ABSTRACT
Numerous hypospadias correction techniques were described in the literature. The technique varies according to the position of the meatus and the importance of the chordee. These new techniques and the care taken in the manipulation of the tissues tend to decrease complications like stenoses and fistulas, frequent in the long urethroplasty. The correction of hypospadias should conform to aesthetic and plastic surgery. More than 300 corrections were carried out in our service. Surgical technique varied in the long run. Currently, we choose as often as possible a correction in one time: release of the chordae and urethroplasty. Straightening of the penis is obtained on one hand by release of the cutaneous chordae and wide dissection of the hypoplastic urethral plate and one or more dorsal plications according to Nesbit are carried out if it proves necessary. In the distal, glandular and coronal forms, the correction is of type M.A.G.P.I. (meatal advancement, glanduloplasty). The complication rate is extremely low. The aesthetic and functional result is very satisfactory. In the proximal forms, Duckett technique is used only in the obligatory cases given the large number of complications. It is generally replaced by Onlay technique. The urethral plate is left in continuity and serves as support to the pedicled and vascularized flap. In the intermediate situations with a middle shaft hypospadias, Mathieu technique is again of application. The aesthetic and functional result of this type of surgery requires good knowledge and careful application of the technique adapted to each case.
Subject(s)
Hypospadias/surgery , Adolescent , Adult , Child , Child, Preschool , Humans , Infant , Male , Surgical Flaps/methods , Surgical Procedures, Operative/methodsABSTRACT
Varicocele is a benign pathology, for which the less invasive treatment is percutaneous embolisation. Literature reports results from 70 to 85% (1,2). Laparoscopic treatment seems to be a good alternative for patients suffering from a recurrence, or patients who can not be embolised. We report our experience concerning the first 13 patients treated with laparoscopic technic. In all 13 cases it was possible to practice the technic, and patients were cured.
Subject(s)
Laparoscopy/methods , Varicocele/surgery , Adolescent , Adult , Embolization, Therapeutic , Humans , Male , Recurrence , Treatment Failure , Varicocele/therapyABSTRACT
Urethral duplication is a less frequent malformation. The Williams classification, which is currently admit, classifies them in sagital, hypospadias or complex and collateral duplications. They can be complete, incomplete or reduced to an incomplete sinus. The most severe cases are often accompanied by multi-abnormality syndromes. Clinical manifestations are various: asymptomatic, urinary infection, incontinence, double urinary stream,... We will report two new cases of incomplete epispadias duplication. The first case presents a purulent flow from the fistula, the second a frank epispadiac status. In both cases, corrective surgical treatment was performed, after a complete balance-sheet. The embryological, diagnostical and therapeutical aspects of the different forms of urethral duplication will be studied based on data from literature.
Subject(s)
Hypospadias/surgery , Urethra/abnormalities , Child , Child, Preschool , Congenital Abnormalities/diagnostic imaging , Congenital Abnormalities/surgery , Humans , Male , Urethra/embryology , Urethra/surgery , UrographyABSTRACT
The varicocele is benign pathology which sometimes involves disorders of testicular growth. Those can cause a hypofertility. We saw in a retrospective way the 243 patients having been treated by percutaneous embolisation from May 1985 to August 1993. At 150 patients being 1 year at least of postoperative retreat, 70% of cases present a cure, 15% of patients repeated and were taken again surgically. At 8% of patients, the embolisation was not technically possible for reasons of vascular anomalies or spasm of the vein during the procedure. The morbidity of this technique is low, this involves therefore a right choice of the treatment of the varicocele which does not prevent any surgical treatment in the event of repetition or in the event of technical failure.
Subject(s)
Embolization, Therapeutic/methods , Varicocele/surgery , Adolescent , Adult , Child , Humans , Infertility, Male/etiology , Male , Recurrence , Reoperation , Retrospective Studies , Testis/growth & development , Varicocele/physiopathology , Varicocele/therapyABSTRACT
Liver cell functional heterogeneity has been shown to persist in toxic CCl4 cirrhosis in growing rats, but the zonation observed in cirrhotic nodules may be different in other types of cirrhosis. To investigate this possibility, we looked at the zonal activities of two microsomal enzymes, glucose-6-phosphatase and NADPH dehydrogenase, in cirrhotic nodules from growing rats with chronic cholestasis. Zonal activities were measured by quantitative cytochemistry and microdensitometry. Liver cell heterogeneity was demonstrated, and we confirmed that the metabolic zonation is the mirror image of that observed in toxic cirrhosis, with periportal activity at the nodule periphery and perivenular activity at the nodule centers. Glucose-6-phosphatase activity was 2.06 times higher at the peripheries of the nodules than at the centers, whereas NADPH dehydrogenase activity at the nodule periphery was 72% of the nodule center activity. We conclude that a liver cell functional heterogeneity persists in biliary rat cirrhosis, with zonation the reverse of that previously found in toxic CCl4 cirrhosis.
