Single incision Trans scrotal versus standard inguino-scrotal orchidopexy in children with palpable undescended testis: our experience from April 2007 to April 2010

To compare the efficacy and complications of single incision trans scrotal versus standard inguinal orchidopexy in children with palpable undescended testes. This randomized controlled trial was conducted at the Paediatric Surgery Department Bahawal Victoria Hospital Bahawalpur from April 2007 to April 2010. Children aged 9 months to 12 years, diagnosed as cases of palpable undescended testes were randomized into two groups. In group A orchidopexy was performed through single scrotal incision and in group B by standard two incision inguinal approach. The groups were compared for operative time, hospital stay, scrotal hematoma, wound infection, and secondary ascent. Each group had 134 cases. Mean operative time and hospital stay in group A and B were 28.32 +/- 0.92 minutes and 47.83 +/- 0.76 minutes [p value 0.0001] and 1.027 +/- 0.205 days and 3.023 +/- 0.203 days [p value 0.0001] respectively. There was no significant difference in the formation of scrotal haematoma, wound infection and secondary ascent of testis between the two groups. The conversion rate of surgery in group A was 7.46%.Trans scrotal orchidopexy is the simple, effective and less invasive technique as compared to the standard two incision inguinal approach.

Parotid swelling in children; our experience at department of paediatric surgery B.V.

To describe the clinical and pathological presentation as well as treatment options of parotid swelling in children. Descriptive case series study. Department of Paediatric Surgery Bahawal Victoria Hospital Bahawalpur. From Nov 2005 to Jul 2007. All patients of either sex below the age of 13 years presenting with parotid swelling were included in the study. Clinical presentations, preoperative investigations, operative procedures, histopathology reports, postoperative complications and further management [radiotherapy and chemotherapy] were recorded. Twelve patients presented with parotid swelling. Commonest presentation was a lump over the parotid region [100%] and pain [25%]. Majority of tumours were benign [50%]. Vascular lesions outnumbered solid tumours. 4 patients [33.33%] had haemangioma 1 patient [8.33%] had cystic hygroma, one patient each of pleomorphic adenoma, mucoepidermoid carcinoma and Adenocarcinoma. Salivary gland lesions are most likely inflammatory in origin. Vascular tumours are common benign tumours than epithelial tumours in children. Superficial parotidectomy is the operation for benign tumours and total conservative parotidectomy for malignant tumours

Hypospadias repair

The Departments of Urology, Pediatric Surgery and Plastic Surgery, Quaid-e-Azam Medical College, Bahawal Victoria Hospital, Bahawalpur. Jan 1999 to Dec 2004. Prospective. Patients admitted with hypospadias in these departments were included in this study except patients with multiple failed repairs previously. Standard procedures were practiced for every type of defect i.e. MAGPI and Mathieu's repair for coronal hypospadias, Snodgrass urethroplasty for proximal and distal penile hypospadias. The age range observed during this study was 1.5 to 25 years while 64% of patients were less than 10 years of age. The type of defect was coronal in 25%, penile in 60%, penoscrotal and perineal in 15% of the patients. Initial success rate was 78% and overall success rate was 92%. Complications observed were fistula formation 7%, stenosis of anastomotic site 7% and dehiscence of repair 3%. Thorough evaluation of urethral and penile malformation brings best outcome of surgery for hypospadias. Hypospadias repair should be offered to the child before school going age so as to prevent psychological impacts of genital malformations

Omphalocele: various treatment modalities and their outcome: a study of 53 cases at the department of paediatric surgery B .V. hospital, Bahawalpur

To evaluate the out come of the different treatment modalities for omphalocele. Descriptive. At the department of paediatric surgery Bahawal Victoria hospital Bahawalpur from January 2004 to August 2007. Fifty three patients have been studied, 33 patients with a major defect, 20 patients with a minor defect and male to female ratio of 1:3. All the patients with minor defect were managed with primary closure while same was done in only 4 [12.12%] patients with major defect. Rest of the patients with major defect, 11 [33.33%], were managed conservatively followed by delayed primary closure, silo formation was done in 6 [18.18%] patients and ventral hernia was formed in 5 [15.15%] patients. 100% survival rate was found in patients who were managed conservatively with delayed primary closure. Overall mortality was found in 12 [22.6%] patients. Primary closure is the treatment of choice in exomphalos minor. Delayed primary closure after application of escharating agent is the Management of choice in patients with exomphalos major. Silo formation is considered in exomphalos major with ruptured membrane

Pyelopalsty; Comparison of results of repair with and without stents

To evaluate the outcome of pyeloplasty for congenital pelviureteric junction obstruction and comparison of results between repair with stents and without stents. Patients admitted to the department of Urology with congenital pelviureteric junction obstruction regardless of age were entered in this study. Prospective. Department of Urology, Quaid-l-Azam Medical College/ Bahawal Victoria Hospital, Bahawalpur. From April 1999 to December 2002. A total of 30 patients were grouped into A and B. Either dismembered or non-dismembered pyeloplasty were performed in either group, both with and without D.J. Stents. The results in our study show that there is no gross difference of outcome in pyeloplasty whether done over D.J. Stent or without stents. Dismembered pyeloplasty resulted in better outcome. Open pyeloplasty is the "Gold Standard" treatment option for congenital pelviureteric junction obstruction. The use of D.J. Stents is not necessary in every repair