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Bladder neck incision in infants

Li Yang, Shao-Tao Tang, Shuai Li, T H Aubdoollah, Guo-Qing Cao, Hai-Yan Lei, Xin-Xing Wang
BACKGROUND: Trans-umbilical colostomy (TUC) has been previously created in patients with Hirschsprung's disease and intermediate anorectal malformation (ARM), but not in patients with high-ARM. The purposes of this study were to assess the feasibility, safety, complications and cosmetic results of TUC in a divided fashion, and subsequently stoma closure and laparoscopic assisted anorectoplasty (LAARP) were simultaneously completed by using the colostomy site for a laparoscopic port in high-ARM patients...
November 2014: Journal of Pediatric Surgery
Sang Hoon Song, Aram Kim, Bumjin Lim, Sungchan Park, Kun Suk Kim
OBJECTIVE: To evaluate the effectiveness of endoscopic surgery before or after definitive correction in patients with a persistent cloaca. MATERIALS AND METHODS: The medical records of 16 patients diagnosed with persistent urogenital sinus at our institution were retrospectively reviewed. Of these 16 patients, five underwent endoscopic surgery, such as visual internal urethrotomy or transurethral incision by a single surgeon at the time of or after colostomy formation or corrective surgery...
April 2014: Journal of Pediatric Urology
Ali Tourchi, Abdol-Mohammad Kajbafzadeh, Zahra Aryan, Maryam Ebadi
OBJECTIVE: To represent our experience in the management of posterior urethral valves and concomitant vesicoureteral reflux (VUR). METHODS: A total of 326 children with posterior urethral valve who had underwent valve ablation/bladder neck incision were studied, and those who had persistent VUR and were categorized under 3 main groups were followed up. Group 1 (n = 71) received prophylactic antibiotic, group 2 (n = 50) underwent Deflux injection (2a) (n = 28): Deflux injection alone, group 2b (n = 22) Deflux with concomitant autologous blood injection (HABIT), and group 3 (n = 19) underwent ureteroneocystostomy before referral and was followed up conservatively...
January 2014: Urology
Shaheen Alanee, Priyanka Gupta, Paul Gleich, Aseem R Shukla
OBJECTIVE: To present two cases of type IIA urethral duplication and propose a reproducible surgical approach. METHODS: Two cases are presented in this report. The first was a male child with a type IIA1 urethral duplication with two urethral channels arising from the bladder through separate bladder necks coursing to the glans penis. The second infant had a type IIA2 urethral duplication with a single bladder neck. Both children were repaired using a surgical approach that joined both urethral openings into a single orthopic meatus...
August 2012: Journal of Pediatric Urology
Shiv Narain Kureel, Archika Gupta, Santosh Kumar, Vinita Singh, D Dalela
OBJECTIVE: To report a novel surgical approach for single-stage repair of exstrophy-epispadias, with the specific aim of innervation, preserving sphincteroplasty corporal detachment for penile lengthening and ischio-pubic ramotomy for Linia-alba approximation. MATERIAL AND METHODS: Twenty-five classic exstrophy with compliant bladder plate and 10 incontinent epispadias patients were selected. Preoperative magnetic resonance angiogram of urogenital diaphragm showed triangular space between ischio-cavernosus, bulbo-spongiosus, and transverse-perinei muscles containing sphincteric branch of perineal artery indicating the course of sphincteric nerve...
September 2011: Urology
Raimondo Maximilian Cervellione, Iason Kyriazis, Alan Peden Dickson
PURPOSE: Most attempts to create an umbilicus in the exstrophy abdomen eventually leave the end result of a flat scar rather than an inverted structure. We describe a technique that allows the creation of a better looking inverted umbilicus. MATERIALS AND METHODS: A total of 19 patients between 5 days and 7 years old underwent umbilicoplasty. At the apex of the vertical midline wound the skin and superficial fascia are elevated off the anterior rectus sheath well beyond the top of the skin incision...
October 2008: Journal of Urology
Abdol-Mohammad Kajbafzadeh, Seyedmehdi Payabvash, Golnar Karimian
PURPOSE: We evaluated the effects of simultaneous bladder neck incision and valve ablation on urodynamic abnormalities in patients with posterior urethral valves. MATERIALS AND METHODS: A total of 46 patients with posterior urethral valves entered our prospective study between 1998 and 2003. Group 1 consisted of 22 patients who underwent simultaneous valve ablation and bladder neck incision at the 6 o'clock position. Group 2 consisted of 24 age matched patients with comparable prognostic factors who underwent simple valve ablation...
November 2007: Journal of Urology
Philippos A Androulakakis, Dimitrios K Karamanolakis, Georgios Tsahouridis, Antonios A Stefanidis, Ilias Palaeodimos
OBJECTIVE: To investigate whether myogenic bladder decompensation in patients treated for congenital posterior urethral valves (PUV, the most serious cause of infravesical obstruction in male neonates and infants) may be secondary to bladder neck obstruction, as despite prompt ablation of PUV these patients can have dysfunctional voiding during later childhood or adolescence, the so-called 'valve bladder syndrome'. PATIENTS AND METHODS: The study comprised 18 boys (mean age 14 years, range 6...
July 2005: BJU International
Marcos Perez-Brayfield, Andrew J Kirsch, Terry W Hensle, Martin A Koyle, Peter Furness, Hal C Scherz
PURPOSE: The surgical correction of primary vesicoureteral reflux (VUR) is highly successful. This success decreases in more complex cases and often involves reoperation and increased morbidity. We present our experience with the use of subureteral injection of dextranomer/hyaluronic acid (Dx/HA) in complex cases of vesicoureteral reflux in which open surgery would have been indicated. MATERIALS AND METHODS: Between October 2001 and July 2003, 72 patients 9 months to 31 years old (mean age 5...
October 2004: Journal of Urology
E Merlini, P Lelli Chiesa
Ureterocele is a cystic dilatation of the intravesical ureter that is most commonly observed in females and children, and usually affects the upper moiety of a complete pyeloureteral duplication. According to their position, ureteroceles are divided into intravesical, when the ureterocele is completely contained inside the bladder, and extravesical when part of the cyst extends to the urethra or bladder neck. Most ureteroceles are diagnosed in utero or immediately after birth during an echographic screening of renal malformations...
June 2004: World Journal of Urology
Steve Y Chung, Kirsten Meldrum, Steven G Docimo
PURPOSE: Laparoscopic assisted surgery results in an improved cosmetic appearance by allowing complex reconstruction without a midline upper abdominal incision. We report technique and outcomes in patients undergoing laparoscopic assisted reconstruction during a 7-year period. MATERIALS AND METHODS: A total of 31 consecutive patients with a mean age of 14 years (range 1 to 36) underwent laparoscopic assisted reconstructive surgery through a lower midline or Pfannenstiel incision by a single surgeon (SGD) between June 1995 and July 2002...
January 2004: Journal of Urology
P Caione, N Capozza, A Lais, E Matarazzo
PURPOSE: Continence is a difficult goal in exstrophy-epispadias complex repair. It is presumed that all anatomical components involved in the exstrophy-epispadias abnormality are present but laterally and anteriorly displaced. The penile disassembly technique for epispadias restores the normal anatomical relationship of the male genital components. Its extension to complete primary bladder exstrophy closure enables deeper positioning of the bladder neck within the pelvic diaphragm. We identified the perineal striated muscular complex and present its appropriate periurethral reassembly as a main step in exstrophy-epispadias complex repair...
December 2000: Journal of Urology
T P de Jong, P Dik, A J Klijn, C S Uiterwaal, J D van Gool
PURPOSE: The treatment of ectopic ureterocele is controversial. In addition to debate on optimal therapy, discussion exists on whether there is further risk of deteriorating bladder function after extensive bladder surgery during the first year of life, which is a reason to postpone surgery. In a prospective nonrandomized trial we treated 40 patients regardless of age who had ectopic ureterocele with complete surgical reconstruction of the lower urinary tract and upper pole resection of poorly functioning upper pole moieties at referral...
December 2000: Journal of Urology
C S Cooper, G Passerini-Glazel, J C Hutcheson, M Iafrate, C Camuffo, C Milani, H M Snyder
PURPOSE: Endoscopic incision was performed as the initial therapy for ureteroceles in children presenting to our institutions between 1985 and 1990. To assess the long-term efficacy of this treatment modality we reevaluated the outcome of these patients. MATERIALS AND METHODS: Parameters reviewed included patient age at surgery, position of the ureterocele, a duplex system, preoperative and postoperative reflux, and the need for additional operations. Statistical analysis consisted of chi-square and Wilcoxon's rank sum tests...
September 2000: Journal of Urology
A Calisti, G Marrocco, G Patti
Among 36 children, mostly less than 1 year of age, referred for a complete duplex-system anomaly, 18 were diagnosed before birth by obstetrical ultrasonography where a diagnosis of dilated upper urinary tract was the most frequent report; in the remaining cases urinary tract infection was the main presenting symptom. Five children had bilateral anomalies. Principal diagnoses associated with the complete duplex system were: 18 ureteroceles (UC) (11 extravesical [EUC] with bladder-neck or urethral extension, 7 intravesical [IUC]), 5 ectopic ureters without UC and 28 lower-polar vesicoureteral reflux (VUR) associated in 6 with upper polar VUR...
July 1999: Pediatric Surgery International
R Mathews, R D Jeffs, M Maizels, L S Palmer, S G Docimo
PURPOSE: Ureteral ectopia is frequently associated with dysplasia of the associated renal segment in girls with ureteral duplication. However, single system ureteral ectopia is an uncommon anomaly more frequently noted in boys. We report on 6 boys with single system ureteral ectopia into the prostatic urethra above the verumontanum, who presented with radiological and clinical findings of bladder outlet obstruction. MATERIALS AND METHODS: Antenatal ultrasound in 3 boys demonstrated renal abnormalities and postnatal studies suggested the diagnosis of posterior urethral valve obstruction...
April 1999: Journal of Urology
P Dahm, L R King
OBJECTIVES: The value of primary transurethral ureterocele incision was investigated in the treatment of ureteroceles in infants and children. METHODS: The charts and radiographic studies of 13 patients between the ages of 2 weeks and 8 years who underwent transurethral incision of 14 ureteroceles as primary surgical therapy at our institution were reviewed. RESULTS: 57% of the ureteroceles were intravesical and 43% extravesical. 64.3% were associated with the upper pole of a duplicated system...
1998: Urologia Internationalis
R Petschnigg, H Lipsky
The experience with 32 patients with functional bladder neck obstruction is presented and this condition is discussed. This disease occurred mainly in males from the age of 6 months to 50 years. There was only one female patient. The most important investigations were the micturating cystogram, the flow-rate and the measurement of the residual urine. The bladder neck incision, as proposed by Turner-Warwick, relieved symptoms and obstruction in all patients efficiently.
September 1983: Der Urologe. Ausg. A
N Koleilat, A A Sidi, R Gonzalez
Intermittent catheterization is used commonly to treat bladder dysfunction. We treated 10 patients who were experiencing difficulty with intermittent catheterization, 9 of whom had a false urethral passage. Of these patients 6 had previously undergone a bladder neck or urethral operation. Endoscopy was helpful to diagnose the condition. Treatment consisted of stenting in 3 patients, transurethral incision and stenting in 3, and fulguration and stenting in 4. An indwelling catheter was left in place for 2 to 3 weeks, after which intermittent catheterization was resumed with a softer catheter...
November 1989: Journal of Urology
H Watanabe, T Hori, S Sasaki, Y Noguchi, H Washida
A case of cecoureterocele in a 22-month-old girl is reported. She was admitted because of recurrent urinary tract infection associated with fever and dysuria. Excretory urogram showed a left duplex kidney with hydroureteronephrosis of the upper and lower moieties. Although the left upper moiety was hypofunctioned, some excretion of contrast medium was noted. Voiding cystourethrography demonstrated reflux into the left upper moiety, and a prominent dilation of the bladder neck and the urethra. Bladder sonography demonstrated an ectopic ureterocele at the bladder neck, and it was diagnosed as a cecoureterocele by endoscopic examination...
December 1989: Nihon Hinyōkika Gakkai Zasshi. the Japanese Journal of Urology
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