Publications by authors named "Arunachalam Pavai"

Purpose: The purpose was to study the correlation between age at surgery and functional recovery after infant pyeloplasty.

Materials And Methods: All infants who underwent pyeloplasty were analyzed retrospectively in this multicenter study. Anteroposterior diameter (APD) >2 cm, split renal function (SRF) <40%, and Society of Fetal Urology (SFU) grade 3-4 were surgical indications.

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Article Synopsis
  • The study focuses on a new surgical technique developed for bladder augmentation in children with failed bladder exstrophy, utilizing an ileocecal segment to create a catheterizable channel and preventing urine reflux.
  • The surgical method involves complex reconfiguration of the ileocecal segment around the appendix, enabling effective bladder neck surgery and ureteric re-implantations when needed.
  • Out of 100 children treated, 95 achieved continent status with catheterization, showing significant improvement in their urinary function post-surgery.
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The occurrence of ovarian cyst in the neonate is rare and antenatally diagnosed by ultrasonography. This study aims to increase awareness about its occurrence and histological features. We performed a retrospective review on 10 cases of neonatal ovarian cyst (NOC) during 4 years (2016-2020) in a tertiary care center in South India.

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Introduction: Associated congenital anomalies, operative structural injury, and postoperative neurovesical dysfunction combine to cause urinary retention in children with a history of surgery for anorectal malformation (ARM).

Aim: To study the presentation and management of urinary retention in patients with a history of ARM surgery.

Methodology: Retrospective study.

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Priapism due to pseudoaneurysm of the cavernosal artery is very rare. Herein, we describe the magnetic resonance imaging and digital subtraction angiographic findings of pseudoaneurysm in the right corpus cavernosum in a 7-year-old boy who presented with pain in the penis and lower abdomen and priapism with an obscure history of trauma. This was managed by endovascular embolization of the aneurysm.

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Introduction: Giant non cloacal neonatal hydrocolpos is a rare entity where early recognition of the underlying cause and drainage of the distended vagina is paramount. Conventionally, immediate management has been by abdominal tube vaginostomy or, in urogenital sinus by vaginal clean intermittent catheterisation (CIC). Though effective in providing temporary relief, the abdominal tube vaginostomy is replete with complications, making it imperative to search for alternatives.

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Objective: To report background intussusception epidemiology in children under-two years in Coimbatore district of Tamil Nadu state, India, prior to rotavirus vaccine (RVV) introduction.

Methods: Prospective sentinel surveillance was done at four hospitals in Coimbatore during April 2016 to September 2017. The children aged >1 mo and < 24 mo with diagnosed intussusception were recruited and data on clinical, treatment, diet, immunization, and sociodemography were collected.

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Introduction: Y-duplication is a rare subtype of urethral duplication whose surgical correction has traditionally yielded less than satisfactory results. Herein we report 18 patients, 17 of whom have completed successful urethral reconstruction.

Materials And Methods: A retrospective analysis was done on 18 children who have undergone repair of Y-duplication urethra in two tertiary care institutes from 2013 to 2020.

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Urogenital involvement in neurofibromatosis is extremely rare and thus is less documented. Herein, we discuss a 11-year-old boy who was referred with a diagnosis of neurofibroma bladder on bilateral flank ureterostomy with mild renal failure. A diagnosis of neurofibroma of the bladder with ureterohydronephrosis had been made and partial excision had been attempted, followed by bilateral ureterostomy because of increasing ureterohydronephrosis.

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Isolated osteochondroma presenting as hemothorax is a rare entity. A 7-year-old boy presented with respiratory distress and diagnosed with hemothorax, and computed tomography showed osteochondroma and removal with resection of the rib was curative.

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Introduction: Uretero-enteric anastomosis with concomitant neobladder/augmentation/conduit becomes necessary when the bladder is unavailable or unfit for reimplantation or the ureters are short after high diversion or resection of lower ureteric pathology. Aiming to prevent both obstruction and reflux, we report a novel technique of sero-muscle denuded extra mural uretero-colic anastomosis.

Operative Technique: (Fig 1) The ureter was brought through the colonic mesentery.

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Introduction: Fashioning a functioning neo urethra in a boy with aphallia is one of the unsolved problems in this condition.

Aim: We present our technique and outcome of operative exposure and neo urethral construction in four aphallic boys.

Materials And Methods: Retrospective study of the records of four aphallic boys operated in the period 2015-2019 was undertaken.

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Introduction: The traditionally accepted method of bladder re closure in dehisced exstrophy involves osteotomy assisted pubic bone approximation (PBA). Continent voluntary voiding is achieved in a small proportion of children sometimes after many operative procedures. We propose a simple yet reliable method of repair of the dehisced bladder using Rectus abdominis muscle flap (RAM) instead of PBA to bridge the inter-pubic gap, followed by concomitant or subsequent bladder augmentation (BA).

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Objective: Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children.

Methods: Intussusception in children 2-23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016).

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Objective: The objective of this study is to find out whether the reused catheters for clean intermittent catheterization (CIC) are colonized before insertion and its association with urinary tract infection (UTI).

Materials And Methods: This is a study conducted on 28 pediatric surgery patients who are on CIC via a Mitrofanoff port and who were reusing catheters, in a tertiary care private medical college hospital for 6-month period. Catheters to be used for the next catheterization were sent for culture along with urine culture.

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Objective: The objective is to assess the level of parental satisfaction of pediatric day-care surgery and its different determinants.

Materials And Methods: This is a descriptive study performed in a tertiary care hospital in India among parents of pediatric day-care surgery patients from June 2013 to March 2015. The core questionnaire for the assessment of patient satisfaction for general day care (COPS-D) was used.

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We report four female children with externally visible but stenosed fecal orifice which proved to be a high anorectal malformation (Type IV pouch colon). They were managed by an abdominoperineal approach with excellent results. We emphasize the correct recognition of this pathology.

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The residual terminal bowel after pull-through surgery for anorectal malformation has been reported to cause urinary complications. We report two boys where residual bowel has fistulated postoperatively into the alimentary tract causing metabolic and septic complication in one and a large pelvic mass with urinary and rectal obstruction in the other.

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Neourethral diverticulum secondary to distal neourethral stenosis is not uncommon after proximal hypospadias repair. We describe a technique using the neo urethral diverticular roof and overlying skin as a composite flap to reconstruct the urethral stenosis distal to the diverticulum. The composite flap is advanced distally for reconstruction of the stenosed urethra either as a tube or as an onlay.

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Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children.

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We report on a child with several café au lait spots in association with a lumbar lipomeningomyelocele as an apparently new association. Cutaneous markers, the identification of which plays a crucial role in the early diagnosis and management of spinal malformations, can accompany occult spinal dysraphism. Herein we report a case of lumbar lipomeningomyelocele associated with an overlying café au lait spot that served as a marker of occult spinal dysraphism.

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Ex-utero intrapartum treatment (EXIT) is performed for fetuses diagnosed with large neck masses. A case report of a fetus diagnosed with a large cystic hygroma and cord around the neck who was delivered by EXIT is presented. The airway challenges and optimal positioning is discussed.

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Cow's milk protein allergy (CMPA) typically presents with persistent diarrhea or dysentery, vomiting and bleeding per rectum in young infants. CMPA is reported to mimic Hirschsprung's disease and malrotation. We report, a neonate who presented with recurrent attacks of segmental enteritis due to CMPA and the last episode presented with signs of peritonitis.

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