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Objective To summarize the success of congenital penile curvature. Methods 401 cases of con-genital penile curvature,whose average age is 2. 5 years ,ranging from 1 year to 26 years old. Of all cases ,383 patients who have both hypespadias and penile cun, ature, only 18 patients are congenital penile curvatures. 295 paitents are slight curvature,85 patients are moderate curvature and 21 patients are severe curvature. Curvature correction was per-formed on a case-by-case basis by solution fibric trabs of ventrial urethra and surrounding,skin de-gloving, ff necessa-ry,dorsal plication,and confirmed by Gittes test. Results . Curvature correction was possible by mobilization of ure-thra after penile degloviag,only a few need dorsal plieation. Followup for 6 months to 2 years,396 patients are success at once. The others after a second surgery had 100% success. Conclusions Solution fibrie trabs of ventrial urethra and surrounding, skin de-gloving, if necessary,dorsal plication ,is the first choice to repair of the congenital penile cur-vature and have good results.
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Objective To discuss the treatment of urethral stricture after hypospadias reDair.Methods Thirty-seven cases of urethral stricture after hypospadias repair from 1999 to 2006 were ret-rospectively analyzed. Of 37 patients,the stricture was located at the distal end of urethra in 7 cases.There were 3 1 cases with anastomotic stricture.There was 1 case with distal urethral stricture and anastomotic structure.There were 1 3 patients with the simple urethral stricture and the complicated 24 cases.Of 13 simple urethral stricture patients,4 patients were repaired with urethro-meatomy,6 patients with shelf operation and 3 patients with transurethral holmium laser urethrotomy.Eight Pa-tients with complicated urethral fistula,6 patients with urethral diverticula,4 patients with phallo-campsis and 6 patients with many times of postoperative urethral stricture were repaired with shelf op-eration or penis skin flap or septum of scrotum skin flaps urethroplasty. Results The simple stric-tures of 1 2 patients were cured by stage 1 operation,the other one cured after second surgery.Of 8 patients with fistula,7 were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with diverticulum,all were cured at stage 1.Of 4 patients with phallocampsis,3 cases were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with recurrent strictures,all were cured at stage 1.A1l patients were followed up 1 2 to 24 months.The micturition was without difficuItv at stand position. Conclusions Urethral stricture is one of the most common complications after hypos-padias repair.The simple urethral stricture could be repaired with urethro-meatomy or sheIf operation or transurethral holmium laser urethrotomy.The complicated urethral stricture could be reDaired with shelf operation or penis skin flaps or septum of scrotum skin flaps urethroplasty and overjetted with dortos of scrotum flaps.
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Objective To investigate the security and result of operation of one side polycystic kidney removal and homonymy kidney transplantation simultaneously for giga-polycystic kidney di-sease of terminal stage. Methods Forty-five patients with polycystic kidney of transplantation were retrospectively analyzed. The patients were divided into 2 groups. Patients of group A (n=23) under-went resection of the cystic kidney by extraperitoneum and the other 22 patients(group B) didn't re-move the cystic kidney. The data including average length of hospital stay, variance of blood pressure, lessen of abdominal circumference, lung capacity, total lung capacity, FEV1.0/FVC, incidence rate of delayed graft function (DGF) and 1 year patient/kidney survival rate of the 2 groups were compared. Results The average length of post-operative hospital stay of group A was (14.5±2.6)d,lessen of blood pressure was (30.0±0.7/13.34±8.4)mm Hg, lessen of abdominal circumference was (11.0+ 6. 3) cm, lung capacity increased (1.4±0.3)L, total lung capacity increased (2.0±1.0)L, FEV1.0/ FVC increased (5.3±1.0) %, the incidence rate of DGF was 8.7% (2/23), 1 year patient/ kidney survival rate was 100.0%/95.7%. The average length of post-operative hospital stay of group B was (28.45±7.9)d,lessen of blood pressure was (3.9±11.2/2.9±12. 0)ram Hg, lessen of abdominal circumference was (3.3±2.2)cm, lung capacity increased (0.44±0.3)L, total lung capacity increased (0.8±0.2) L, FEV1.0/FVC increased (2.0±0.9)%, the incidence rate of DGF was 9.1%(2/22), 1 year patient/kidney survival rate was 100.0%/95.5%. There were no significant differences of the incidence rate of DGF and 1 year patient/kidney survival rate between the 2 groups. While there were significant differences of the other data between the 2 groups(P＜0.05). Conclusions It is safe and convenient for one side polycystic kidney removal and homonyrny kidney transplantation simultaneous-ly for giga-polycystic kidney disease of terminal stage. The procedure could be applied to the patients of graveness complication or giga-polycystie kidney hampering operation of transplantation.
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Objective To investigate the effect of nephrostomy on the infections after ureteroscopic holmium laser lithotripsy.Methods From March 2007 to May 2008,100 patients with unilateral upper ureteral calculi complicated with hydronephrosis were divided into control and experiment groups according the patients number (50 cases in each). Ureteroscopic holmium laser lithotripsy was carried out in the control group,while in the experiment group,nephrostomy was performed two days prior to ureteroscopic holmium laser lithotripsy. The clinical data including highest body temperature after the operation,recovery of body temperature,blood routine and urine routine,as well as hospital cost,were compared between the two groups. Results Compared with the control group,patients in the experiment group showed significantly lower highest temperature [(37.8?0.5) ℃ vs (38.6?0.5) ℃,t=-8.000,P=0.000],quicker recovery of body temperature [(1.6?0.2) d vs (2.8?0.4) d,t=-18.974,P=0.000],blood routine [(2.7?0.4) d vs (4.1?0.6) d,t=-13.728,P=0.000],and urine routine [(3.6?0.6) d vs (5.2?0.7) d,t=-12.271,P=0.000],as well as lower hospital cost [(8.6?1.5) thousand RMB vs (9.5?1.1) thousand RMB,t=-3.421,P=0.000]. Conclusion Nephrostomy shows positive effect on relieving infections after ureteroscopic holmium laser lithotripsy.
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Objective To summary our experiences on the clinical management of early complications caused by ureteroscopy and pneumatic lithotripsy. Methods From May 2002 to December 2007,totally 660 patients received ureteroscopy and pneumatic lithotripsy in our hospital,25 of them had surgical complications. Their clinical data were analyzed retrospectively. Results Among the 25 cases,22 patients had ureteral perforation,2 had ureteral disruptions,and 1 showed pelvic hematoma owing to ureteral perforation and injury to the ovary vein. Of the 22 cases of ureteral perforation,13 patients received lithotripsy and placement of a double J stent into the renal pelvis via the perforation site;and 4 patients underwent repair of the ureter. The other 5 of the 22 cases refused open surgery,and showed symptoms of urinary extravasation,loin pain,fever,or hematuria postoperatively;PCN was successfully completed in 3 of them but failed in the other 2,who underwent open surgery afterwards. For the 2 patients with ureteral disruptions,ureteroureteral anastomosis was performed. And in the case of pelvic hematoma,we carried out open surgery to ligate the bleeding vessels. All of the 25 patients were cured and discharged from hospital prosperously. The double J stent was withdrawn in 2 months after the operation,and 1-year follow-up showed no ureteral stenosis or obstruction by intravenous pyelography. ConclusionsPrimary management of ureteral injury by indwelling double J stent or percutaneous nephrostomy results in significantly deceased rate of re-operation. Conversion to open surgery timely can stop the incidence of other severe complications.
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Objective To evaluate vagina reconstruction with the use of sigmoid colon. Methods 21 cases underwent vagina reconstruction with the use of sigmoid colon were reviewed of which 13 were male pseudohermaphrodism and 8 congenital devoid of vagina. Results The appearence of the reconstructed vagina has been good in all the 21 patients.15 of the 21 have been followed up for 3～24 months with no overproduction of mucus and no need of routine dilatation. Conclusions Vagina reconstruction with the use of an isolated sigmoid loop is an ideal procedure for juveniles and adults.