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Depinder Kaur, Saurabh Anand
BACKGROUND: Efficacy of caudal bupivacaine plus ketamine on postoperative pain in children. AIMS: The aim of this study was to compare the analgesic efficacy and safety of caudal block with mixture of bupivacaine and ketamine to bupivacaine alone for postoperative analgesia in pediatric patients undergoing infraumbilical surgery. SETTINGS AND DESIGN: A prospective randomized study was conducted in a tertiary care teaching hospital. STATISTICAL ANALYSIS: Data were collected; mean value and standard deviation were computed for age, weight, duration of surgery, and duration of analgesia...
September 2016: Anesthesia, Essays and Researches
Aderivaldo Cabral Dias Filho, Ruytemberg Oliveira Rodrigues, Cassio L Z Riccetto, Paulo Gonçalves Oliveira
PURPOSE: Compare surgical outcomes between patients with intravaginal testicular torsion (TT) submitted or not to manual detorsion. PATIENTS AND METHODS: We retrospectively analyzed consecutively surgically treated TT patients, examined within 24 hours of symptoms, submitted or not to manual detorsion in our emergency department between January 2012 and September 2015. Explanatory variables were: age, presentation delay (PrD, time between symptoms and urological examination), surgical waiting time (SurgWait, time from examination to surgery), whether detorsion was attempted, and, if attempted, whether it was declared successful...
September 30, 2016: Journal of Urology
Christian Radmayr, Hasan S Dogan, Piet Hoebeke, Radim Kocvara, Rien Nijman, Raimund Stein, Shabnam Undre, Serdar Tekgul
CONTEXT: Undescended testis is the most common endocrinological disease in the male newborn period. Incidence varies between 1.0% and 4.6% in full-term neonates, with rates as high as 45% in preterm neonates. Failure or delay of treatment can result in reduced fertility and/or increased testicular cancer risk in adulthood. OBJECTIVE: To provide recommendations for the diagnosis and treatment of boys with undescended testes which reduce the risk of impaired fertility and testicular cancer in adulthood...
September 15, 2016: Journal of Pediatric Urology
Salvatore Arena, Pietro Impellizzeri, Patrizia Perrone, Gianfranco Scalfari, Antonio Centorrino, Nunzio Turiaco, Saveria Parisi, Pietro Antonuccio, Carmelo Romeo
PURPOSE: To report our experience in surgical management of nonpalpable intraabdominal testis (NPIT) by inguinal orchidopexy without division of the spermatic vessels. METHODS: We reviewed the records of NPIT patients who underwent orchidopexy between 2012 and 2015. All patients were evaluated ultrasonographically. When the testis was not detected ultrasonographically, a laparoscopic exploration was performed. If the testis was found on laparoscopy, surgery was resumed through an inguinal incision...
September 5, 2016: Journal of Pediatric Surgery
Aderivaldo Cabral Dias, João Ricardo Alves, Hélio Buson, Paulo Gonçalves de Oliveira
PURPOSE: To investigate the roles of age, testicular rotation and time in the surgical outcome of intravaginal testicular torsion (iTT). PATIENTS AND METHODS: We retrieved the records of all iTT patients treated in our unit from January 2012 to January 2014. Explanatory variables were: age (years); presentation delay (PrD, time between symptoms and hospitalization); surgical delay (SurgD, time between hospitalization and surgery) and testicular rotation (rotation), with surgical outcome (orchidopexy, orchidectomy) as response variable...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Jorgen Thorup, Dina Cortes
When considering long-term prognosis and results in adult age following treatment of cryptorchidism in childhood there are three main issues to be discussed: cosmetics, fertility, and malignancy. In the present review, the most recent research on the topics related to summaries of well-known knowledge on the field is presented.To some extent a smaller testis in a higher scrotal position than normal must be accepted as a fair cosmetic result after orchidopexy in childhood. The smaller testis size is related to the impaired fertility potential of the testis...
October 2016: European Journal of Pediatric Surgery
S Zundel, G Blumenstock, A Herrmann-Werner, M Trueck, A Schmidt, S Wiechers
BACKGROUND: Undescended testis in boys is common. Guidelines recommend surgical treatment between the ages of 6 months and 2 years; nevertheless, orchidopexy is frequently performed at later ages. One reason is the belated diagnosis due to a perceived difficulty in the physical examination (PE) and correct localization of the testis. OBJECTIVES: We aimed to find an effective method for teaching the physical examination of the testis in a child. STUDY DESIGN: An interdisciplinary team developed teaching sessions, including an educational video and a simulator...
August 8, 2016: Journal of Pediatric Urology
E Haraux, P Ravasse, D Sharma, J P Canarelli, R Gouron, X Tillou
INTRODUCTION: Practical training of the surgery resident is based on the companionship currently hampered in particular by the increase of the number of residents in training. We created a teaching tool to promote learning and validation of a technique of classic urologic surgery, inguinal orchidopexy. The objective is to evaluate the applicability and the relevance of this tool. MATERIAL AND METHODS: The tool is a technical evaluation sheet made from reference documentation...
September 2016: Progrès en Urologie
Faruk Hadziselimovic, Katharina Gegenschatz-Schmid, Gilvydas Verkauskas, Maria J Docampo-Garcia, Philippe Demougin, Vytautas Bilius, Dalius Malcius, Darius Dasevicius, Michael B Stadtler
The whole genome RNA profiling of testicular biopsies by DNA strand-specific RNA sequencing was examined to determine a potential causative role of isolated congenital cryptorchidism in azoospermia and/or infertility in the context of our previously published GeneChip data. Cryptorchid patients, aged 7 months to 5 years and otherwise healthy, were enrolled in this prospective study. During surgery, testicular tissue biopsies were obtained for histological examination and RNA sequencing. Fifteen patients were selected based on the histological results and were divided into 2 groups...
2016: Sexual Development: Genetics, Molecular Biology, Evolution, Endocrinology, Embryology, and Pathology of Sex Determination and Differentiation
Jaya Vikraman, John M Hutson, Ruili Li, Jorgen Thorup
Undescended testes (UDT), where one or both testes fail to migrate to the base of the scrotum, can be congenital (2-5% of newborn males) or acquired (1-2% of males). The testis may be found in any position along its usual line of descent. Cryptorchidism affects the developing testicular germ cells and increases the risk of infertility and malignancy. Clinical management aims to preserve spermatogenesis and prevent the increased risk of seminoma. Examination to document the testicular position will guide the need for imaging, medical management and the surgical approach to orchidopexy...
August 2016: Seminars in Pediatric Surgery
Shaoguang Feng, Huajun Yang, Xiang Li, Junjia Yang, Jie Zhang, Aihe Wang, Xin-He Lai, Yuhui Qiu
PURPOSE: We performed a systematic review and meta-analysis to compare the efficacy and safety between single-incision, transscrotal orchidopexy, and the traditional inguinal orchidopexy in children. METHODS: A systematic search of the electronic databases was conducted to identify studies compared the transscrotal orchidopexy (SO) and inguinal orchidopexy (IO) for children. Parameters, such as operative time, the incidence of patent processus vaginalis, and postoperative complications, including wound infection, testicular atrophy, testicular reascent, hernia, or hydrocele, were pooled and compared by meta-analysis...
October 2016: Pediatric Surgery International
Dusanka Dobanovackić, Nada Vucković, Andelka Slavković, Biljana Lucić Prostran, Tanja Lakić, Ivana Gajić
INTRODUCTION: Undescended testis or cryptorchidism is detected in 3% of full-term male newborns, and inup to 33% of preemies. As the testicular descent may sometimes resolve spontaneously during first months of life, cryptorchidism is found in 1% of boys one year old. According to Consensus of Nordic experts in. pediatric urology regarding cryptorchidism the optimal period for surgery is 12-18 months of age. The goal of this study was to identify the age of patients with congenital undescended testis at the time of surgery...
March 2016: Medicinski Pregled
A U Nwaopara, Erefagha Leonardo P Allagoa
Introduction. DSM-5 identifies two disorders: somatic symptom disorder and illness anxiety disorder, to replace hypochondriasis in DSM-IV. Patients with both disorders are intensely anxious about the possibility of an undiagnosed illness or devote excessive time and energy to health concerns and are not easily reassured. Both disorders cause considerable distress and life disruption, even at moderate levels. However, hypochondriasis (DSM-IV) is an indication for neither orchidopexy nor orchidectomy. This is the rationale for this report which is the first of its kind to the best of available literature...
2016: Case Reports in Psychiatry
Yi Wei, Sheng-de Wu, Yang-Ca Wang, Tao Lin, Da-Wei He, Xu-Liang Li, Jun-Hong Liu, Xing Liu, Yi Hua, Peng Lu, De-Ying Zhang, Sheng Wen, Guang-Hui Wei
OBJECTIVES: Research suggesting progressive deterioration in an undescended testis (UDT) has led to the reduction in the target age for orchidopexy to 6-12 months of age. However, it is still unknown whether changing targets have altered practice. The objective was to determine the current age at orchidopexy in China and whether changing targets have altered practice. MATERIALS AND METHODS: The demographics of orchidopexies performed in Children's Hospital of Chongqing Medical University between 1993 and 2014 were reviewed...
July 19, 2016: BJU International
J Durell, N Johal, D Burge, R Wheeler, M Griffiths, L Kitteringham, M Stanton, S Manoharan, H Steinbrecher, P Malone, S J Griffin
BACKGROUND: With the Nordic consensus statement advocating orchidopexy at an earlier age, the present study sought to investigate the outcomes of primary paediatric orchidopexy at a tertiary UK centre. OBJECTIVE: To prospectively assess testicular atrophy following primary orchidopexy for undescended testes in a paediatric population. Secondary outcomes were complication rates and whether outcomes were dependent on grade of operating surgeon. STUDY DESIGN: Prospective data regarding age at operation, classification of the undescended testis, length of follow-up, and subjective comparison of intraoperative and postoperative testicular volumes compared with the contralateral testis were collected...
August 2016: Journal of Pediatric Urology
Austin G Hester, Stanley J Kogan
INTRODUCTION: Epididymal and vasal abnormalities are frequently recognized with undescended testes. The most common defect identified is the extended or elongated epididymis, an anomaly in which the epididymal tail extends distally beyond the testis before looping back upon itself, then following its normal course. Although the impact on fertility has not been established, the necessity of recognizing these vaso-epididymal abnormalities surgically is obvious as these frequently simulate a blind-ending spermatic cord leading to inadvertent excision or leaving the unseen testis more proximally in the abdomen...
July 7, 2016: Urology
Muhammad Saleem, Uzma Ather, Bilal Mirza, Shahid Iqbal, Afzal Sheikh, Mahmood Shaukat, Muhammad Tahir Sheikh, Farooq Ahmad, Tariq Rehan
BACKGROUND: Persistence of mullerian duct derivatives in otherwise normal male child is a very rare disorder. This may lead to diagnostic as well as management dilemma. MATERIALS AND METHODS: The medical record of 27 cases of persistent mullerian duct syndrome (PMDS) operated in three teaching hospitals more than a period of 24years is retrieved and analyzed for demography, clinical presentation, investigations, and treatment. RESULTS: There were a total of twenty seven male children with PMDS...
October 2016: Journal of Pediatric Surgery
Gilvydas Verkauskas, Dalius Malcius, Audrone Eidukaite, Juozas Vilimas, Darius Dasevicius, Vytautas Bilius, Faruk Hadziselimovic
INTRODUCTION: A transient increase in gonadotropins and testosterone during mini-puberty causes gonocytes to differentiate into Ad spermatogonia, which establish male germ cell memory and male-specific DNA methylation pathways. Over half of patients with unilateral cryptorchidism and the majority of patients with bilateral cryptorchidism display an abnormal spermiogram, which indicates that unilateral cryptorchidism is a bilateral disease; therefore, it represents a serious andrological problem...
August 2016: Journal of Pediatric Urology
Adolfo Jiménez-Garrido, Moisés Mieles-Cerchar, María José Llamas-Centeno, Carlos Miguélez-Lago
OBJECTIVE: To present a retrospective, descriptive and observational study performed on a group of patients diagnosed with palpable undescended testicle (PUT) and surgically treated by pre-scrotal access, the "Bianchi technique". METHODS: The sample consists of a group of patients from 6 to 168 months old, diagnosed with palpable undescended testicle and treated by orchidopexy through pre-scrotal access Bianchi type (4), from January 2008 to June 2015 by the Pediatric Urology Equipment of Malaga, where the authors belong...
June 2016: Archivos Españoles de Urología
Priya Dhandore, Narendra Narayan Hombalkar, Mohd Hamid Shafique Ahmed
Abnormal findings in the inguinal canal during Herniotomy are not very rare for a paediatric surgeon. These abnormal findings may range from opposite gender sex organ (e.g. uterus and fallopian tube during orchidopexy) to unexpected malignancy (e.g. Rhabdomyosarcoma) to the abnormal embryological development (Splenogonadal fusion). Though abdominal tuberculosis is common, abdominal tuberculosis presenting as an inguinal hernia is exceedingly uncommon. We report an unusual case of abdominal tuberculosis presenting as inguinal hernia...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
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