Browsing by Author "Stojanović, Borko (54390096600)"

Myelomeningocele (MMC), a severe congenital anomaly resulting from neural tube closure defects, poses significant urological challenges necessitating specialized care. This review explores the intricate landscape of MMC within urological practice, advocating for a multidisciplinary approach to optimize patient outcomes. By surveying diverse treatment modalities, this review aims to offer insights into enhancing urological management strategies for MMC and guiding future research directions. At the heart of the conversation lies the pathophysiology of neurogenic bladder dysfunction in children with MMC, with a particular focus on the complexities of diagnosis and the various paradigms guiding urological management. Common complications such as recurrent urinary tract infections are examined alongside non-surgical interventions like intermittent catheterization (CIC) and pharmacotherapy, notably oxybutynin. Additionally, surgical options including botulinum toxin injection and reconstructive procedures are explored to enhance urological outcomes for affected children. By unpacking the complexities of neurogenic bladder dysfunction in MMC, this review emphasizes the imperative of a collaborative, multidisciplinary approach in urological care, ultimately aiming to enhance patient well-being and functional outcomes. © 2025 by the authors.

Introduction Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. Many various tissues are used (local skin flaps, bladder mucosa grafts, buccal mucosa grafts etc.) for the reconstruction of the neourethra. Objective Our aim was to evaluate advantages and disadvantages of combined buccal mucosa graft and penile skin flap in urethral reconstruction in severe hypospadias repair. Methods Between December 2005 and August 2009, 48 patients with severe hypospadias, aged from nine months to 12 years (mean age 23 months) underwent surgery. Thirty-four (71%) had penoscrotal and 14 (29%) scrotal hypospadias. Ventral penile curvature was present in all cases, and was corrected by incision of the short urethral plate. Urethroplasty was performed using a buccal mucosa graft combined with dorsal penile skin flap. Results Mean follow-up was 22 months (range from 9 months to 3 years). Satisfactory functional and aesthetic results were achieved in 40 (83%) patients. Fistula was noted in six cases and was solved by minor revision. Urethral stenosis in two cases wasresolved by simple dilatation. Conclusion Urethral reconstruction using the buccal mucosa graft and dorsal penile skin flap in severe hypospadias repair could be the method of choice. Using this technique, single stage urethral reconstruction is possible with satisfactory esthetical and functional results.