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“Purpose: Rectourinary fistula is a devastating

complication of rectal and genitourinary surgery. Spontaneous closure is rarely successful and failure in conservative management calls for surgical intervention. We present our experience with rectourinary fistula repair using a modified York-Mason technique.

Materials and Methods: We retrospectively reviewed the medical records of all 12 patients who underwent modified York-Mason repair at our institution between 1998 and 2008. Rectourinary fistula developed in 10 patients after radical prostatectomy and in 2 following high intensity focused ultrasound. Six patients were initially treated with fecal diversion. Our approach begins with a transanal incision at the 2 o’clock position representing a modification of the classically described midline incision extending from the coccyx to the anal verge. Key aspects of the York-Mason procedure are maintained. However, we do not close the urethra after fistula excision, and instead perform a multilayer, nonoverlapping closure of the anterior rectal wall only.

Results: With a median followup of 22 months we observed the complete resolution of rectourinary fistula in all 12

patients. Three patients required multiple York-Mason Dorsomorphin mouse procedures to achieve resolution of symptoms. All patients reported intact fecal continence. Median operative time and estimated

blood loss were 63 minutes and 100 ml, respectively. Median hospital stay was 4 days.

Conclusions: Our modified York-Mason technique is safe and effective for the repair of small, iatrogenic rectourinary fistula. We report 75%, 92% and 100% rectourinary fistula resolution after 1, 2 and 3 York-Mason procedures, respectively, with 100% fecal continence. This technique can be performed multiple times without a significant increase in operative time, estimated blood loss or fecal incontinence.”
“The hypothesis of an early vulnerability of the serotonergic system to prion infection was investigated in a murine model of bovine spongiform encephalopathy (BSE). Behavioral tests I-BET-762 order targeted to 5-HT functions were performed in the course of infection to evaluate circadian activity, anxiety-like behavior, pain sensitivity and the 5-HT syndrome. The first behavioral change was a decrease in nocturnal activity detected at 30% of incubation time. Further behavioral alterations including nocturnal hyperactivity, reduced anxiety, hyperalgesia and exaggerated 5-HT syndrome were observed at 60%-70% of incubation time, before the onset of clinical signs. The same tests performed in 5-HT-depleted mice and in prion protein-deficient mice revealed behavioral abnormalities similar in many aspects to those of BSE-infected mice.