Abstract:
INTRODUCTION:Redo orchiopexy involves a hazardous dissection inside the inguinal canal (IC) where scar tissue encircles the testicular vessels (TesV), vas deferens (VD), and the testis. OBJECTIVE:The aim was to describe and evaluate a combined preperitoneal and inguinal approach (CPI) through a single cutaneous incision and accomplish this task as safely as possible, at the same time permitting additional maneuvers for cord lengthening. MATERIAL AND METHODS:We prospectively studied eight patients aged from 2.7 to 13 years (mean 7 years) reoperated for failed orchiopexy using the CPI approach. Reoperation took place 12 months to 11 years (mean 4.4 years) after the initial operation. Through a single transverse skin crease incision over the IC, at the level of the deep inguinal ring (DIR), we gained access to both the preperitoneal space (PPS) and the IC. We first entered the PPS, the peritoneum is retracted, and the VD and TesV are seen entering the DIR. They are gently dissected and two vascular lacets are passed around them. We introduce the backside of an anatomic forceps through the DIR, just under the anterior IC wall, until it is impeded by adhesions and then incise above the forceps, thus protecting the cord structures. Through that opening we transpose one of the lacets that encircle the VD and TesV and exercise traction upon them (figure, 1), revealing step by step the points where adhesiolysis must take place (figure, 2). The testis is dissected last of all and delivered back, through the DIR, into the PPS. There, the TesV and VD are freed from their retroperitoneal attachments (figure, 3). Finally, the testis is fixed into a Dartos pouch. RESULTS:In all cases the testes were relocated to the scrotum without any mishaps. All testes were inside the scrotum at first month examination and with good consistency. At 6 months, one testis ascended at mid-scrotum. At 2 years they all retained their position and their good standing, according to clinical and ultrasonographic findings. DISCUSSION:Several procedures of redo orchiopexies have been published so far, most of them rely on the surgeon's dexterity for good results. The CPI procedure offers a practical maneuver to protect the cord elements while dissecting and also exposes all the regions where dissection will offer lengthening of the cord. CONCLUSION:Our results have demonstrated that the CPI can be considered as a safe and efficient procedure for redo orchiopexy.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Sfoungaris D,Mouravas Vdoi
10.1016/j.jpurol.2015.05.035subject
Has Abstractpub_date
2016-02-01 00:00:00pages
43.e1-6issue
1eissn
1477-5131issn
1873-4898pii
S1477-5131(15)00298-3journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Acute pyelonephritis is associated with renal scarring in up to 30% of patients. Renal scarring may cause significant long-term morbidity. The pathogenesis of acute pyelonephritis remains unclear, although it involves interaction among uroepithelium, the immune system cells, and the locally produced cytokine...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.05.025
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Congenital megaprepuce is a specific form of buried penis. Children affected by this malformation usually suffer from a subjective difficulty in voiding which is the main indication for early surgical correction. The aim of this study was to report a single center's 12-year experience in the treatment of mega...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.10.010
更新日期:2013-12-01 00:00:00
abstract:INTRODUCTION:Pediatric Ewing sarcoma (ES)/primitive neuro-ectodermal tumor (PNET) occurring in the genitourinary system has been rarely reported. And the result of long-term follow-up is still a matter of debate. OBJECTIVE:The aim of the study was to identify the characteristics, therapeutic strategies, and long-term ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.06.022
更新日期:2019-10-01 00:00:00
abstract::Hyponatremic hypertensive syndrome is a combination of renovascular hypertension and hyponatremia. Although reported in adults, it is rare in children. We report a 7-year-old boy having renal artery stenosis associated with hyponatremic hypertensive syndrome. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.01.204
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Elevated body mass index (BMI) is a well-known risk factor for perioperative complications in adults, but has not been investigated in children undergoing urologic procedures. Given the low rate of complications associated with urologic surgery, a large sample is required for their characterization, but BMI ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.04.014
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND/AIM:Endoscopic stenting is an accepted treatment option for children with symptomatic or progressive primary obstructive megaureter (PROM). Here, long-term outcomes with endoscopic stenting are reviewed. METHODS:Patients with PROM treated surgically over a 12-year period were identified using a prospectivel...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.09.011
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Videourodynamics is the key follow-up examination of children with myelomeningocele. However, it has been performed in specific institutions focused on the urological management of children due to the difficulty in its interpretation. Although a neurogenic bladder frequently appears elongated vertically an...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.09.015
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Most children with symptoms of urolithiasis and urinary solute excretion abnormalities leading to stone formation have no calculi revealed by ultrasound or X-ray plain film ("occult urolithiasis"). This covers a large group of children presenting with common symptoms such as abdominal pain, hematuria, and dy...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2016.12.021
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:Congenital obstructive uropathy (COU) is a leading cause of pediatric chronic kidney disease (CKD). Urinary tract infections (UTIs) pose a risk for ascending infections and CKD in patients with COU. We evaluated the impact of comorbid UTIs on hospital charges and length of stay (LOS) for pediatric COU discharge...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2011.10.021
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the emotional and behavioral functioning of children with bladder exstrophy-epispadias complex (BEEC), taking into account developmental and gender considerations. This study also sought to overcome methodological limitations of previous studies evaluating psychological well-being of children with...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.07.013
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:Stomal stenosis is the most common complication after the creation of a continent catheterizable channel (CCC), but is challenging to treat. OBJECTIVE:To describe early experience with triamcinolone injection for the treatment of stomal stenosis. MATERIALS AND METHODS:A retrospective review was performed...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.06.007
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Congenital pelviureteric junction obstruction (PUJO) is one of the most frequent causes of neonatal hydronephrosis. Obstruction at the PUJ has potential severe adverse outcomes, such as renal damage. While pyeloplasty has been established as the definitive treatment, the exact pathophysiology of congenital...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.07.014
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:We review outcomes after management of meatal balanitis xerotica obliterans (BXO). The primary outcome was recurrent meatal BXO. METHODS:A database comprising mostly hypospadias patients was queried for meatal BXO. The disease was confirmed histologically in all cases. Management included topical steroids...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.10.014
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:Recurrent urinary tract infections (UTIs) are common in patients with neurogenic bladder (NGB) performing clean intermittent catheterization (CIC) treated with or without oral antibiotic prophylaxis. OBJECTIVE:The authors aim to determine if daily neomycin-polymyxin or gentamicin bladder instillations red...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.12.001
更新日期:2019-04-01 00:00:00
abstract::Laparoscopy is an increasingly popular choice for treatment of the impalpable testis. There are many anatomical variants that may be found at operation. We present a case of a 1-year-old boy who presented with an impalpable right testis and absent right kidney, and at laparoscopy was found to have a persistent mesonep...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.05.012
更新日期:2007-04-01 00:00:00
abstract:PURPOSE:We report percutaneous nephrolithotomy for the management of stones in anomalous kidneys in children. MATERIALS & METHODS:We performed PCNL on 6 children (one with bilateral stones), 3 boys and 3 girls with anomalous kidneys. Three had horseshoe kidneys, 2 malrotated kidneys, and one crossed fused ectopic kidn...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.02.025
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:Testicular microlithiasis (TM) is a condition characterized by calcium deposits within the testis, usually detected incidentally during ultrasonography of the scrotum. TM has been associated with the presence of, and possibly the development of, testicular malignancy. Our aim was to document international ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.12.007
更新日期:2018-04-01 00:00:00
abstract:INTRODUCTION:Dorsal inlay graft urethroplasty using inner-face preputial graft was described as an adjunct method to the classic tubularized incised plate (TIP) urethroplasty, aiming at reducing the risk of neourethral stenosis. OBJECTIVES:To evaluate the impact of dorsal inlay grafting of preservable narrow plates, i...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.05.002
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:Intestinal bladder augmentation predisposes the patient to many complications. The aim of this study was to determine whether augmentation has an adverse effect on growth. MATERIALS AND METHODS:Longitudinal growth data were collected and analyzed for nine patients with bladder exstrophy and augmentation, and c...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.07.002
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Laparoscopic or retroperitoneoscopic pyeloplasty for ureteropelvic junction obstruction in children has become a routine procedure. The aim of this study was to evaluate functional outcome for patients who had undergone a laparoscopic dismembered pyeloplasty. PATIENTS AND METHODS:Seventy children underwent a...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.10.015
更新日期:2010-08-01 00:00:00
abstract:INTRODUCTION:Recent studies have suggested contradictory trends in the incidence of undescended testis (UDT) and hypospadias (HYP), partly because of methodological issues and ascertainment bias. The recently described association of "testicular dysgenesis syndrome" links concomitant UDT and HYP, with decreasing sperm ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.07.003
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Large bladder diverticulae, i.e. with a diameter measuring at least one-third of the bladder diameter on voiding cystourethrography, constitute an unusual but serious cause of obstructive uropathy in childhood. Their operative management entails meticulous reconstruction of the lower urinary tract. We report ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.01.005
更新日期:2005-08-01 00:00:00
abstract:INTRODUCTION:Extensive skin bridging with replacement of glans epithelium by shaft skin is an unusual complication of newborn circumcision not previously described. MATERIALS AND METHODS:Patients with extensive skin bridges and replacement of at least 50% of glans epithelium with shaft skin underwent lysis of the brid...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.01.010
更新日期:2006-12-01 00:00:00
abstract:INTRODUCTION:The nocturnal polyuria is considered a significant predictive value for response to desmopressin. The cutoff value useful to define nocturnal polyuria is still a matter of debate. Moreover, it is current notion that maximal voided volume (MVV) could be used as a predictor for desmopressin response. OBJECT...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.11.004
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Both, fluoroscopic voiding cystourethrography (fVCUG) and direct isotope cystography (DIC) are diagnostic tools commonly used in pediatric urology. Both methods can detect vesicoureteral reflux (VUR) with a high sensitivity. Whilst the possibility to depict anatomical details and important structures as fo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.08.015
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Congenital adrenal hyperplasia (CAH) consists of a group of diseases characterized by an enzyme deficiency, particularly 21-hydroxylase deficiency. The condition may present in the simple virilizing form or in the salt-wasting form, with varying degrees of genital ambiguity. The non-heterosexual orientation ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2018.08.004
更新日期:2018-12-01 00:00:00
abstract::Nephrogenic adenoma (NA) is a rare benign tumour of the urinary tract and is found most commonly in the bladder. Here are presented four cases of paediatric NA, two bladder and two urethral. Their diagnostic and management features in the context of differential diagnosis and natural history are discussed. A 3-year-ol...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.02.004
更新日期:2006-08-01 00:00:00
abstract:INTRODUCTION:'Transition' not only involves finding an adult healthcare provider, but also includes the process of developing the patient's ability to care for him/herself. Recent literature states that 40% of young adults with special healthcare needs are receiving the tools needed for transition. Pediatric urologists...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.04.015
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To explore the effectiveness of the enuresis alarm with overlearning for treatment of primary nocturnal enuresis (PNE). A key objective was to explore the effect of overlearning on treatment gains, and its impact on relapse. PATIENTS AND METHODS:The RMIT University Psychology Clinic has been treating PNE in ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.08.008
更新日期:2014-04-01 00:00:00
abstract:PURPOSE:Ureteropelvic junction obstruction (UPJO) is the major cause of hydronephrosis in children and may lead to renal injury and early renal dysfunction. However, diagnosis of the degree of obstruction and severity of renal injury relies on invasive and often inconclusive renal scans. Biomarkers from voided urine th...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.10.008
更新日期:2016-04-01 00:00:00