MP60-04 PILOT EXPERIMENTAL ANALYSIS OF MEATUS CONFORMATION AND DEVELOPMENT OF NOVEL MEASUREMENTS FOR ABERRANT URINARY STREAM IN 3D PRINTED URETHRAS DERIVED FROM CADAVERIC MODEL

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (MP60)1 Apr 2020MP60-04 PILOT EXPERIMENTAL ANALYSIS OF MEATUS CONFORMATION AND DEVELOPMENT OF NOVEL MEASUREMENTS FOR ABERRANT URINARY STREAM IN 3D PRINTED URETHRAS DERIVED FROM CADAVERIC MODEL Andrew Cohen*, German Patino, Seyed Mirramezani, Sudarshan Srirangapatanam, Anas Tresh, Bhagat Cheema, Jenny Tai, Dylan Romero, Anthony Enriquez, Shawn Shadden, and Benjamin Breyer Andrew Cohen*Andrew Cohen* More articles by this author , German PatinoGerman Patino More articles by this author , Seyed MirramezaniSeyed Mirramezani More articles by this author , Sudarshan SrirangapatanamSudarshan Srirangapatanam More articles by this author , Anas TreshAnas Tresh More articles by this author , Bhagat CheemaBhagat Cheema More articles by this author , Jenny TaiJenny Tai More articles by this author , Dylan RomeroDylan Romero More articles by this author , Anthony EnriquezAnthony Enriquez More articles by this author , Shawn ShaddenShawn Shadden More articles by this author , and Benjamin BreyerBenjamin Breyer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000929.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: An estimated 10% of male adults have split or dribbled stream which can lead to poor hygiene, embarrassment, inconvenience and social distress. There is no metric that measures the degree of stream deviation from normal, nor is there a definition of normal in this context. Our objective is to develop an innovative method to measure spray. We also evaluate the effect of common pathologies in the distal urethra and corrective surgeries on the urine stream. METHODS: We use cadaveric tissues and 3D Printed models to define distal meatus conformations and their impacts on stream characteristics (Figure). We developed a novel platform to reliably measure spray of urinary flow. Silicone was used to cast the lumen of cadaveric urethra, this was subsequently converted to 3D printable model. Cadaveric penile tissue and 3D printed models were affixed to fluid pump and used to simulate micturition events. Dyed fluid captured on fabric allowed for spray detection. Spray pattern area, deviation from normal location, and flowrates were recorded as obstructions were surgically created in cadaveric tissue or modelled using 3D printing. RESULTS: Characteristic voiding scenarios were validated with high precision. Spray patterns of each void were recorded (Figure d). Obstructions at the penile tip worsen spray dynamics and reduce urinary flow. Ventral meatotomy improves flow rate and reduces spray compared to tips obstructed ventrally, dorsally or in the fossa naviculars. 3D printed models to do not fully reproduce parameters of their parent cadaver material. All other variables constant, the flow rate from 3D model is 3 ml/sec less than that of the penis from which it was derived (p=0.03). Nonetheless, increasing obstruction in 3D models leads to the same pattern of reduced flow rate and worse spray. Via dynamic modelling, distal obstruction was experimentally shown to worsen fluid vorticity. CONCLUSIONS: We developed a robust method to measure urine spray in a research setting. Dynamic 3D printed models hold promise as a methodology to study common pathologies in the distal urethra and corrective surgeries on the urine stream. We recapitulate clinical observations that increased meatal obstruction worsen flow and spray whereas meatotomy leads to improvements. These novel methods require further validation, but offer promise as a powerful research and clinical tool. Source of Funding: Alafi Fund © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e890-e890 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Cohen* More articles by this author German Patino More articles by this author Seyed Mirramezani More articles by this author Sudarshan Srirangapatanam More articles by this author Anas Tresh More articles by this author Bhagat Cheema More articles by this author Jenny Tai More articles by this author Dylan Romero More articles by this author Anthony Enriquez More articles by this author Shawn Shadden More articles by this author Benjamin Breyer More articles by this author Expand All Advertisement PDF downloadLoading ...