RESUMO
In 1992 a retrospective review was conducted of 190 patients evaluated and treated for complications of hypospadias surgery during 1979 through 1990 at the Devine Center for Genitourinary Reconstructive Surgery of Sentara Norfolk General Hospital and Children's Hospital of the King's Daughters. We could not contact 13 patients and 8 are awaiting a second stage procedure. Of the 177 patients 167 (94.35%) have had a successful outcome, defined as a controllable urinary stream, functional erection and an acceptable cosmetic appearance, and 2 (1.13%) are considered failures. Details of presenting problems, surgical techniques and recent modifications of these procedures are presented.
Assuntos
Hipospadia/cirurgia , Complicações Pós-Operatórias/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Divertículo/cirurgia , Fístula/cirurgia , Humanos , Hipospadia/complicações , Lactente , Masculino , Pessoa de Meia-Idade , Mucosa/transplante , Pênis/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Uretra/cirurgia , Doenças Uretrais/cirurgia , Bexiga Urinária/transplanteRESUMO
Alpha blockade is a well-established form of therapy for bladder outlet obstruction. We introduce a new drug to the regimen that appears to facilitate relaxation of both the bladder outlet and external sphincter mechanism in patients with a spastic urinary sphincter.
Assuntos
Guanfacina/uso terapêutico , Obstrução do Colo da Bexiga Urinária/tratamento farmacológico , Algoritmos , HumanosRESUMO
Arterial inflow is essential for graft function after liver transplantation. Sometimes the recipient celiac axis is not suitable for anastomosis, and in these cases a conduit from either the aorta or iliac artery is an alternative. We retrospectively reviewed 32 patients who required arterial conduits and compared them with a matched control group who underwent standard arterial reconstruction (donor celiac artery to recipient celiac artery). The indications and surgical technique for arterial conduits are presented. There were no differences in intraoperative vascular flow studies, postoperative liver function, or incidence of rejection in the two groups. There were, however, more deaths in the conduit group, two of which are related to the retropancreatic conduit technique, with the others caused by the patients' underlying condition at transplantation. There was no morbidity or death associated with the antepancreatic conduit techniques. We therefore believe the use of arterial conduits from the aorta or iliac artery, when placed antepancreatically, are safe and should be used without reservation when indicated.
