Muhammad F, Octavian I, Karim MI. Male adult with incomplete urethral duplication: A case report from Indonesia. Urol Case Rep 2023; 48:102383. [PMID: 37035721 PMCID: PMC10074494 DOI: 10.1016/j.eucr.2023.102383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
Urethral duplication is a rare disease with diverse clinical symptoms and more common in male; only fewer than 300 instances have been reported. In this case report, a 20-year-old male patient came to the urology polyclinic with two holes on the glans penis, accompanied by daily clear discharge in the upper hole. This complaint has been experienced since birth. The patient underwent an excision of the dorsal accessory urethra to correct penile anomalies.
Collapse
|
8
|
Congenital Anterior Urethral Diverticulum in Identical Twins. Urology 2023; 171:205-207. [PMID: 36244471 DOI: 10.1016/j.urology.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
Congenital anterior urethral diverticulum (CAUD) is an uncommon abnormality of the male urethra. In the literature, cases of CAUD affecting both children within a set of identical twins or presenting concomitantly with another urethral condition are exceedingly rare. We describe 2 cases of CAUD in identical twins: a pair of newborns in which Twin 1A and Twin 1B both present with CAUD, and a second pair of newborns in which only Twin 2A presents with CAUD along with a partial collateral urethral duplication. In doing so, we aim to add to the incomplete literature on the embryological development of CAUD.
Collapse
|
9
|
Nnabugwu II, Onoh WC, Ukekwe FI, Nwosu EO, Iwenofu CA, Anakebe IN, Nnabugwu CA, Onuh AC. Urethral duplication associated with complex chordee: a narrative review of literature and report of a case. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Urethral duplication (UD) is reportedly rare. It is rarer in females. Knowledge on this anomaly comes from isolated report of cases. The aim of this review is to summarize information available on this anomaly thereby revealing gaps in knowledge, and to appropriately situate a recently managed case.
Methods
Publications on UD in English language from 2001 to 2021 were searched for in the literature. Of importance were age at presentation, class of UD, nature of associated penile deformity and other structural anomalies. Available information was used to synthesize opinions after descriptive analyses using SPSS® version 21 (IBM Co., Armonk, NY, USA). In addition, a recently managed case of UD was reported and appropriately situated in the discourse.
Result
In all, 115 articles met the inclusion criteria. Majority (75.7%) were individual case reports, while the rest were retrospective review of case series. These provided a total of 269 reported cases. Of this lot, 38 cases were excluded because they either had no Effmann’s class or were not described well enough for an Effmann’s class to be assigned. Ultimately, 231 cases formed the basis for this review. Male to female ratio was 12:1. Types III and IIB had more females. Types IIA 2 (26.0%), IIA 2 “Y” (26.4%) and IA (22.5%) were frequently reported. About 61.8% males and 68.4% females had no associated defects. Isolated dorsal chordee was prevalent (7.1%), especially among type IA (16.7%) UD. Reported in 10.4%, vesicoureteric reflux may not be attributable always to high pressure voiding.
A boy who presented at the age of 18 years with Effmann type IA UD and an associated complex chordee of the penile shaft was reported. The complex nature of the chordee adds to the challenge of explaining associated penile defects in UD.
Conclusion
UD is rare, but reported from all parts of the globe. There are a number of associated defects involving the external genitalia and other organs reported in UD in the male. The mechanisms of these defects are yet to be fully understood.
Collapse
|
10
|
Garriboli M, Dzwigala M, Clothier J. Posterior urethral valves and urachal cyst: an unusual combination. BMJ Case Rep 2022; 15:e248460. [PMID: 35418380 PMCID: PMC9014000 DOI: 10.1136/bcr-2021-248460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Combination of posterior urethral valves and urachus remnants has been described as rare occurrence. We report a case of a baby boy with normal antenatal scans, in whom the presence of large urachal cyst and posterior urethral valves causing high pressure bladder and chronic kidney disease was found. The patient underwent ablation of posterior urethral valves at 23 days of life and urachal cyst removal at age of 4 and a half months.
Collapse
Affiliation(s)
- Massimo Garriboli
- Paediatric Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Stem Cells & Regenerative Medicine Section, Developmental Biology & Cancer Programme, UCL Institute of Child Health, London, UK
| | - Monica Dzwigala
- Paediatric Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Joanna Clothier
- Paediatric Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
11
|
Acharya PT, Ponrartana S, Lai L, Vasquez E, Goodarzian F. Imaging of congenital genitourinary anomalies. Pediatr Radiol 2022; 52:726-739. [PMID: 34741177 DOI: 10.1007/s00247-021-05217-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/12/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022]
Abstract
Congenital genitourinary anomalies are among the most frequent types of birth defects in neonates. Some anomalies can be a significant cause of morbidity in infancy, while others remain asymptomatic even until adulthood and can be at times the only manifestation of a complex systemic disease. The spectrum of these anomalies results from the developmental insults that can occur at various embryologic stages, and an understanding of the formation of the genitourinary system is helpful in the evaluation and treatment of a child with a congenital genitourinary anomaly. Imaging plays an essential role in the diagnosis of congenital genitourinary anomalies and treatment planning. In this article, we highlight the embryologic and characteristic imaging features of various congenital genitourinary anomalies, demonstrate the utility of different imaging modalities in management, and review specific imaging modalities and protocols for image optimization.
Collapse
Affiliation(s)
- Patricia T Acharya
- Department of Radiology, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #81, Los Angeles, CA, 90027, USA. .,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. .,Loma Linda University School of Medicine, Loma Linda, CA, USA.
| | - Skorn Ponrartana
- Department of Radiology, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #81, Los Angeles, CA, 90027, USA.,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lillian Lai
- Department of Radiology, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #81, Los Angeles, CA, 90027, USA.,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Evalynn Vasquez
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Urology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Fariba Goodarzian
- Department of Radiology, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #81, Los Angeles, CA, 90027, USA.,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
12
|
Norris JJ, Raj JP, Thomas TT, Maleperambil TT, Shubha AM. Effects of oxybutynin in children with posterior urethral valves post fulguration: Report in a select cohort of children. J Family Med Prim Care 2021; 10:3706-3711. [PMID: 34934669 PMCID: PMC8653479 DOI: 10.4103/jfmpc.jfmpc_2554_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/27/2021] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives: Posterior urethral valves (PUV) is the commonest obstructive uropathy with varied consequences. Though valve fulguration is the treatment of choice, appropriate bladder management modifies outcome and includes rational use of anticholinergics. Here, we aim to evaluate the effects of oxybutynin on the bladder and urinary tract morphology and function. Concurrently, we document adverse effects encountered, patient compliance, and medication adherence. Methods: A retrospective study of children below 5 years of age (2012–2017) post fulguration and on oxybutynin for at least 6 months. Patient demographics, clinical features, renal ultrasound, micturating cystourethrogram, dimercaptosuccinic acid scan, adverse effects, and pill count for medication adherence were collated. Results: 48 children below the age of 5 years were included, and 12 were excluded either due to the presence of concomitant problems or were not on oxybutynin. Of the 36, four were lost to follow-up and one had died due to an unrelated condition. Thus, a total of 31 children were analyzed. At follow-up, 28/31 patients were asymptomatic, two had daytime incontinence, and one had recurrent urinary tract infection. All patients except one have preserved renal function tests. On ultrasonography, hydroureteronephrosis worsened in only 1/25 children and two showed significant post void residues. The resolution of vesicoureteral reflux was noted in almost 50%. 4/31 renal units had progressive scars. Only two parents defaulted medication. Urodynamic study done in half of these children showed stable bladder pressures except in two. Conclusion: Oxybutynin therapy following adequate valve fulguration aids upper tracts preservation by stabilizing deranged bladder dynamics. The medication is well tolerated with minimal or no side effects.
Collapse
Affiliation(s)
| | - Jeffrey Pradeep Raj
- Department of Pharmacology, St. John's Medical College, Bengaluru, Karnataka, India
| | - Tia Teresa Thomas
- Medical Student, St. John's Medical College, Bengaluru, Karnataka, India
| | | | | |
Collapse
|
13
|
Barnewolt CE, Acharya PT, Aguirre Pascual E, Back SJ, Beltrán Salazar VP, Chan PKJ, Chow JS, Coca Robinot D, Darge K, Duran C, Ključevšek D, Kwon JK, Ntoulia A, Papadopoulou F, Woźniak MM, Piskunowicz M. Contrast-enhanced voiding urosonography part 2: urethral imaging. Pediatr Radiol 2021; 51:2368-2386. [PMID: 34386854 DOI: 10.1007/s00247-021-05116-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/17/2021] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
Ultrasound (US) has been increasingly used as an important imaging tool to assess the urethra in children. The earliest reports of pediatric urethral sonography involved imaging the urethra in a non-voiding state, during physiological voiding of urine, and after instillation of saline. The introduction of US contrast agents has continued to improve visualization of urethral anatomy. Contrast-enhanced US of the urethra can be performed during the voiding phase of a standard contrast-enhanced voiding urosonography (ceVUS) exam or with retrograde instillation of a contrast agent, depending on the exam indication. Both techniques are well tolerated by children and provide accurate information about urethral pathology and periurethral soft tissues. This article reviews the technical aspects and imaging findings of urethral pathologies in children using contrast-enhanced US, both by the voiding and retrograde instillation techniques.
Collapse
Affiliation(s)
- Carol E Barnewolt
- Department of Radiology, Boston Children's Hospital, Harvard University, 300 Longwood Ave., Boston, MA, 02115, USA.
| | - Patricia T Acharya
- Department of Radiology, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Susan J Back
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivian P Beltrán Salazar
- Department of Radiology, Hospital Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Pui Kwan Joyce Chan
- Department of Radiology, Hong Kong Children's Hospital, Hong Kong (SAR), People's Republic of China
| | - Jeanne S Chow
- Department of Radiology, Boston Children's Hospital, Harvard University, 300 Longwood Ave., Boston, MA, 02115, USA
| | - David Coca Robinot
- Department of Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Carmina Duran
- Department of Radiology, Hospital Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - Damjana Ključevšek
- Department of Radiology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - Jeannie K Kwon
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Aikaterini Ntoulia
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Magdalena M Woźniak
- Department of Pediatric Radiology, Medical University of Lublin, Lublin, Poland
| | | |
Collapse
|
14
|
Tlili G, Ahmed KB, Acacha E, Taghrid T, Ktari K, Wiem M, Jaidane M, Saad H. Duplication of the urethra in an adult male presenting with scrotal fistula: a rare case report. J Surg Case Rep 2021; 2021:rjab429. [PMID: 34603685 PMCID: PMC8480524 DOI: 10.1093/jscr/rjab429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 12/02/2022] Open
Abstract
Urethral duplication is a rare congenital abnormality with varied clinical manifestations; to this day, <300 cases were reported in the literature. It is affecting mainly males and is nearly always diagnosed in childhood or adolescence. It may be complete or incomplete, and the most widely accepted classification of the different types of urethral duplication was developed by Effman et al. Herein, we present a rare case of urethral duplication revealed by scrotal fistula in an adult man. A duplication is an unusual form of Y-type duplication: it is an incomplete urethral duplication urethra opening on the scrotum without communication with the urethra or bladder.
Collapse
Affiliation(s)
- Ghassen Tlili
- Department of Urology, Sahloul Teaching Hospital, Sousse, Tunisia
| | - Khaled Ben Ahmed
- Department of Urology, Sidi Bouzid Hopsital, Sidi Bouzid, Tunisia
| | - Emir Acacha
- Department of Urology, Sahloul Teaching Hospital, Sousse, Tunisia
| | - Tlili Taghrid
- Department of Cytology, Farhat Hached Hospital, Sousse, Tunisia
| | - Kamel Ktari
- Department of Urology, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| | - Majdoub Wiem
- Department of Cytology, Sahloul Teaching Hospital, Sousse, Tunisia
| | - Mehdi Jaidane
- Department of Urology, Sahloul Teaching Hospital, Sousse, Tunisia
| | - Hamadi Saad
- Department of Urology, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia
| |
Collapse
|
15
|
Naini AR, Kapkanova N, Zelesco M. Fetal urinary ascites and spontaneous bladder rupture—A rare case of anterior urethral valves: A case report. SONOGRAPHY 2021. [DOI: 10.1002/sono.12285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Anitha Reddy Naini
- Department of Medical Imaging Fiona Stanley Hospital Murdoch Western Australia Australia
| | - Natasha Kapkanova
- Department of Medical Imaging Fiona Stanley Hospital Murdoch Western Australia Australia
| | - Marilyn Zelesco
- Department of Medical Imaging Fiona Stanley Hospital Murdoch Western Australia Australia
| |
Collapse
|
16
|
Rousseau S, Peycelon M, Grosos C, Bidault V, Poupalou A, Martin G, Dobremez É, Harper L, Raquillet C, Arnaud A, Sapin E, Scalabre A, Buisson P, Levard G, Pommepuy I, Pons M, Fourcade L, Ballouhey Q. Management of lower urinary tract fibroepithelial polyps in children. J Pediatr Surg 2021; 56:332-336. [PMID: 32641248 DOI: 10.1016/j.jpedsurg.2020.05.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Fibroepithelial polyps (FEP) of the lower urinary tract are relatively common in adults but rare in children, with fewer than 250 cases reported in the literature to date. OBJECTIVE The aim of this study was to address the experience of FEP management in children. STUDY DESIGN A retrospective multicenter review was undertaken in children with defined FEP of the lower urinary tract managed between 2008 and 2018. The data at 18 pediatric surgery centers were collected. Their demographic, radiological, surgical, and pathological information were reviewed. RESULTS A total of 33 children (26 boys; 7 girls) were treated for FEP of the lower urinary tract at 13 centers. The most common presentation was urinary outflow as hematuria (41%), acute urinary retention (25%), dysuria (19%), or urinary infections (28%). A prenatal diagnosis was made for three patients with hydronephrosis. Almost all of the children (94%) underwent ultrasound imaging of the urinary tract as the first diagnostic examination, 23 (70%) of them also either had an MRI (15%), cystourethrography (25%), computerized tomography (6%), or cystoscopy (45%). Two of these children (6%) had a biopsy prior to the surgery. The median preoperative delay was 7.52 (range: 1-48) months. Most of the patients were treated endoscopically, although four (12.1%) had open surgery and two (6.1%) had an additional incision for specimen extraction. The median hospital stay was 1.5 (range: 1-10) days. There were no recurrences and no complications after a median follow-up of 13 (range: 1-34) months. DISCUSSION The main limitation of our study is the retrospective design, although it is the largest one for this pathology. CONCLUSION This series supports sonography as the most suitable diagnosis tool before endoscopy to confirm the diagnosis and to perform the resection for most FEP in children. This report confirms the recognized benign nature in the absence of recurrences. LEVEL OF EVIDENCE Level V.
Collapse
Affiliation(s)
- Sybille Rousseau
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France
| | - Matthieu Peycelon
- Service de chirurgie et urologie pédiatrique, Hôpital Universitaire Robert-Debré, APHP - Centre de Référence Maladies Rares « MARVU », Université de Paris, Paris, France; Pediatric Urology, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Céline Grosos
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France
| | - Valeska Bidault
- Service de chirurgie et urologie pédiatrique, Hôpital Universitaire Robert-Debré, APHP - Centre de Référence Maladies Rares « MARVU », Université de Paris, Paris, France
| | - Anna Poupalou
- Service de Chirurgie Pédiatrique, Hôpital HUDERF-ST Pierre (Université Libre de Bruxelles-ULB), Brussels, Belgium
| | - Garance Martin
- Service de chirurgie pédiatrique, Hôpital Trousseau, Paris, France
| | - Éric Dobremez
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Luke Harper
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Claire Raquillet
- Service de chirurgie pédiatrique, Centre Hospitalier Ballanger, Aulnay-sous-Bois, France
| | - Alexis Arnaud
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Rennes, Bordeaux, France
| | - Emmanuel Sapin
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Dijon, Bordeaux, France
| | - Aurélien Scalabre
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Saint Etienne, Bordeaux, France
| | - Philippe Buisson
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire d'Amiens, Bordeaux, France
| | - Guillaume Levard
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Poitiers, Bordeaux, France
| | - Isabelle Pommepuy
- Service d'anatomo-pathologie, Centre Hospitalier Universitaire de Limoges, Bordeaux, France
| | - Maguelonne Pons
- Service de chirurgie pédiatrique, Centre Hospitalier Universitaire de Clermont-Ferrand, Bordeaux, France
| | - Laurent Fourcade
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France
| | - Quentin Ballouhey
- Service de chirurgie pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Limoges, 8 Avenue Dominique Larrey 87042, Limoges, France.
| |
Collapse
|
17
|
Roux M, Bouchard M, Kmita M. Multifaceted Hoxa13 function in urogenital development underlies the Hand-Foot-Genital Syndrome. Hum Mol Genet 2020; 28:1671-1681. [PMID: 30649340 DOI: 10.1093/hmg/ddz013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/14/2018] [Accepted: 01/08/2019] [Indexed: 02/05/2023] Open
Abstract
Hand-Foot-Genital syndrome is a rare condition caused by mutations in the HOXA13 gene and characterized by limb malformations and urogenital defects. While the role of Hoxa13 in limb development has been extensively studied, its function during the development of the urogenital system remains elusive mostly due to the embryonic lethality of Hoxa13 homozygous mutant mice. Using a conditional inactivation strategy, we show that mouse fetuses lacking Hoxa13 function develop megaureters, hydronephrosis and malformations of the uterus, reminiscent of the defects characterizing patients with Hand-Foot-Genital syndrome. Our analysis reveals that Hoxa13 plays a critical role in Müllerian ducts fusion and in ureter remodeling by regulating the elimination of the caudal common nephric duct, eventually preventing the separation from the nephric duct. Our data also reveal a specific role for Hoxa13 in the urogenital sinus, which is in part mediated by Gata3, as well as Hoxa13 requirement for the proper organization of the ureter. Finally, we provide evidence that Hoxa13 provides positional and temporal cues during the development of the lower urogenital system, a sine qua non condition for the proper function of the urinary system.
Collapse
Affiliation(s)
- Marine Roux
- Genetics and Development Research Unit, Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada
| | - Maxime Bouchard
- Goodman Cancer Research Centre and Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Marie Kmita
- Genetics and Development Research Unit, Institut de Recherches Cliniques de Montréal, Montreal, Quebec, Canada.,Department of Experimental Medicine, McGill University, Montreal, Quebec, Canada.,Département de Médecine (Programme de Biologie Moléculaire), Université de Montréal, Montreal, Quebec, Canada
| |
Collapse
|
18
|
Gopalkrishna A, Sharma SM, Ananda B. Anterior urethral diverticulum: A rare presentation. Indian J Plast Surg 2019; 49:265-267. [PMID: 27833294 PMCID: PMC5053004 DOI: 10.4103/0970-0358.191304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Congenital anomalies of the urogenital tract are the most common anomalies found in the foetus, neonates and infants, but anterior urethral valves and diverticula are rare. Here, we present a case with congenital anterior urethral diverticulum associated with patent ductus arteriosus and polydactyly.
Collapse
Affiliation(s)
| | | | - B Ananda
- J. Watumull Global Hospital and Research Centre, Mount Abu, Rajasthan, India
| |
Collapse
|
19
|
Harrison J, Corley K, Kearney C, Mushtaq I. Single stage urethroplasty for perineal hypospadias in a foal. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Harrison
- Urology Department; Great Ormond Street Hospital; London UK
| | - K. Corley
- Anglesey Lodge Equine Hospital; The Curragh Co Kildare Ireland
| | - C. Kearney
- School of Veterinary Medicine; University College Dublin; Belfield Ireland
| | - I. Mushtaq
- Urology Department; Great Ormond Street Hospital; London UK
| |
Collapse
|
20
|
Affiliation(s)
| | - Yoshino Tamaki Sameshima
- Diagnostic Imaging Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, São Paulo, 05652-901, Brazil
| |
Collapse
|
21
|
Duran C, Beltrán VP, González A, Gómez C, Riego JD. Contrast-enhanced Voiding Urosonography for Vesicoureteral Reflux Diagnosis in Children. Radiographics 2018; 37:1854-1869. [PMID: 29019761 DOI: 10.1148/rg.2017170024] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Contrast-enhanced voiding urosonography (ceVUS) is a dynamic imaging technique that makes it possible to study the structure of the urinary tract after the administration of intravesical contrast material. Initially, ceVUS was indicated mainly to study vesicoureteral reflux (VUR); however, since the ability of ceVUS to depict the structure of the urethra was demonstrated in both sexes, ceVUS is now indicated for examination of the entire urinary tract. The main benefit of ceVUS is that it does not use ionizing radiation. In recent years, fundamental changes have occurred in the understanding of VUR. The lessening effect of VUR and the low rate of occurrence of urethral pathologic conditions have given rise to changes in the indications for tests for these conditions. In addition to being able to help confirm a diagnosis of VUR, the ceVUS technique can be used to depict obstructive and nonobstructive urethral pathologic conditions, as well as normal variants, on high-quality images. Furthermore, ceVUS enables real-time assessment of voiding function. For these reasons, ceVUS should be not only an alternative to voiding cystourethrography, but also the technique of choice for the study of the entire urinary tract in pediatric patients. Online supplemental material is available for this article. ©RSNA, 2017.
Collapse
Affiliation(s)
- Carmina Duran
- From the Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Spain
| | - Viviana P Beltrán
- From the Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Spain
| | - Amàlia González
- From the Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Spain
| | - Carles Gómez
- From the Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Spain
| | - Javier Del Riego
- From the Department of Radiology, UDIAT Centre Diagnòstic, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell 08208, Spain
| |
Collapse
|
22
|
Mark A, Meister M, Opara B, Chow R. Nontraumatic urinary bladder rupture presenting as renal pseudo-failure and ascites. Radiol Case Rep 2017; 12:304-307. [PMID: 28491176 PMCID: PMC5417767 DOI: 10.1016/j.radcr.2017.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/05/2017] [Accepted: 03/06/2017] [Indexed: 11/29/2022] Open
Abstract
A 24-year-old man, with past medical history significant only for nocturnal enuresis until the age of 12 years, presented to the emergency department with acute abdominal pain after an episode of difficulty with micturition in the middle of the night. On presentation, physical examination was suggestive of ascites and laboratories revealed an elevated serum creatinine of 1.88 mg/dL. He was subsequently found to have a ruptured bladder, without any inciting trauma, which required surgical repair. His only surgical history is an unknown, apparently urologic, surgery when he was 11-12 years old. The patient's unique presentation prompts discussion of bladder rupture and its manifestations, the role of clinical information in informing imaging protocol, and the importance of sagittal images in identifying pathology.
Collapse
Affiliation(s)
- Andrew Mark
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201, USA
| | - Moshe Meister
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201, USA
| | - Benjamin Opara
- Division of Urology, Department of Surgery, University of Maryland Medical Center, Midtown Campus, Baltimore, MD, USA
| | - Robert Chow
- Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201, USA
| |
Collapse
|
23
|
Jonuzi A, Popovic N, Zvizdic Z, Milišic E, Karavdic K, Paddy D. Female Epispadias Presenting as Urinary Incontinence. APSP J Case Rep 2017; 8:10. [PMID: 28401037 PMCID: PMC5371683 DOI: 10.21699/ajcr.v8i2.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 02/24/2017] [Indexed: 11/25/2022] Open
Abstract
Isolated female epispadias without bladder exstrophy is a rare congenital anomaly affecting 1 in 484,000 females. The presenting features of female epispadias are urinary incontinence and abnormal anatomical features. A 6-year-old girl presented with primary urinary incontinence who on physical examination had a bifid clitoris and labia minora. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux and a funnel shaped proximal urethra. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck, labia minora and clitoris was performed.
Collapse
Affiliation(s)
- Asmir Jonuzi
- Clinic of Pediatric Surgery, Clinical Center University in Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina
| | - Nusret Popovic
- Clinic of Pediatric Surgery, Clinical Center University in Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina
| | - Zlatan Zvizdic
- Clinic of Pediatric Surgery, Clinical Center University in Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina
| | - Emir Milišic
- Clinic of Pediatric Surgery, Clinical Center University in Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina
| | - Kenan Karavdic
- Clinic of Pediatric Surgery, Clinical Center University in Sarajevo, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina
| | | |
Collapse
|
24
|
Incomplete Urethral Duplication Associated with a Dermoid Cyst in a Dog with Urinary Obstruction. J Comp Pathol 2016; 156:29-32. [PMID: 27890404 DOI: 10.1016/j.jcpa.2016.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/28/2016] [Accepted: 10/17/2016] [Indexed: 11/20/2022]
Abstract
A 20-month-old male miniature dachshund was evaluated for a 10-week history of intermittent stranguria, pollakiuria, haematuria and obstructive urolithiasis. Retrograde urethrocystography revealed a subcutaneous saccular structure in the perineal area connected to the intrapelvic urethra associated with urolithiasis. After excision of the perineal saccular structure, microscopical examination confirmed the presence of transitional epithelium lining the diverticulum, with isolated submucosal smooth muscle bundles. This structure was attached to another saccular structure lined by stratified squamous keratinizing epithelium with hair follicles, sebaceous glands and apocrine glands. An incomplete urethral duplication with dermoid cyst was diagnosed. The dog recovered uneventfully from surgery and was still urinary continent and free from clinical signs 5 months after surgery. To the authors' knowledge this is the first report of an incomplete urethral duplication with a dermoid cyst and concurrent obstructive urolithiasis in a dog.
Collapse
|
25
|
Nork JJ, Yap MK, Kaplan GW. Verumontanum Cyst Associated With Lower Urinary Tract Symptoms in an Adolescent. Urology 2015; 88:192-4. [PMID: 26498735 DOI: 10.1016/j.urology.2015.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/06/2015] [Accepted: 10/13/2015] [Indexed: 11/18/2022]
Abstract
Urinary tract polyps occur anywhere from the renal pelvis to the anterior urethra. Lower tract polyps occur less frequently than upper tract polyps and are a rare finding in children. Symptoms include obstruction, dysfunctional voiding, or hematuria. We report the case of a 17-year-old male who presented with persistent leakage of urine following voiding. Ultrasound demonstrated a small cystic lesion in the posterior aspect of the prostate and a voiding cystourethrogram was suggestive of a utricular cyst or polyp. He underwent a cystoscopy that demonstrated a large cystic structure originating from the verumontanum, nearly obstructing the prostatic urethra.
Collapse
Affiliation(s)
- Justin J Nork
- Department of Urology, Naval Medical Center San Diego, San Diego, CA.
| | - Mike K Yap
- Rady Children's Hospital San Diego, San Diego, CA
| | | |
Collapse
|
26
|
Georgas KM, Armstrong J, Keast JR, Larkins CE, McHugh KM, Southard-Smith EM, Cohn MJ, Batourina E, Dan H, Schneider K, Buehler DP, Wiese CB, Brennan J, Davies JA, Harding SD, Baldock RA, Little MH, Vezina CM, Mendelsohn C. An illustrated anatomical ontology of the developing mouse lower urogenital tract. Development 2015; 142:1893-908. [PMID: 25968320 DOI: 10.1242/dev.117903] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 04/01/2015] [Indexed: 01/10/2023]
Abstract
Malformation of the urogenital tract represents a considerable paediatric burden, with many defects affecting the lower urinary tract (LUT), genital tubercle and associated structures. Understanding the molecular basis of such defects frequently draws on murine models. However, human anatomical terms do not always superimpose on the mouse, and the lack of accurate and standardised nomenclature is hampering the utility of such animal models. We previously developed an anatomical ontology for the murine urogenital system. Here, we present a comprehensive update of this ontology pertaining to mouse LUT, genital tubercle and associated reproductive structures (E10.5 to adult). Ontology changes were based on recently published insights into the cellular and gross anatomy of these structures, and on new analyses of epithelial cell types present in the pelvic urethra and regions of the bladder. Ontology changes include new structures, tissue layers and cell types within the LUT, external genitalia and lower reproductive structures. Representative illustrations, detailed text descriptions and molecular markers that selectively label muscle, nerves/ganglia and epithelia of the lower urogenital system are also presented. The revised ontology will be an important tool for researchers studying urogenital development/malformation in mouse models and will improve our capacity to appropriately interpret these with respect to the human situation.
Collapse
Affiliation(s)
- Kylie M Georgas
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Jane Armstrong
- Center for Integrative Physiology, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Janet R Keast
- Department of Anatomy and Neuroscience, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Christine E Larkins
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610, USA
| | - Kirk M McHugh
- Centre for Molecular and Human Genetics, The Research Institute at Nationwide Children's Hospital and Division of Anatomy, The Ohio State University, Columbus, OH 43205/10, USA
| | - E Michelle Southard-Smith
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Martin J Cohn
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610, USA Department of Biology, Genetics Institute, University of Florida, Gainesville, FL 32610, USA Howard Hughes Medical Institute, University of Florida, Gainesville, FL 32610, USA
| | | | - Hanbin Dan
- Columbia University, Department of Urology, New York, NY 10032, USA
| | - Kerry Schneider
- Columbia University, Department of Urology, New York, NY 10032, USA
| | - Dennis P Buehler
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Carrie B Wiese
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Jane Brennan
- Center for Integrative Physiology, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Jamie A Davies
- Center for Integrative Physiology, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Simon D Harding
- MRC Human Genetics Unit, MRC IGMM, Western General Hospital, Edinburgh EH4 2XU, UK
| | - Richard A Baldock
- MRC Human Genetics Unit, MRC IGMM, Western General Hospital, Edinburgh EH4 2XU, UK
| | - Melissa H Little
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Chad M Vezina
- University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI 53706, USA
| | - Cathy Mendelsohn
- Columbia University, Department of Urology, New York, NY 10032, USA
| |
Collapse
|
27
|
Atobatele MO, Oyinloye OI, Nasir AA, Bamidele JO. Posterior urethral valve with unilateral vesicoureteral reflux and patent urachus: A rare combination of urinary tract anomaliess. Urol Ann 2015; 7:240-3. [PMID: 25836363 PMCID: PMC4374267 DOI: 10.4103/0974-7796.150496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 05/29/2013] [Indexed: 11/18/2022] Open
Abstract
Posterior urethral valve (PUV) is a common cause of lower urinary tract obstruction in male infants with an incidence of 1:5000-8000. PUV continues to be a significant cause of morbidity and ongoing renal damage in infants and children. It can coexist with vesicoureteral reflux (VUR) in about 50% of cases and also with patent urachus in about one-third of cases. It is a case of a 22-day-old full-term male child who presented with poor urinary stream and progressive abdominal distension of 5-day duration as well as leakage of clear fluid from umbilicus of 1-day duration. Abdominopelvic ultrasonography showed bilateral hydronephrosis. Micturating cystourethrogram also showed features of bladder outlet obstruction and PUV. In addition, a grade V left VUR and a fistulous tract between the dome of the urinary bladder and the umbilicus, which was consistent with a patent urachus was demonstrated. In conclusion, this case demonstrates a rare combination of congenital urinary tract anomalies involving PUV, left VUR and patent urachus.
Collapse
Affiliation(s)
- Mutiu O Atobatele
- Department of Radiology, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Olalekan I Oyinloye
- Department of Radiology, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Abdulrasheed A Nasir
- Department of Surgery, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - John O Bamidele
- Department of Radiology, Paediatric Surgical Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| |
Collapse
|
28
|
Palm CA, Glaiberman CB, Culp WTN. Treatment of a urethral duplication in a dog using cyanoacrylate and coil embolization. J Vet Intern Med 2015; 29:727-31. [PMID: 25776807 PMCID: PMC4895500 DOI: 10.1111/jvim.12571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/06/2015] [Accepted: 02/04/2015] [Indexed: 02/05/2023] Open
Affiliation(s)
- C A Palm
- School of Veterinary Medicine, University of California-Davis, Davis, CA
| | | | | |
Collapse
|
29
|
A case of urethral duplication arising from the posterior urethra to the scrotum with urinary stone in a 6-year-old male. Case Rep Pediatr 2014; 2014:290623. [PMID: 25525546 PMCID: PMC4261629 DOI: 10.1155/2014/290623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/06/2014] [Indexed: 11/17/2022] Open
Abstract
Urethral duplication is a rare congenital anomaly. We report a 6-year-old male with type IIA2 (Y-type) using Effmann's classification. The accessory urethra, in which a urinary stone existed, arose from the posterior urethra to the scrotum. Because of recurrent urinary tract infection and urinary discharge from the accessory urethra, surgical removal of the accessory urethra through a scrotal incision was performed. At 7-month postoperative follow-up the patient was completely free from urinary incontinence and urinary tract infection.
Collapse
|
30
|
Di Meglio L, Mazzarelli LL, Boscaino A, Cancemi D, Morelli F, Lonardo MC, Lonardo V, Friso P, Spampanato C, Urciuoli M, Ventruto M, Ventruto V. Congenital megaurethra in a fetus with Meckel syndrome and in a fetus with female pseudoermanphroditism. The first report of these occurrences. J Prenat Med 2014; 8:42-46. [PMID: 26266000 PMCID: PMC4510562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE the purpose of this paper is to report the first case of megaurethra in a fetus with Meckel syndrome and in a fetus with femal pseudoermaphroditism. RESULTS the former case refers to a fetus of 13 weeks gestation with the three following prominent anomalies, observed by transonic scan and confirmed by autopsy: congenital megaurethra, anal atresia, single umbelical artery. The latter case refers to a fetus of 18 weeks gestation. Autopsy confirmed penile malformation and revealed ovaries in the abdomen. The karyotype was 46,XX with normal molecular karytype. The megaurethra was discovered by sonography at 18 weeks gestation. Autopsy confirmed penile malformation and revealed ovaries in the abdomen. The karyotype was 46,XX with normal molecular karyotype (Array-CGH, 1 Mb of resolution). METHODS transonic scan, autopsy, karyotype, array-CGH. CONCLUSIONS the first prenatal cases of two genetic syndromes with megaurethra have been reported, concening respectively a fetus with Meckel syndrome and a fetus with femal pseudoermaphroditism. The latter was confirmed by both autopsy and the normal female 46,XX karyotype.
Collapse
Affiliation(s)
| | | | | | - Dino Cancemi
- ”Cancemi” Research and Genetic Diagnosis, Naples, Italy
| | - Franco Morelli
- Institute of Genetics and Biophysics Buzzati-Traverso, CNR Naples, Italy
| | | | | | | | | | | | | | - Valerio Ventruto
- Institute of Genetics and Biophysics Buzzati-Traverso, CNR Naples, Italy
| |
Collapse
|
31
|
Bos EME, Kuijper CF, Chrzan RJ, Dik P, Klijn AJ, de Jong TPVM. Epispadias in boys with an intact prepuce. J Pediatr Urol 2014; 10:67-73. [PMID: 23863474 DOI: 10.1016/j.jpurol.2013.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 06/10/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To present an overview of the clinical presentation and pathological anatomy, and the results of surgical correction of 7 cases of epispadias with intact prepuce; a rare condition that has only occasionally been reported in literature. PATIENTS AND METHODS A retrospective search was performed in the surgical and diagnoses database between 1991 and 2011. Seven cases of epispadias with intact prepuce were identified. Five presented as a webbed and buried penis, 1 as phimosis and 1 with suspicion for congenital anomaly of the genitalia. RESULTS In 3 of 7 cases, epispadias was suspected or diagnosed at first presentation and could be surgically corrected in the first intervention. In the other 4 cases, epispadias was discovered during surgery, requiring an additional intervention to perform epispadias repair in 3 cases. One boy was diagnosed with glandular, 3 with coronal, 1 with shaft and 2 with penopubic epispadias. Epispadias repair was successful with regard to cosmesis and erectile function. Five patients developed normal continence after surgery, 1 after intensive urotherapy. An under average penile length was the main reported problem during follow-up. CONCLUSION In the diagnostic process for a concealed penis, the possibility of epispadias should be considered. If epispadias is suspected or confirmed, epispadias repair can occur in the first intervention, reducing the number of additional interventions. Epispadias with intact prepuce appears to have a better prognosis concerning urinary continence compared to classical epispadias.
Collapse
Affiliation(s)
- E M E Bos
- Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands.
| | - C F Kuijper
- Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands.
| | - R J Chrzan
- Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands.
| | - P Dik
- Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands.
| | - A J Klijn
- Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands.
| | - T P V M de Jong
- Department of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands.
| |
Collapse
|
32
|
Prostatic stromal neoplasms: differential diagnosis of cystic and solid prostatic and periprostatic masses. AJR Am J Roentgenol 2013; 200:W571-80. [PMID: 23701087 DOI: 10.2214/ajr.12.9741] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objectives of this article are to illustrate the radiologic-pathologic correlation of prostate stromal neoplasms and to review the imaging appearances of cystic and solid prostatic and periprostatic masses that may mimic prostatic stromal neoplasms. CONCLUSION The differential diagnosis for cystic and solid masses in the prostate is broad, and masses arising from periprostatic structures may mimic the appearance of primary prostatic diseases. Attention to clinical and imaging features is helpful in narrowing the differential diagnosis.
Collapse
|
33
|
Abstract
OBJECTIVE The published surgical literatures have referred only to females as having cloacal defects and the incidence in males is not well established. As during embryogenesis, both sexes have to pass through the stage of a cloaca, there is every chance of development of cloacal anomalies in males also. Here, we are presenting our experience of male cloacal malformations. METHODS We identified four cases of male cloaca by reviewing medical records of all anorectal malformation (ARM) patients treated at our institution in the past 19 years. Time of presentation, clinical, radiological, cystoscopic and operative findings, and outcomes were analysed. RESULTS Out of 1,837 patients, we identified four cases (0.2 %) of male cloacal variants. All presented after 45 days (range 46 days to 28 years). Three of them had proximal hypospadias, two had a vaginal remnant and cystoscopic evaluation showed the length of the common channel ranged from 0.5 to 8 cm. One patient died of multiple anomalies and the other patients are doing well following reconstruction. CONCLUSION None of the male cloacal patients presented in the neonatal period, proximal hypospadias was the common external genital abnormality and half of them had a vagina. Surgical outcome was satisfactory. The scarcity of reported cases of this group is a subject of further research.
Collapse
|
34
|
Urethral diverticulum calculi in a male: a case report. Case Rep Urol 2013; 2013:437106. [PMID: 23401841 PMCID: PMC3562601 DOI: 10.1155/2013/437106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 12/31/2012] [Indexed: 11/17/2022] Open
Abstract
A 42-year-old male presented to the urology department, complaining of frequency and dysuria. A large number of calculi were revealed on IVU and USS. On endoscopic investigation, there were 3 stones (1.5 × 1 cm) found in the bladder and 5 more (1.5 × 0.8 cm) in the diverticulum of the posterior urethra. All of the stones were successfully broken down via a transurethral approach. This paper contains a detailed description of the case.
Collapse
|
35
|
Servaes S, Epelman M. The Current State of Imaging Pediatric Genitourinary Anomalies and Abnormalities. Curr Probl Diagn Radiol 2013; 42:1-12. [DOI: 10.1067/j.cpradiol.2012.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
36
|
Genitourinary imaging: part 1, congenital urinary anomalies and their management. AJR Am J Roentgenol 2012; 199:W545-53. [PMID: 23096198 DOI: 10.2214/ajr.11.8197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Congenital urinary anomalies may be symptomatic or encountered during imaging for other clinical indications. The array of abnormalities is related to the embryologic stage at the time of the developmental insult, and these abnormalities result in a spectrum of conditions ranging from insignificant to incompatible with life. CONCLUSION Understanding the implications of common congenital urinary anomalies is the key to detecting associated anomalies, initiating therapy, and avoiding both complications and unnecessary intervention.
Collapse
|
37
|
Ramareddy RS, Alladi A, Siddappa OS. Urethral duplication: Experience of four cases. J Indian Assoc Pediatr Surg 2012; 17:111-5. [PMID: 22869976 PMCID: PMC3409898 DOI: 10.4103/0971-9261.98127] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Our experience of 4 cases of urethral duplication is reported here. MATERIALS AND METHODS A retrospective chart review. RESULTS The age at presentation varied from newborn to 10 years. The clinical presentation ranged from prepubic sinus to diphallus urethra. There were 2 each incomplete duplication with only external openings (Type IA) and complete duplication of Effmann Type IIA2. All underwent complete excision of accessory urethra and corrections of associated anomalies. CONCLUSIONS Urethral duplications have a varied presentation. At follow up, all are asymptomatic with good cosmetic result.
Collapse
Affiliation(s)
- Raghu S Ramareddy
- Department of Pediatric Surgery, Vanivilas Hospital, Bangalore Medical College and Research Institute, Bangalore, India
| | | | | |
Collapse
|
38
|
Syringocoele of the bulbourethral duct with additional lower genito-urinary anomalies. Pediatr Radiol 2011; 41:1201-4. [PMID: 21607602 DOI: 10.1007/s00247-011-2060-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 08/24/2010] [Accepted: 12/08/2010] [Indexed: 10/18/2022]
Abstract
The ultrasonographic (US) appearance of a syringocoele of the bulbourethral (Cowper) duct, with correlative urethrocystoscopic images, is demonstrated. An infant boy, 5 weeks of age, who presented with E. coli infection of the urinary tract also had bilateral hydroureteronephrosis, small bilateral simple ureterocoeles, and posterior urethral valve leaflets.
Collapse
|
39
|
Comeglio P, Chavalmane AK, Fibbi B, Filippi S, Marchetta M, Marini M, Morelli A, Penna G, Vignozzi L, Vannelli GB, Adorini L, Maggi M. Human prostatic urethra expresses vitamin D receptor and responds to vitamin D receptor ligation. J Endocrinol Invest 2010; 33:730-8. [PMID: 20386089 DOI: 10.1007/bf03346679] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Chronic inflammation is now considered a determinant of benign prostatic hyperplasia (BPH), promoting, together with the hormonal milieu, prostate overgrowth and lower urinary tract symptoms (LUTS). Prostatic urethra actively participates in determining progression of LUTS associated with BPH. AIM To investigate the expression of the vitamin D receptor (VDR) and the ability of the VDR agonist elocalcitol to reduce inflammatory responses in human prostatic urethra (hPU) cells. MATERIALS AND METHODS Human prostatic urethra, prostate and bladder neck were obtained from patients affected by BPH. Immunohistochemical studies for VDR expression were performed in tissue samples, from which primary cell cultures were also derived. In hPU cells, proliferation and chemiotaxis were studied, along with Rho kinase (ROCK) activity (MYPT-1 phosphorylation) by western blot. Quantitative RT-PCR was performed for VDR, cyclooxygenase (COX-2), and interleukin (IL)-8 expression. RESULTS Urethra displays higher VDR expression compared to prostate and bladder neck tissues. The VDR agonist elocalcitol partially reverts COX-2 and IL-8 mRNA upregulation induced by a pro-inflammatory cytokine mixture (IL-17, interferon-γ, tumor necrosis factor-α) and inhibits cell migration in urethral cells. Elocalcitol prevents activation of ROCK, as previously demonstrated in bladder and prostate cell cultures. CONCLUSIONS Our results suggest that prostatic urethra is, within the lower urinary tract, a novel target for VDR agonists, as shown by the capacity of elocalcitol to inhibit ROCK activity and to limit inflammatory responses in human primary urethra cells.
Collapse
Affiliation(s)
- P Comeglio
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, V.le Pieraccini 6, 50139 Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Atilgan D, Uluocak N, Erdemir F, Parlaktas BS. Female epispadias: a case report and review of the literature. Kaohsiung J Med Sci 2010; 25:613-6. [PMID: 19858041 DOI: 10.1016/s1607-551x(09)70565-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Isolated female epispadias without exstrophy is an extremely rare syndrome. The symptoms of female epispadias are primary urinary incontinence and abnormal anatomical features. A 12-year-old girl presented with primary urinary incontinence. On physical examination, bifid clitoris and labia minora were seen. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux. With the diagnosis of isolated female epispadias, one-stage reconstruction of the urethra, bladder neck and labia minora and clitoris was performed.
Collapse
Affiliation(s)
- Dogan Atilgan
- Department of Urology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey.
| | | | | | | |
Collapse
|