Reconstructive Group

The YAU Trauma and Reconstructive Urology Working Party currently includes 10 members of different expertise in the broad field of Reconstructive Urology; e.g. urethroplasty, trauma surgery, incontinence surgery, fistula repair, ureteral repair, pyeloplasty, penile reconstructive surgery, corporoplasty, urinary diversion, transgender surgery, 3D modelling, tissue engineering, robotic surgery, andrology, and sexual medicine. We embrace the heterogeneity and diversity of our group, which widens the spectrum of research interest and allows views from different angles on each project, as you can see below.

Aims of our working party

Our YAU group was founded in March 2017 and thus, is the ‘youngest’ together with the Urotech group. Embodying the main principles of the YAU, we aim to provide evidence-based medicine, specifically into the field of Reconstructive Urology and urethroplasty, for which (EAU) guidelines-based recommendations have been published not until spring 2021 for the first time.

  • One of our main projects is merging already existing retrospective institutional databases and create prospective multi-institutional registries. Based on these datasets, we develop new risk models on different surgical outcomes and validate Patient-Reported Outcome Measures (PROMs) for urethral stricture disease
  • Our group actively supports the new upcoming EAU Guidelines Section on urethral stricture disease by providing systematic reviews and meta-analyses on topics which lack evidence
  • Within the EAU, we collaborate with different institutions such as European School of Urology (ESU) and European Society of Genital Urinary Reconstructive Surgeons (ESGURS). We believe in the importance for international collaborations with already formed research groups such as the American Trauma Urologic Reconstructive Network Surgeons (TURNS) and The European Society of Sexual Medicine (ESSM) Scientific Collaboration and Partnership (ESCAP) to create high-quality projects
  • Furthermore, our group initiates collaborative projects with other YAU working groups; e.g. a special edition on sequelae of prostate cancer therapy: avoidance strategies and management options, which includes the Prostate Cancer, Functional, Robotic, Men’s Health and Trauma and Reconstructive Urology Working Parties.

Finally, we invite academic practicing urologists in Europe with a major interest in trauma and reconstructive urology to actively collaborate and thereby creating a group of young “key opinion leaders” in the field of trauma and reconstructive urology in Europe.

Ongoing projects and plans for the future

Retrospective, prospective and randomized controlled trials, surveys and fellowship programs

  • ESGURS Survey on urethral stricture practices
  • Collaborative multi-institutional European urethroplasty database of patients who undergo urethroplasty for urethral stricture disease
  • Prospective randomized controlled trial comparing surgical outcomes and donor site morbidity between buccal mucosa and lingual mucosa graft urethroplasty for anterior urethral strictures using the European Association of Urology quality criteria for standardized reporting
  • Prospective randomized controlled trial comparing urethrotomy vs. urethral dilation using sequential dilators for bulbar urethral strictures
  • Prospective study on the main therapy for Peyronie’s disease including the use of all injection’s therapies (including Clostridium collagenase histolyticum) by measuring success, recurrence, shift to surgery and surgical reports. By using Hu-Care trial application (https://www.hu-care.com), physicians can enter the data and patients can enter the results, independently, through a specially created app.
  • YAU Andrology Scholarship Program to encourage and support the young urologists to improve their skills and increase their experience in the field of impotence and penile diseases management procedures namely penile Implants and penile reconstructive surgery.
  • (Recurrent) anastomotic strictures to compare Holmium Laser Incision vs cold knife incision in vesicourethral anastomotic stenoses in patients who underwent radical prostatectomy for prostate cancer (prospective multi-institutional study)
  • Primary urethral realignment vs suprapubic catheter for posterior urethral (traumatic) injuries (retrospective multi-institutional study)
  • Long-term follow-up for patients operated by paediatric surgeons for distal hypospadias (retrospective study)
  • Accuracy of retrograde urethrogram vs. urethral ultrasound in urethral stricture diagnosis and characterization (prospective study)
  • Catheter management and risk stratification in Patients with acute Epididymitis (prospective multi-institutional study)
  • Evaluation of antibiotic treatment, catheter management and risk stratifications in female inpatient suffering from acute cystitis and pyelonephritis (retrospective and prospective multi-institutional study)
  • The impact of preoperative double-J stent on perioperative complications, recurrence and quality of life in adult patients undergoing pyeloplasty (retrospective and prospective multi-institutional study)
  • Participating in prospective DoVe Trial: Dorsal Onlay Versus Ventral Onlay in Isolated Bulbar Urethral Strictures

Review articles (narrative and systematic) and meta-analyses

  • Clinical safety and outcomes of surgical patch for Peyronie’s disease surgery: a systematic review and meta-analysis
  • Is Clostridium collagenase histolyticum a contraindication for patch surgery?
  • Urinary Diversion as Last Resort for the Devasted Bladder Outlet Obstruction
  • Tissue Engineering and its Potential to Reduce Prostate Cancer Treatment
  • Current Management of Urorectal Fistulae Due to Prostate Cancer Treatment
  • Current Management of Membranous Urethral Strictures Due to Radiation
  • Cold knife versus hot knife Direct Vision Internal urethrotomy (DVIU) in the treatment of male urethral strictures
  • Intraurethral application of platelet-rich plasma after internal urethrotomy to reduce stricture recurrence
  • Consequences of bulbar urethroplasty surgery on erectile function
  • Impact of the COVID-19 Pandemic on Reconstructive Urology Practice in Europe: A Reflection from the European Association of Urology Young Academic Urologists Trauma and Reconstructive Working Party
  • The role of topical steroids for lichen sclerosus-associated urethral stricture
  • Detailed consequences of oral and sublingual graft harvesting
  • Stoma complications and quality of life after ileal conduit diversions (starting phase): which tool?
  • 3D modeling in Reconstructive Urology
  • Tissue engineering in Reconstructive Urology – the current status and critical insights to set future directions

Previous publications

Penile length and circumference dimensions: A large study in young Italian men – A. Cocci, L.A Kluth. Collaboration with Men’s Health working group. Andrologia. 2021 Mar 21:e14053.

Exploring the intersection of functional recurrence, patient-reported sexual function, and treatment satisfaction after anterior buccal mucosal graft urethroplasty – MW Vetterlein, L.A. Kluth. World J Urol. 2021 Mar 11.

Primary Squamous Cell Carcinoma of the Male Proximal Urethra: Outcomes from a Single Centre – F. Castiglione. Eur Urol Focus. 2021 Jan;7(1):163-169.

Impact of Cardiovascular and Metabolic Risk Factors on Stricture Recurrence After Anterior One-stage Buccal Mucosal Graft Urethroplasty – M.W. Vetterlein, L.A. Kluth. Urology. 2020 Dec;146:253-259.

Is Standardization Transferable? Initial Experience of Urethral Surgery at the University Hospital Frankfurt – M.W. Vetterlein, L.A. Kluth. Front Surg. 2020 Dec 14;7:600090.

Contemporary Management of Vesico-Urethral Anastomotic Stenosis After Radical Prostatectomy – C.M. Rosenbaum, M.W. Vetterlein. Front Surg. 2020 Nov 26;7:587271.

Buccal mucosal graft urethroplasty for radiation-induced urethral strictures: an evaluation using the extended Urethral Stricture Surgery Patient-Reported Outcome Measure (USS PROM) – M.W. Vetterlein, L.A. Kluth, C.M. Rosenbaum. World J Urol. 2020 Nov;38(11):2863-2872.

May patients receiving 5-alpha-reductase inhibitors be in higher risk of COVID-19 complications? – J. Adamowicz. Med Hypotheses. 2020 Jul;140:109751.

Intratunical injection of autologous adipose stromal vascular fraction reduces collagen III expression in a rat model of chronic penile fibrosis – F. Castiglione. Int J Impot Res. 2020 May;32(3):281-288.

A critical outcome analysis of Asopa single-stage dorsal inlay substitution urethroplasty for penile urethral stricture – L.A. Kluth, M.W. Vetterlein. World J Urol. 2020 May;38(5):1283-1294.

Development of a conductive biocomposite combining graphene and amniotic membrane for replacement of the neuronal network of tissue-engineered urinary bladder – J. Adamowicz. Sci Rep. 2020 Apr 2;10(1):5824.

Management of male anterior urethral strictures in adults. Results from a national survey among urologists in Spain – F. Campos-Juanatey. Actas Urol Esp. 2020 Mar;44(2):71-77.

Intratunical Injection of Stromal vascular fraction prevents Fibrosis in a Rat Model of Peyronie’sDisease – F. Castiglione. BJU Int. 2019 Aug;124(2):342-348.

Intratunical Injection of Human Adipose Tissue-Derived Stem Cells Restores Collagen III/I Ratio in a Rat Model of Chronic Peyronie’s Disease – F. Castiglione. Sex Med. 2019 Mar;7(1):94-103.

Characterization of a Standardized Postoperative Radiographic and Functional Voiding Trial after One-Stage Bulbar Ventral Onlay Buccal Mucosal Graft Urethroplasty and the Impact on Stricture Recurrence-Free Survival – M.W. Vetterlein, C.M. Rosenbaum, L.A. Kluth. J Urol. 2019 Mar;201(3):563-572.

The Impact of Surgical Sequence on Stricture Recurrence after Anterior 1-Stage Buccal Mucosal Graft Urethroplasty: Comparative Effectiveness of Initial, Repeat and Secondary Procedures – M.W. Vetterlein, C.M. Rosenbaum, L.A. Kluth. J Urol. 2018 Dec;200(6):1308-1314.

YAU Reconstructive Working Group

L.A. Kluth

Frankfurt a.M. (DE)
Chairman

J. Adamowicz

Bydgoszcz (PL)
Member

F. Campos Juanatey

Santander (ES)
Member

F. Castiglione

London (GB)
Member

A. Cocci

Florence (IT)
Member

G. Mantica

Genoa (IT)
Member

C.M. Rosenbaum

Hamburg (DE)
Member

W. Verla

Ghent (BE)
Member

M.W. Vetterlein

Hamburg (DE)
Member

M. Waterloos

Ghent (BE)
Member

E.A. Fes Ascanio

Eivissa (ES)
Associate