Patrick B Leu

Vanderbilt University, Nashville, Michigan, United States

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Publications (3)5.94 Total impact

  • Harriette M Scarpero · Roger R Dmochowski · Patrick B Leu ·
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    ABSTRACT: Surgical excision is the definitive treatment of urethral diverticulum (UD) and the only reasonable surgical option for treating midurethral and proximal UD. Success depends on proper staging by determining the extent and number of diverticula and attention to surgical technique. This article offers practical guidance in adjusting technique to accommodate commonly encountered difficult clinical scenarios.
    Urologic Clinics of North America 02/2011; 38(1):65-71, vi. DOI:10.1016/j.ucl.2010.12.009 · 1.20 Impact Factor
  • Patrick B Leu · Harriette M Scarpero · Roger R Dmochowski ·
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    ABSTRACT: This article discusses a systematic approach to the repair of cystoceles using interposition grafting. Surgeons' opinions vary regarding which graft is most appropriate as there are several varieties for mesh interposition. High-grade cystocele repair using the porcine dermis interposition graft is successful and associated with few complications. Cystocele repair is typically low grade and does not require additional surgery.
    Urologic Clinics of North America 02/2011; 38(1):47-53, vi. DOI:10.1016/j.ucl.2010.12.007 · 1.20 Impact Factor
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    ABSTRACT: To explore, by histological examination, whether the uterosacral ligament complex is an adequate support structure for vaginal vault suspension and other reconstructive procedures of the female pelvis. We dissected 14 fresh hemipelves from seven adult female cadavers. The uterosacral complexes were excised from the pelvic sidewall immediately beneath the uterosacral pedicle. The specimens were stained with connective tissue-specific Movat stain and evaluated microscopically for the presence of collagen and/or elastin. Uterosacral tissue similar to that identified during pelvic reconstructive surgery was obtained in all cases. Six of the women had had a hysterectomy. A ligamentous structure with clearly aligned collagen and interspersed elastin was identified in only three specimens, two from one cadaver of a young woman who had not had a hysterectomy. The other specimens had an attenuated, poorly organized layer of collagen immediately beneath the peritoneum. We could not consistently identify normal ligamentous tissue in the uterosacral complexes. The overwhelming majority of specimens from women who had had a hysterectomy showed disorganized tissue with reduced cellularity. This reinforces doubts about the integrity of these tissues as structural supports in pelvic reconstructive surgery, particularly in elderly women who have had a hysterectomy.
    BJU International 03/2006; 97(2):345-8. DOI:10.1111/j.1464-410X.2005.05903.x · 3.53 Impact Factor