Frequency of urethrocutaneous fistula following snodgrass hypospadias repair in children

To determine the frequency of urethrocutaneous fistula over a period of three months following snodgrass hypospadias repair for the treatment of distal penile hypospadias in children. This descriptive study was conducted in the pediatric surgery unit, Lady Reading Hospital, Peshawar over a period of eight months from June 2009 to February 2010. Patients with distal penilehypospadia without chordee between 2 and 14 years were included and patients were excluded who had previous repair for hypospadias. All those patients fulfilling the inclusion and exclusion criteria whose parents gave informed consent after explanation of the whole protocol were admitted through outpatient department for the said procedure and data was analyzed. A total of 52 patients were included in the study. All patients were in the range of 2 to 10 years and underwent Snodgrass Tubularized Incised Plate [TIP] urethroplasty for hypospadias repair. The overall rate of urethrocutaneous fistula was 9.6% [5 out of 52 patients]. Mean operative time noted in minutes was 57.52 minutes. No major morbidity or mortality was noted in this study. TIP urethroplasty is simple, single stage operation in the management of hypospadias and has good functional and low complication rate

Unproved tuberculous lesion of penis: A rare cause of saxophone penis treated by a therapeutic trial of anti-tubercular therapy.

Although Tuberculosis (TB) most commonly affects the lungs, any organ or tissue can be involved. In countries with comprehensive diagnostic and reporting systems, extrapulmonary tuberculosis (EPTB) accounts for 20-25% of reported cases. Globally, extrapulmonary cases (without concurrent pulmonary involvement) comprised 14% of notified cases (new and relapse) in 2007. The most common sites of extrapulmonary tuberculosis consist of lymphatic, genitourinary, bone and joint, and central nervous system involvement followed by peritoneal and other abdominal organ involvement. We report a case of a 25 year old male patient who came with multiple discharging sinuses and an urethrocutaneous fistula over the penis treated by a therapeutic trial of Anti-tubercular therapy (ATT).

Obstetric trauma is the commonest cause of urogenital fistulae

To determine incidence of different types of urogenital fistulae, their frequency and success rate of different methods of repair. This descriptive study was conducted at Armed Forces Institute of Urology and Department of Obstetrics and Gynecology, Military Hospital Rawalpindi from January 1997 to January 1998. A total of 44 patients were included in the study. Diagnosis was made by taking comprehensive history, detailed examination and appropriate investigations. Data regarding aetiological and risk factors was gathered. The incidence was 0.26%. Obstetric trauma, mostly prolonged and obstructed labour, was responsible for 53.3% cases and 40% were result of surgical trauma and miscellaneous causes. Forty percent of fistulae were vesico vaginal and same number was simple in type. Nearly 55% were repaired by abdominal route and 75% were successful in 1[st] attempt. Obstetric trauma was the commonest cause of urogenital fistulae. Majority were repaired by abdominal route and 75% were successful in first attempt. Improvement in maternity care in rural areas, easy approach to specialist care and better training of staff in instrumental deliveries may help to decrease the incidence of these fistule

Complicaciones urológicas en el trasplante renal / Urological complication in renal transplantation

Entre 1987 y 1995 se han realizado 51 trasplantes renales en el Hospital Clínico FUSAT, de los cuales 10 de ellos han presentado complicaciones urológicas (19,6 por ciento). De estas complicaciones urológicas 7 corresponden a fístulas, 2 a obstrucciones ureterales y 1 reflujo vesicoureteral masivo. El tratamiento quirúrgico inmediato se llevó a cabo en 7 casos (70 por ciento), todos ellos con evolución favorable. De los tres que no recibieron tratamiento quirúrgico inmediato 1 falleció y 1 se encuentra en diálisis. Se analizan las infecciones conconmitantes, tiempo de hospitalización, las técnicas quirúrgicas, el tiempo de isquemia y la inmunosupresión utilizada. El seguimiento promedio de la serie fue de 59 meses