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urethral stenosis in children

David J Wilkinson, Patrick A Green, Shanthi Beglinger, Jessica Myers, Rachel Hudson, David Edgar, Simon E Kenny
INTRODUCTION: Hypospadias surgery has progressed steadily over recent years. There remains considerable variation in the operative management of boys with hypospadias in the UK, and it is therefore difficult to identify acceptable standards with regards to reoperation rates. OBJECTIVE: To determine the frequency of reoperations and complications from all centres performing hypospadias surgery in England and to identify variables that influence outcome. METHODS: All children undergoing NHS hypospadias surgery in England between 1999 and 2009 were identified using the Hospital Episode Statistics database...
February 20, 2017: Journal of Pediatric Urology
Salvatore Arena, Mario Patricolo
INTRODUCTION: Aim was to investigate the prevalence of primary monosymptomatic and non-monosymptomatic noctural enuresis (PMNE and PNMNE) and associated factors in a major referral centre for NE in Abu Dhabi. MATERIAL AND METHODS: Children referred to a Paediatric Continence Clinic, between 2014 and 2016, for PNE were included. Exclusion criteria were neuropathic bladder, abnormality of the bladder and bowel, urethral stenosis, children with neurological and psychiatric problems, patients that did not complete the diagnostic protocol, patients with follow-up less than six months...
April 17, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
Rajamani Gurusamy, S Vijay Raj, Raghul Maniam, S R Regunandan
AIM: To assess the modifications in the technique of laparoscopic-assisted anorectal pull-through (LAARP) practiced at our institute and to analyze the postoperative outcome and associated complications. MATERIALS AND METHODS: A retrospective study was done to analyze the results for LAARP procedure done for high anorectal malformations (ARMs) from January 2001 to May 2016. A total of 68 patients had undergone LAARP, with 62 male and 6 female children. Staged procedure was done in 55 patients and one child with rectovestibular fistula of 5 months of age had a single-stage procedure...
April 2017: Journal of Indian Association of Pediatric Surgeons
Hamed M Seleim, Hani Morsi, Mohamed M Elbarbary
BACKGROUND: Although staged repair for reconstructing severe hypospadias is more popular, various one-stage repairs have been attempted. Koyanagi repair (parameatal-based and fully extended circumferential foreskin flap urethroplasty) has enabled correction of severe hypospadias in one stage. However, its un-acceptably high incidence of complications has initiated a series of technical modifications, including the "yoke" repair. OBJECTIVES: To retrospectively analyze the outcome of a proposed modification of the originally described yoke repair, for patients with severe hypospadias...
January 14, 2017: Journal of Pediatric Urology
Cenita J Sam, Sudipta Sen, Pavai A Arunachalam
Neourethral diverticulum secondary to distal neourethral stenosis is not uncommon after proximal hypospadias repair. We describe a technique using the neo urethral diverticular roof and overlying skin as a composite flap to reconstruct the urethral stenosis distal to the diverticulum. The composite flap is advanced distally for reconstruction of the stenosed urethra either as a tube or as an onlay. Urethra at the diverticular bed is tubularized to reduce its caliber. This technique has yielded excellent results in three children...
February 2017: Journal of Pediatric Urology
Chen Wang, Shuli Liu, Zhen Chen, Long Li, Wei Zheng
OBJECTIVE: To explore the feasibility and efficacy of laparoscopic surgery in the treatment of children with persistent cloaca. METHODS: Clinical data of 26 female children with high type persistent cloaca undergoing operation in the Capital Pediatric Institution between November 2005 and February 2015 were retrospectively analyzed. Mean age of these children was (1.4±1.6) years old. Distal end of rectum locating in the superior border of pubis was the standard of diagnosis...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Mehdi Shirazi, Ali Ariafar, Amir Hossein Babaei, Abdosamad Ashrafzadeh, Ali Adib
BACKGROUND: Urethrocutaneous fistula (UCF) is the most prevalent complication after hypospadias repair surgery. Many methods have been developed for UCF correction, and the best technique for UCF repair is determined based on the size, location, and number of fistulas, as well as the status of the surrounding skin. OBJECTIVES: In this study, we introduced and evaluated a simple method for UCF correction after tubularized incised plate (TIP) repair. METHODS: This clinical study was conducted on children with UCFs ≤ 4 mm that developed after TIP surgery for hypospadias repair...
November 2016: Nephro-urology Monthly
Alice Faure, Rebecca Cooksey, Aurore Bouty, Alan Woodward, John Hutson, Mike O'Brien, Yves Heloury
BACKGROUND: Effective bladder emptying by clean intermittent catheterization for children with severe bladder dysfunction is critical for renal preservation and social integration. Use of a continent catheterizable conduit (CCC) as urethral alternative procedure provides effective bladder drainage. However, it brings a substantive maintenance. METHODS: Retrospective review of the indications and long-term outcomes of 54 patients with a Mitrofanoff procedure in a single center over a 20-year period (1995-2015)...
March 2017: Journal of Pediatric Surgery
Raghu S Ramareddy, Anand Alladi
AIM: To report a series of scrotal abscess, a rare problem, their etiology, and management. MATERIALS AND METHODS: A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management. RESULTS: Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]...
October 2016: Journal of Indian Association of Pediatric Surgeons
Hazem Elmoghazy, Mohamed M Hussein, Elnisr Mohamed, Abdelbasset Badawy, Gamal Alsagheer, Ahmed Mamdouh Abd Elhamed
BACKGROUND: Several techniques have been used to repair mid-penile hypospadias; however, high failure rates and major complications have been reported. In this study, we describe a novel technique using a well-vascularized flap of the inner and outer preputial skin. METHODS: A total of 110 male children with hypospadias underwent repair by our technique between 2008 and 2015. The inclusion criteria were children with mid-penile or slightly more proximal hypospadias, with or without ventral chordae, and an intact prepuce of the cobra eyes variety...
December 2016: International Urology and Nephrology
N C Bush, T D Barber, D Dajusta, J C Prieto, A Ziada, W Snodgrass
BACKGROUND: Teaching and learning hypospadias repair is a major component of pediatric urology fellowship training. Educators must transfer skills to fellows, without increasing patient complications. Nevertheless, few studies report results of surgeons during their first years of independent practice. PURPOSE: To review outcomes of distal hypospadias repairs performed during the same 2-year period by consecutive, recently matriculated, surgeons in independent practice, and to compare them to results by their mentor (with >20 years of experience)...
June 2016: Journal of Pediatric Urology
Chao Chen, Ti-Quan Yang, Jia-Bo Chen, Ning Sun, Wei-Ping Zhang
PURPOSE: To compare the effects of staged tranverse preputial island flap(TPIF) urethroplasty and Byars two-stage procedure for proximal hypospadias with severe chordee. MATERIALS AND METHODS: A total of 87 consecutive children of proximal hypospadias with severe chordee were included in the study from March 2011 to March 2014. While 42 children were repaired with stged TPIF (group 1), 45 children were treated with two-stage Byars urethroplasty (group 2). Mean age at first stage surgery were 26...
May 31, 2016: Journal of Urology
Alice Faure, Aurore Bouty, Yoke Lin Nyo, Mike O'Brien, Yves Heloury
INTRODUCTION: Although two-stage graft urethroplasty is widely used, the literature regarding the complication rates and functional characteristics of reconstructed neourethra is relatively modest. OBJECTIVES: The aim was to analyze the complication rates and uroflow data of boys who have previously undergone a two-stage graft urethroplasty procedure for proximal and complicated hypospadias. PATIENTS AND METHODS: We retrospectively reviewed the clinical outcomes of 52 boys with proximal (n = 44) and complicated (n = 8) hypospadias who underwent two-stage graft urethroplasty repair (median age of 15 months and 3 years respectively) between 2004 and 2015...
October 2016: Journal of Pediatric Urology
A Bhat, M Bhat, V Kumar, R Kumar, R Mittal, G Saksena
INTRODUCTION: The American Academy of Pediatrics recommends operating on hypospadias between the ages of 6-12 months. Since most births in developed countries are conducted in a hospital, parents are likely to be well informed and counseled about the hypospadias. However, significant numbers of births in developing countries are still conducted at home, with illiteracy, poverty and ignorance often leading to late presentation at the hospital. Reported hypospadias-repair complication rates are higher in adults compared with those having surgery in childhood...
April 2016: Journal of Pediatric Urology
Süleyman Cüneyt Karakuş, Naim Koku
To describe a modification of tubularized incised plate (TIP) urethroplasty which we refer to as "frenuloplasty". We retrospectively reviewed 155 children who underwent TIP urethroplasty between June 2008 and August 2011 in our institution. In our technique, the circumcision incision went on through the mucocutaneous junction obliquely in order to form frenular wings instead of linear circumscribing incision joined the urethral plate vertically. The little triangle-shaped skin flaps between the oblique mucocutaneous incisions and urethral plate incisions were excised...
December 2015: Indian Journal of Surgery
Haytham Badawy, Ahmed Fahmy
INTRODUCTION: The surgical reconstruction of distal penile hypospadias in a single stage is the standard practice for managing anterior hypospadias. Unfortunately, it is not simple to extrapolate the same principle to proximal hypospadias. There is no consensus among hypospadiologists about whether a single- or multi-stage operation is the optimal treatment for proximal hypospadias. In this review, we assess the currently reported outcomes and complications of both techniques in proximal hypospadias repair...
June 2013: Arab Journal of Urology
Andrea Bischoff, William DeFoor, Brian VanderBrink, Jens Goebel, Jennifer Hall, Maria Alonso, Pramod Reddy, Alberto Peña
BACKGROUND/PURPOSE: Mortality from end stage renal disease (ESRD) in patients with anorectal malformation (ARM) is reported to be between 2.5 and 6%. The risk differs depending on the type of ARM (6.4% "high" vs. 1.1% "low"). The purpose of this study was to review the characteristics of the ARM patients who received a kidney transplant (KT) to potentially identify if any modifiable factors existed that may have prevented ESRD. METHODS: The Colorectal Center and the kidney transplant databases at Cincinnati Children's Hospital were queried to identify patients with ARM and a KT...
August 2015: Pediatric Surgery International
M Zornoza, J M Angulo, A Parente, S Simal, L Burgos, R Ortiz
CLINICAL PROBLEM: We diagnosed 8 patients with late-stage posterior urethral valves (PUV) between 1 and 14 years of age. Five patients complained of symptoms related to voiding dysfunction. The other 3 patients required urethrocystoscopy for other reasons (hypospadias fistulae, difficulty with catheterisation and high-grade vesicoureteral reflux [VUR]). A second review of the first 2 patients' medical history showed voiding dysfunction symptoms. All patients underwent preoperative ultrasonography: 3 patients had normal results and 5 had renal or vesical disorders...
December 2015: Actas Urologicas Españolas
Ahmed M Al-Adl, Tarek M El-Karamany, Ayman S Bassiouny
OBJECTIVES: To objectively assess the functional and cosmetic outcomes of a modified tubularised incised-plate (TIP) urethroplasty (Snodgrass) technique, with particular attention to the uroflowmetry study and Hypospadias Objective Scoring Evaluation (HOSE) score. PATIENTS AND METHODS: In a prospective case-series study, 43 consecutive patients with primary distal hypospadias were evaluated. The modified Snodgrass technique included an extension of the midline relaxing incision of the urethral plate from within the hypospadiac meatus to the very tip of the glans...
June 2014: Arab Journal of Urology
Wenyong Xue, Jinchun Qi, Caiyun Yang, Qiang Gao, Junxiao Chen, Xiaoqian Su, Lei Du, Shuwen Yang, Chanebao Qu
OBJECTIVE: To investigate the clinical effect of modified Koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias. METHODS: 49 cases with severe hypospadias treated from Jan. 2009 to Sep. 2011 were retrospectively studied. 25 patients underwent Koyanagi technique with coverage by tunica vaginalis of testis. 24 cases underwent one-stage Duplay + Duckett technique in the same term. The patients were followed up for 7-24 months. RESULTS: Among the 25 children treated with Koyanagi procedure, 20 cases were cured, 5 patients had postoperative complications, including urethral fistula in 3 cases,urethral stenosis in 2 cases...
November 2014: Zhonghua Zheng Xing Wai Ke za Zhi, Zhonghua Zhengxing Waike Zazhi, Chinese Journal of Plastic Surgery
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