Variant Presentations of the Exstrophy-Epispadias Complex: A 40 Year Experience To investigate the diagnosis, surgical management and outcomes in patients with variant EEC. Variant presentations of the exstrophy-epispadias complex (EEC) span a wide range of abnormalities. The rarity and diversity of EEC variants can lead to challenges in the diagnosis and subsequent management of this population.
Moving Patient Reported Outcomes Towards Disease Specific Knowledge We would like to thank [insert name of reviewer] for [his/her] thoughtful examination of this manuscript. As outlined, a major finding of this work is that patients with high-risk non-muscle invasive bladder cancer (NMIBC) as defined by the European Urological Association and American Urological Association [ref] had significantly worse patient reported outcomes compared to those with non-high-risk disease. The survey tools utilized for the Medicare Health Outcomes Survey (MHOS) are not cancer specific instruments, yet still demonstrated statistically and clinically significant decreases in physical and mental health-related quality of life.
Testicular Acute Segmental Infarct Following Endovascular Repair of a Juxta-renal Abdominal Aortic Aneurysm: Case Report and Literature Review A 61-year-old male presented to our Accident & Emergency department with a three-day history of nausea and vomiting. On examination, he had a soft non-tender abdomen but pronounced pulsation of his abdominal aorta. A CT angiogram revealed a 6 cm juxta-renal abdominal aortic aneurysm with thrombus within the aneurysm sac and juxta-renal neck segment. There was also moderate atherosclerotic change of the common, internal and external iliac arteries bilaterally. Given the lack of a suitable infra-renal sealing zone for the stent graft, he underwent a complex endovascular aortic aneurysm repair using a stent graft (Cook Medical, Limerick, Ireland) with supra-renal coverage with four-vessel fenestrations (coeliac axis, superior mesenteric and left and right renal arteries).
Predictors Of Post-Operative Urinary Incontinence After Holmium Laser Enucleation Of The Prostate: 12 Months Follow Up Holmium laser enucleation of the prostate (HoLEP) is a well-studied, contemporary surgical treatment for benign prostatic hyperplasia (BPH), with multiple series reporting on its efficacy and safety.1-8 In these reports, varying rates of post-operative urinary incontinence (UI) have been described. During the early post-operative period, UI is common, but typically transient. Reported post-operative incontinence rates at less than 6 months range from 16.6-29.4%,1-6 with rates at 12 month follow up decreasing to 0-3.3%.
Sarcomatoid Cancer of Penis in a 45 Year Old Male A 42-year-old male patient presented to the outpatient department of our hospital with purulent discharge per urethra when voiding and a mass at the tip of the penis for the past 3 months. The patient had visited multiple practitioners of alternative medicine at his hometown before visiting our centre, but had no relief in his symptoms along with a progression in the size of the mass. There was no history of any surgical intervention or intervention on the penis in the past. The patient was sexually active and monogamous.
Comment on “Low-intensity Extracorporeal Shock Wave Therapy for Erectile Dysfunction: A Systematic Review and Meta-analysis.” We recently read with great interest the article published in Urology by Man Libo et al1, which described a systematic review and meta-analysis of low-intensity extracorporeal shock wave therapy (LI-ESWT) for erectile dysfunction (ED). Their meta-analysis included nine randomized controlled trials (RCTs) to investigate the LI-ESWT for patients with ED, the therapeutic efficacy of LI-ESWT for patients with ED, and the relationship of therapeutic efficacy and different setup parameters and protocols.
Obstructing Nephrolithiasis in an 84-year-old Patient With a Diaphragmatic Herniated Ureter Diaphragmatic herniations of the ureter are a rare occurrence overall, with fewer than 10 cases reported. Obstructing nephrolithiasis in the setting of diaphragmatic ureteral herniation has sparsely been documented. Management options to consider include ureteroscopy and laser lithotripsy to alleviate obstruction in herniated ureters. The abnormal path of the ureter and surrounding structures pose unique risks that require careful attention and a high level of operator skill.We present imaging of an 84-year-old woman incidentally found to have right ureteral herniation through the diaphragm with an obstructing 8 mm stone in the right proximal ureter with moderate hydronephrosis.
Urologic Management of Priapism Secondary to Chronic Myeloid Leukemia A 27-year-old Caucasian male with a history of chronic myeloid leukemia (CML), diagnosed at age 19, presented to his local emergency department with a painful persistent erection of 9 hours duration. He reported a history of 2 prior episodes of painful erections unrelated to sexual activity over the last 2 months, with each episode lasting less than 4 hours. Although his CML had been managed long-term with Imatinib (Gleevec), on presentation he admitted to medication noncompliance with Imatinib over the past year.
Partially Obstructed Longitudinal Vaginal Septum Presenting in Adulthood With Complaint of Urinary Incontinence A longitudinal vaginal septum can be obstructive or nonobstructive. We report on an adult woman who presented with involuntary fluid loss per vagina and had a partially obstructive longitudinal vaginal septum. A 36-year-old nulliparous female presented with malodorous, clear, leakage per vagina that she described as “urinary incontinence.” Examination revealed a fluid-filled fluctuant anterior vaginal wall with a draining sinus. Imaging revealed a solitary right kidney with duplicated ectopic fluid-filled ureters inserting into a partially obstructed left hemivagina with a longitudinal vaginal septum.
“Re: Direct Vision Internal Urethrotomy for Short Anterior Urethral Strictures and Beyond: Success Rates, Predictors of Treatment Failure, and Recurrence Management” I have read the articles of Kluth et al named “Direct Vision Internal Urethrotomy for Short Anterior Urethral Strictures and Beyond: Success Rates, Predictors of Treatment Failure and Recurrence Management” with interest.1 In the discussion part of the article, publications of Zehri et al were referenced.2 It is stated in the article that the success rate after internal urethrotomy is given as 37% in writing of Zehri et al titled “Predictors of recurrence of urethral stricture disease following optical Urethrotomy.” However, in abstract section of original article of Zehri et al, it is said: “For a mean follow up of 8.9+/-11 months, the overall recurrence rate was 37%, with mean time to recurrence of 4.5 months.” This means 37% is not a success rate, it is the rate of repeat (unsuccess).
Robotic-assisted Proximal Perineal Urethroplasty: Improving Visualization and Ergonomics 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.
Isoflavone Intake in Early Pregnancy and Hypospadias in the Japan Environment and Children's Study To explore the association between isoflavone intake in early pregnancy (the critical window of masculinisation) and hypospadias. Since oestrogen is likely to contribute to the differentiation of male external genitalia, dietary intake of isoflavone, which has a similar structure to human oestrogen, may be associated with the occurrence of hypospadias. However, there has been little evidence of this association.
The DACRON Ureter: A Case of Ureter to Aorto-Femoral Dacron Graft Fistulization We present a case of chronic, severe, intermittent hematuria found to be associated with a ureteral to aorto-femoral bypass fistulization. The graft was directly visualized on ureteroscopy and identified as the source of hematuria during exploratory laparotomy. Ureteral fistulization is a rare etiology of hematuria. Ureteral fistulization to an arterial graft has been reported several times in past decades. However, no cases have reported direct visualization of the dacron graft on ureteroscopy.
Case of Delayed Ileal Conduit Necrosis Related to Infiltrative Diffuse Large B-cell Lymphoma The ileal conduit (IC) is the most common form of urinary diversion, accounting for 33%-84% of all diversions performed in the United States.1,2 IC is an excellent reconstructive option for patients who require cystectomy for bladder cancer, other pelvic malignancies or benign conditions such as neurogenic bladder/spina bifida, refractory radiation cystitis, and bladder fistulae. While IC is the simplest form of urinary diversion to construct and manage long-term, early and late complications are not uncommon.
Dermatofibrosarcoma Protuberans in a Male Infant Dermtofibrosarcoma protuberans is a rare cutaneous malignancy known to be locally aggressive. It is uncommonly seen in the pediatric population and can be difficult to distinguish from other benign skin lesions. We present a case of dermatofibrosarcoma protuberans of the penis in a 6-month-old child managed with surgical resection. This case highlights the challenges of diagnosis of genital lesions in children and the complexities of genitourinary reconstruction following surgical resection.
Onabotulinum toxin A Injections in Men With Refractory Idiopathic Detrusor Overactivity To establish the effectiveness and safety profile of Onaboulinum toxin A (BTX-A) in men with idiopathic detrusor overactivity and compare with the outcomes observed in women. Several randomized trials have demonstrated the effectiveness of intradetrusor BTX-A injections in improving symptoms and quality of life in patients with overactive bladder (OAB) symptoms. Most trials however contained relatively few men or excluded men altogether.
Primary Extrarenal Type 2 Papillary Renal Cell Carcinoma: A Case Report Type 2 papillary renal cell carcinoma (PRCC) is a malignant tumor originated from renal tubular epithelial cells. Here we present a rare case of extrarenal type 2 PRCC which is located at the right lateral side of the retroperitoneal inferior vena cava. No suspicious lesions were detected in the bilateral kidneys. The diagnosis was confirmed by histopathological examination after complete excision of the tumor. No recurrence was observed in 5 months of follow-up after surgery.
The Treatment of Genitoperineal Hidradenitis Suppurativa: A Review of the Literature 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. The multidisciplinary care team includes rheumatology, wound care, and reconstructive urologic surgery.
Renal Replacement Lipomatosis: From Conception to Birth Renal replacement lipomatosis is a rare disease characterized by renal parenchymal atrophy and proliferation of inflammatory and fatty cells within the renal sinus, hilum, and perirenal region. The exact pathogenesis is unknown, however more than 75% of cases are associated with renal stones. Here, we provide images from a case with 10 years of follow-up, outlining the radiographic progression of the disease through time. Although only histopathology can confirm the diagnosis, high clinical suspicion in combination with the radiographic findings can differentiate the disease from other fat-containing entities.
Rare Images of Urethral Hemangioma and its Management Hemangioma of the genitor-urinary tract commonly involves the kidney and the bladder. Urethral hemangioma is rarely encountered with only case reports available in literature.1 Larger lesions involving almost the entire penile urethra in length and width, and requiring open excision and reconstruction, are even rarer. We report the case of a 23-year-old male presenting with recurrent, intermittent urethral bleeding with normal urination for 3 years. Evaluation revealed a urethral growth which was managed with excision and reconstruction using buccal mucosa.
Cystadenoma of the Seminal Vesicle: A Case Report of Rare Seminal Vesical Tumor and Review of Literature Although the secondary involvement of the seminal vesicles by prostate cancer is relatively common, seminal vesicle as a primary site for neoplastic disease is uncommon.1 There are a wide variety of tumors among primary seminal vesicle tumors that are derived from both the epithelium and stroma. Hence, they have been classified as mixed epithelial-stromal tumors. This report describes a 32-year-old man who presented with a retrovesical cystic mass that was initially thought to be a prostatic tumor but demonstrated pathologically to be a cystadenoma of the seminal vesicles.
Vapoenucleation of the Prostate Using 180 W GreenLight Laser The vapoenucleation of the prostate using green laser is an alternative hybrid technique between vaporization and enucleation. It consists of vaporizing the lateral lobes and enucleating the median lobe.The advantages compared with photoselective vaporization of the prostate (PVP) are: a fairly fast operation, low reoperation rates, it is suitable for large glands and provides pathology specimen.The aim of this video is to demonstrate the vapoenucleation technique step-by-step.
Management of High-grade, Nonmuscle Invasive Urothelial Carcinoma in a Prepubertal Patient With TURBT and Intravesical BCG High-grade urothelial carcinoma of the bladder is rare in the pediatric population with no established guidelines for management. We treated a single female patient, 10 years of age, who was found to have high-grade, nonmuscle invasive urothelial carcinoma endoscopically and with intravesical bacille calmette guerin (BCG). Given the child's age, no local adult institution could provide BCG therapy. Utilizing the experience of the local adult institutions, we developed a comprehensive protocol for first-time delivery of BCG at a free-standing children's hospital.
Real-World Impact of Minimally Invasive Versus Open Radical Cystectomy on Perioperative Outcomes and Spending To evaluate the effect of the minimally invasive approach on spending and perioperative outcomes for patients undergoing radical cystectomy for bladder cancer. In a randomized control trial conducted at high-volume centers, robotic, and open cystectomy were shown to have similar outcomes. However, because the majority of cystectomies are performed in low-volume centers, it is unknown whether these findings are broadly generalizable.
A Serrated Hyperplastic Colonic Polyp of the Urinary Bladder Intestinal metaplasia of the urinary bladder can occur within the surface urothelium due to chronic irritation in repaired exstrophic urinary bladder. Colonic villous adenomas and tubulovillous adenomas with high-grade dysplasia and associated adenocarcinoma have been reported in adult patients with a history of augmented exstrophic bladder. To our knowledge, we report the first example of a nonadenomatous serrated hyperplastic colonic polyp in an elderly patient with a history of exstrophic bladder.
Extreme Price Variation for Generic Benign Prostatic Hyperplasia Medications To characterize geographic variability of generic benign prostatic hyperplasia (BPH) medications in order to improve drug price transparency and improve patient access to affordable medication sources. This is of interest because BPH is one of the most common chronic diseases in men and contributes to individual healthcare cost. Medical therapy is the main treatment modality for BPH, burdening patients with lifelong medication expenses which may impact adherence and subsequent outcomes. With an aging population, this is compounded by many older individuals requiring multiple daily medications.
An Antenatally Detected Pure Malignant Rhabdoid Tumor of the Bladder Pediatric malignant rhabdoid tumors are a rare entity with poor prognosis. The extrarenal variants of this disease are sparsely presented within the literature. Our case represents, to our knowledge, the first antenatally detected bladder-variant. At 19 months of age, this patient has benefited from early detection and intervention and remains disease free following partial cystectomy and chemotherapy.
Risk of Ovarian Malignancy in Patients Undergoing Radical Cystectomy for Bladder Cancer To determine whether there is an increased risk of ovarian cancer in women undergoing radical cystectomy (RC) for bladder cancer using a large population-based data source. Current American Urologic Association guidelines suggest removal of ovaries during RC in women with bladder cancer, presumably to mitigate the risk ovarian cancer. However, recent data have demonstrated an increased risk of all-cause mortality, cardiovascular disease, osteoporosis, cognitive impairment, and diminished sexual function in some populations of women after oophorectomy.
Diabetic Bladder Dysfunction:A Review Diabetic bladder dysfunction affects almost half of all diabetic patients, making it one of the most common complications of diabetes mellitus. The clinical presentation of diabetic bladder dysfunction can be varied and may be extremely bothersome to patients, negatively impacting their quality of life. Despite this, it remains understudied and under-represented in the medical literature. This review summarizes the current literature on pathophysiology, clinical presentation, urodynamic findings, evaluation, and management.
Re: Dal Moro: Concerns About the Use Of A Free Graft During York-Mason Intervention (Urology 2018;XX:XXX–XXX) While we recognize the thoughtful nature of this critique regarding the use of interposing fat grafts during the modified York-Mason procedure, we disagree with the concept of aberrant functionality or healing results. On the contrary, urinary and fecal streams are individually repaired to completion—the fat graft then is placed between the water-tight suture lines as a finalizing barrier. We reject the notion that interposing fat in this manner creates anatomic distortion of any physiological significance.
Concerns About the Use of a Free Graft During York-Mason Intervention I would like to congratulate McKibben et al1 on their recent paper, focused on the York-Mason intervention in the treatment of iatrogenic rectourinary fistulas. The analysis of the functional results of their series demonstrated that this approach is safe and efficacious in treating this devastating complication of prostatic surgery. Interestingly, they introduced an adjunctive maneuvre modifying the original York-Mason technique: the interposition of a local free graft of subcutaneous fat between the urothelial and the rectal tissues.
Hypoglycemia in Renal Cell Carcinoma: A Rare Paraneoplastic Syndrome A 65-year-old male adult foster care patient presented to the emergency room with altered mental status and respiratory depression which required intubation. The patient was also found to be hypoglycemic and hypertensive. He was admitted to the medical intensive care unit where a chronic type B aortic dissection and an exophytic superior pole right renal mass measuring 4.5 × 5.5 cm were discovered on computed tomography scan (Fig. 1). He continued experiencing recurrent episodes of hypoglycemia during his admission and was placed on double portion meals and intravenous glucose with dextrose 10% (D10) in water.
A Large Urinary Bladder Hemangioma Mimicking Urachal Cancer: A Case Report and Literature Review Urinary bladder hemangiomas are rare, especially in children and adolescents. We present a case of a 17-year-old young man with persistent gross hematuria for 1 month. Computed tomography revealed a 3.6 cm mass on the superior anterior wall of the urinary bladder, which was highly suspected as an urachal tumor. We carried out an en bloc resection of the urachus and bladder tumor. The pathologic report indicated a cavernous hemangioma of the urinary bladder. No tumor recurrence or bleeding was found during the 2-year follow-up.
Herniated Kidney Postoperative incisional hernia is a relatively common complication following abdominal surgery. Herniation of the kidney is a less common entity and typically occurs as a congenital or acquired diaphragmatic defect, and rare case reports have demonstrated partial flank or lumbar herniation of the kidney. Herein we present a unique case of a postoperative incisional hernia containing the entire right kidney.
Post-prostatectomy Lymphocoele Presenting With Renal Failure Since its advent in 2001, robotic-assisted laparoscopic prostatectomy has become the gold standard treatment for the management of localized prostate cancer.Pelvic lymphocoele is most commonly found after gynecological or renal transplant surgery or following extensive pelvic lymphadenectomy. Its formation following prostatectomy is not uncommon1 but it seldom causes major complications or morbidity.2We present a case of a 66-year-old man who presented with left-sided abdominal pain, a palpable infra-umbilical mass, and renal failure.
Active Surveillance of Small Renal Masses Most renal masses in the United States are incidentally detected via abdominal imaging. This has led to an increase in the incidence of small renal masses (≤4 cm). Active surveillance is, an oncologically safe option in slow growing and indolent tumors in other organs and has recently become more widely studied in small renal masses. For selected patients, particularly those who harbor significant comorbidities, active surveillance is a safe option for small renal masses. Renal biopsy may be helpful in the decision making process, but remains an optional component for the active surveillance of small renal masses.
Testosterone therapy for high-risk prostate cancer survivors: a systematic review and meta-analysis A systematic review and meta-analysis was performed to determine the relationship between testosterone therapy and risk of recurrence in testosterone-deficient survivors of curatively treated high-risk prostate cancer. Primary outcome was the risk of biochemical recurrence (BCR) in 109 high-risk patients in 13 included studies (1997-2017). Biochemical and symptomatic effects of therapy were also reviewed. The BCR rate was 0.00 (0.00-0.05), lower than the expected rate for high-risk prostate cancer survivors, suggesting that testosterone therapy may not increase their BCR risk.
The History of Urology at the Minneapolis Veterans Affairs Health Care System The Section of Urology at the Minneapolis Veteran's Affairs (VA) Medical Center has a long history of contributions to Urology including the Gleason Score, Fuhrman Grading system, testicular tumor marker development and the birth of Endourology. The objective of this manuscript is to compile and present the Urologic history of the Minneapolis VA.
Reply by the Authors: Shock-wave Lithotripsy for Pediatric Patients: Which Nomogram Can Better Predict Postoperative Outcomes? The prediction of the success rate of shock-wave lithotripsy is an important issue, especially for pediatric patients. Therefore, clinicians should use these nomograms more often in daily practice to improve surgical planning. In our study, we compared the accuracy of the Onal and Dogan nomograms. We demonstrated that both nomograms are effective and independent predictors of stone-free rate. We used objective variables such as gender, age, stone size, number of stones, stone localization, and history of previous treatment.
Variability of Retail Pricing of Generic Urologic Medications in a Major US Metropolitan Area Objective: To investigate retail pricing for generic urologic medications in the St. Louis area as a function of pharmacy type, zip-code, and median income.Materials and Methods: Pharmacies spanning 51 zip-codes were identified. From May-June 2017, pharmacies were inquired regarding cost, without insurance, for 30- and 90-tablet prices for finasteride 5mg, tamsulosin 0.4mg, oxybutynin 5mg, and oxybutynin ER 5mg and 10mg. Median income was determined using US census data.K-means clustering defined groupings based on zip-code, median income, and a combination of the two.
Comparison of RENAL, PADUA, CSA, and PAVP Nephrometry Scores in Predicting Functional Outcomes After Partial Nephrectomy To evaluate the accuracy of radius, exophytic/endophytic, nearness to collecting system/sinus, anterior/posterior, and location relative to polar lines (RENAL), preoperative aspects and dimensions used for anatomical classification (PADUA), contact surface area (CSA), and preoperative assessment of volume preservation (PAVP) nephrometry scores in predicting postoperative renal functional outcomes after partial nephrectomy (PN). Few studies have compared the accuracy of tumor complexity systems directly in the same set of PN patients.
High Catastrophizing in Subjects With Painful Mesh Complications Leads to Worse Outcomes To identify the rate of catastrophizing in a cohort of subjects with chronic pain after self-reported mesh complications and identify interactions of catastrophization with other patient factors, such as age, number of pelvic surgeries, and intent to sue. Catastrophizing has been shown to be a risk factor for chronicity of pain, disability, and depression.
Association Between Exstrophy-epispadias Complex And Congenital Anomalies: A German Multicenter Study To further investigate associated anomalies in exstrophy-epispadias complex (EEC) patients congenital uro-rectal malformations network (CURE-Net) database was systematically screened. In literature the EEC comprises a spectrum of anomalies, mainly occurring “isolated” without additional congenital defects. Nevertheless, previous epidemiological studies indicated a higher association with renal, anorectal, and lower neurotubular anomalies, which may originate from the same developmental morphogenetic fields.
The Prognostic Value of PIK3CA Copy Number Gain in Penile Cancer To determine whether phosphatidylinositol-4,5-bisphosphate 3- kinase, catalytic subunit alpha (PIK3CA) copy number gain in penile cancer has prognostic value and association with histopathological parameters, human papillomavirus (HPV), and clinical outcome.
Complications of Delivery Among Mothers With Spina Bifida To determine rates and types of peripartum morbidity among delivering women with spina bifida (SB) compared to those without SB. The rates of pregnancy and delivery among women with SB have been significantly increasing. Current knowledge of peripartum outcomes for these women is limited.
Growing Teratoma Syndrome of Testicular Origin A 20-year-old Hispanic male who is a semiprofessional soccer player with no medical history presented to the emergency department with 1 month of abdominal distension and 4 days of left lower extremity swelling. During initial interview, the patient offered that his testicle had been enlarged for approximately 4-6 years, without any workup or intervention. A firm nontender abdomen, enlarged left hemiscrotum, and left lower extremity swelling were noted on physical examination. A left supraclavicular lymph node was also palpable.
Bladder Agenesis and Associated Pelvic Arterial Anomaly in 2 Female Pediatric Patients Bladder agenesis is an extremely rare congenital anomaly of the genitourinary tract. Two female patients with known diagnoses of bladder agenesis presented for prerenal transplant evaluation and neobladder creation. Similar unique pelvic arterial malformations were identified through preoperative imaging and intraoperative examination. With these similar findings, it could be proposed that such anatomical variants are products of the same insult or involve a causal relationship, with vascular aberrancies potentially provoking pelvic organ maldevelopment.
Impact of Statin Intake on Kidney Stone Formation To determine whether statin intake affects nephrolithiasis risk, and whether higher lipid levels correlate with stone risk. Dyslipidemia is a known independent risk factor for urolithiasis, and emerging evidence suggests common biological pathways. Previous work has suggested that statins protect against new stone formation, but these findings have not been verified by other investigators.
Dual Pathology Causing Congenital Bladder Outlet Obstruction Anterior urethral syringocele is an uncommon congenital deformity characterised by cystic dilatation of bulbo-urethral gland ducts and is usually asymptomatic. We present a case on 4-day-old male neonate who presented with bilateral antenatal hydroureteronephrosis and renal impairment and found to have urethral syringocele and posterior urethral valves (PUV).
Author Reply The comments of the editor truly reflect the findings of our study on the surgical treatment of giant penoscrotal lymphedema. All the 19 patients described in the study were to be treated by surgery. Eight patients, however, defaulted, possibly because of their belief in alternative traditional herbal medicine and or financial constraint, because health insurance schemes are yet to be fully established in our environment.
WITHDRAWN: Stented or Unstented Distal Hypospadias Repair The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.urology.2017.04.057. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
WITHDRAWN: Reply The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.urology.2015.08.053. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
WITHDRAWN: Editorial Comment The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.urology.2013.02.086.The duplicate article has therefore been withdrawn.
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