ABSTRACT
PURPOSE: To evaluate the usefulness of an inferior pubectomy and a gracilis muscle flap for the reconstruction of a complicated posterior urethral stricture, where urethroplasty had failed, or due to a long urethral defect. MATERIALS AND METHODS: A total of sixty eight patients with complicated posterior urethral strictures, following a pelvic bone fracture, were managed by a one-stage perineal repair at Pundang CHA hospital between March 1998 and April 2002. End-to-end anastomosis was performed in all cases, with corporeal body separation, or an inferior pubectomy and transposition of the gracilis muscle flap performed in a progressive manner if required. RESULTS: The success rate of all the cases was 95.6%. Additional procedures made no differences to the incidence of impotence, and the incidences of restricture and incontinence were low. CONCLUSIONS: Our results shows that an inferior pubectomy and a gracilis muscle flap can be useful methods in the treatment and prevention of incontinence and restricture in most cases of complicated posterior urethral strictures.
Subject(s)
Humans , Male , Erectile Dysfunction , Incidence , Pelvic Bones , Urethral StrictureABSTRACT
Cryptorchidism is a well-known and accepted risk factor for malignant germ cell tumors. Orchiopexy does not reduce the risk of testicular tumor. However, nonseminomas arising in the undescended testes are uncommon, and most of these tumors are in the advanced stage at diagnoses. In addition, an endodermal sinus tumor from an undescended testicle in adults has been reported to be quite rare. The management of these tumors is similar to the therapy for a testicular tumor in normally descended testis. Here we report a case of 27-year-old man who had a giant endodermal sinus tumor arising in the left intraabdominal undescended testis, which was successfully treated with an en bloc excision and EP (etoposide and cisplatin) chemotherapy. The patient has been free of recurrence for 15 months after surgery.