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Keihani S.,Pediatric Urology Research Center | Kajbafzadeh A.-M.,Pediatric Urology Research Center
Urology | Year: 2015

Posterior urethral valves (PUVs) are the most common cause of infravesical obstruction in children, whereas anterior urethral valves and/or diverticula (AUV/D) are less commonly encountered. Concomitant AUV/D and PUV is believed to be very rare and may be missed on the initial evaluation. In this review, we provide brief information on embryology of AUV/D and PUV to explain the concurrent presence of these anomalies. We also summarize the information on published cases of concomitant AUV/D and PUV in the English literature with a special focus on diagnosis and the importance of both voiding cystourethrography and careful urethrocystoscopy. © 2015 Elsevier Inc.

Sharifi E.,Tehran University of Medical Sciences | Azami M.,Tehran University of Medical Sciences | Kajbafzadeh A.-M.,Tehran University of Medical Sciences | Kajbafzadeh A.-M.,Pediatric Urology Research Center | And 6 more authors.
Materials Science and Engineering C | Year: 2016

Bone tissue is a composite material made of organic and inorganic components. Bone tissue engineering requires scaffolds that mimic bone nature in chemical and mechanical properties. This study proposes a novel method for preparing composite scaffolds that uses sub-micron bioglass fibers as the organic phase and gelatin/collagen as the inorganic phase. The scaffolds were constructed by using freeze drying and electro spinning methods and their mechanical properties were enhanced by using genipin crosslinking agent. Electron microscopy micrographs showed that the structure of composite scaffolds were porous with pore diameters of approximately 70-200 μm, this was again confirmed by mercury porosimetery. These pores are suitable for osteoblast growth. The diameters of the fibers were approximately 150-450 nm. Structural analysis confirmed the formation of desirable phases of sub-micron bioglass fibers. Cellular biocompatibility tests illustrated that scaffolds containing copper ion in the bioglass structure had more cell growth and osteoblast attachment in comparison to copper-free scaffolds. © 2015 Elsevier B.V.

Elmi A.,Pediatric Urology Research Center | Kajbafzadeh A.-M.,Pediatric Urology Research Center | Sadeghi Z.,Pediatric Urology Research Center | Tanhaeivash R.,Pediatric Urology Research Center | Mirzadeh H.,Iran Polymer And Petrochemical Institute
Urology | Year: 2010

Objectives: To investigate short-term results of symphysis pubis reapproximation in a simulated animal model of pubic diastasis using biodegradable plate and screw, in comparison with animals with no fixation, in terms of inflammatory reaction, histologic changes, and three-dimensional pelvic bone CT (3D-CT) scan. Methods: Fifteen male goats were divided in 3 groups and underwent midline pubic symphysiotomy. In GI (n = 6), the pubes were brought together with sutures through the bone and fixed by placing a biodegradable plate and screws. In GII (n = 3), symphysis was brought together by inserting sutures. Animals' pubes received no fixation in GIII (n = 6). Three-dimensional CT scan was performed, after 3 months in GII, and at the third and sixth months in GI and GIII. Furthermore, tissue-implant interface was examined for tissue reaction and implant degradation. Results: Pelvic bone 3D-CT scan in the biodegradable group revealed characteristic differences in pubic diastasis, iliac wing angle, and inter-triradiate distance compared with GII and GIII. Decreases of 21.8 ± 0.7 mm, 7.28 ± 0.4 mm, and 7.43 ± 1.5° were observed in pubic diastasis, inter-triradiate distance, and iliac wing angle, respectively, in biodegradable group in comparison with GIII in the sixth month. Neither clinical nor histologic evidence of inflammation due to insertion of biodegradable system was reported. Conclusions: Pubic bone adaptation with biodegradable plate and screws is a safe and reliable procedure for secure anterior pubic fixation in bladder exstrophy. Easy intraoperative handling, no long-term traction, biocompatibility, and no disturbance in skeletal growth are important prerequisites for introduction of this method of pubic approximation into clinical practice. © 2010.

Kajbafzadeh A.-M.,Pediatric Urology Research Center | Tourchi A.,Pediatric Urology Research Center | Bazargani S.,Pediatric Urology Research Center | Nezami B.G.,Pediatric Urology Research Center
Journal of Urology | Year: 2010

Purpose: We describe a single incision miniature open pyeloplasty and retroperitoneal herniorrhaphy technique in infants. Materials and Methods: A total of 22 patients with ureteropelvic junction obstruction and concomitant inguinal hernia were referred to our center between November 2003 and November 2008. A total of 13 patients (mean age 5 months) with extensively dilated pelves (extending down to pelvic cavity) and ipsilateral inguinal hernia underwent single incision miniature open pyeloplasty and retroperitoneal herniorrhaphy. All patients had decreased differential renal function (less than 40%), urinary tract infection, palpable kidney and obstructive pattern on renal diethylenetriamine pentaacetic acid scan. The incision was made along the most dependent part of the lower quadrant. After dissection of the ureteropelvic junction component, we pulled out the affected section and performed classic dismembered pyeloplasty without renal pelvis reduction. Next, we performed retroperitoneal herniorrhaphy from the same incision. Surgical incision size, operative time, hospital stay, postoperative analgesic use and complication rate were recorded for further evaluation. Results: The operation was uneventful in all patients. Mean operative time was 64 minutes (range 47 to 93) and patients were discharged home after a mean ± SD of 19 ± 3 hours (15 to 24). Incision size was 12 to 18 mm and the incision was closed by inserting a mini Hemovac® closed drain. No narcotic supplementation was required postoperatively and there were no complications during followup. Conclusions: Single incision miniature pyeloplasty with ipsilateral inguinal herniorrhaphy in an extensively dilated pelvis and ipsilateral inguinal hernia is technically feasible and safe in selected cases. The exact incision site must be reconfirmed intraoperatively by physical examination or renal ultrasound. The technique adds the advantages of minimally invasive procedures (small incision, negligible postoperative pain) to the short operative time and high success rate of the open approach. © 2010 American Urological Association Education and Research, Inc.

Kajbafzadeh A.-M.,Pediatric Urology Research Center | Farrokhi-Khajeh-Pasha Y.,Pediatric Urology Research Center | Ostovaneh M.R.,Pediatric Urology Research Center | Nezami B.G.,Pediatric Urology Research Center | Hojjat A.,Pediatric Urology Research Center
Journal of Urology | Year: 2010

Purpose: We present the long-term results of simultaneous "teapot" ureterocystoplasty and ureteral Mitrofanoff in patients with bilateral megaureters due to neurogenic bladder, and compare urodynamic results before and after the procedure. Materials and Methods: We treated 13 children (mean age 7.3 years) with end stage neurogenic bladder and refluxing megaureters (mean diameter 5.5 cm) with simultaneous teapot ureterocystoplasty and Mitrofanoff appendicovesicostomy between April 1995 and May 2001. The larger ureter was used for teapot bladder augmentation while keeping its distal 2 cm tubularized. The Mitrofanoff channel was then created using the opposite ureter. Results: Followup ranged from 109 to 169 months (median 121). At the end of the followup period all patients were dry with clean intermittent catheterization and/or voiding. No repeat augmentation was needed and there were no bladder calculi during followup. Median postoperative bladder capacity was 430 ml (IQR 380 to 477), which was increased significantly compared to preoperative evaluations (210 ml, IQR 181 to 230, p = 0.001). During followup bladder compliance also improved significantly (p = 0.001) and serum creatinine level decreased (p = 0.021). Conclusions: Although neurogenic bladder and high grade reflux are poor prognostic factors for ureterocystoplasty, the present modification resulted in enduring bladder augmentation with no calculus formation. Bladders remained compliant with good capacity, presumably because sufficient tissue and blood supply were provided for the augmented flap. © 2010 American Urological Association Education and Research, Inc.

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