Balloon dilation of a urethral stricture caused by a congenital obstructive proximal urethral membrane (COPUM) in a dog

2020 ◽  
Vol 8 (2) ◽  
pp. e001084
Author(s):  
Darren Kelly ◽  
Ingrid Isaac ◽  
Judith Cruzado-Perez ◽  
Florence Juvet

Congenital urethral strictures are well recognised in human beings and have recently been described in two cats but have not been previously reported in dogs. A 10-month-old female English Bull Terrier presented with a life-long history of being unable to pass a normal stream of urine. Urethrocystoscopy confirmed the presence of a stricture lesion in the proximal urethra. This thin, membranous structure was effaced under endoscopic visualisation using a 10 mm diameter balloon-dilation catheter. Complete and sustained resolution of clinical signs occurred after a single dilation procedure. To the best of our knowledge, this is the first report of a congenital urethral stricture in a dog and the term congenital obstructive proximal urethral membrane may be useful for describing these lesions in the future.

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691986717
Author(s):  
Javier Rincon Alvarez ◽  
Victoria Smith ◽  
Cameron Broome

Case summary A proximal urethral stricture was diagnosed by retrograde urethrogram in a 2-year-old female neutered cat, which was referred following a 2-month history of stranguria, pollakiuria and urinary incontinence. Cystoscopic examination confirmed the presence of a severe narrowing of the proximal urethra near to the bladder neck, consisting of a membrane arising from the urethral mucosa. Fluoroscopy-guided balloon dilation was performed. Twelve months after the procedure, the cat did not show any recurrence of clinical signs. Relevance and novel information To our knowledge, this is the first report of a proximal urethral stricture in a cat. Management by fluoroscopy-guided balloon dilation proved to be a successful and minimally invasive option with an excellent outcome.


2021 ◽  
pp. 81-103
Author(s):  
James A. Harris

‘Religion' discusses Hume’s various treatments of religion, particularly in the essay ‘Of Miracles’, Dialogues concerning Natural Religion, and ‘The Natural History of Religion’. Hume's earlier writings show some interesting implications for religion, including A Treatise of Human Nature and the essay ‘Of National Characters’. Looking at ‘Of Miracles’ shows that Hume’s theme was not the possibility of miracles as such, but rather the rational grounds of belief in reports of miracles. Considering the Dialogues emphasizes the distinction between scepticism and atheism. Meanwhile, ‘Natural History’ emphasizes Hume’s interest in the dangerous moral consequences of monotheism. What is the future for religion? Perhaps Hume was unlikely to have supposed that his writings would do anything to reduce religion’s hold on the vast majority of human beings.


2020 ◽  
Vol 8 (2) ◽  
pp. e001034
Author(s):  
Darren Kelly ◽  
Tobias Wagner ◽  
Valerie Lamb

A 16-week-old Persian kitten was referred for investigation of constipation and failure to grow. The owner reported that the kitten had always strained to defecate. Abdominal radiographs confirmed megacolon and CT pneumocolography confirmed the presence of a caudal rectal stricture. During a single procedure and under fluoroscopic guidance, the stricture was effaced by sequentially dilating 10-mm and 15-mm balloons. Shortly after discharge, the owner reported complete resolution of clinical signs and oral laxatives were stopped. Repeat radiographs 1 month post dilation showed resolution of the diffuse megacolon and the cat appeared well and had gained weight. This is the first report of a congenital rectal stricture in a kitten and one of the few reports documenting balloon dilation for the treatment of stenotic anorectal lesions (congenital or acquired) in cats.


Author(s):  
Anthony R. Mundy ◽  
Daniela E. Andrich

Urethral strictures are common and almost all urologists will deal with them on a regular if not daily basis. They have always been common and the history of the subject stretches back to 3,000 BC. Urethral dilators have been found in the tombs of the pharaohs so that they might be able to catheterize themselves or dilate their own strictures in the afterlife. Urethrotomy and dilatation are two of the most frequently performed procedures in urology. But these are usually only palliative, and curative treatment by urethroplasty is performed by very few urologists. In part this is because most strictures are bulbar strictures and most non-bulbar strictures are seen only by reconstructive urologists; but in part this represents a somewhat ambivalent attitude of most urologists to urethral stricture disease. In this chapter, we will attempt to clarify the current approach to this problem.


2021 ◽  
Vol 14 (3) ◽  
pp. 156-163
Author(s):  
V.P. Glukhov ◽  
◽  
A.V. Ilyash ◽  
V.V. Mitusov ◽  
D.V. Sizyakin ◽  
...  

Introduction. Extended spongy urethral strictures require the use of plastic surgery techniques. In most cases, a one-stage urethral repair can be performed. However, staged urethroplasty and permanent urethrostomy are important in patients with extremely complex urethral strictures. Purpose of the study. To determine the clinical features of spongy urethral strictures, which cannot be cured by one-stage urethroplasty, but are subject to multistage plastic or permanent urethrostomy. Materials and methods. The study included 158 patients who underwent surgery for urethral strictures in 2010 − 2019. Inclusion criteria: spongy urethral strictures requiring staged urethroplasty or permanent urethrostomy. Exclusion criteria: age<18 years, proximal urethral strictures, urethra-vesical anastomosis and bladder neck stenosis, previously untreated congenital anomalies (hypospadias and epispadias), and history of any other urethral surgery not meeting the inclusion criteria. Results. The age of the patients ranged from 18 to 88 years. Iatrogenic (34.8%) and inflammatory (32.3%) urethral lesions predominate in the structure of etiological factors with the most common penile localization of narrowing (43.7%). The length of strictures in half of the patients exceeds 6 cm; a quarter of the sample has subtotal and total spongy urethral lesions. The proportion of recurrent urethral strictures is 56.3%. The average duration of the urethral stricture disease reaches 8 years. In 61.3% of cases, the disease is accompanied by complications from both local tissues and organs of the urinary and reproductive systems. Conclusion. Clinical evaluation of patients with spongy urethral strictures requiring multi-stage urethroplasty or permanent urethrostomy reveals a particular severity of urethral stricture disease. This category of patients has a high risk of unsuccessful outcomes with one-stage surgery. In these cases, patients require a multi-staged urethroplasty or a permanent urethrostomy.


2021 ◽  
Vol 9 (2) ◽  
pp. 16-24
Author(s):  
M. M. Alibekov ◽  
M. I. Katibov ◽  
A. S. Skorovarov ◽  
G. A. Gazimagomedov ◽  
K. M. Arbuliev ◽  
...  

Introduction. The literature highlights isolated studies examining approaches to the treatment of patients with a combination of stones and urethral stricture. In this regard, the problem of creating optimal tactics for managing such patients remains relevant.Purpose of the study. To analyze of own experience in treating patients with a combination of stricture and urethral stone using balloon dilation with urethral stone extraction.Materials and methods. The study included 7 men with short urethral stricture and stone, who underwent balloon dilation with urethral stone extraction. The age of patients ranged from 47 to 65 years (median - 52 years). The length of the urethral stricture ranged from 3 to 10 mm (median - 7 mm). The stricture in 2 (28.6%) cases was localized in the penile part of the urethra and 5 (71.4%) in the bulbous part. An etiology of urethral strictures: traumatic - in 2 (42.9%) patients, inflammatory - in 1 (14.3%) of cases, idiopathic - in 4 (57.1%) of cases. All patients had 1 urethral stone. The sizes of the stone ranged from 4 to 9 mm (median - 6 mm).Results. The operation time ranged from 11 to 19 min (median - 13 min). No patient had any intraoperative complications. UTIs was observed in the early postoperative period in 1 patient. The duration of postoperative hospital stay ranged from 1 to 5 days (median - 3 days). Postoperative follow-up ranged from 3 to 24 months (median - 14 months). Only 1 (14.3%) patient had a recurrence of urethral stricture 18 months after treatment. Thus, the overall treatment success in this group of patients was 85.7% (6/7).Conclusion. We used this conjunction approach when combined stricture and urethral stone in men for the first time in the world. It seems quite promising given the results.


Author(s):  
Sara Diani

The Coronavirus pandemic is a major challenge to human wellbeing; it directly affects health, and indirectly involves the economic, politic and social spheres. This, in turn, is going to have major systemic, worldwide health, social and environmental consequences. In this paper, I will briefly sum up the history of the pandemic, the worldwide diffusion, the major different political reactions, as well as health and political countermeasures, and the economic consequences / evaluations for the future. The aim of this paper is to show and address all the different spheres involved and their relationships. Emphasis will be placed on the paradoxical presence of a large amount of data and the big uncertainty for the future. The outcomes will be briefly analyzed on a healthcare, political and socio-economical level. The point of view is systemic with human beings, institutions and the environment seen as a whole. Systemic thinking allows interdisciplinary research to be decisive in understanding the worldwide reaction to the pandemic. The global response to this crisis is of historical significance, and therefore potentially decisive for the multi-layered future of the world.


2018 ◽  
Vol 57 (4) ◽  
pp. 588-615 ◽  
Author(s):  
Peter Wagner

Reinhart Koselleck showed that the decades around 1800 witnessed a major transformation of political language. Around 1800, the horizon of expectations gained distance from the space of the experiences that human beings were making, and thus possibilities for the future opened up widely. In particular, the future would be the time during which ‘peoples’ would gain their capacity for self-determination, called popular sovereignty. This would occur in two particular versions that crystallized in the course of the 19th century, namely as ‘nations’ that would unify or liberate themselves from monarchical and/or imperial domination to form the polities proper to them, or as a ‘class’ that embodied the universal interest of humankind and would assert itself in a second revolution, following up on the French Revolution. Political concepts acquired during that period the meaning that they still had in the late 20th century, i.e. the time when Koselleck developed his approach to the history of concepts, but they may be challenged in the present time, and with them the entire self-understanding of modern polities. The recent Catalan conflict serves to better understand this challenge. ‘People’ and ‘nation’ are there used in ways that are reminiscent of this politico-conceptual tradition, but in a highly ambiguous way. On the one hand, they are employed in exactly their historical meaning: the Catalan people and nation are seen to be finally fulfilling their historical role of reaching political self-determination. On the other hand, these concepts are re-deployed to place them in the current context of existing democratic commitments and institutions as well as high interdependence between polities, all the while claiming that Catalan independence opens up a new normative horizon of democracy, rights, and freedom. This article will try to show that this undeclared ambiguity is characteristic of our current situation in general. This is a situation in which the historically created political concepts have sedimented in institutions, and thus appear to have ‘consolidated’ and moved beyond their historicity. At the same time, they remain impregnated with particular historical experiences that can be re-interpreted to be mobilized in political struggles of the present. To assess the validity and acceptability of any such re-interpretation requires explicit reflection about the persistence of historicity in political concepts.


2020 ◽  
Vol 56 (1) ◽  
pp. 23-29
Author(s):  
Taylor Estes Gin ◽  
Patty Secoura ◽  
Tonya Harris ◽  
Shelly Vaden

ABSTRACT Balloon dilation has been described infrequently as a treatment for benign urethral strictures in dogs but is often a first-line therapeutic option for humans. Additional evidence is needed to evaluate the potential role of this procedure in veterinary medicine. The aim of the study was to describe the techniques used and evaluate the response to balloon dilation of benign urethral strictures in dogs. Medical records were reviewed from eight client-owned dogs who underwent balloon dilation of a benign urethral stricture over a 13 yr period in this retrospective case series. Clinical signs improved for five of eight dogs after a single balloon dilation during a follow-up period of 1 wk to 3 yr. After a second procedure, an additional dog demonstrated improvement for 5.5 yr. Adverse outcomes included urinary incontinence in two dogs and recurrent bacteriuria in four dogs. Findings suggest that balloon dilation is an effective, minimally invasive procedure for the treatment of benign urethral strictures in dogs. Urinary incontinence, urinary tract infection, and stricture recurrence are potential outcomes for dogs undergoing this procedure either as a result of the nature of the underlying disease or as a result of the procedure.


1999 ◽  
Vol 35 (2) ◽  
pp. 107-110 ◽  
Author(s):  
ME Reimer ◽  
MS Leib ◽  
MS Reimer ◽  
GK Saunders ◽  
SA Johnston

An 18-month-old, spayed female Australian terrier cross was presented with a 10-month history of chronic large bowel diarrhea. Ulceration and two proliferative masses in the rectum were seen on colonoscopy. Surgical resection was performed to remove the masses, and the dog recovered without complications related to surgery. Histopathology was consistent with the diagnosis of ganglioneuroma. The dog had no clinical signs of disease within three months of surgery and was completely normal 2.5 years after diagnosis. This is the first report providing follow-up and successful outcome of a ganglioneuroma in the gastrointestinal tract of a dog.


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