2016
TRAUMA, AND GENITAL AND URETHRAL RECONSTRUCTION
urethras likely have some degree of tissue compromise and, in general, constitute a higher risk population. I look forward to seeing more data from this group going forward to help clarify this issue and answer other important clinical questions. Allen F. Morey, MD 1. Simhan J, Morey AF, Singla N et al: 3.5 cm Artificial urinary sphincter cuff erosion occurs predominantly in irradiated patients. J Urol 2015; 193: 593.
Re: The Fate of Transitional Urology Patients Referred to a Tertiary Transitional Care Center R. Chan, J. Scovell, Z. Jeng, S. Rajanahally, T. Boone and R. Khavari Department of Urology, Houston Methodist Hospital and Scott Department of Urology, Baylor College of Medicine, Houston, Texas Urology 2014; 84: 1544e1548.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.03.039 available at http://jurology.com/ Editorial Comment: What happens to adolescents and young adults suffering from congenital urogenital abnormalities after they have outgrown the pediatric hospital? Specialists such as the authors of this article make a strong case for a refined approach to the transition from pediatric to adult urological care in patients with neurogenic lower urinary tract dysfunction. In this series of 24 transitional patients more than 70% had a change in bladder management after careful urodynamic reevaluation, and 38% required bladder augmentation or cystectomy due to dangerously poor bladder compliance. Allen F. Morey, MD
Re: Buccal Mucosal Graft in Reconstructive Urology: Uses beyond Urethral Stricture A. Pandey, R. Dican, J. Beier and H. Keller Department of Urology, Pediatric Urology and Urological Oncology, Sana Hospital Hof, Hof, Germany Int J Urol 2014; 21: 732e734.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.055 available at http://jurology.com/ Editorial Comment: Buccal mucosa has been used worldwide for urethral reconstruction for the last 2 decades. This article examines a small series of patients who received buccal grafts for nonurethral reconstructions, including glans, ureter and stomal stenosis. The 3 ureteral reconstruction cases reported are of significance because they add to an emerging body of evidence supporting this strategy. The authors describe an onlay technique done through a flank approach after a stent had been placed for 4 weeks to maintain patency. The defect (4 to 7 cm) was opened and grafted, then wrapped with an omental flap. Followup after several years was apparently unremarkable. Stay tuned for more reports on ureteral buccal graft reconstructions, especially robotic applications. Ileal ureter remains an effective gold standard salvage procedure for long segment upper ureteral strictures but a robotic buccal graft technique would obviously be preferred if this strategy pans out. Allen F. Morey, MD
TRAUMA, AND GENITAL AND URETHRAL RECONSTRUCTION
urethras likely have some degree of tissue compromise and, in general, constitute a higher risk population. I look forward to seeing more data from this group going forward to help clarify this issue and answer other important clinical questions. Allen F. Morey, MD 1. Simhan J, Morey AF, Singla N et al: 3.5 cm Artificial urinary sphincter cuff erosion occurs predominantly in irradiated patients. J Urol 2015; 193: 593.
Re: The Fate of Transitional Urology Patients Referred to a Tertiary Transitional Care Center R. Chan, J. Scovell, Z. Jeng, S. Rajanahally, T. Boone and R. Khavari Department of Urology, Houston Methodist Hospital and Scott Department of Urology, Baylor College of Medicine, Houston, Texas Urology 2014; 84: 1544e1548.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.03.039 available at http://jurology.com/ Editorial Comment: What happens to adolescents and young adults suffering from congenital urogenital abnormalities after they have outgrown the pediatric hospital? Specialists such as the authors of this article make a strong case for a refined approach to the transition from pediatric to adult urological care in patients with neurogenic lower urinary tract dysfunction. In this series of 24 transitional patients more than 70% had a change in bladder management after careful urodynamic reevaluation, and 38% required bladder augmentation or cystectomy due to dangerously poor bladder compliance. Allen F. Morey, MD
Re: Buccal Mucosal Graft in Reconstructive Urology: Uses beyond Urethral Stricture A. Pandey, R. Dican, J. Beier and H. Keller Department of Urology, Pediatric Urology and Urological Oncology, Sana Hospital Hof, Hof, Germany Int J Urol 2014; 21: 732e734.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.02.055 available at http://jurology.com/ Editorial Comment: Buccal mucosa has been used worldwide for urethral reconstruction for the last 2 decades. This article examines a small series of patients who received buccal grafts for nonurethral reconstructions, including glans, ureter and stomal stenosis. The 3 ureteral reconstruction cases reported are of significance because they add to an emerging body of evidence supporting this strategy. The authors describe an onlay technique done through a flank approach after a stent had been placed for 4 weeks to maintain patency. The defect (4 to 7 cm) was opened and grafted, then wrapped with an omental flap. Followup after several years was apparently unremarkable. Stay tuned for more reports on ureteral buccal graft reconstructions, especially robotic applications. Ileal ureter remains an effective gold standard salvage procedure for long segment upper ureteral strictures but a robotic buccal graft technique would obviously be preferred if this strategy pans out. Allen F. Morey, MD
