Trauma/ Reconstruo Highlights Steven B Brandes, M.D. Division of Urologic Surgery Andr Guilherme Cavalcanti. Prof. Adjunto Urologia UNIRIO Trauma e Reconstruo 28 - Uretroplastia 5 - Trauma 5 - Reconstruo genital 4 - Reconstruo ureteral 4 - Esclerose de colo vesical 4 -Medicina regenerativa 3 -A U S 3 -Neuro-urologia 1 -Modelos animais A: 85 Working Toward a Research Definition of Success after AnteriorUrethroplasty N= 164;62 Anast, 102 substituio. FU 15 meses; Sucesso 96% - Anast, 80% - Sub A: 85 Working Toward a Research Definition of Success after AnteriorUrethroplasty Take Home Message Qual a definio de sucesso aps a uretroplastia? Ausncia de novos procedimentos hiper estima. Cistoscopia maior acurcia. AUA SS < 8, Q max > 15 = bom A5: Prospective evaluation of a new visual prostate symptom score, the international prostate symptom score and uroflowmetry before and after treatment in men with urethral stricture disease. VPSS 5 cm LSEtiologia inflamatria e iatrognica. A7: Anastomotic reconstruction of radiotherapy induced posterior urethral stenosis N= 78; 2.4 cm, FU 2.7 anos Sucesso- > 16 fr lumen Take Home 72% sucesso (pior do que a anastomose standard) Sem efeito sobre a DE. Altas taxas de IU 51% 17% -AUS RENAL AUTOTRANSPLANTATION -AN EXCELLENT CHOICE FOR EXCELLENT RESULTS Richard Johnston a, Natalya Lopushnyan b, Thomas Hefty a, Paul Kozlowski a

aVirginia Mason Medical Center b University of Washington Medical Center, Seattle WA Background Extensive ureteral defects, renal artery aneurisms and recurrent stone disease associated with pain may present management problems not solved with minimally invasive options Goal To evaluate our experience with renal autotransplantation and to assess the safety and outcomes of this option Methods Retrospective review of patients who underwent renal autotransplantation at Virginia Mason Medical Center 2006-2012 Demographic and clinical characteristics were assessed and reported Results Characteristic Result [mean (range)] N patients21 Age (yr)49 (25-74) Solitary kidney 3 (14%) Cr Preoperative/Postoperative (mg/dL)1.20 mg/dL/ 0.96 mg/dL Peak Cr (mg/dL) mean1.70 mg/dL Length of stay (days)5.8 (4-11) Length of follow up (mo) median24 (3-54) Complications (%)2 (9.5%) Complications Thrombosis of the renal artery immediate take back Postoperative sepsis and respiratory failure ICU admission Conclusions Renal autotransplantation is technicallychallenging, but viable management option fora selected group of patients.Testosterone recovery in poly-trauma and scrotal injury in patients from Operation Enduring Freedom and Operation Iraqi Freedom Molly Williams, MD1, Inger Rosner, MD1,2, Yongmei Chen, PhD2, J ennifer Cullen, PhD2,J ames J ezior, MD1, Robert Dean, MD1 1 Walter Reed National MilitaryMedical Center, Urology Service, Bethesda, MD ; 2Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Rockville, MD Introduction: Over 50,000 soldiers injured in OEF and OIF 10% genitourinary, majority involving the external genitalia Burn literature supports the use of exogenous androgens to attenuate protein loss and wasting ultimately leading to quicker recovery Animal models and trauma literaturedemonstrate that a low testosterone state in the immediate post injury period is protective Objective: Evaluate testosterone recovery in scrotal trauma Methods: 84 patients retrospectively identified All had minimum of 2 testosterone values All had a testosterone value within 40 days of injury Results: The time to testosterone replacement is inversely related to the degree of scrotal injury (p=0.0005). The time to recovery did not vary based on the degree of scrotal injury (p=0.3486) Initial testosterone level was statistically different between the group that recovered and the group who received testosterone replacement (p=0.0063). With the exception that the initial testosterone did not vary between the recovery group and the replacement group in patients with testicular tissue loss (p=0.4218). Testosterone velocity was predictive of the recovered and the replacement group (