ABSTRACT
Hypospadias can be repaired in the majority cases in 1-stage with a high success rate. We reviewed clinical experience of 50 patients who underwent primary hypospadias repair by 1 surgeon using 1-stage repairs except 3 cases in a 30-month period. The results were 1). The half of patients were younger than 5 years (48%). 2). A total of 34 cases (68.0%) had an associated ventral curvature. The dorsal tunica albuginea plication to correct intrinsic curvature was done in 21 cases (61.8%) and dividing the urethral plate in only 3 cases (8.8%). 3). Associated anomalies were cryptorchidism in 7, hydrocele in 3 and severe penoscrotal transposition in 8 cases. 4). 19 cases of anterior hypospadias were repaired by meatoplasty using Heineke-Mikulicz tissue rearrangement (9 cases), MAGPI (3 cases), pyramid procedure (4 cases), Mathieu urethroplasty (2 cases) and onlay island flap (1 case). Of the 31 cases of middle and posterior hypospadias onlay island flap repair was performed in 24 cases (77.4%). 5). The success rates in anterior, middle and posterior hypospadias were 94.7, 64.7 and 42.9%, respectively. The overall success rate was 70%. 6). The most commonly used procedure was onlay island flap urethroplasty. Only 14 of 25 cases (56.0%) were successful with this method but the last 8 cases were repaired with no complications. 7). The most common complications were urethrocutaneous fistula (11 cases) and meatal retraction (3 cases). The complications were managed by rotational advancement flap (11 cases), meatal based flap (2 cases) and urethral advancement (1 case) and the success rate was 73.3%. In conclusion, to achieve more satisfactory results the choice of operation depends on the configuration of either glans or meatus, presence or absence of chordee and status of ventral penile skin in anterior hypospadias. Although the 2-stage repair remains a safe and reliable alternatives for severe hypospadias 1-stage repair was more useful except severe hypospadias combined with penoscrotal transposition."
Subject(s)
Female , Humans , Male , Cryptorchidism , Fistula , Hypospadias , Inlays , SkinABSTRACT
Megameatus intact prepuce (MIP) is an unusual variant of hypospadias and comprised 3 percent of all hypospadias. Embryologically, maldevelopment of glandular epithelial infolding would appear to be the abnormal process responsible for MIP formation. We have performed the pyramid procedures in 3 patients seen with the MIP variant during 14 months and achieved good results. The pyramid procedure optimizes a safe and simple dissection of the megameatus-urethra, and allows for subsequent reduction and caliber of both with excellent functional and cosmetic results.
Subject(s)
Female , Humans , Male , HypospadiasABSTRACT
The Page kidney is a recognized cause hypertension. Post-traumatic subcapsular hematoma is the most common clinical counterpart to the Page`s experimental model of parenchymal compression. We herein report a case of the Page kidney resulting from massive bilateral subcapsular hematoma
Subject(s)
Hematoma , Hypertension , Kidney , Models, TheoreticalABSTRACT
90 cases of spinal cord injured patients admitted to St. Mary`s Hospital, Catholic Medical College, during the period from January 1969 to December 1978 were analyzed. All of these patients had initial bladder management by a careful indwelling catheter. This method reduced the incidence of the vesico-ureteral reflux, but the incidence of bladder stone was increased in flaccid neurogenic bladder than spastic type. The final stage of neurogenic bladder was reached eventually, usually within the first 3 months after injury. 57 cases of the 90 patients remained catheter-free and 21 cases remained indwelling catheter. In the early part of this series transurethral resection was done as the primary operation and external sphincterectomy was done when this failed. Since this was not always successful the combined procedure, external sphincterotomy and transurethral resection was tried, In this series T.U.R. and/or external sphincterotomy was done in 8 cases and all the cases were successful.
Subject(s)
Humans , Catheters, Indwelling , Incidence , Muscle Spasticity , Spinal Cord Injuries , Spinal Cord , Urinary Bladder , Urinary Bladder Calculi , Urinary Bladder, Neurogenic , Vesico-Ureteral RefluxABSTRACT
90 cases of spinal cord injured patients admitted to St. Mary`s Hospital, Catholic Medical College, during the period from January 1969 to December 1978 were analyzed. All of these patients had initial bladder management by a careful indwelling catheter. This method reduced the incidence of the vesico-ureteral reflux, but the incidence of bladder stone was increased in flaccid neurogenic bladder than spastic type. The final stage of neurogenic bladder was reached eventually, usually within the first 3 months after injury. 57 cases of the 90 patients remained catheter-free and 21 cases remained indwelling catheter. In the early part of this series transurethral resection was done as the primary operation and external sphincterectomy was done when this failed. Since this was not always successful the combined procedure, external sphincterotomy and transurethral resection was tried, In this series T.U.R. and/or external sphincterotomy was done in 8 cases and all the cases were successful.