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Abdelwahab K, Eliwa AM, Seleem MM, El Galaly H, Ragab A, Desoky EA, Naguib M, Ali MM, Saber S, Kamel H. Role of Preoperative Testicular Shear Wave Elastography in Predicting Improvement of Semen Parameters After Varicocelectomy for Male Patients With Primary Infertility. Urology 2017; 107:103-106. [DOI: 10.1016/j.urology.2017.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/09/2017] [Accepted: 04/17/2017] [Indexed: 12/21/2022]
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Abd Elwahab KM, Eliwa AM, Seleem MM, Ali MM, El-Babouly IM, Ragab A, Naguib M, Desouky HM, Desoky EAE, Omran M, Kamel HM. W-pouch With Modified Non-isolated Extra Limb for Continence in Cutaneous Diversion After Radical Cystectomy. Urology 2017; 105:202-207. [PMID: 28411100 DOI: 10.1016/j.urology.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/11/2017] [Accepted: 04/03/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To report the functional results of continent cutaneous ileal urinary diversion using modified W-pouch with non-isolated extra limb for continence. PATIENTS AND METHODS From January 2013 to January 2016, 21 patients with muscle-invasive bladder cancer with median (interquartile range) of 59 (56.5-62.5) years old underwent radical cystectomy with pelvic lymphadenectomy; they then had an ileal continent cutaneous pouch constructed from W-pouch with non-isolated extra limb for continence. The technique entails the creation of a detubularized ileal W-pouch with extra limb fashioned from 59 cm of the terminal ileum. This extra limb is not isolated from the pouch. The proximal part of this limb is tailored and fixed in a subserous extramural tunnel for continence, whereas the distal part is left continuous with the pouch. The median (interquartile range) of follow up was 12 (8-17) months. Evaluation of the technique included operative time, continence efficiency, overall complications, and quality of life questionnaire for the patients. RESULTS The median (interquartile range) of operative time of the operation was 4.7 (3.9-5.4) hours. The median (interquartile range) of operative time of the cutaneous pouch creation was 39 (33-43) minutes. No perioperative mortality had occurred. The incidence of continence was 95.2%. The overall complications were 42.8%, and most of them were grade 1 or 2 on Clavien-Dindo classification system. CONCLUSION Modification of W-pouch with non-isolated extra limb as continent cutaneous pouch can simplify the technique and shorten the operative time with efficient continence, less side effects, and good quality of life.
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Affiliation(s)
| | - Ahmed M Eliwa
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohammed M Seleem
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Maged M Ali
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Islam M El-Babouly
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Ragab
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohammed Naguib
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hamdy M Desouky
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Esam A E Desoky
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohammed Omran
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hussein M Kamel
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Seleem MM, Eliwa AM, Elsayed ER, Desouky H, El Galaly H, Abdelwahab K, Khalil S, El Adl M. Single versus multiple instillation of povidone iodine and urographin in the treatment of chyluria: A prospective randomised study. Arab J Urol 2016; 14:131-5. [PMID: 27489740 PMCID: PMC4963147 DOI: 10.1016/j.aju.2016.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 12/29/2015] [Accepted: 01/12/2016] [Indexed: 11/26/2022] Open
Abstract
Objective To compare the safety, efficacy and complications of single vs multiple instillations of povidone iodine (PI) and urographin as a sclerosing agent in the treatment of chyluria. Patients and methods The study included 58 patients diagnosed with chyluria between March 2006 and January 2013. The inclusion criteria were either severe attacks of chyluria or patients with mild-to-moderate chyluria who had failed conservative treatment. The patients were randomly allocated to one of two groups: those in Group A had a single instillation of a combination of PI 0.2% plus the contrast-agent urographin 76%, while those in Group B had multiple instillations of the same combination twice daily for 3 successive days. Results The mean (SD) age of the patients in Groups A and B was 38.22 (10.67) and 37.9 (10.86) years, respectively. Chyluria was severe in eight patients (14.8%), moderate in 25 (46.3%) and mild in 21 (38.9%). The success rate in Group A (single instillation) was 85.2% and in Group B (multiple instillation) was 88.9%. The recurrence rate in Group A was 14.8% with a disease-free duration (DFD) of 4–15 weeks, while in group B it was 11.1% with a DFD of 6–18 weeks. Conclusion There was no significant difference between a single instillation of a combination of PI 0.2% and urographin 76% as a sclerosing agent in the treatment of chyluria and multiple instillations. However, the single instillation protocol is more cost effective with a shorter hospital stay.
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Affiliation(s)
- Mohammed M Seleem
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Ahmed M Eliwa
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Ehab R Elsayed
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Hamdy Desouky
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Hazem El Galaly
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Khalid Abdelwahab
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Salem Khalil
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
| | - Mahmoud El Adl
- Department of Urology, Faculty of Medicine, Zagazig University, Egypt
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Ahmed H, Youssef MK, Salem EA, Fawzi AM, Desoky EAE, Eliwa AM, Sakr AMN, Shahin AMS. Efficacy of laparoscopically assisted high ligation of patent processus vaginalis in children. J Pediatr Urol 2016; 12:50.e1-5. [PMID: 26421498 DOI: 10.1016/j.jpurol.2015.05.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 05/06/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Laparoscopic hernia repairs have been proven to be efficient and safe for children, despite the slightly higher recurrence rate compared with the classic surgical repair. They have the advantage of easy and precise identification of the type of defect and its correction, both in ipsilateral and contralateral sides. OBJECTIVES The objectives of this study were to evaluate the efficacy, safety and outcome of the laparoscopically assisted piecemeal high ligation of a patent processus vaginalis (PPV) in children. METHODS A total of 40 children were enrolled into this prospective study; they were aged ≥ 6 months and had an inguinal hernia. The peritoneal cavity, including the contralateral side, was inspected for the possibility of bilateral hernias using a 3-mm 30° telescope. Another 3-mm port was introduced through the same infra-umbilical incision. The hernia was manually reduced or with the aid of a working infra-umbilical grasper. A prolene or vicryl 2/0 or 3/0 suture on a curved semicircle round-bodied taper-ended 25-30 mm needle was introduced through a very small inguinal skin-crease incision. It was passed through the abdominal wall layers to the peritoneum and was manipulated by the laparoscopic grasper to pick up the peritoneum in piecemeal all around the internal ring. The needle was then pushed to the outside near to the entrance site, thus forming a semicircle around the internal ring. The suture was then tied and the knot was subcutaneously buried. The primary outcome of the procedure was the incidence of intraoperative diagnosis and surgical repair of contralateral hernias in pre-operatively diagnosed unilateral cases. The secondary outcomes were defined as the incidence of complications and hernia recurrence. DISCUSSION The exploratory laparoscopy found contralateral patent processus vaginalis (CPPV) with a detection rate of 28.1%. Chan et al., Esposito et al., Toufique et al. and Niyogi et al. reported similar figures for laparoscopic contralateral hernia detection rates of 28%, 39%, 39.7% and 29.2%, respectively. The limitations of this study were the small sample size, plus the risk factors and clinical significance for CPPV. CONCLUSION Laparascopically assisted piecemeal closure of the internal inguinal ring in children is a safe and effective procedure. It helps in detecting a contralateral hernia without prolonging the operative time.
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Affiliation(s)
- H Ahmed
- Benha University, Faculty of Medicine, Dept. of General Surgery, Egypt.
| | - M K Youssef
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
| | - E A Salem
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
| | - A M Fawzi
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
| | - E A E Desoky
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
| | - A M Eliwa
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
| | - A M N Sakr
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
| | - A M S Shahin
- Zagazig University, Faculty of Medicine, Dept. of Urology, Zagazig, Egypt.
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Elsayed ER, Alam MN, Sarhan OM, Elsayed D, Eliwa AM, Khalil S. Closure of bladder exstrophy with a bilateral anterior pubic osteotomy: Revival of an old technique. Arab J Urol 2011; 9:203-6. [PMID: 26579298 PMCID: PMC4150575 DOI: 10.1016/j.aju.2011.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 08/18/2011] [Accepted: 08/25/2011] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate the results of simple closure using bilateral anterior pubic osteotomy to achieve a tension-free approximation of the pubis and abdominal wall in patients with bladder exstrophy. Patients and methods A prospective study carried out between 2006 and 2009 included 15 patients (13 boys and 2 girls; age range 3–47 months). Of these patients, three had recurrent exstrophy while 10 were operated primarily. An elective surgical technique was used for all patients, which included dissection of the exstrophic bladder from the abdominal wall, closure of the bladder and reconstruction of the urethra, then dissection of the rectus muscle and sheath lateral to the attachment of muscle to pubic bone, which makes osteotomy of the superior pubic ramus easy, thus facilitating closure. Results For closure of the bladder and anterior abdominal wall the results were excellent for all patients soon after surgery, but there was soft-tissue infection in two patients. Of all 15 patients, one had incomplete bladder dehiscence and another had a vesico-cutaneous fistula; both needed surgical intervention later. Conclusions Simple closure with anterior pubic osteotomy is a feasible and effective means to facilitate both bladder and abdominal closure for patients with bladder exstrophy. It is advantageous in being a rapid procedure, and can be completed by the paediatric urologist.
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Affiliation(s)
- Ehab R Elsayed
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed N Alam
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Osama M Sarhan
- Urology and Nephrology Centre, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Diab Elsayed
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed M Eliwa
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Salem Khalil
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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