1,721,057 research outputs found
Aptness and complications of labial mucosa grafts for the repair of anterior urethral defects in children and adults: single centre experience with 115 cases
No full textComparison of musculoskeletal and urological functional outcome in patients with bladder exstrophy undergoing repair with and without osteotomy
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Use Of The Prepuce For Urethroplasty In Primary Severe Hypospadias: A Comparison Of Surgical Complications In Flap Vs. Graft, And One-Stage Vs. Staged Repairs.
No full textSemplified Management After Primary Endoscopic Decompression Of Duplex System Ureteroceles In Infancy: Can We Reduce The Need For Secondary Surgery?
No full textModified VQZ-Plasty for the Creation of a Catheterizable Stoma Suitable as a Neoumbilicus in Selected Bladder Exstrophy Patients
No full textTo present a modified VQZ-plasty technique to create a catheterizable stoma appearing as a normal-looking neoumbilicus that may be used in selected bladder exstrophy (BE) patients. Acatheterizable conduit is created according to the Mitrofanoff principle. An asymmetric V flap, with the base at the level selected as the upper margin of the neoumbilicus, is created and incorporated into the spatulated appendix. Then a Q flap is developed parallel to the shorter margin of the V flap, rotated, and anastomosed to the upper edge of the appendix and to the free margin of the V flap on the contralateral side. The skin gap is filled by a rotational flap overlying the emerging appendix and stoma site. To date the technique has been used in 2 BE patients. After a follow-up of 10 and 6 months, respectively, both have good cosmetic and functional results, with an easily catheterizable stoma. The described technique allows for the creation of a nearly ideal stoma that looks like a normal neoumbilicus in selected BE patients yet without an umbilicus and requiring the placement of a catheterizable condui
Radical soft tissue mobilization and reconstruction (Kelly procedure) for bladder exstrophy repair in males: initial experience with nine cases
No full textPurpose to report the early experience with the Kelly procedure for the treatment of bladder exstrophy (BE) in
males. Materials and methods Nine boys with BE were treated at our institute. One had an untouched BE, four had epispadias after neonatal bladder closure, and four were secondary phalloplasties. Data on surgical complications,
continence status, presence of erections and parental satisfaction with penile appearance and length are reported. Results Mean patient age was 4.7 (1–8.9) years. No intraoperative complications occurred. Two secondary cases experienced formation of a bladder-neck fistula and glans ischemia, respectively. The latter led to glans loss. All the patients had some residual degree of hypospadias after surgery. After a median follow-up of 18.1 (10–22) months, one patient developed chronic bladder outlet obstruction.
Overall, five patients are dry (including two on clear intermittent catheterization and one with a Minz II pouch). The other four are still younger than 3 years, all have spontaneous micturitions and dry interval between 30 and 120 min. Of the eight patients without phalloplasty complications, all had erections, and parents judged the penile length and appearance as being satisfactory in six cases.Conclusion The Kelly procedure is feasible in a vast array of BE patients, but may be formidable, especially in secondary phalloplasties. It allows for complete reconfiguration and lightening of the penis, but exposes to
potentially catastrophic complications, such as partial or complete penile loss. Longer follow-up is needed to assessthe results in terms of continence
Modifica della tecnica VQZ per la creazione di uno stoma cateterizzabile e di un neo-ombelico in pazienti con estrofia della vescica
No full textSurgical management of penile amputation in children
No full textAbstract Purpose: Penile amputation in children is rare. If the amputated organ cannot be salvaged, standard treatment options include sex reassignment or creation of a penoid with a musculocutaneous flap. We describe our experience with phallic reconstruction after amputation. Methods: Between 2005 and 2007, we observed 3 patients with penile amputation. All presented a flat pubic scar and a severe urethral stricture for which urinary diversion had been performed in two.The first step of the procedure was penile augmentation. The latter included dissection and advancement of the residual erectile tissue by either division of the suspensory ligament (n = 2) or detachment of the corpora cavernosafromthepubicbones.Then,meataladvancementwasattemptedandcombinedwithastagedoral mucosa urethroplasty, if necessary. Finally, skin coverage was achieved using local flaps (n = 2) or a free graft harvested from the inguinal region. In 2 patients, a pseudoglans was sculptured from the pubic scar. Results: Innocasetheprocedurecouldbeperformedinasinglestage.Inonepatient,2additionalcosmetic revisions wererequired.Goodpenileaugmentationwasachievedinallthe3cases.Allpatientspresentedat least nocturnal erections and reported to be satisfied with the cosmetic results. Conclusions: Our experience suggests that an attempt to phallic reconstruction by retrieval of any residual erectile tissue might be worthwhile before embarking on a penile replacement. In a few cases, this may allow recreation of a penis with good cosmesis and functio
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