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Background: Ovarian cancer cytoreductive surgery necessitates the use of advanced Simulation-Based Learning (SBL) to optimise skill-based teaching and achieve technical proficiency. Objective: We describe and appraise the role of a novel postgraduate cadaveric course for cytoreductive surgery for advanced ovarian/fallopian tube or primary peritoneal cancer. Materials and Methods: Several consultant-level surgeons with expertise in upper gastrointestinal, colorectal, hepatobiliary and urological surgery, were invited to teach their counterpart gynaecological oncology (GO) surgeons. The 2-day course curriculum involved advanced dissections on thiel-embalmed cadavers. All dissections included applicable steps required during GO cytoreductive surgeries. Outcome measures: We used a feedback questionnaire and structured interviews to capture trainers and delegates views respectively. Results: All delegates reported a positive educational experience and improvement of knowledge in all course components. There was no difference in the perception of feedback across junior versus senior consultants. Trainers perceived this opportunity as a "2-way learning" whether they got to explore in depth the GO perspective in how and which of their skills are applicable during cytoreductive surgery. Conclusions: Collaborating with other surgical specialities promotes a "learning from the experts" concept and has potential to meet the rapidly increased demand for multi-viscera surgical excellence in GO surgery. What's new?: The concept of involving experts from other surgical disciplines in advanced cadaveric courses for cytoreductive surgery in ovarian cancer, will solidify the effort to achieve excellence in the GO training. Such courses can be essential educational adjunct for most GO fellowships.

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An electrochemical deposition technique was used to fabricate polypyrrole (Ppy)/NiO nanocomposite electrodes for supercapacitors. The nanocomposite electrodes were characterized and investigated by Fourier transform infrared spectroscopy (FTIR), X-ray Diffraction (XRD), scanning electron microscopy (SEM), cyclic voltammetry (CV), galvanostatic charge-discharge (GCD) and electrochemical impedance spectroscopy (EIS). The performance of supercapacitor electrodes of Ppy/NiO nanocomposite was enhanced compared with pristine Ppy electrode. It was found that the Ppy/NiO electrode electrodeposited at 4 A/cm-2 demonstrated the highest specific capacitance of 679 Fg-1 at 1 Ag-1 with an energy density of 94.4 Wh kg-1 and power density of 500.74 W kg-1. Capacitance retention of 83.9% of its initial capacitance after 1000 cycles at 1 Ag-1 was obtained. The high electrochemical performance of Ppy/NiO was due to the synergistic effect of NiO and Ppy, where a rich pores network-like structure made the electrolyte ions more easily accessible for Faradic reactions. This work provided a simple approach for preparing organic-inorganic composite materials as high-performance electrode materials for electrochemical supercapacitors.

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Oxidation-reduction potential (ORP) is a newer integrated measure of the balance between total oxidants (reactive oxygen species-ROS) and reductants (antioxidants) that reflects oxidative stress in a biological system. This study measures ORP and evaluates the effect of exogenous induction of oxidative stress by cumene hydroperoxide (CH) on ORP in fresh and frozen semen using the MiOXSYS Analyzer. Semen samples from healthy donors (n = 20) were collected and evaluated for sperm parameters. All samples were then flash-frozen at -80°C. Oxidative stress was induced by CH (5 and 50 µmoles/ml). Static ORP (sORP-(mV/106 sperm/ml) and capacity ORP (cORP-µC/106 sperm/ml) were measured in all samples before and after freezing. All values are reported as mean ± SEM. Both 5 and 50 µmoles/ml of CH resulted in a significant decline in per cent motility compared to control in pre-freeze semen samples. The increase in both pre-freeze and post-thaw semen samples for sORP was higher in the controls than with 50 µmoles/ml of CH. The change from pre-freeze to post-thaw cORP was comparable. The system is a simple, sensitive and portable tool to measure the seminal ORP and its dynamic impact on sperm parameters in both fresh and frozen semen specimens.

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The aim of the study was to evaluate endourological techniques in the management of iatrogenic ureterovaginal fistula. Seventeen patients referred to us after gynecologic surgery were diagnosed as having iatrogenic ureterovaginal fistula. First, retrograde double-J stenting was tried. If this failed, percutaneous nephrostomy using an antegrade double-J stent was performed. If this also failed, open surgical repair was performed. The retrograde double-J stent bypassed the fistula in 2 patients (11.8%). Percutaneous nephrostomy was performed in the remaining 15. The antegrade double-J stent bypassed the fistula in another 2 of these patients (11.8%). Open surgical repair was performed in the remaining 13 patients (67.5%) (direct ureteroneocystostomy) with nipple valve in 11 patients and Boari flap with psoas hitch in 2 patients). Of all patients, 2 had ureteral stricture, one after antegrade double-J stenting and the other after open repair. It was concluded that early intervention is recommended in the treatment of iatrogenic uretrovaginal fistula, causing minimal morbidity and discomfort, and being less expensive.

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We have managed 164 bilharzial ureteral strictures endourologically. The site was at the pelviureteral junction in 4, at the pelvic inlet in 22, juxtavesical in 78, and intramural in 60. These lesions were categorized according to the line of management. Type I or simple stricture, present in 116 cases, was managed by retrograde bougie dilation to 16F. Dilation was preceded by transurethral ureterotomy in 54 cases. Type II or difficult strictures (24 cases) were managed by percutaneous antegrade dilation. Type III or complicated strictures (24 cases) were managed by antegrade placement of a guidewire down to the bladder followed by transureteral meatotomy and bougie dilation in one sitting under C-arm fluoroscopy. Three types of stenting procedures and diversion were used according to the length of the stricture and the quality of renal function. After 6 to 72 months, an overall successful clinical outcome with decompression of the upper urinary system and improved drainage pattern was achieved in 87.8% (144 cases) v only 50% in patients with strictures longer than 2 cm. Postoperative reflux was seen in 21 cases (18%) of Type I strictures compared with 4 (17%) of Type II and 13 (54%) of Type III strictures. We concluded that this scheme of combined endourologic management for ureteral strictures is safe, simple, and less traumatic and produces excellent results. It should be the approach of choice, although it needs special equipment and operator experience. Open surgery should be restricted to the lesions that prove undilatable on both retrograde and antegrade procedures.

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