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Management of complex and redo cases of pelvic fracture urethral injuries

Asian Journal of Urology 2018年第2期5卷 107-117页

作者： Sanjay BKulkarni Sandesh Surana Devang JDesai hazem orabi Subramanian Iyer Jyotsna Kulkarni Ajit Dumawat Pankaj M.Joshi Department of Reconstructive Urology Kulkarni Reconstructive Urology CentrePuneIndia

Objectives:Pelvic fracture urethral injuries(PFUI)result from traumatic disruption of the urethra.A significant proportion of cases are complex rendering their management *** described management strategies for eight different complex PFUI ***:Our centre is a tertiary referral centre for complex PFUI *** maintain a prospective database(1995e2016),which we retrospectively *** patients with PFUI managed at our institute were ***:Over two decades 1062 cases of PFUI were managed at our institute(521 primary and 541 redo cases).Most redo cases were referred to us from other *** cases had up to five prior attempts at *** managed complex cases,which included bulbar ischemia,young boys and girls with PFUI,PFUI with double block,concomitant PFUI and iatrogenic anterior urethral *** ischemia merits substitution urethroplasty,most commonly,using pedicled preputial *** in young girls is usually associated with urethrovaginal *** boys with PFUI commonly have a long gap necessitating trans-abdominal *** success rate with individualised management is 85.60%in primary cases,79.13%in redo cases and 82.40%in cases of bulbar ***:The definition of complex PFUI is ever *** best chance of success is at the first *** urethroplasty for PFUI should be performed in experienced hands at high volume centres.

关键词： Urethral reconstruction Pelvic fracture urethral distraction defects Pelvic fracture urethral injuries Bulbar necrosis Long gap Bladder neck injury Rectourethral fistula

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Tunica albuginea allograft： a new model of LaPeyronie＇s disease with penile curvature and subtunical ossification

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Asian Journal of Andrology 2014年第4期16卷 592-596页

作者： Ludovic Ferretti Thomas M Fandel Xuefeng Qiu Haiyang Zhang hazem orabi Alex K Wu Lia Banie Guifang Wang Guiting Lin Ching-Shwun Lin Tom FLue Department of Urology University of Bordeaux Bordeaux France Department of Urology Knuppe Molecular Urology Laboratory University of California San Francisco San Francisco California USA Hospital d'lnstruction des Armees Robert Picque Villenave D'Ornon France 4Department of Urology Assiut University Assiut Egypt. Department of Urology Assiut University Assiut Egypt.

The pathophysiology of LaPeyronie＇s disease （PD） is considered to be multifactorial, involving genetic predisposition, trauma, inflammation and altered wound healing. However, these factors have not yet been validated using animal models. In this study, we have presented a new model obtained by tunica albuginea allograft. A total of 40, 16-week-old male rats were used. Of these, 8 rats served as controls and underwent a 10 × 2-mm-wide tunical excisionwith subsequent autografting, whereas the remaining 32 underwent the same excision with grafting of the defect with another rat＇s tunica. Morphological and functional testing was performed at 1, 3, 7 and 12 weeks after grafting. Intracavernous pressure, the degree of penile curvature and elastic fiber length were evaluated for comparison between the allograft and control groups. The tissues were obtained for histological examination. The penile curvature was significantly greater in the allografted rats as compared with the control rats. The erectile function was maintained in all rats, except in those assessed at 12 weeks. The elastin fiber length was decreased in the allografted tunica as compared to control. SMAD2 expression was detected in the inner part of the allograff, and both collagen-Ⅱ- and osteocalcin-positive cells were also noted. Tunica albuginea （TA） allograft in rats is an excellent model of PD. The persistence of curvature beyond 12 weeks and the presence of ossification in the inner layer of the TA were similar to those observed in men with PD. Validation studies using this animal model would aid understanding of the PD pathophysiology for effective therapeutic interventions.

关键词： allograft animal model osteogenesis penile curvature penile surgery peyronie's disease

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Stem cell applications for pathologies of the urinary bladder

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World Journal of Stem Cells 2015年第5期7卷 815-822页

作者： Noha A Mousa Hisham A Abou-Taleb hazem orabi Zewail University of Science and Technology 1 Center Of Excellence for Stem Cells and Regenerative Medicine (CESC) Department of Gynecology and Obstetrics Assiut University Department of Urology Assiut University Department of Surgery Laval University Centre de recherche en organogénèse expérimentale de l’Université Laval/LOEX Division of Regenerative Medicine CHU de Québec Research Centre

New stem cell based therapies are undergoing intense research and are widely investigated in clinical fields including the urinary system. The urinary bladder performs critical complex functions that rely on its highly coordinated anatomical composition and multiplex of regulatory mechanisms. Bladder pathologies resulting in severe dysfunction are common clinical encounter and often cause significant impairment of patient's quality of life. Current surgical and medical interventions to correct urinary dysfunction or to replace an absent or defective bladder are sub-optimal and are associated with notable complications. As a result, stem cell based therapies for the urinary bladder are hoped to offer new venues that could make up for limitations of existing therapies. In this article, we review research efforts that describe the use of different types of stem cells in bladder reconstruction, urinary incontinence and retention disorders. In particular, stress urinary incontinence has been a popular target for stem cell based therapies in reported clinical trials. Furthermore, we discuss the relevance of the cancer stem cell hypothesis to the development of bladder cancer. A key subject that should not be overlooked is the safety and quality of stem cell based therapies introduced to human subjects either in a research or a clinical context.

关键词： Stem cells Urinary bladder Urethra Bladderreconstruction Incontinence Cancer stem cells Safety

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