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Search Results: 1 - 10 of 1703 matches for " Jalil Hosseini "
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A Comparative Study of Long-Term Results of Buccal Mucosal Graft and Penile Skin Flap Techniques in the Management of Diffuse Anterior Urethral Strictures: First Report in Iran
Jalil Hosseini,Kaveh Soltanzadeh
Urology Journal , 2004,
Abstract: Purpose: To compare Buccal Mucosa Graft with Penile Skin Flap techniques in the management of anterior urethral diffuse strictures longer than 3 cm. Materials and Methods: Thirty seven patients with a mean age of 28.5 (range 5 to 50) years had been treated by these two techniques using the ventral onlay patch from February 1997 to March 2002. Patients' follow-up included physical examination, history taking, retrograde urethrography, cystoscopy and uroflowmetry at the month six, at the end of the first and the second years, and then yearly if required. Results: These techniques were applied for anterior urethral strictures (bulbar and penile) longer than 3 cm. Buccal mucosal graft (BMG) was used in 18 patients and penile skin flap (PSF) in 19. Mean follow-up was 27.5 (range 6 to 50) months. Mean age was 30.8 ± 11.8 years for BMG group and 27.8 ± 15.6 years for PSF group. Urethral stricture etiology, surgery history, and previous endoscopic surgery history were similar in both groups. The stricture site in BMG group was penile in 2 patients (11.1%), bulbar in 8 patients (44.4%), and penobulbar in 8 patients (44.4%). In PSF group the stricture site was penile in 11 patients (57.9%), bulbar in 5 patients (26.3%) and penobulbar in 3 patients (15.8%). Success rate in 6-month follow-up was 93.9% for BUG group and 83% for PSF. By performing dilatation and internal rethrotomy for mild strictures, the success rate with mean follow-up of 27.5 months was 13.8% for BMG group and 78.9% for PSF. Only one patient from BMG developed temporary impotence for about 12 months. Conclusion: BMG and PSF are considered as simple and proper techniques with good long term outcomes in the management of diffuse anterior urethral strictures. These 2 techniques could be applied in patients with history of several surgeries. The results of BMG were better than PSF, still, this difference was not statistically significant.
Surgical Repair of Posterior Urethral Defects: Review of Literature and Presentation of Experiences
Jalil Hosseini,Kamyar Tavakkoli Tabassi
Urology Journal , 2008,
Abstract: Introduction: The main objective of the present review article was to study the different aspects of reconstructive surgery for posterior urethral defects by reviewing the published articles and presentation of our experiences in the reconstructive urology division at Shohada-e-Tajrish hospital. Materials and Methods: The Medline was searched with the keywords of posterior urethroplasty, end-to-end anastomosis, excisional urethroplasty, anastomotic urethroplasty, pelvic fracture, bulboprostatic anastomosis, and urethral repair. The search was limited to papers published from 1980 to September 2008. We selected the relevant published articles in this database and also presented our experience at our reconstructive urology division. Results: Of over 5000 search results, we selected 38 relevant articles with substantial contribution to the subject. Pelvic fracture due to accidents was the most common etiology of pelvic fracture urethral distraction defect that usually involved the membranous urethra. Surgical treatment of this disorder with perineal anastomotic urethroplasty was accompanied by a success rate of 82% to 95% in different studies. The most important complications of this surgery include urinary incontinence and impotence; however, the incidence of these complications has been reduced by using new surgical techniques. Conclusion: Complete preoperative assessment, the use of suitable reconstructive techniques, and in particular, the use of flexible cystoscopy can lead to acceptable outcomes of the surgical repair of pelvic fracture urethral distraction defects.
Delayed Retropubic Urethroplasty of Completely Transected Urethra Associated With Pelvic Fracture in Girls
Jalil Hosseini,,Kamyar Tavakkoli Tabassi,Abdollah Razi
Urology Journal , 2009,
Abstract: Introduction: The objective of the present study was to evaluate the results and the complications of delayed retropubic urethroplasty of completely transected urethra associated with pelvic fracture in girls. Materials and Methods: From 2002 to 2008, a total of 7 girls with complete urethral disruption after pelvic fracture were referred to our center and all of them underwent delayed retropubic urethroplasty with end-to-end anastomosis of the urethra. Results: Seven female patients with a median age of 6 years old underwent delayed end-to-end anastomosis. The median time to surgery was 6 months from the trauma. Voiding was normal after catheter removal in all of the patients. The median follow-up was 36 months. Three patients had mild stress urinary incontinence after catheter removal. Conclusion: There are some different strategies for management of complete urethral avulsion in females who have sustained pelvic fracture, including early realignment, bladder flaps, and end-to-end anastomosis. The strategy of delayed end-to-end anastomosis urethroplasty with retropubic approach is sound and produces acceptable results. The use of flexible cystoscope and omental flap is effective in achieving continence after urethroplasty in such cases.
A Huge Penile Mass Which Turned Out to Be an Epidermoid Inclusion Cyst
Ali Kaviani,Jalil Hosseini,Ali Reza Vazirnia
Urology Journal , 2009,
Clean Intermittent Catheterization With Triamcinolone Ointment Following Internal Urethrotomy
Jalil Hosseini,Ali Kaviani,Ali Reza Golshan
Urology Journal , 2008,
Abstract: Introduction: Our aim was to evaluate clean intermittent catheterization (CIC) results in combination with triamcinolone ointment for lubrication of the catheter after internal urethrotomy. Materials and Methods: Seventy patients who underwent internal urethrotomy were assigned into 2 groups and performed CIC with either triamcinolone 1% ointment or a water-based gel (control) for lubrication of the catheter. They continued CIC regimen up to 6 month and were followed up for 12 months. Retrograde urethrography and urethrocystoscopy were done 6 and 12 months postoperatively. In case of obstructive symptoms or any difficulty in passing the urethral catheter, internal urethrotomy would be performed, if needed, and the same follow-up protocol would be started again. The recurrence rates after the first and second urethrotomy attempts were compared between the two groups. Results: Thirty patients in the triamcinolone group and 34 in the control group completed the study. There were no significant differences in the baseline characteristics of the patients or the etiology of the stricture between the two groups. There was a 30.0% recurrence rate in the patients of the triamcinolone group versus 44.1% in those of the control group after the first internal urethrotomy (P = .24). Following the second internal urethrotomy, the urethra was stabilized in 88.9% of the patients in the triamcinolone group and 60.0% those in the control group (P = .15). Conclusion: Administration of triamcinolone ointment in patients on CIC regimen after internal urethrotomy only slightly decreased the stricture recurrence rate, and its possible effects should be more investigated.
Diagnostic Application of Flexible Cystoscope in Pelvic Fracture Urethral Distraction Defects
Seyed Jalil Hosseini,Ali Kaviani,Mohammad Jabbari,Mojtaba Mohammad Hosseini
Urology Journal , 2006,
Abstract: Introduction: The aim of this study was to evaluate the diagnostic value of antegrade flexible cystoscopy in pelvic fracture urethral distraction defects (PFUDD). Materials and Methods: Between 1999 and 2004, a total of 111 patients with PFUDD were evaluated by antegrade flexible cystoscopy. The flexible cystoscope was introduced into the posterior urethra and the area was evaluated for any probable fistula, false passages, or displacement of the posterior urethra. For preventing misalignment, flexible cystoscope was also used during the urethroplasty to open the posterior urethra at its exact distal point. Results: Posterior urethra ended distal to the external sphincter in 16 patients (14.4%). Five (4.5%) and 9 (8.1%) patients had severe displacement of the posterior end of the urethra and bladder neck false passage, respectively. Prostatic urethrorectal fistula was detected in 1 patient. Another 1 patient had bladder rhabdomyoma. Conclusion: Flexible cystoscopy is a valuable procedure in the evaluation of the bladder, the bladder neck, and the posterior urethra in patients with urethral distraction defects and complements voiding cystography before the surgery. It is also helpful for showing the exact distal point of the proximal urethra during urethroplasty in cases with displaced posterior urethra.
Dorsal Versus Ventral Oral Mucosal Graft Urethroplasty
Jalil Hosseini,Ali Kaviani,Mokhtar Hosseini,,Mohammad Mohsen Mazloomfard
Urology Journal , 2011,
Abstract: PURPOSE: To evaluate success rate of dorsal versus ventral oral mucosal graft for anterior urethroplasty.MATERIALS AND METHODS: In a retrospective study, the results of the ventral and dorsal oral mucosal graft (OMG) anterior urethroplasty were assessed in 24 and 29 patients, respectively. Demographic and clinical characteristics of subjects were gathered from the medical records.RESULTS: Patients were followed up for a mean duration of 32 months (range, 25 to 51 months). The success rates of dorsal and ventral anterior OMG urethroplasty were 83.3% and 75.8%, respectively (P = .5). At penile site, dorsal and ventral OMG were done for 9 and 10 patients with stricture lengths of 3.7 ± 1.1 cm and 3.9 ± 1.2 cm, respectively (P = .7). Success rates of dorsal and ventral penile OMG were 88.9% and 70%, respectively (P = .3). At the bulbar site, dorsal and ventral OMG were performed on 15 and 19 patients with stricture lengths of 4.1 ± 1.1cm and 4.2 ± 1.5 cm, respectively (P = .7). The success rates of dorsal and ventral bulbar OMG were 80% and 79%, respectively (P = .94).CONCLUSION: Oral mucosal graft is a versatile and an effective procedure for management of strictures throughout the anterior urethra, and in experienced hands, the outcomes are similarly favorable whether a dorsal or ventral approach is taken.
Monti’s procedure as an alternative technique in complex urethral distraction defect
Hosseini, Jalil;Kaviani, Ali;Mazloomfard, Mohammad M.;Golshan, Ali R.;
International braz j urol , 2010, DOI: 10.1590/S1677-55382010000300008
Abstract: purpose: pelvic fracture urethral distraction defect is usually managed by the end to end anastomotic urethroplasty. surgical repair of those patients with post-traumatic complex posterior urethral defects, who have undergone failed previous surgical treatments, remains one of the most challenging problems in urology. appendix urinary diversion could be used in such cases. however, the appendix tissue is not always usable. we report our experience on management of patients with long urethral defect with history of one or more failed urethroplasties by monti channel urinary diversion. materials and methods: from 2001 to 2007, we evaluated data from 8 male patients aged 28 to 76 years (mean age 42.5) in whom the monti technique was performed. all cases had history of posterior urethral defect with one or more failed procedures for urethral reconstruction including urethroplasty. a 2 to 2.5 cm segment of ileum, which had a suitable blood supply, was cut. after the re-anastomosis of the ileum, we closed the opened ileum transversely surrounding a 14-16 fr urethral catheter using running vicryl sutures. the newly built tube was used as an appendix during diversion. results: all patients performed catheterization through the conduit without difficulty and stomal stenosis. mild stomal incontinence occurred in one patient in the supine position who became continent after adjustment of the catheterization intervals. there was no dehiscence, necrosis or perforation of the tube. conclusion: based on our data, monti’s procedure seems to be a valuable technique in patients with very long complicated urethral defect who cannot be managed with routine urethroplastic techniques.
Detection of Recurrent Bladder Cancer NMP22 Test or Urine Cytology?
Jalil Hosseini,Ali Reza Golshan,Mohammad Mohsen Mazloomfard,Abdolrasoul Mehrsai
Urology Journal , 2012,
Abstract: Purpose: To assess the accuracy of voided urine cytology versus urinary nuclear matrix protein 22 (NMP22) qualitative assay in the diagnosis of various grades and stages of recurrent bladder transitional cell carcinoma (TCC). Materials and Methods: From July 2007 to February 2009, all patients with history of superficial bladder TCC were included in this multi-center study. Each patient provided three serial voided urine samples for cytologic examination and one sample for the NMP22 qualitative assay prior to urethrocystoscopy. The sensitivity and specificity of urine cytology and the NMP22 test were determined.Results: The sensitivities of the NMP22 test and cytology for detection of recurrence were 78.8% and 44.2%, respectively (P = .001), while the specificities were 69.6% and 83.7%, respectively (P = .019). The NMP22 test showed significantly higher sensitivity than cytology in detecting recurrences in low-risk and intermediate-risk groups.Conclusion: The NMP22 assay could be used for detection of superficial bladder cancer, especially in low- and intermediate-risk groups; however, the value of the test is limited by its low specificity.
Fistula Repair After Hypospadias Surgery Using Buccal Mucosal Graft
Jalil Hosseini,Ali Kaviani,Mojtaba Mohammadhosseini,Alireza Rezaei
Urology Journal , 2009,
Abstract: Introduction: The aim of this study was to evaluate the success rate of urethrocutaneous fistula repair using buccal mucosal graft in patients with a previous hypospadias repair. Materials and Methods: We reviewed records of our patients with urethrocutaneous fistula developed after hypospadias repair in whom buccal mucosal graft fistula repair had been performed. All of the patients had been followed up for 24 postoperative months. A successful surgical operation was defined as no fistula recurrence or urethral stricture. Retrograde urethrography and urethrocystoscopy would be performed in patients who had any history of decreased force and caliber of urine or any difficulty in urination. Results: Fistula repair using buccal mucosa patch graft had been done in 14 children with urethrocutaneous fistula developing after hypospadias reconstruction. The mean age of the children was 8.70 ± 1.99 years old (range, 4 to 11 years). Seven fistulas were in the midshaft, 4 were in the penoscrotal region, and 3 were in the coronal region. Repair of the fistulas was successful in 11 of 14 patients (78.6%). In the remaining children, the diameter of the fistula was smaller than that before the operation, offering a good opportunity for subsequent closure.
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