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OBJECTIVES: The aims of this study were: (1) To evaluate the urethral orifice cross‐section size immediately and 12 days post‐operatively following a perineal urethrostomy procedure. (2) To assess the correlation between the cross‐section size and stricture formation during a 6‐month period following the perineal urethrostomy. ANIMALS: Twenty‐four male cats with feline lower urinary tract disease that failed to respond to medical treatment and underwent perineal urethrostomy. MATERIALS AND METHODS: The urethral orifice cross‐section size was estimated by the largest size of the urinary catheter that was possible to insert facilely through the urethrostomy site. The urethral orifice cross‐section size was measured in three different times: Pre‐operative (LUCpr), immediately post‐operative (LUCi) and 12 days post‐operative (LUCp). Urinary obstruction recurrence and urethrostomy site stricture formation were documented for 6 months after the surgical procedure. The probabilities for obstruction recurrence in cases of LUCi ≤ 8Fr and LUCi > 8Fr were calculated. RESULTS: Urinary obstruction and urethrostomy site stricture occurred in 5 of 24 (~20%) of the operated cats at an average of 92 ± 25 days post‐perineal urethrostomy. LUCi ranged from 6 to 10 (median 10) Fr and the LUCp ranged from 4 to 10 (median 8) Fr. There was a significant decrease of 0.15 ± 0.09 mm² of the urethral orifice cross‐section area 12 days post‐operative compared to the measurements taken immediately post‐operative. The probabilities for post‐operative urinary obstruction of the LUCi ≤ 8Fr cases (intra‐operative urethral orifice cross‐section area equal or larger than 5.5 mm²) and in the LUCi > 8Fr cases were 44 and 6%, respectively. Recurrence of obstruction was documented in all cases (three cats) in which LUCi was 6Fr. CONCLUSION AND CLINICAL SIGNIFICANCE: The largest size of the urinary catheter that is possible to insert during surgery is a simple method to evaluate urethrostomy cross‐section size. Contraction of the urethral orifice diameter is expected during the wound healing phase. Post‐operative urinary obstruction is more likely in cases where LUCi

Objectives The aim of this study is to develop a method to evaluate the fluid dynamics of urine flow in the lower urinary tract (LUT), especially that of vorticity. Materials and methods This investigation included three sub-studies to demonstrate urine flow in the entire LUT. First, we attempted to observe vorticity generation in the urinary bladder during spontaneous voiding using transabdominal color Doppler ultrasonography (CDUS). Second, we performed transrectal CDUS to evaluate the vorticity of urine flow in the prostatic urethra. Patients with prostate cancer were enrolled before robotic surgery and divided into the vorticity and non-vorticity groups based on CDUS findings for comparisons of longitudinal urethral diameter and prostatic urethral angle. Third, the vorticity of the voided urine stream was observed using a high-speed video-camera. Micturition was done in a standing position while synchronously monitored for urine flow using uroflowmetry. Results Vorticity formation could be dynamically demonstrated in the urinary bladder and prostatic urethra using CDUS. The prostatic urethral angle of the vorticity group was more than that of the non-vorticity group. High-speed video recording could clearly capture vorticity and spiral shape generation in voided urine. The distance from the external urethral orifice to the first twist changed in accordance with urine flow rate. Conclusions In a series of sub-studies, this investigation proved vorticity generation in the LUT and voided urine. Vorticity was detectable in the LUT and in voided urine using CDUS and a high-speed video-camera. Vorticity generation might be associated with urethral morphology.

Summary This report describes the repair of an iatrogenic phallectomy that occurred during an attempted castration of a horse that was discovered to be a unilateral cryptorchid (inguinal testis). Use of a modification of a described phallectomy and sheath ablation technique allowed penile retroversion to be avoided, decreasing excessive dissection and post-operative morbidity, despite the urethral orifice being positioned more caudally than previously reported.

A 52-year-old woman was admitted because of a vaginal-wall tumor adjacent to the external urethral orifice. The tumor had been causing disturbances in micturition for the past year. Magnetic resonance imaging and computed tomography images indicated a 6 x 3 cm solid mass in the anterior vaginal wall. The tumor was enucleated surgically through a median longitudinal incision of the anterior vaginal wall. Micturitional disturbances were rectified after surgery. Histologically, the tumor was a mixture of a high-cellularity area with a mitosis rate of 7 per 30 high-power fields, and a less cellular area without mitosis. Immunohistochemical staining was performed for both areas. The prognostic implications of the tumor are discussed.

The urethral fold of 30 mares was split transversely into dorsal and ventral shelves, and the ventral shelf was used to help create a urethral extension. The dorsal shelf was stretched caudally and sutured to the roof of the extension so that it covered at least the cranial half of the extension. For 20 mares, a relaxing, vaginal incision was created cranial to the external urethral orifice to enable the dorsal shelf to be retracted further caudally. Ten of the 30 mares (33.3 per cent) developed a defect, but none developed a defect in that portion covered by the dorsal shelf of the urethral fold. Two of the 30 mares (6.7 per cent) developed a defect so small that the defect could be detected only by inserting a dye, under pressure, into the tunnel. The total number of mares that developed only a grossly visible and palpable defect was eight of 30 (26.6 per cent). Four of the 10 mares that did not receive the relief incision and six of 20 mares that did receive the relief incision developed a defect in the extension. Modifying the McKinnon technique by transversely splitting the urethral fold and retracting the dorsal half helps prevent a defect from forming in the cranial portion of the extension. The dorsal shelf can be retracted further caudally by creating a relief incision on the floor of the vagina.

The sexual function of 82 patients treated for hypospadias was assessed. It was concluded that the sexual function in these patients was unsatisfactory only following incomplete or incorrect surgery. The aim of surgery should be to achieve a straight penis with an adequate urethral lumen and a urethral orifice situated at the tip of the glans. Proper assessment of chordee and meticulous care in surgical technique are the prerequisites for success. They are the only preventive measures of the physical, psychic, sexual and social handicaps to which hypospadiacs are subjected.

A case of a 66 years old female who had a nephrogenic adenoma recurring three times during a 6 months course of her illness is reported. With each recurrence, the lesion moved toward the urethral orifice, suggesting an intimate relationship between the recurrent process and physical stimuli to the mucosa. Electron microscopy revealed merely non-specific morphological features of epithelial cells in the lesion. There were no positive morphological clues in the lesion for supporting the lesion to resemble mesonephric and/or mesodermal tissue. The diagnostic term of tubular metaplasia for the lesion is preferable instead of nephrogenic adenoma.