Search Our Scientific Publications & Authors

Hernia 2019 Mar 18. Epub 2019 Mar 18.

Departments of Digestive and General Surgery, Hospital Saint-Antoine AP-HP, Sorbonne Université, Paris, France.

Purpose: Perineal hernia (PH) is a tardive complication following abdomino-perineal resection (APR). Many repair methods are described and evidences are lacking. The aim of this study was to report PH management, analyze surgery outcomes and review the available literature. Read More

Urology 2019 Mar 14. Epub 2019 Mar 14.

Department of Plastic Reconstructive and Aesthetic Surgery, Erciyes University School of Medicine Gevher Nesibe Hospital, 38030 Melikgazi, Kayseri. Electronic address:

Objective: To reconstruct the defect secondary to Fournier's gangrene, which is an infection localized in the perineum and the lower abdominal region, characterized by large tissue loss following debridement. A large tissue loss caused by Fournier's gangrene brings with repair problems. The primary goal is to achieve cosmetically and functionally successful results. Read More

Front Pediatr 2019 19;7:24. Epub 2019 Feb 19.

Urology Unit, Department of Surgery, Hospital de Niños Ricardo Gutierrez, associated to the University of Buenos Aires, Buenos Aires, Argentina.

Management of partial or complete traumatic urethral disruptions of the posterior urethra in children and adolescents, secondary to pelvic fracture poses a challenge. Controversy exists as to the correct acute treatment of posterior urethral injuries and delayed management of PFPUDDs. We reviewed the urological literature related to the treatment of traumatic posterior urethral injuries and delayed repair of these distraction defects in children and adolescents. Read More

J Plast Reconstr Aesthet Surg 2019 Jan 9. Epub 2019 Jan 9.

Division of Plastic and Reconstructive Surgery, University of Ottawa, Ottawa, Ontario, Canada. Electronic address:

Purpose: Pelvic reconstruction following abdominoperineal resection or pelvic exenteration is associated with signification surgical site morbidity. Immediate pelvic reconstruction with a muscle flap is now the gold standard, associated with reduced perineal morbidity compared to primary closure alone. The purpose of the present study was to directly compare outcomes of VRAM and gracilis flap pelvic reconstruction following oncologic resection. Read More

J Pediatr Surg 2018 Dec 29. Epub 2018 Dec 29.

Pediatric Surgery Department, Cà Foncello Hospital, Treviso, Italy.

Aim: Perineal hemangiomas rarely occur in patients with anorectal malformations (ARMs), but they can pose a significant challenge and warrant special attention. Surgical incision of posterior sagittal anorectoplasty (PSARP) may involve the hemangioma site resulting in hemorrhage, damage to blood supply, leading to complications and adversely affecting outcome. The aim of this study was to review the experience of the ARM-Net Consortium in the management of perineal hemangioma associated with ARM and evaluate treatment strategies. Read More

J Urol 2019 Jan 28. Epub 2019 Jan 28.

Departments of Urology, University of California-San Francisco, San Francisco.

Purpose: Perineal urethrostomy is a viable option for many complex urethral strictures. However, to our knowledge no comparison with anterior urethroplasty regarding patient reported outcome measures has been published. We compared these groups using a large multi-institution database. Read More

Ther Adv Urol 2019 Jan-Dec;11:1756287218813787. Epub 2019 Jan 8.

Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA.

Radical prostatectomy (RP) is the most frequent treatment with curative intent performed for prostate cancer to date. Different surgical approaches (perineal, transperitoneal, and extraperitoneal) and techniques (laparoscopic and robot assisted) have been described to increase the efficiency and potentially diminish the postoperative complications of this procedure. The aim of this narrative review is to investigate and define the factors that influence postprostatectomy urinary continence. Read More

Microsurgery 2019 Mar 21;39(3):263-266. Epub 2019 Jan 21.

Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Fournier's gangrene is lethal necrotizing fasciitis that involves the perineum and external genitalia. We describe the case of a 52-year-old man with Fournier's gangrene who underwent reconstruction of an extensive perineoscrotal defect using three pedicled perforator flaps. Three debridement procedures resulted in a skin and soft tissue defect of 36 × 18 cm involving the perineum, scrotum, groin, medial thigh, buttocks, and circumferential perianal area and left the perforating arteries originating from these locations unavailable for reconstruction. Read More

J Obstet Gynaecol Res 2019 Jan 16. Epub 2019 Jan 16.

Department of Gynecology and Obstetrics, Development and Related Disease of Women and Children Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China.

Aim: To compare total pelvic floor reconstruction with vaginal mesh (TVM) and laparoscopic uterus/sacrocolpopexy (LSC) for the treatment of pelvic organ prolapse (POP).

Methods: Six hundred and seventy patients with POP stage 3 and 4 underwent LSC (n = 350) or TVM (n = 320) at the West China Second Hospital, Sichuan University between January 2011 and December 2016. Retrospective analysis was done to compare the POP-Q value before operation and 6 months, 5 years after operation, also compare the, patient global impression of change (PGI-C), pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7). Read More

Ann Plast Surg 2019 Jan 9. Epub 2019 Jan 9.

University of Rochester School of Medicine and Dentistry, Rochester, NY.

Background: Abdominoperineal resection is the treatment for many anorectal malignancies. The laparotomy approach allows for harvest of the rectus abdominis muscle for perineal reconstruction. However, with increasing numbers of robotic abdominoperineal resections being performed, the morbidity associated with a laparotomy incision is avoided. Read More

Wounds 2019 Jan;31(1):15-18

Osiris Therapeutics, Inc, Columbia, MD.

Introduction: Surgical closure of late-stage pressure ulcers (PUs) poses challenges in the immobilized population due to the high rate of complications, including infection, dehiscence, and recurrence. Muscle flap closure is the standard treatment for chronic, late-stage (stage 4) PUs, characterized by the European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel as full-thickness tissue loss with exposure of bone, tendon, or muscle.

Objective: The aim of this study is to evaluate the outcomes associated with the use of a cryopreserved placental membrane containing viable cells (vCPM) graft for the augmentation of surgical flap closure in nonhealing perineal ulcers. Read More

Int J Low Extrem Wounds 2019 Jan 8:1534734618818685. Epub 2019 Jan 8.

1 Ruijin Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China.

Fournier's gangrene is a rare, rapidly progressing, and life-threatening infection associated with necrotizing fasciitis in the perineal, genital, and/or lower abdominal regions. Septic shock and multiple organ dysfunction syndrome due to the condition are even rarer events. We describe the case of a 58-year-old man who visited the emergency department with severely painful swelling in the scrotal, perianal, and lower abdominal regions. Read More

Vet Surg 2019 Jan 7. Epub 2019 Jan 7.

Centro Veterinario Luni Mare, La Spezia, Italy.

Objective: To describe a temporary end-on colostomy to treat the dehiscence of a transanal rectal pull-through in a dog.

Study Design: Case report ANIMAL: A 7-year-old intact female Australian shepherd dog that was treated for a rectal adenocarcinoma with a transanal rectal pull-through.

Methods: Partial dehiscence of the previous end-to-end colorectal anastomosis and formation of a perianal sinus tract were diagnosed 4 days after surgery. Read More

Int J Colorectal Dis 2019 Jan 4. Epub 2019 Jan 4.

Department of Plastic and Hand Surgery, Faculty of Medicine, University of Freiburg, im Breisgau, Germany.

Aim: Perineal defects following the resection of anorectal malignancies are a reconstructive challenge. Flaps based on the rectus abdominis muscle have several drawbacks. Regional perforator flaps may be a suitable alternative. Read More

Ann Med Surg (Lond) 2019 Feb 21;38:28-33. Epub 2018 Dec 21.

Department of Colorectal Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicestershire, UK.

Introduction: The optimal method for perineal reconstruction after extralevator abdominoperineal excision (elAPE) for low rectal cancer remains controversial. This study aimed to assess whether simultaneous perineal reconstruction and parastomal reinforcement with Strattice™ Reconstructive Tissue Matrix after elAPE could prevent hernia formation.

Methods: In this prospective, multicentre, observational, non-comparative study of consecutive patients undergoing elAPE for low rectal cancer underwent simultaneous perineal reconstruction and colostomy site reinforcement with Strattice™ mesh. Read More

Wilderness Environ Med 2019 Mar 24;30(1):59-62. Epub 2018 Dec 24.

Department of Vascular Surgery, University Hospital Coventry and Warwickshire, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK.

Extremities are the area of the body most commonly affected by frostbite, which can also affect the face, ears, perineum, or genitals. Optimum management has moved away from early amputation and debridement toward maximizing tissue preservation and delaying surgical intervention. Increasing length of digit amputation increases morbidity, in terms of loss of hand function, experienced by patients. Read More

J Vet Med Sci 2019 Feb 26;81(2):237-240. Epub 2018 Dec 26.

Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, #120 Neungdong-ro, Gwangjin-gu, Seoul 05029, South Korea.

A castrated male Shih-Tzu dog was presented for evaluation of urine leakage after urethrotomy. A fistula with urine leakage was identified in the perineal region. On retrograde urethrography, the contrast extravasated from the penile urethra into the subcutaneous tissue of the perineum. Read More

Microsurgery 2018 Dec 17. Epub 2018 Dec 17.

Department of Plastic and Reconstructive Surgery, China Medical University, Taichung, Taiwan.

Background: The medial thigh is a well-hidden area. The two most common flaps from this area are the transverse upper gracilis (TUG) and profunda artery perforator (PAP) flaps. Herein, we explored the applications of combined TUGPAP flap to reconstruct large and complex defects in different regions. Read More

Ann Plast Surg 2019 Feb;82(2):218-223

Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham NC.

Background: Primary perineal closure following abdominal perineal resection (APR) is reported to have a wound complication rate as high as 66%, whereas flap reconstruction reduces wound complications to 15% to 35%. A modified de-epithelialized V-Y fasciocutaneous flap aims to further improve results in this patient population.

Methods: To study the breaking force of a simple interrupted suture in either skin or subcutaneous fat, various quantitative assessments were performed in a porcine flap model using uniaxial static tensile testing with an Instron tensiometer, with a single or triple row of 3 Vicryl sutures in both skin and fat. Read More

Colorectal Dis 2019 Mar 16;21(3):365-369. Epub 2019 Jan 16.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia.

Aim: Perineal wound complications and pelvic abscesses remain a major source of morbidity after total pelvic exenteration. The void created in the pelvis after these multi-visceral resections leads to fluid accumulation and translocation of bowel within the pelvic cavity, which may increase the risk of pelvic abscess, perineal fluid discharge with perineal wound dehiscence and prolonged ileus. This study describes a novel technique using degradable synthetic mesh with overlying omentum to preclude small bowel and fill the empty space after total pelvic exenteration, and aimed to investigate the rate of pelvic abscess and perineal wound-related complications in this group. Read More

Medicine (Baltimore) 2018 Dec;97(49):e13289

Department of Neurosurgery, Peking University Third Hospital, Beijing, China.

Rationale: Currently, interventional injection of albumin glue and nerve sleeve plasty by cyst excision is the main treatment for sacral cysts. However, albumin glue can only be used in patients with partial cystic neck stenosis, and surgical treatment may result in postoperative complications such as numbness and cyst recurrence. Here, a modified radiculoplasty is presented, in which the lamina is restored with the nerve root wrapped with 3-dimensional (3D)-printed artificial dura mater. Read More

Ann Surg Treat Res 2018 Dec 26;95(6):324-332. Epub 2018 Nov 26.

Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea.

Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes.

Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. Read More

Ann Chir Plast Esthet 2018 Nov 30. Epub 2018 Nov 30.

Service de chirurgie orthopédique et traumatologie, chirurgie du rachis, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.

Background: Sacral chordomas are rare primary bone tumors and represent more than half of all primary malignant sacral tumors. Surgical resection is the only treatment with close to 50% of remission at 10 years, with or without radiotherapy. This tissue removal can be very extensive and morbid, particularly for evolved tumors. Read More

Curr Probl Cancer 2018 Sep 23;42(5):486-492. Epub 2018 Nov 23.

Brigham and Women's Hospital, Boston, Massachusetts.

Anal squamous cell carcinoma (SCC) is a rare cancer and accounts for approximately 4% of all cancers of the lower alimentary tract. The dominant etiology is infection with human papilloma virus (HPV), which is the most common sexually transmitted disease in the United States. Integration of HPV DNA into the host genome seems to be the driving mechanism behind carcinogenesis. Read More

Turk J Urol 2018 Nov 21;45(2):139-145. Epub 2018 Nov 21.

King George's Medical University, Lucknow, India.

Objective: The management of recurrent posterior urethral strictures developing after pelvic fracture urethral injury (PFUI) is a challenging task. Despite availability of many surgical approaches, there is no consensus regarding the optimal approach. The objective of this study was to present our 10-year experience in the management of recurrent urethral strictures due to PFUI. Read More

Cureus 2018 Sep 17;10(9):e3319. Epub 2018 Sep 17.

Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, USA.

Background: Hidradenitis suppurativa (HS) is a physically debilitating disease that greatly impairs the quality of life of affected individuals. Advanced disease is often difficult to treat with topical and systemic therapies. Surgical resection of diseased skin has become paramount in HS management but proposes challenges of wound care and closure. Read More

Am J Surg 2018 Oct 10. Epub 2018 Oct 10.

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Background: Post-operative bedrest is common following perineal reconstruction despite little supporting data. We sought to determine the safety of early ambulation following colorectal oncologic resection and flap-based perineal reconstruction.

Methods: A retrospective cohort study was conducted with two cohorts: standard bedrest (BC) and early ambulation (EAC). Read More

J Am Coll Surg 2018 Dec;227(6):627-628

Besançon, France.

Urology 2019 Mar 16;125:230-233. Epub 2018 Nov 16.

Department of Urology, University of California San Diego, San Diego, CA. Electronic address:

Objective: To describe the use of the robotic platform for proximal suture placement during perineal urethroplasty in the posterior and proximal anterior urethra. Repair of posterior urethral and proximal bulbar strictures requires deep perineal dissection, making visualization and accurate placement of sutures challenging. The robotic platform has demonstrated benefits in these characteristics in deep pelvic surgery. Read More

Colorectal Dis 2019 Feb 11;21(2):138-155. Epub 2019 Jan 11.

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.

Aim: Perineal wound complications after abdominoperineal resection (APR) have become a major clinical challenge. Myocutaneous flap closure has been proposed in place of primary closure to improve wound healing. We conducted this comprehensive meta-analysis to evaluate the current scientific evidence of primary closure vs myocutaneous flap closure of perineal defects following APR for colorectal disease. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Nov;32(11):1454-1457

Department of Pediatric Surgery of Children's Medical Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu Sichuan, 610072, P.R.China.

Objective: To investigate the application of cavernosum reduction technology in glanuloplasty during the repair of moderate-severe hypospadias and evaluate the effectiveness.

Methods: The clinical data of 192 patients with moderate-severe hypospadias between November 2015 and May 2017 were retrospectively analyzed. Among them, 103 patients were treated with the cavernosum reduction technology in glanuloplasty during the repair (observation group), 88 patients were treated with repair and glanuloplasty without the cavernosum reduction technology (control group). Read More

Ginekol Pol 2018 ;89(10):558-562

Warsaw Proctology Centre, Saint Elisabeth Hospital, Warsaw, Poland, Poland; Department of General Surgery, District Hospital in Wołomin, Poland, Gdynska 1/3, 05-200 Wolomin, Poland.

Objectives: One of the most serious complications of vaginal delivery is 3rd and 4th degree perineal tear and its incorrect management results in anal incontinence. Animal-based anatomical models of childbirth-induced perineal tear are an important element of the physicians' practical training [1]. The proposed new model, prepared using porcine tongue and intestine, closely mimics all the tissues and organs subjected to injury during complicated deliveries and constitutes an educational opportunity for the reconstruction of the injuries. Read More

Int J Surg Case Rep 2018 29;53:115-119. Epub 2018 Oct 29.

Dermatology, OhioHealth Marion Area Physicians, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA. Electronic address:

Introduction: Cutaneous squamous cell cancer (cSCC) is a common condition, with straight forward and well-known heuristics regarding diagnosis, treatment, and surveillance. cSCC arising in an epidermal inclusion cyst is rare, but not unheard of. In contrast, the authors' are unaware of any prior reports of cSCC arising in an epidermal inclusion cyst within an atypical cavernous and cavitating lesion in the perineum. Read More

Urology 2019 Feb 2;124:1-5. Epub 2018 Nov 2.

Department of Urology, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Hidradenitis suppurativa is a chronic inflammatory condition affecting the axilla, genitals, perineum, and perianal regions. The pathophysiology of hidradenitis suppurativa is complex and requires a multidisciplinary approach to treatment involving medical and surgical management when indicated. We describe our multidisciplinary protocol for treatment, which includes rheumatology-monitored immunotherapy, medical management, wide surgical resection, wound care, and reconstruction. Read More

Cent European J Urol 2018 25;71(3):326-333. Epub 2018 Jun 25.

Carpe Vitam, Center of Reconstructive Pelvic Floor Surgery, Hannover, Germany.

Introduction: High failure and recurrent prolapse remains an important issue for pelvic organ prolapse (POP) surgery. The posterior intravaginal slingplasty (PIVS) is a minimally invasive, transperineal technique providing level I support, by creating neo-sacrouterine ligaments using a mesh. In order to reduce the POP recurrence rate, achieve a safer apical support and thereby better functional outcomes, we attached PIVS tape to the sacrospinous ligament bilaterally and compared the anatomical and functional outcomes for our modified technique versus the original PIVS. Read More

Pediatr Surg Int 2019 Feb 30;35(2):263-269. Epub 2018 Oct 30.

Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001-2, Ansari Nagar, New Delhi, 110029, India.

Purpose: We assessed the surgical outcome of cloacal malformation (CM) with emphasis on need and timing of vaginal replacement.

Methods: An ambispective study of CM was carried out including prospective cases from April 2014 to December 2017 and retrospective cases that came for routine follow-up. Early vaginal replacement was defined as that done at time of bowel pull through. Read More

J Pediatr Adolesc Gynecol 2019 Feb 24;32(1):7-14. Epub 2018 Oct 24.

Nationwide Children's Hospital, Columbus, Ohio.

Patients born with complex anorectal malformations often have associated Müllerian anomalies, which might affect fertility and obstetrical outcomes. Other vertebral-anorectal-tracheoesophageal-renal-limb associations, such as renal or cardiac anomalies, could also affect pregnancy intention, fertility rates, and recommendations about mode of delivery or obstetrical outcomes. Associated conditions present at birth, like hydrocolpos, could also potentially affect fertility. Read More

Int Wound J 2019 Feb 10;16(1):96-102. Epub 2018 Oct 10.

Plastic Surgery Service, Ospedale Santa Maria della Misericordia, Udine, Italy.

Many post-vulvectomy vulvar reconstruction solutions, using local fasciocutaneous flaps where possible, have been proposed. We report the use of V-Y advancement flaps from the gluteal fold in medium to large vulvar reconstructions and a simple modification we made to the technique in order to minimise wound-related complications. Between 2006 and 2016, 30 vulvar reconstructions were performed via a total of 59 flaps, 24 of which were raised using the proposed modification to the plasty design. Read More

Wounds 2018 Oct;30(10):290-299

Wright State University, Boonshoft School of Medicine, Division of Plastic Surgery, Dayton, OH.

Introduction: Fournier's gangrene (FG) remains a forbidding necrotizing soft tissue infection (NSTI) that necessitates early recognition, prompt surgical excision, and goal-directed antibiotic therapy. Traditionally, surgical management has included wide radical excision for sepsis control, but this management often leaves large, morbid wounds that require complex wound coverage, prolonged hospitalizations, and/or delayed healing.

Objective: The purpose of this case series is to report the outcomes of FG using a surrogate approach of concurrent debridement of spared skin and soft tissue, negative pressure wound therapy (NPWT), and serial delayed primary closure (DPC). Read More

BMJ Case Rep 2018 Sep 25;2018. Epub 2018 Sep 25.

Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Post-traumatic vesicocutaneous fistula (VCF) is a rare variant of urinary fistulas. These fistulas may externally communicate to abdomen, perineum, buttocks, scrotum or very rarely thigh. These fistulas usually develop at a variable time duration after trauma and are usually preceded with thigh swelling or abscess formation followed by spontaneous rupture. Read More

J Laparoendosc Adv Surg Tech A 2019 Feb 25;29(2):256-260. Epub 2018 Sep 25.

2 Department of Pediatric Surgery, Cairo University Specialized Pediatric Hospital , Faculty of Medicine (Kasr Alainy), Cairo, Egypt .

Introduction: Surgical management of the high urogenital sinus (UGS) is challenging. Presence of a short urethra is a contraindication for UGS mobilization as this is likely to affect urinary continence. In addition, vaginal reconstruction of the high suprasphincteric confluence is complex and prone to complications and failure. Read More

BMC Surg 2018 Sep 24;18(1):77. Epub 2018 Sep 24.

Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China.

Background: Perineum necrotizing fasciitis, also known as Fournier gangrene (FG), is a rare but highly mortal infectious necrotizing fasciitis with or without involvement of the underlying muscle. Evidence exists that negative pressure wound therapy (NPWT) combined with a split thickness skin graft (STSG) can help to heal wounds with FG. However, when the wound spreads to the anal area, it can easily be contaminated by faeces, causing a more extensive wounds; thus, faecal diversion is considered. Read More

Rev Int Androl 2018 Sep 17. Epub 2018 Sep 17.

Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España.

Vesicourethral anastomotic stenosis is a relatively uncommon problem after radical prostatectomy, but it could become recurrent and difficult to treat. Risk factors are known, and they can help to decrease the incidence. When discussing the therapeutic plan, we must consider the stenosis risk, and also the urinary continence after the prostatectomy. Read More

Transl Androl Urol 2018 Aug;7(4):567-579

Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Given its complex anatomy, injury to the posterior urethra may result in a number of reconstructive challenges. With the appropriate operative planning and experience, surgical repair can be very successful. This review discusses the applicable techniques for the perineal approach to posterior urethral stenosis, including bulbomembranous anastomosis for pelvic fracture urethral injury and repair of vesicourethral anastomotic stenosis (VUAS) following prostate surgery. Read More

Colorectal Dis 2018 Sep;20 Suppl 5:5-23

University of Bath, Bath, UK.

Background: Perineal wound morbidity is common following abdominoperineal excision of the rectum (APE). There is no consensus on the optimum perineal reconstruction method after APE, and in particular 'extra-levator APE' (ELAPE).

Methods: A systematic review of the PubMed, Embase and Cochrane databases was performed. Read More

Urol J 2018 Aug 26. Epub 2018 Aug 26.

Department of female urology, Shahid Hasheminejad Hospital, Iran university of medical sciences, Tehran, Iran.

In this article we present two-year-old male patient who had history of Fournier gangrene of scrotum. Extensive perineal and scrotal debridement with suprapubic cystostomy tube insertion had been done for him in the emergency setting One year later his parents brought him back for scrotal reconstruction. A novel technique by using rotational perineal flap was used. Read More

Urology 2018 Dec 20;122:169-173. Epub 2018 Aug 20.

Department of Urology, UT Southwestern Medical Center, Dallas, TX. Electronic address:

Objective: To evaluate procedural trends and outcomes for reconstruction of complex strictures at our tertiary center over the last decade.

Methods: We retrospectively reviewed complex urethral reconstruction comparing 3 techniques: (1) buccal mucosal graft (BMG), (2) penile skin flap, or (3) perineal urethrostomy (PU) at our center (2007-2017) with ≥6 months follow-up. Strictures amenable to anastomotic repair were excluded. Read More

World J Gastroenterol 2018 Aug;24(30):3440-3447

Department of Colorectal and Anal Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

Aim: To introduce a novel, modified primary closure technique of laparoscopic extralevator abdominal perineal excision (LELAPE) for low rectal cancer.

Methods: We retrospectively analyzed data from 76 patients with rectal cancer who underwent LELAPE from March 2013 to May 2016. Patients were classified into the modified primary closure group (32 patients) and the biological mesh closure group (44 patients). Read More

Int J Dermatol 2018 Dec 13;57(12):1471-1480. Epub 2018 Aug 13.

Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Background: Lymphedema is a debilitating complication of hidradenitis suppurativa (HS) that can be therapeutically challenging. Systematic evaluation of the clinical presentation and management of this condition has yet to be performed.

Methods: OVID MEDLINE and EMBASE databases were searched along with a review of the references of searched articles for all English reports discussing lymphedema secondary to HS. Read More