Laetitia M O de Kort

Utrecht University | UU · University Medical Center Utrecht

Introduction We previously presented promising results with a Burch-type colposuspension (BC) in a heterogeneous group of girls with therapy-resistant daytime incontinence (DUI). In view of our clinical observations, we expect that a small group of girls with refractory DUI based on stress-urinary incontinence (SUI) might also benefit from a BC in...

Samenvatting Seksueel misbruik komt veelvuldig voor, in het bijzonder bij mensen met een lichamelijke, zintuiglijke of verstandelijke beperking die in een instelling verblijven. In een wooninstelling zijn patiënten afhankelijk van zorgverleners, hetgeen een risicofactor vormt voor misbruik. Ook kan seksueel grensoverschrijdend gedrag bij bewoners o...

Samenvatting Aangeboren urologische afwijkingen variëren van veelvoorkomende ziektebeelden, zoals hypospadie of niet ingedaalde testis, tot extreem zeldzame afwijkingen, zoals blaasexstrofie. Als deze patiënten volwassen worden houdt de zorg rond deze afwijkingen meestal op. Complicaties op latere leeftijd van deze ziektebeelden zijn echter niet on...

Background and objective Video-based learning may be beneficial in surgical education, both in the preparation for surgery and to evaluate surgical performance. The use of a video is not yet anchored in European urology residency programs, and it is unclear how frequently residents use videos. The purpose of this study is to investigate whether and...

Introduction A continent catheterizable channel (CCC) may be a solution for patients with impaired bladder emptying and difficult transurethral access. Leakage of the CCC is a common complication. To prevent leakage, the pressure in the CCC has to be higher than the reservoir (bladder/pouch) pressure in at least one location. It has not been clearl...

Introduction Bladder outflow obstruction (BOO) is a urethral resistance (UR) at a level above a clinically relevant threshold. UR is currently graded in terms of the existence and severity of the BOO based on maximum flowrate and associated detrusor pressure only. However, the pressure‐flow relation throughout the course of voiding includes additio...

Background A congenital disease is for life. Posterior hypospadias, the severe form of hypospadias with a penoscrotal, scrotal, or perineal meatus, is a challenging condition with a major impact on lifelong quality of life. Aim Our network meeting is aimed to identify what is currently missing in the lifelong treatment of posterior hypospadias, to...

Background. Infertility in men is a common and worldwide problem with limited registered treatment options and licensed therapies. Clomiphene citrate (CC) is an empirical off-label therapy. CC is a selective estrogen receptor modulator that may improve testicular function, including sperm quality, by stimulating steroidogenesis and spermatogenesis....

Introduction Continent catheterizable channels (CCC) provide an alternative route to the bladder in both pediatric and adult patients. This study compared very long‐term complications and revision‐free survival of three different CCC techniques: appendicovesicostomy (AVS), ileum (Monti), and tubularized bladder flap (TBF). Materials and Methods A...

Samenvatting Met het ondertekenen van de Green Deal Zorg 3.0 staan wij voor de uitdaging om vóór 2030 het gebruik van primaire grondstoffen met 50% te reduceren. Dit onderzoek is een eerste inventarisatie in de praktijkvariatie van materiaalgebruik binnen de urologische praktijk in Nederland. Deze landelijke uitvraag bevestigt dat er grote verschil...

Introduction An Indiana Pouch (IP) is a heterotopic, continent, urinary diversion from an ileocolonic segment. Numerous studies have investigated its long‐term outcomes, albeit none extending beyond a 5‐year follow‐up period. IPs can be used as urinary diversion for benign indications and as such are constructed in typically young patients. As a co...

The urogenital tract is a target for many congenital and acquired diseases, both benign and oncogenic. In males, the urethra that transports urine and semen can be obstructed by a fibrotic disease called urethral stricture disease (USD). In severe USD, the whole organ including the vascular embedding, the corpus spongiosum (CS), is affected. Recurr...

Introduction: A pressure flow study (PFS), part of the International Continence Society standard urodynamic test, is regarded gold standard for the classification and quantification of the urethral resistance (UR), expressed in the bladder outflow obstruction (BOO). For men with benign prostatic hyperplasia, the minimum urethral opening pressure (...

Introduction: Several patients, who underwent major reconstruction under the care of an experienced pediatric urologist are now, as adults, several years later, appearing with long term problems and complications. This consensus process was undertaken to give an overview of long term consequences (and their management) of urological childhood surg...

Over the past 40 years, hypospadias research has focused on the development of novel surgical procedures, including new suture types and uses of autologous tissue harvested from local and distant sites. Although postoperative outcomes have steadily improved over time, complication rates remain extremely high, particularly in cases of severe hypospa...

Objective: To improve our transitional care, we explored how childhood dysfunctional voiding (DV) develops into adulthood. DV is a common condition in both children and adults. However, the long-term course of childhood DV into adulthood is unknown and treatment over the ages differs. Methods: A cross-sectional follow-up was performed in a cohor...

Background: Hypogonadism is a worldwide problem among men causing sexual, physical and mental problems. Testosterone therapy is the first-choice treatment for male hypogonadism, with several side effects, that is, subfertility. Clomiphene citrate (CC) is an alternative off-label therapy for a certain group of hypogonadal males, especially for thos...

Samenvatting De urineblaas kan worden aangetast door verschillende, vaak zeldzame inflammatoire blaasaandoeningen. De meeste van deze aandoeningen zullen een verregaand negatief effect hebben op de individuele gezondheid en kwaliteit van leven. Het behandelen van deze aandoeningen is complex en vereist frequent multidisciplinaire zorg. Momenteel is...

Samenvatting Recreatief ketaminegebruik neemt toe in Nederland. Ketaminemisbruik kan leiden tot schade aan de urinewegen, waardoor urogenitale klachten ontstaan met forse impact op de kwaliteit van leven. Dit artikel gaat over de eerste Nederlandse themapoli met diagnose- en behandelprotocol voor patiënten met ketamine-geïnduceerde urogenitale klac...

Background: Male infertility is a prevalent and worldwide problem with various difficulties in treatment. Clomiphene citrate (CC) is a selective estrogen receptor modulator and may improve semen quality by stimulating hormone synthesis and spermatogenesis. There is lack of evidence on the efficacy of CC as therapy for male infertility. Objectives...

Objectives Hypogonadism is a worldwide problem among men causing sexual, physical and mental problems. Testosterone therapy is the first-choice treatment for male hypogonadism, with several side-effect i.e. subfertility. Clomiphene citrate (CC) is an alternative off-label therapy for hypogonadal men especially for those with an active or future chi...

Objectives Hypogonadism is a worldwide problem among men causing sexual, physical and mental problems. Testosterone therapy is the first-choice treatment for male hypogonadism, with several side-effect i.e. subfertility. Clomiphene citrate (CC) is an alternative off-label therapy for hypogonadal men especially for those with an active or future chi...

Objective The purpose of this study is to report development of a malignant testicular germ cell tumor (GCT) in two young adult males with Familial Male-limited Precocious Puberty (FMPP) due to (LHCGR) pathogenic variants in two families. Secondary, to study the possible relation between FMPP and testicular tumors and to investigate whether FMPP mi...

Background Lower urinary tract dysfunction or functional urinary incontinence is a common condition with a prevalence up to 21% between 6 and 8 year-old children. It is associated with an impaired quality of life, lower self-esteem, and social stigmatization. Urotherapy is the first treatment of choice for functional daytime urinary incontinence (D...

Purpose Arterio-ureteral fistula (AUF) is an uncommon diagnosis, but potentially lethal. Although the number of reports has increased over the past two decades, the true incidence and contemporary urologists’ experience and approach in clinical practice remains unknown. This research is conducted to provide insight in the incidence of AUF in The Ne...

Background : Male hypogonadism is a clinical and biochemical androgen insufficiency syndrome, becoming more prevalent with age. Exogenous testosterone is first choice therapy, with several side-effects, including negative feedback of the hypothalamic-pituitary-gonadal axis, resulting in suppression of intratesticular testosterone production and spe...

Objective To evaluate the relation between clinically relevant stricture recurrence after first urethroplasty and prior endoscopic treatments (dilatation and/or direct visual internal urethrotomy) or intermittent self-dilatation (ISD). Methods Patients with bulbar urethral strictures treated with first urethroplasty between 2011 and April 2019 wer...

In a group of 53 subfertile men 43% showed a better volume/progressive concentration/ motility product without significant adverse events.

In a group of 153 hypogonadal men with wish to father clomiphene citrate showed to be a good alternative for testosteronsuppletion.

Background Urethral stricture disease is a common problem amongst men in Western countries often leading to a decreased quality of life. Current endoscopic treatment procedure shows an unsatisfying stricture recurrence rate which could be improved by addition of local therapies. Objectives To provide an overview of both preclinical and clinical st...

Purpose: AUF is an uncommon diagnosis, but increasingly reported and potentially lethal. This systematic review comprehensively presents risk factors, pathophysiology, location and clinical presentation of AUF aiming to increase clinical awareness of this rare but life-threatening condition, and to put this entity into a contemporary perspective w...

Introduction Girls with an anterior deflected urinary stream (ADUS) are known to wet the toilet rim and their buttocks while voiding. This deviation may prevent adopting an ideal toileting position and can thus develop into a functional voiding disorder. Although surgical correction of the urinary stream by a meatotomy is part of standard care in g...

Study objective : Müllerian (paramesonephric) duct anomalies (MDAs) are associated with several coexisting congenital abnormalities, including renal abnormalities. Although congenital renal abnormalities may remain asymptomatic, the consequences should not be underestimated. In both the literature and clinical practice, it remains necessary to impr...

Purpose of review: The aim of this article is to give an overview of recent literature on transitional care of children with complex urological disease. Recent findings: Most studies on transitional care concerned spina bifida patients. Assessment of current practices revealed that formalized clinics for transitional care may improve healthcare....

Several urological structures, such as the male urethra, have a tubular organization consisting of different layers. However, in severe urethral disease, urologists are limited to replacing solely the epithelial layer. In case of severe hypospadias and urethral stricture disease, the underlying supporting structure (the corpus spongiosum) is either...

Samenvatting In deze cross-sectionele epidemiologische studie is nagegaan wat de relatie is tussen maximale detrusorcontractiekracht en leeftijd bij patiënten die waren verwezen met lower urinary tract symptoms (LUTS). Hiertoe is een retrospectieve analyse uitgevoerd op de resultaten van urodynamisch onderzoek dat werd uitgevoerd bij 1.308 patiënte...

Objective: To assess urological function, sexual function, and quality of life in patients with exstrophy or epispadias. Little is known regarding these outcome in adult patients; our aim is to determine where improvements are needed for long-term management. Methods: The study population comprised adult (>18 years) patients. Demographic data we...

Objective: The objective of this study is to investigate the coping styles used by patients with hypospadias. Long-term hypospadias studies generally show satisfying outcomes, but some report a lower quality of life (QoL) or poorer psychosocial adjustment, particularly in patients with proximal hypospadias. A lower QoL or psychosocial adjustment w...

Objective To report clinical epidemiology of detrusor (bladder) muscle contraction maximum related to ageing in patients referred with signs and symptoms of lower urinary tract dysfunction. Study Design and Setting One thousand three hundred and eight urodynamic pressure-flow measurements were analyzed in retrospective. Standard measures of detrus...

Objective: A normal penile cosmesis is an important goal in distal hypospadias repair. Depending on cultural standards, repairs are combined with a preputioplasty or circumcision to attain a 'normal' penile appearance. Although short-term complication rates of preputioplasty are available, data on long-term outcomes are scarce. Therefore, this stu...

Purpose: Urethral reconstruction is performed in patients with urethral strictures or for correction of congenital disorders. In the case of shortage of tissue, engineered tissue may enhance urethral reconstruction. As the corpus spongiosum (CS) is important in supporting the function of the urethra, tissue engineering of the urethra should be com...

Spinal dysraphism occurs in patients with spina bifida aperta or occulta and will affect the functionality of bladder and sphincter complex. The incidence has changed over the past decades from 1:3000 live births to 1:6000 as a result of the use of folic acid and also as a result of early abortion.

Objective To study long‐term urinary and sexual function and cosmetic outcomes in adult hypospadias patients, who underwent a single‐stage transverse preputial island tube (TPIT) in childhood. Long‐term data on outcomes of proximal hypospadias patients with severe coexisting curvature and insufficient urethral plate are scarce, but are necessary to...

Introduction: The use of hormonal therapy was first described in 1971 before hypospadias surgery, and it has been debated ever since. The long-term outcomes after puberty of patients treated with pre-operative testosterone in childhood are lacking. Objectives: Possible long-term effects of testosterone are often asked about in daily practice. Th...

Purpose: To compare long-term results of three different techniques used to create continent catheterizable channels (CCCs) in children in a single institution. Patients and methods: Data were retrospectively collected from 112 children who had a CCC [appendicovesicostomy (APV), tubularized bladder flap (TBF) or Monti] created between December 1...

Objective Superficial bladder neck incision (SBNI) is controversial at young age, with retrograde ejaculation after puberty as main concern. The aim of the study is to investigate the long-term effect of SBNI on ejaculation and incontinence in boys with primary and secondary bladder neck obstruction (BNO). Materials and methods In boys with infrav...

Introduction: Tissue engineering of corporal tissue is a new development in otherwise untreatable erectile dysfunction and in urethral reconstructions to treat hypospadias or severe urethral stricture disease. Multiple complications can arise with the current treatments, whereas engineered tissue, if well vascularized and existing of autologous ce...

Aims: To grade detrusor voiding contraction three parameters are used: the Sch?fer pressure-flow nomogram (LinPURR), the bladder contractility index (BCI) and the maximum Watt factor (Wmax ). Because these methods to quantify detrusor contraction and/or to diagnose detrusor underactivity (DU) have not yet been mutually compared, this study compare...

Aims: To assess the long-term effects of two treatment strategies (low threshold endoscopic desobstruction vs. conservative treatment) on urinary incontinence (UI) and urgency-frequency in boys. Methods: Boys with persistent overactive bladder symptoms treated in two tertiary referral centers between 2006 and 2009 were included. Treatment strate...

Bij kinderen met neurogeen blaaslijden wordt vaak een vesicostoma aangelegd om clean intermittent catheterization mogelijk te maken. Bij veel stoma’s zien we op den duur echter stenosering, lekkage en fausse-routevorming. Wij voerden een retrospectief dossieronderzoek uit naar de langetermijnuitkomsten van verschillende operatietechnieken (appendix...

Background: Individuals with spinal cord injury (SCI) have an increased risk of developing urological complications. Therefore, long-Term routine urological surveillance is recommended. Objective: To describe urological surveillance in individuals with longterm SCI and to determine factors associated with urologic ultrasonography (UU) outcome. Meth...

IntroductieGedetailleerde kennis van de architectuur van het corpus spongiosum is nodig voor tissue engineering, maar ontbreekt. MethodenTwee penissen van overleden mannen die hun lichaam ter beschikking van de wetenschap hadden gesteld werden ingevroren; één penis in slappe toestand, de ander artificieel in erectie gebracht. Transversale en fronta...

Background: Tissue engineered (TE) urethra is desirable in men with urethral disease (stricture or hypospadias) and shortage of local tissue. Although ideally a TE graft would contain urethral epithelium cells, currently, bladder epithelium (urothelium) is widely used, but morphologically different. Understanding the differences and similarities o...

Background: Although uroflowmetry is a widely used diagnostic test, reference values of uroflowmetry parameters in women are lacking making it difficult to interpret the test results. Aim: To quantify the range of results in uroflowmetry parameters in healthy women based on a systematic review. Methods: A search was made in the International C...

Study limitations: single treatment investigation under resting conditions only. In conclusion, onabotulinumtoxinA intradetrusor injections do not seem to affect resting state cardiac function. Short-term changes such as total power might rather result from natural cardio-vascular responses to the procedure itself (e.g. discomfort, stress). Furthe...

Purpose: Urethral reconstruction is performed for urethral stricture or for correction of hypospadias. Research on urethral tissue engineering (TE) is increasing. Because the corpus spongiosum (CS) is important to support the urethra, TE of the urethra should ideally be combined with reconstruction of a CS. This study describes a method to visuali...