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Biomedical subjects

Georg Bartsch

Publications and source records attributed to Georg Bartsch.

At least 73 records · Page 4Linked to original sources
PubMed2005

Effects of local estrogen therapy on recurrent urinary tract infections in young females under oral contraceptives.

BACKGROUND: Previous studies have demonstrated the efficacy of local application of estrogen in treating postmenopausal women with recurrent urinary tract infections (RUTI) and urinary incontinence. Younger women under oral contraceptives (OC) can suffer from similar symptoms. The aim of this pilot study was to evaluate the effectiveness of local estrogens on RUTI and the impact of local hormonal supplementation on bladder neck vascularization. METHODS: 30 women (mean age 22.7 years) with a longstanding history of RUTI were included. Pre-treatment investigation included complete clinical history, urinalysis, urine culture and cystoscopy. All subjects completed a questionnaire about onset and duration of disease and quality of life before and after treatment. Local (vaginal) estrogen therapy consisted of 1mg estriol (E3) 7 times a week for two weeks and twice a week for two additional weeks. Sonographic examination of bladder vascularization was performed before and after treatment using transperineal color Doppler ultrasound (6 MHz, Acuson Sequoia 512, Mountain View, CA, USA) with a filled bladder. After angle correction, peak systolic blood flow velocity (PSBFV) and end diastolic blood flow velocity (EDBFV) were measured in 2 bladder arteries; and the Resistive Index (RI) was calculated. Flow velocity in each vessel was measured at least four times and the mean value determined. RESULTS: All patients completed the therapy course without severe side effects. Patients had a mean history of RUTI over 2.3 years; the mean period under OC was 3.2 years. In the follow-up period of 11 months after treatment, 24/30 patients reported no symptoms of cystitis and used no additional medication. Normal bladder epithelium in control cystoscopy after E3 therapy was seen in all patients with trigonal metaplasia and vulnerable, highly vascularized urothelium at the initial investigation. RI decreased from 0.945 to 0.705 after treatment (p<0.001), concomitantly the mean EDBFV increased highly significantly from 0.82 cm/sec to 4.45 cm/sec after estrogen treatment (p<0.001). INTERPRETATION: In a majority of young patients under OC and a longstanding history of RUTI, a considerable infection-free period was achieved after local application of estrogen. Decreased RI and increased EDBFV indicate vasodilatation and less peripheral vascular resistance. Responsiveness to local E3 may correspond to improved cystoscopic findings as a consequence of increased bladder perfusion.

Administration, Intravaginal↗
PubMed2005

The cyclopentenone prostaglandin PGA2 costimulates the maturation of human dendritic cells.

OBJECTIVE: Dendritic cells (DCs), also referred to as the sentinels of the immune system, induce and coordinate important functions of immune surveillance. Prostaglandin E2 (PGE2), a member of the eicosanoid family of arachidonic acid derivatives, is widely used to enhance the TNF-alpha-driven maturation of human monocyte-derived DCs (moDCs) both in basic research and in clinical settings. However, PGE2 is known to rapidly undergo nonenzymatic dehydration to produce PGA2, a member of the cyclopentenone PGs, which have been implicated in anti-inflammatory processes. METHODS: In a side-by-side analysis we therefore compared the influence of PGE2 and PGA2 on the TNF-alpha-induced maturation of human moDCs. Phenotypic changes, migratory responses towards MIP-3beta, and T-cell responses induced by the differentially matured moDCs were assessed. RESULTS: We found that PGA2 is nearly as potent as PGE2 in costimulating the TNF-alpha-induced phenotypic maturation of human moDCs. Both PGE2 and PGA2 further enhanced the migratory and T-cell-stimulatory capacity of TNF-alpha-treated moDCs. Maturation of moDCs with either PGE2 or PGA2 resulted in enhanced IFN-gamma, TNF-alpha, and IL-5 production and repressed IL-10 production in allogeneic mixed leukocyte cultures. PGE2 was always more potent than PGA2. CONCLUSIONS: Our data suggest that some of the effects attributed to PGE2 may in fact be mediated by its degradation product PGA2. This work also demonstrates that cyclopentenone PGs may have pro-inflammatory properties and that both PGE2 and PGA2 can contribute to the development of Th1-type immune responses.

Adjuvants, Immunologic↗
PubMed2005

Androgen receptor down regulation by small interference RNA induces cell growth inhibition in androgen sensitive as well as in androgen independent prostate cancer cells.

We investigated the effects of androgen receptor (AR) down regulation with a small interference RNA molecule (siRNA_AR(start)) on androgen sensitive LNCaP and androgen independent LNCaPabl prostate cancer cells, the latter representing an in vitro model for the development of therapy resistance in prostate cancer. Although LNCaPabl cells express increased levels of AR in comparison with androgen sensitive LNCaP cells, the protein was significantly down regulated in response to siRNA_AR(start) treatment. This AR down regulation resulted in a marked cell growth inhibition in both cell lines. By contrast, DU-145 prostate cancer cells, which lack AR expression, were not inhibited by the siRNA_AR(start). In consequence to AR down regulation, both cell lines, LNCaP and LNCaPabl, shared a highly similar gene expression profile in terms of major changes in cell cycle regulatory genes. The cell cycle inhibitor p21(Waf1/Cip1) as well as cyclin D1 were significantly up regulated by siRNA_AR(start) treatment, considering a switch in cyclin expression towards cell cycle retardation. Control molecules had moderate effects on cell proliferation and gene expression, respectively. In summary, we found that AR inhibition with siRNA induces cell growth retardation in androgen sensitive as well as in androgen independent prostate cancer cells and thus may represent an interesting approach to combat hormone-refractory prostate cancer.

Androgen Receptor Antagonists↗
PubMed2005

Staging bladder carcinoma by three-dimensional ultrasound rendering.

Organ-confined staging for bladder cancer has major impact on further treatment. Most imaging techniques for this purpose are insufficient. We, therefore, assessed the value and the limitations of a new diagnostic tool, the 3-D ultrasound (US) rendering, to distinguish invasive from noninvasive bladder cancers. A total of 63 patients underwent 3-D US of the bladder before transurethral resection or radical cystectomy. The US findings were compared with the pathologic stages of the transurethral resection material or the cystectomy specimens. Superficial (pTa) carcinomas were correctly staged in 66% by 3-D US. Lamina propria infiltrating (pT1) were correctly staged in 83% and the quota of correct staging of infiltrating carcinomas (>pT1) by 3-D rendering was 100%. The overall accuracy was 79%. Three-dimensional US rendering is most valuable to discriminate between superficial stages pT1. This new technique might improve staging of bladder cancer.

Cystectomy↗
PubMed2005

Suprapubic electroresection of prostate in three patients with benign prostatic hyperplasia and previous surgery for long urethral stricture.

The treatment of patients presenting with severe symptoms of obstruction due to benign prostatic hyperplasia and a history of previous surgery for long urethral stricture is still a matter of discussion. We report on 3 patients in whom resection of the prostate was performed using a dilated cystostomy approach under spinal anesthesia. All men had undergone dorsal onlay urethroplasty for long urethral stricture before prostate resection. The good outcome demonstrated the feasibility and safety of prostate resection using a suprapubic approach, which may become a treatment option in this group of patients.

Aged↗
PubMed2005

Model to predict prostate biopsy outcome in large screening population with independent validation in referral setting.

OBJECTIVES: To develop a model capable of predicting prostate biopsy outcomes in a large screening population, with independent validation in the referral setting. METHODS: Data from 3814 men participating in the Tyrol screening project were used to develop the model. Prospectively collected data from two independent sites in the United States (Virginia Mason Clinic, Seattle, Wash and Stanford University, Stanford, Calif) were used to validate the model independently. The Tyrol data was split randomly into three cross-validation sets, and a feed-forward, back error-propagation artificial neural network (ANN) was alternately trained on a combination of two of these data sets and validated on the remaining data set. Similarly, three logistic regression (LR) models were produced and validated using identical cross-validation data sets. The Tyrol model with the median area under receiver operating characteristic curve (AUROC) was then validated against the Virginia Mason (n = 491) and Stanford University (n = 483) data sets. RESULTS: The AUROCs for the three cross-validations were 0.74, 0.76, and 0.75 for the ANN and 0.75, 0.76, and 0.75 for the LR models. The mean AUROC for both ANN and LR was 0.75 with a standard deviation of 0.009 for ANN and 0.006 for LR. The AUROCs for the Virginia Mason and Stanford University data were 0.74 (both ANN and LR) and 0.73 (ANN) and 0.72 (LR), respectively. CONCLUSIONS: This model, designed to predict the prostate biopsy outcome, performed accurately and consistently when validated with data from two independent referral centers in the United States, suggesting that it generalizes well and may be of clinical utility to a broad range of patients.

Aged↗
PubMed2005

Detection rates and biologic significance of prostate cancer with PSA less than 4.0 ng/mL: observation and clinical implications from Tyrol screening project.

OBJECTIVES: To investigate the prostate cancer (PCa) detection rates and Gleason scores in patients with serum prostate-specific antigen (PSA) levels of 2.0 to 3.9 ng/mL and 4.0 to 10 ng/mL (free PSA 18% or less), in a population-based screening project. With the use of prostate-specific antigen (PSA) screening, more PCa is being diagnosed at PSA values of less than 4 ng/mL. METHODS: A total of 3446 consecutive screening volunteers with a PSA level of 2.0 to 10.0 ng/mL (free PSA 18% or less) were assessed. Ten systematic prostate biopsies and an additional five Doppler-enhanced targeted biopsies were performed on the basis of age-specific PSA reference ranges. The cumulative frequency of detection and the Gleason scores were analyzed. RESULTS: The PCa detection rate for patients with a PSA value of 2.0 to 3.9 ng/mL (n = 1522, group 1) and 4.0 to 10.0 ng/mL (n = 1924, group 2) was 21% (n = 320) and 30% (n = 572), respectively. Of the PCa cases detected, 37% were in men with a PSA level of 2 to 4 ng/mL. Statistically significant differences were found in age and prostate volume between groups 1 and 2, with patients in the lower PSA group younger and having a smaller mean prostate volume (P = 0.0001). Of 313 patients with PCa and a PSA value of 2 to 3.9 ng/mL, 24% had a Gleason score of 7 or greater compared with 33% of 560 patients with a PSA value of 4.0 to 10.0 ng/mL (P = 0.004). CONCLUSIONS: Our data suggest that in a screening population, more than one third of PCa cases in men with a PSA level of 2 to 10 ng/mL will occur in those with a PSA value of 2 to 3.9 ng/mL. Also, PCa cases with a low PSA level occur in younger patients and at lower stages with a smaller prostate volume.

Adult↗
PubMed2005

Propagation, expansion, and multilineage differentiation of human somatic stem cells from dermal progenitors.

We isolated multipotential mesenchymal stem cells (MSC) from human postnatal dermal tissues. The isolated cells were expanded and maintained for over 100 population doublings with retention of their chromosomal complement and potential for multilineage differentiation. Progeny of cell lines established from a single dermal MSC could be differentiated into adipogenic, osteogenic, and myogenic lineages, consistent with the conclusion that we established a clonal, multipotential, somatic MSC cell line. This study is the first to show potential growth of multipotential human MSC cell lines from a single cell that can be used for the engineering of tissues in vivo. Clonal growth of MSCs presents profound implications in our understanding of differentiation and development, and should provide a valuable resource for tissue repair.

Adipocytes↗
PubMed2005

An embryological study of fetal development of the rectourethralis muscle--does it really exist?

PURPOSE: The so-called rectourethralis muscle is widely described in the urological literature. However, its description is subject to variations concerning extent and morphology. Moreover, little is known about its fetal development, which would allow a better understanding of the adult anatomy. The aim of this study was to investigate the morphology, extent and development of the rectourethralis muscle in fetal specimens. MATERIALS AND METHODS: A total of 15 normal human male fetuses were included in the study. Age ranged from 13th week of gestation to term. The histological study used plastination and standard and immunohistochemical techniques to identify the developing muscular structures in serial sections of the rectourethral space. Investigations in all 3 planes (coronal, sagittal and transverse) were performed. RESULTS: In all sections of the proximal aspect of the rectourethral space no developing muscle fibers could be identified leaving the anterior wall of the rectum to join the rhabdosphincter or the apical prostate. In the distal aspect of the rectourethral space an independent muscular structure located between the external muscular layer of the anorectal canal and the dorsal bundles of the rhabdosphincter could be clearly demonstrated. This structure consisted of connective, smooth and striated muscle tissue, and was deeply anchored to the apical perineal body. CONCLUSIONS: This study suggests that the so-called rectourethralis muscle is a misnomer in the urological literature. In the fetal period a developing muscular structure could be clearly identified as a part of the apical perineal body, which would correspond to the rectoperinealis muscle in the adult.

Humans↗
PubMed2005

Neoadjuvant gonadotropin-releasing hormone therapy before surgery may improve the fertility index in undescended testes: a prospective randomized trial.

PURPOSE: Subfertility is considered the principal consequence of cryptorchidism even after timely orchiopexy. Gonadotropin-releasing hormone (GNRH) treatment appears to improve fertility later in life by inducing germ cell maturation. In a prospectively randomized trial we investigated whether preoperative GNRH therapy improves the fertility index in primary cryptorchidism. MATERIALS AND METHODS: A total of 42 boys 11 to 100 months old (median 33.5) with 63 undescended testes were prospectively assigned to 2 groups during a 6-month period. Patients were randomized to receive either orchiopexy alone (21 patients) or with neoadjuvant GNRH therapy (21) as a nasal spray for 4 weeks at 1.2 mg per day. In both groups testicular biopsies were performed at the time of orchiopexy and histopathological fertility index was determined. RESULTS: Mean fertility index in the group treated with GNRH before surgery was significantly higher (1.05, SD +/- 0.71) compared to the group without hormonal stimulation (0.52, SD +/- 0.39, p <0.05). The subgroup of neoadjuvant stimulated boys younger than 24 months achieved the best results compared to the age matched boys without hormonal treatment. CONCLUSIONS: Neoadjuvant GNRH treatment improves fertility index in prepubertal cryptorchidism. Consequently, preoperative hormone therapy should improve fertility in adulthood. Additionally, the nasal application is well tolerated, safe and already recommended in an adjuvant setting after orchiopexy. Maximum salvage of active germinal tissue is achieved by treating cryptorchidism before the end of the first year of life.

Chemotherapy, Adjuvant↗
PubMed2005

Fetal development of the female external urinary sphincter complex: an anatomical and histological study.

PURPOSE: We investigated the fetal development of the smooth (lissosphincter) and striated (rhabdosphincter) female external urinary sphincter. Growth and organization of the muscle fibers around the urethra and morphological modifications due to the development of the vagina were analyzed in detail. MATERIALS AND METHODS: A total of 28 human female fetal specimens were investigated in an anatomical and histological study. The sections were processed according to plastination technology. This technique allows examination of structures and organs of the small pelvis with minimal artifacts in all 3 planes. RESULTS: At gestational week 9 the primordium of the external urethral sphincter complex was observed extending along the anterior aspect of the urogenital sinus, before the development of the primitive urethra and the vaginal primordium. From 15 weeks of gestation the lissosphincter and rhabdosphincter could be identified and clearly distinguished. After 20 weeks of gestation both elements acquired an omega-shaped configuration with a narrow posterior connective tissue raphe that was constantly present, fixing both components to the ventral vaginal wall. Both muscles were mainly located in the middle third of the urethra. In the proximal third of the urethra growth of the vagina led to disappearance of the striated muscle fibers of the rhabdosphincter, whereas the lissosphincter seemed to intermingle with the internal layer of the detrusor musculature of the bladder. CONCLUSIONS: The important morphological characteristics of the female adult rhabdosphincter and lissosphincter (omega-shaped configuration, presence of a narrow connective tissue raphe posteriorly and maximum thickness in the middle third of the urethra) are already evident early in fetal development and do not evolve during postnatal growth or by the influence of sex hormones.

Female↗
PubMed2005

Prostate cancer detection in men with prostate specific antigen 4 to 10 ng/ml using a combined approach of contrast enhanced color Doppler targeted and systematic biopsy.

PURPOSE: Transrectal gray scale ultrasound guided biopsy is the standard method for diagnosing prostate cancer (PC). Improved cancer detection with ultrasound contrast agents is related to better detection of tumor vascularity. We evaluated the impact of a combined approach of contrast enhanced, color Doppler targeted biopsy (CECD) and systematic biopsy (SB) for the PC detection rate in men with prostate specific antigen (PSA) 4.0 to 10 ng/ml. MATERIALS AND METHODS: We examined 380 screening volunteers with a total PSA of 4.0 to 10 ng/ml (percent free PSA less than 18). CECD was always performed before SB. Another investigator blinded to contrast enhanced findings performed 10 SBs. The cancer detection rate for the CECD, SB and combined approaches was assessed. RESULTS: PC was detected in 143 of 380 patients (37.6%, mean total PSA 6.2 ng/ml). The PC detection rate for CECD and for SB was 27.4% and 27.6%, respectively. The overall cancer detection rate with the 2 methods combined was 37.6%. For targeted biopsy cores the detection rate was significantly better than for SB cores (32.6% vs 17.9%, p <0.01). CECD in a patient with cancer was 3.1-fold more likely to detect PC than SB. CONCLUSIONS: CECD allows for the detection of lesions that cannot be found on gray scale ultrasound or SB. CECD allows for assessment of neovascularity associated with PC. However, the combined use of CECD and SB allows for maximal detection of PC with a detection rate of 37.6% in our patients with PSA 4 to 10 ng/ml.

Adult↗
PubMed2005

Loss of interstitial cells of Cajal and gap junction protein connexin 43 at the vesicoureteral junction in children with vesicoureteral reflux.

PURPOSE: Symmetrical muscular contractions and unidirectional peristalsis are prerequisites for competent valve function at the ureterovesical junction. Interstitial cells of Cajal (ICCs) are pacemaker cells that create and coordinate peristaltic motility. We investigated ureteral endings immunohistochemically to elucidate the presence of c-kit positive ICCs as well as the occurrence of gap junction protein connexin 43 in children with vesicoureteral reflux (VUR) to identify a possible pathogenic factor of an insufficient antireflux mechanism. MATERIALS AND METHODS: Distal ureteral specimens were obtained from 27 children undergoing antireflux surgery. Routine histological paraffin embedded sections were immunostained detecting the c-kit proto-oncogene to study the presence of ICCs as well as connexin 43 positive cells to determine the gap junction density within the ureteral wall. Age matched nonrefluxing ureteral endings served as controls. All investigations were done using high power field magnification for semiquantitative analysis and statistically analyzed. RESULTS: ICCs were present in refluxing and nonrefluxing ureteral endings. Healthy individuals displayed significantly more ICCs than children with VUR. Connexin 43 immunoreactivity was significantly decreased in all refluxing ureteral specimens, whereas it was homogeneously distributed in normal controls. CONCLUSIONS: C-kit positive ICCs are found at the ureterovesical junction. Refluxing ureteral endings significantly lack these pacemaker cells, implying a malfunctioning valve mechanism permitting VUR. A substantial decrease in gap junctions in this region adversely affects intercellular signaling, aggravating coordinated peristalsis, which is essential for a competent anti-reflux mechanism.

Biomarkers↗
PubMed2005

Urinary acetonitrile concentrations correlate with recent smoking behaviour.

OBJECTIVES: To assess the concentration of acetonitrile (a saturated aliphatic nitrile) in the urine of habitual cigarette smokers and non-smokers, as exposure to smoke can be measured by monitoring ambient air or by in vivo tests, but acetonitrile measured in exhaled breath is reportedly a quantitative marker of recent smoking behaviour. SUBJECTS AND METHODS: The study included 101 volunteers (57 men and 44 women, mean age 49 years). An absence of urinary tract infection on urine analysis or clinical history was mandatory. The subjects were classified into five groups, i.e. a control group of non-smokers and four groups according to the number of cigarettes smoked daily. Urine samples were stored at 8 degrees C until acetonitrile was measured, within 24 h of collection, using proton-transfer reaction mass spectrometry (PTR-MS). Each measurement was repeated at least 10 times, and the mean used for statistical analysis. RESULTS: The mean (sd) acetonitrile level in the urine of 46 non-smokers was 3.74 (1.78) parts per billion volatile (ppbv). The concentration of acetonitrile increased with the number of cigarettes smoked daily, the highest concentration being in the subgroup of 13 very heavy smokers (>30 cigarettes/day) with means up to 28.04 (5.38) ppbv. CONCLUSION: PTR-MS is a quick, noninvasive online method for determining urinary acetonitrile levels, a marker for recent active and passive smoking behaviour, and thus for checking compliance. As smoking has been shown to affect the genesis of bladder cancer, further studies are required to determine the association of acetonitrile with bladder cancer.

Acetonitriles↗
PubMed2005

Influence of nitrate levels in drinking water on urological malignancies: a community-based cohort study.

OBJECTIVE: To evaluate the effect of nitrate levels in the drinking water on the incidence of urological malignancies in a German community. PATIENTS AND METHODS: For 28 years (1957-86) the community of Bocholt, Germany (70,000 inhabitants) had a drinking water supply with different nitrate levels, i.e. 60 mg/L in group A (57,253 inhabitants) and 10 mg/L in group B (10,037 inhabitants). All newly diagnosed cases of urological malignancies were registered from 1986 to 1997. The incidence was calculated using an age standardization based on the German population. RESULTS: In all, there were 527 urological malignancies recorded (urothelial cancer 39.8%, renal cell carcinoma 10.8%, testicular tumours 8.0%, penile carcinoma 1.7%, prostate cancer 39.7%). The incidence per 100,000 inhabitants/year of urinary tract tumours was 33.8 in group A and only 17.1 in group B (relative risk, RR 1.98, 95% confidence interval, CI, 1.10-3.54). The RR was 0.87 (0.34-2.22) for renal tumours, 0.66 (0.14-2.88) for penile cancer and 1.06 (0.76-1.48) for prostate cancer. For testicular tumours there was an inverse association with nitrate level, with a RR of 0.43 (0.21-0.90). CONCLUSION: This study showed an association of nitrate load in drinking water and the incidence of urothelial cancer in both genders, with an inverse correlation to testicular tumours and no correlation with renal, penile and prostatic tumours.

Adolescent↗
PubMed2005

Anatomical radical retropubic prostatectomy: 'curtain dissection' of the neurovascular bundle.

OBJECTIVE: To investigate the topographical relationship of the cavernosal nerves (CNs) to seminal vesicles, prostate, rhabdosphincter and urethra during the development of the prostate, and to use the resulting morphological data to modify the surgical technique of nerve-sparing radical prostatectomy. MATERIALS AND METHODS: The study included 29 male fetuses (gestational age 9-37 weeks) and eight adult specimens assessed anatomically and histologically. Using the plastination technique and anatomical dissection, the course of the CNs was investigated in all specimens. Based on these morphological results, the technique of dissecting the CNs during nerve-sparing radical retropubic prostatectomy was modified. RESULTS: During early fetal development the fibres of the CNs enclose the prostatic and membranous urethra dorsally and laterally. During the growth of the prostate, the CNs running along the prostate become displaced further anteriorly and spread, thus forming a concave shape (like a 'curtain') of the neurovascular bundles (NVB). Therefore, dissection of the NVB has to start anteriorly to preserve all the nerve fibres that are spread along the surface of the lateral lobes of the prostate. CONCLUSIONS: From these anatomical findings we propose a modified 'curtain dissection' to improve preservation of the CNs running in the NVB, in which the incision of the periprostatic fascia and dissection of the NVB is far more anterior than previously described.

Aged↗
PubMed2005

A comparison of one-stage procedures for post-traumatic urethral stricture repair.

OBJECTIVE: To compare the results and complication rates of various one-stage treatments for repairing a post-traumatic urethral stricture. PATIENTS AND METHODS: The medical records of 153 patients who had a post-traumatic urethral stricture repaired between 1977 and 2003 were evaluated retrospectively, and analysed for the different types of urethral reconstruction. RESULTS: The procedures included direct end-to-end anastomosis in 86 (56%) patients, free dorsal onlay graft urethroplasty using preputial or inguinal skin in 40 (26%), ventral onlay urethroplasty using buccal mucosa in seven (5%) and ventral fasciocutaneous flaps on a vascular pedicle in 20 (13%). At a mean (median, range) follow-up of 75.2 (38, 12-322) months, 121 (79%) patients had no evidence of recurrent stricture, while in 32 men (21%) they were detected at a mean follow-up of 30.47 (1-96) months. Patients having a dorsal onlay urethroplasty had the longest strictures. The re-stricture rate was lowest after a dorsal onlay urethroplasty (5% vs 27% when treated with end-to-end anastomosis, 15% after fasciocutaneous flaps and 57% after a ventral buccal mucosal graft). The surgical technique used had no effect on postoperative incontinence or erectile dysfunction rates. CONCLUSION: In patients with strictures which are too long to be excised and re-anastomosed, tension-free dorsal onlay urethroplasty is better than ventral graft or flap techniques. In patients with short urethral strictures direct end-to-end anastomosis remains an option for the one-stage repair of urethral stricture.

Adolescent↗