Undescended testes: do we need to fix them earlier?

Patients with undescended testes [UDT] may present with acute testicular torsion or incarcerated hernia requiring immediate surgical intervention. The exact incidence of these two complications among cases of UDT is not known. The aim of this study was to investigate the frequency of such conditions in our series of undescended testes, and to evaluate whether early intervention in undescended testes could eliminate such problems. All the data of patients with undescended testes admitted for surgery in Aseer Central Hospital, Abha Saudi Arabia, over a 6-year period were reviewed. In two hundred and ninety patients, 18 presented acutely with torsion of the undescended testicle in the inguinal canal [n=11] or incarcerated inguinal hernias [n=7]. The data of these 18 patients were looked up for patient characteristics. Methods of diagnosis, preoperative preparation, operative findings, operative interventions, histopathological results and outcome were all analyzed. Ten out of 18 patients [55.5%] were less than six months. Nine out of eleven patients with testicular torsion required orchiectomy. The other two underwent orchiopexy, which ended up with atrophy. All patients with incarcerated hernia had simultaneous hernia repair and orchiopexy; of which, three atrophied. Acute testicular torsion and hernia incarceration in cases of cryptorchidism may be more prevalent than initially thought. Orchiopexy, as early as 3 months of age, may reduce the incidence of such problems. 'Therefore, earlier intervention in undescended testes [between 3-6 months] is recommended

Abdominal twin foetuses-in-foetu in an infant: Case report and review of literature

We present a case of intra-abdominal twin foetuses-in-foetu in the left upper retroperitoneal space attached uniquely to the pancreas in a 5-month-old male infant. Antenatal ultrasonography demonstrated the presence of the mass. Although a bony component was present in the mass; the plain x-ray abdomen was not helpful in the diagnosis and abdominal computed tomography was the main diagnostic tool. Diagnosis was only confirmed at laparotomy

Mathieu procedure with urethro-vesical drainage for distal hypospadias repair: a review of 157 cases

To evaluate Mathieu repair in providing a normal looking penis with a normal functioning urethra and to evaluate the complications of this procedure using urethro-vesical urine diversion technique. The author peiformed 157 consecutive Mathieu repairs in a 5-year period [1998-2002]. Two-layer anastomnosis was used with optical magnification. All cases had a feeding tube size 6for bladder drainage through the urethra. All patients were kept in the hospital 5-7 days post-operatively. The follow up period ranged between 4 months to 36 months. Circumcision was offered 3-4 months post-operatively after successful repair in 151 cases. Initial outcome was excellent in 117 patients [74.5%] and satisfactory in four [2.5%]. Despite an initial complication rare of 25.5%, yet the final successful rate was 97.5%. Three patients [1.9%] refused further treatment after failure of the first trial of post-operative fistula repair. The initial complications included fistula in 29 patients [18.5%], meatal stenosis in two [1.3%], meatal retraction in four [3.2%] and flap necrosis in five. Fistulae occurred most commonly within one month after surgery [22 patients, 14%]. The multipemforated bladder drainage tubes caused fewer complications than those with two openings at the tip. Mathieu urethroplasty was a reasonable procedure that allowed successful treatment of most anterior hypospadias. However, there was an initial high complication rate mostly due to urine drainage problems in this series