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the urethroplasty technique described is based on the concept of biomechanical reconstruction, with meatoplasty described as the reconstruction of the urethra as it would be after loss of length or narrowing due to trauma or congenital malformation. this concept of reconstruction is based on the hypothesis that the integrity of the urethra is maintained through the control of the resistance offered to the flow of urine, in which the tissues and/or sphincters are pushed to be pushed back to their normal state. in a practical sense, this would be achieved by, for example, positioning a penile constrictor around the urethra.
ideally, anyone wishing to avoid the development of cardiovascular disease should engage in at least 3 hours per week of continuous moderate-intensity physical activity and, ideally, 5 or more hours per week of vigorous physical activity. monitoring physical activity should include an assessment of both physical activity intensity and frequency of activity.
a large study of almost 6000 middle-aged japanese americans showed that the simultaneous combination of many ideal health factors and health behaviors is associated with survival and particularly with healthy aging without disability. wilcox et al 48 reported outcomes for 5252 men who were followed up for approximately a quarter of a century. health behaviors and health factors were measured at a mean age of 506 years, and overall survival and disease-free survival (exceptional survival) were observed to ages >85 years. in middle age, avoidance of overweight (bmi 25 kg/m2), hyperglycemia, hypertension, ever smoking, and heavy alcohol use, among other factors, were each associated with both overall survival to older age and exceptional survival free of chd, stroke, cancer, chronic obstructive pulmonary disease, parkinson disease, and treated diabetes. exceptional survival beyond age 85 years occurred in 55% of men with all ideal health factors and health behaviors in middle age but in only 9% of those with 6 or more unfavorable factors and behaviors. 48
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