Manejo ortopédico de la extrofia vesical / Orthopedic management of bladder exstrophy

La extrofia vesical es una deformidad congénita compleja, que incluye el aparato músculo esquelético, en la parte anterior de la pelvis se observa diastasis del pubis, y la parte posterior se muestra en rotación externa. Está demostrada la importancia de la osteomía pélvica en estos casos para permitir la relajación de los tejidos blandos y as¡ el éxito en la reconstrucción urológica. Se describen los resultados del manejo ortopédico de la extrofia vesical en el Hospital Nacional de Niños, donde se destacan dos aspectos, la intervención quirúrgica ortopédica temprana, en etapa neonatal, y el tipo de osteotomía, la cual se considera muy propia del centro. Los resultados obtenidos son muy buenos, con escasas complicaciones, se incluyen 9 pacientes, con 9 a 18 años de evolución de su cirugía, se analizan los resultados radiológicos y funcionales.

Seno prepúbico congénito. A propósito de un caso / Congenital prepubic sinus: case report

El seno prepúbico congénito es un tipo de duplicación uretral poco frecuente, de etiología desconocida. Se han propuesto distintas teorías embriológicas, como así también diversas clasificaciones. La mayoría de los casos se diagnostican en la infancia, la cistouretrografía retrógrada y miccional es el estudio fundamental, tanto para confirmar el diagnóstico como para establecer el tipo de anomalía y la mejor opción terapéutica. Presentamos un caso de seno prepúbico congénito en un varón de 39 años de edad, diagnosticado por secreción purulenta a nivel de un meato accesorio en base del pene (AU)

The prepubic congenital sinus is a rare type of urethral duplication of unknown origin. Different embryological theories and classifications has been proposed. Most cases are diagnosed during childhood. The Retrograde Urethrocystography is very important as it determines the diagnosis and helps choosing the best treatment option. We present a case of a prepubic congenital sinus in a 39 years old male who presented with purulent discharge from an accessory meatus in the base of the penis (AU)

[Variants of formation of v. testicularts sinistra in children with varicocele].

Biopsies of veins of 20 boys with varicocele were studied morphologically. Three types of veins were observed. The first type was represented by veins with a wide lumen and the wall consisting of three layers of smooth muscle cells. The second morphological variant--veins of varying diameter of irregular shape and thin, frequently sclerosed wall. The third type were veins of a small diameter with well developed muscular layer. Immunohistochemical studies detected disturbances of vascular wall components suggesting the development of varicocele as a complex of congenital pathology with secondary alteration and destabilisation of compensatory processes.

Laparoscopy in pediatric urology: challenge and opportunity.

The development of operative laparoscopic techniques in Pediatric Urology has been generally cautious. It is premature to attempt an assessment of the ultimate impact of laparoscopy in pediatric urology, yet several areas of application have significant potential. Diagnostic laparoscopy for cryptorchidism has evolved into operative laparoscopy for intra-abdominal testes, and a significant number of cases have been performed successfully, with the possibility of improved results over open techniques. Laparoscopic nephrectomy and nephroureterectomy have been spring-boards for complex reconstructive renal surgery, although it is clear that new tissue joining technologies are needed. Complex reconstructive surgery is just beginning, yet may have a role in practice. These developments and the current status of laparoscopy in pediatric urology will be reviewed.

Laparoscopy in pediatric urology: too much of a good thing?

Laparoscopy is still an evolving technique; its rightful place in pediatric urology has yet to be defined. Although both the first reported use of diagnostic laparoscopy in pediatric surgery and its initial use in pediatric urology were published in 1973, the field lay dormant until recently. Once operative laparoscopy was initiated with the report of laparoscopic cholecystectomy in 1987, a torrent of articles followed; many operative procedures in adult urology and subsequently in pediatric urology appeared. This article presents the advantages and the disadvantages of several of the more important and common possible indications for laparoscopy in pediatric urology.

[Idiopathic left-sided varicocele. An ontogenetic abnormality?]. / Die idiopathische linksseitige Varikozele. Eine ontogenetische Fehlentwicklung?

Phlebograms for sclerotherapy of varicoceles were performed in 659 patients. In 484 cases no valves of the left spermatic vein could be demonstrated. However, 172 patients showed sufficient valves or absent insertions of the spermatic veins at typical point with retrograde flow through collaterals (persistent intercardinal anastomoses). The value of nutcracker phenomena I and II is discussed. Ontogenetic disorders in the development of the secondary abdominal venous system are responsible for the occurrence of the idiopathic left-sided varicocele.

Anomalías del tractus génito-urinario asociadas a la hispospadia

Cincuenta niños portadores de hipospadia, fueron investigados y en quince de ellos, o sea el 30 por ciento fue hallada otra anomalía del tractus génito-urinario....(AU)