RESUMO
Genital self-mutilation is a rare event that is commonly associated with psychotic disorders. However such injuries have also been reported from nonpsychotic patients as a result either from bizarre autoerotic acts, attempts at crude sex change operation by transsexuals or secondary to complex religious beliefs and delusions regarding sexual guilt. We report two cases of genital self-mutilation in nonpsychotic married heterosexual males as a result of conflict and frustration.
RESUMO
BACKGROUND AND PURPOSE: Open dismembered pyeloplasty by a retroperitoneal approach remains the reference standard for correcting ureteropelvic junction (UPJ) obstruction in children. We prospectively compared the results of laparoscopic and open pyeloplasty in children with UPJ obstruction. PATIENTS AND METHODS: During the period April 2003 to March 2005, 15 children underwent laparoscopic pyeloplasty and 14 children underwent open pyeloplasty. The two groups were similar in age and mean weight. We prospectively analyzed and compared operative time, postoperative pain and activity, complications, and hospital stay in the two groups. The mean follow-up was 23 and 24 months in the laparoscopy and open surgery group, respectively. RESULTS: The mean operative time was significantly shorter in the open surgery group (159 +/- 21.39 [SD] v 214 +/- 32.26 minutes; P = 5.874 x 10(-6)). Postoperative discomfort/pain on day 7 was significantly less in the laparoscopic group, and the mean hospital stay was significantly shorter (P = 0.018019). CONCLUSIONS: The benefits of laparoscopic pyeloplasty include a high reproducible success rate comparable to the results achieved by open pyeloplasty. Our results indicate minimal morbidity such as pain and a quick return to normal activities. The hospital stay is significantly reduced, although the operative times are long compared with open pyeloplasty.
