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ObjectiveTo determine whether ejaculatory dysfunction (EjD) and post-void dribbling (PVD) after urethroplasty are associated, providing evidence for a common etiology.MethodsWe reviewed a prospectively maintained database for first-time, anterior urethroplasties. One item from the Male Sexual Health Questionnaire (MSHQ) assessed EjD: "How would you rate the strength or force of your ejaculation". One item from the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM) assessed PVD: "How often have you had slight wetting of your pants after you had finished urinating?". The frequency of symptoms was compared after penile vs. bulbar repairs, and anastomotic versus augmentation bulbar repairs. Associations were assessed with chi-square.ResultsA total of 728 men were included. Overall, postoperative EjD and PVD were common; 67% and 66%, respectively. There was a significant association between EjD and PVD for the whole cohort (p

To compare peri- and postoperative outcomes following artificial urinary sphincter (AUS) insertion using an abdominal versus a sub-inguinal counterincision for pressure regulating balloon (PRB) placement.This was a retrospective review of all AUS placements by a single surgeon from 2010-2020. Demographic, clinical, and surgical details were obtained from chart review. The cohorts were divided by PRB placement technique (sub-inguinal, abdominal, and attempted sub-inguinal converted intra-operatively to abdominal ["conversion group"]).There were 182 AUS devices placed. The sub-inguinal approach was successfully completed in 132/144 (92%) and converted to abdominal PRB placement in 12/144 (8.3%). The risk of conversion was not increased by prior laparoscopically-assisted robotic prostatectomy (LRP) or radiotherapy (RT). Median operative time was 62, 75, and 77 minutes for sub-inguinal, abdominal, and conversion groups, respectively ( P = 0.30). Time to device activation was 25.0, 32.0, and 37.5 days for abdominal, sub-inguinal, and conversion groups, respectively (P0.01). There were no bowel or bladder injuries and no PRB herniation in any group; however, there were five instances of pump migration superiorly, all in the sub-inguinal or conversion groups (P = 0.05).The sub-inguinal approach to PRB placement during AUS is safe and can be successfully completed over 90% of the time. However, it is not faster than the abdominal approach to PRB placement and it is associated with an increased risk of pump migration, though the latter may be confounded by the sub-dartos pouch for pump placement that was used in all sub-inguinal cases.

To determine if a history of urinary stone surgery in individuals with spinal cord injury (SCI) is associated with an increased incidence of SCI-related complications and lower quality of life (QOL).The Neurogenic Bladder Research Group (NBRG) registry is a multicenter, prospective, observational study which measures QOL after acquired SCI. Over 1.5 years, 1479 participants were enrolled and grouped according to history of stone surgery. We evaluated SCI-related complications, QOL, and associations between patient factors and prior stone surgery using multivariable regression.Participants were a median of 11 years post-SCI and 189 (12.8%) reported prior bladder or kidney stone surgery; 95.8% of these occurred after the SCI. Median time between SCI and first stone was 5.6 years (IQR: 1.8-12.8). Hospitalizations were higher for those with prior stone surgery, with common reasons including UTIs, blood clots, pressure ulcers, and pneumonia (p 0.001). During the year of observation, the incidence of stone surgery was 17% in those with a prior history of stone surgery and 2% per year in those without prior stone surgery (p 0.001). Controlling for covariates, bladder management strategy, age, BMI, and years since SCI were associated with history of stone surgery.People with SCI and a history of surgical stone disease are at high risk for episodes of recurrent stones and increased hospitalizations, particularly those with kidney stones and indwelling catheter use. Identification of high-risk patients may guide tailored surveillance for complications and stone prevention strategies.

INTRODUCTION AND OBJECTIVE:The LSE anterior urethral stricture classification system has previously been validated for its interrater reliability and ability to predict urethroplasty technique. Her...

INTRODUCTION AND OBJECTIVE:Post-void dribbling (PVD) and ejaculatory dysfunction (EjD) are common after urethroplasty (UP). Although the etiology remains unknown, they are thought to share a simila...

INTRODUCTION AND OBJECTIVE:The Urethral Stricture Symptom and Impact Measure (USSIM) is a condition-specific outcome measure for men with urethral stricture. Concept elicitation, cognitive, and pri...

INTRODUCTION AND OBJECTIVE:Measurement of objective measures following urethroplasty (e.g., urethral patency, uroflowmetry) is vital, but patient-reported input via condition-specific outcome measu...

INTRODUCTION AND OBJECTIVE:A urethral stricture classification system based on stricture length (L), segment (S) and etiology (E) has been previously validated to have sufficient inter-rater reliab...

INTRODUCTION AND OBJECTIVE:A urethral stricture classification system based on stricture length (L), segment (S) and etiology (E) has been previously validated to have sufficient inter-rater reliab...