The Koyanagi-Nonomura 1-stage bucket repair of severe hypospadias with and without penoscrotal transposition.

Purpose: We report our experience with 1-stage Koyanagi-Nonomura hypospadias repair, which may be performed even when penoscrotal transposition is present. Repair involves bilateral parameatal skin flaps based on the meatus and urethral plate.

Materials And Methods: A total of 14 boys 10 to 20 months old underwent 1-stage Koyanagi-Nonomura repair for severe hypospadias.

Utero vaginal malformations: a trap for the unsuspecting surgeon.

Eighteen girls with major uterovaginal malformations were admitted to the Pediatric Surgical Service over a 17-year period. The diagnosis was not suspected or delayed in more than one half of the patients. The encountered anomalies were divided into four groups: I, isolated uterovaginal malformations (UVM) (4); II, UVM with anorectal anomalies (8); III, UVM with cloacal (urogenital sinus) abnormalities (5); and IV, caudal twinning (1).

Early gender assignment in true hermaphroditism.

True hermaphroditism is a rare form of intersex anomaly where both male and female gonads are present. True hermaphrodites diagnosed in the past have been preferentially reared as males. However, based on the appearance of their external genitalia and the ability to reconstruct a functional genitourinary system, most of these children should be raised as girls.

Crossed testicular ectopia with bilateral duplication of the vasa deferentia: an unusual finding in cryptorchism.

A very unusual association of crossed testicular ectopia, with bilaterally duplicated vasa deferentia, was encountered in an otherwise normal 10-year-old boy who presented with bilateral cryptorchism. The left testis was palpable in the groin; the right was nonpalpable. Because of ductal fusion, both testes were brought down on the same side to avoid damage during separation, with placement of the testes in either hemiscrotum through a transseptal incision.

Alleged resection of the vas deferens: medicolegal implications.

New York state law requires that significant complications be reported by telephone within 24 hours, followed by a full written report within five days with the names of the alleged involved physicians. This case illustrates the potential medicolegal consequences following the mandated immediate nonsubstantiated report of an alleged bilateral vas deferens injury during a bilateral inguinal herniorrhaphy in a 7-month-old male. Review of the surgical pathologic specimen showed that both hernial sacs did indeed contain segments of vas deferens structures, which based on the findings at reexploration, were consistent with duplication or embryonic remnants of the vas deferens.