ABSTRACT
PURPOSE: To evaluate long-term results and complications we reviewed the records of 42 consecutive men 18 to 47 years old (mean age 22.5) who underwent hypospadias repair between 1979 and 1999. MATERIALS AND METHODS: The study population was divided into groups 1 consisting of 8 patients without previous hypospadias surgery, 2 consisting of 12 who underwent 1 or more procedures in childhood but in whom local tissue was relatively intact and 3 consisting of 22 who underwent multiple unsuccessful hypospadias repairs with various degrees of penile deformity and loss of local tissue. RESULTS: Complications were noted in 3 of 8 (37.5%), 5 of 12 (41.67%) and 14 of 22 (63.6%) patients in groups 1 to 3, including 3 (100%), 4 (80%) and 10 (71.4%), respectively, in whom secondary surgery was successful in the long term. A patient in group 2 and 2 in group 3 await further surgery, while 2 in group 3 were lost to followup. Overall primary complications developed in 22 of the 42 men (52.3%) and 5 of the 22 (22.7%) had secondary complications. There was long-term success in 37 of 42 cases (88.1%). CONCLUSIONS: The results of hypospadias repair in adulthood differ from the results of similar procedures in childhood. Although the various techniques are similar, there is clearly a difference in terms of wound healing, infection, complication rates and overall success. Adults undergoing hypospadias repair must be counseled on all of these variables to avoid unreasonable expectations.
Subject(s)
Hypospadias/surgery , Postoperative Complications/epidemiology , Adult , Case-Control Studies , Follow-Up Studies , Humans , Male , Reoperation/statistics & numerical data , Surgical Wound Infection/epidemiology , Time Factors , Treatment Outcome , Wound HealingABSTRACT
The koro syndrome is a psychiatric disorder characterized by acute anxiety and a deep-seated fear of shrinkage of the penis and its ultimate retraction into the abdomen, which will cause death. Concurrence of the koro (genital retraction) syndrome with a pathological condition of the urogenital system has rarely been described. We report a case of koro associated with infertility. Within 3 weeks of treatment with haloperidol the classic symptoms of koro disappeared. To our knowledge this case represents the sixth report of the koro syndrome associated with urogenital pathology and the first report of its association with infertility.
Subject(s)
Infertility, Male/complications , Jews , Koro/complications , Adult , Humans , MaleABSTRACT
Laparoscopy was performed on 107 patients 8 months to 18.5 years old (mean age 46.9 months) with 119 nonpalpable testes. The procedure accurately determined the location of the gonad in 95.3% of the patients, while 16 were spared formal surgical exploration with the laparoscopic visualization of blind-ending spermatic vessels and vasa deferentia. Additionally, patency of the internal inguinal ring, determined laparoscopically, was an accurate predictor of testicular salvageability. We advocate the use of laparoscopy for all boys with a nonpalpable gonad in conjunction with operative intervention if necessary.
Subject(s)
Cryptorchidism/diagnosis , Laparoscopy , Preoperative Care , Adolescent , Child , Child, Preschool , Cryptorchidism/surgery , Humans , Infant , Male , Testis/blood supply , Vas DeferensABSTRACT
We report on 2 cases of congenital urethrocutaneous fistulas in otherwise normal children. There were no associated congenital anomalies. Satisfactory surgical results were obtained. Potential causes are discussed.
