Personalized Surgical Management Offers Full Restitution and Unimpaired Quality of Life to Patients with Duplex Kidneys and Associated Pathologies: 30-year Follow-up at a Tertiary Referral Center.

Background: Duplex kidneys may be associated with additional pathologies with an indication for surgery. Various surgical approaches have been described. However, little is known about long-term outcomes and quality of life (QoL) for these patients.

Mixed reality for teaching catheter placement to medical students: a randomized single-blinded, prospective trial.

Background: Cost-effective methods to facilitate practical medical education are in high demand and the "mixed-reality" (MR) technology seems suitable to provide students with instructions when learning a new practical task. To evaluate a step-by-step mixed reality (MR) guidance system for instructing a practical medical procedure, we conducted a randomized, single-blinded prospective trial on medical students learning bladder catheter placement.

Methods: We enrolled 164 medical students.

The SIGHT questionnaire: A novel assessment tool for Satisfaction In Genital Hypospadias Treatment.

Purpose: Psychosexual development is currently underrepresented in hypospadias outcome research. The aim of this study was to develop and validate a questionnaire addressing psychosexual long-term satisfaction, specifically of adolescent patients, after hypospadias repair.

Materials And Methods: In a multistep participative design we identified key interests of adolescent patients with hypospadias.

Adipose-Derived Stem Cells Support Lymphangiogenic Parameters In Vitro.

It is a common complication to develop a secondary lymphedema after surgery or radiation, for example, after axillary lymph node dissection due to breast cancer and current therapies are mainly symptomatic. Since these surgical procedures result in both, loss of adipose tissue and loss of lymphatic nodes and vessels, tissue engineering could be a new promising approach, to create an adipose tissue substitute comprised with a lymphatic network. We have conducted co-culture experiments to investigate the effects of human adipose-derived stem cells (ASCs) on human lymphatic endothelial cells (LECs) in terms of gene expression profile, proliferation, migration, and tube formation in vitro.

Analgesia-free flexible ureteroscopic treatment and laser lithotripsy for removal of a large urinary stone: a case report.

Introduction: Urinary stone formation is a frequent complication after continent urinary tract diversion and can require complex surgical management. Therapy options include open, percutaneous, transurethral, or transstomal stone fragmentation and extraction. The transstomal approach is considered to be one of the more complex treatment modalities.

Single-Incision Transumbilical Surgery (SITUS) versus Single-Port Laparoscopic Surgery and conventional laparoscopic surgery: a prospective randomized comparative study of performance with novices in a dry laboratory.

Purpose: To evaluate the Single-Incision Transumbilical Surgery (SITUS) technique as compared to an established laparoendoscopic single-site surgery (LESS) technique (Single-Port Laparoscopic Surgery, SPLS) and conventional laparoscopy (CLS) in a surgical simulator model.

Methods: Sixty-three medical students without previous laparoscopic experience were randomly assigned to one of the three groups (SITUS, SPLS and CLS). Subjects were asked to perform five standardized tasks of increasing difficulty adopted from the Fundamentals of Laparoscopic Surgery curriculum.

Game-based e-learning is more effective than a conventional instructional method: a randomized controlled trial with third-year medical students.

Background: When compared with more traditional instructional methods, Game-based e-learning (GbEl) promises a higher motivation of learners by presenting contents in an interactive, rule-based and competitive way. Most recent systematic reviews and meta-analysis of studies on Game-based learning and GbEl in the medical professions have shown limited effects of these instructional methods.

Objectives: To compare the effectiveness on the learning outcome of a Game-based e-learning (GbEl) instruction with a conventional script-based instruction in the teaching of phase contrast microscopy urinalysis under routine training conditions of undergraduate medical students.

The glandular resection and central embedding modification (GRACE) in Duckett and Barcat hypospadias repair.

Introduction: We recently reported a novel modification of the Barcat technique termed glandular resection and central embedding (GRACE). Here, we report results from a large patient population and apply this modification also to Duckett hypospadias repair.

Patients And Methods: We retrospectively evaluated 488 patients who had undergone primary or secondary hypospadias repair by Barcat or Duckett using the GRACE modification.

Glandular resection and central embedding in hypospadias repair--a novel modification of the Barcat technique.

Purpose: Urethrocutaneous fistula and urethral or meatal stricture, to date, remain the commonest complications of hypospadias repair, with increased tissue tension being a major cause of failure. We developed a novel technique comprising glandular resection and central embedding of the neourethra to specifically address this critical issue. We report the results of the first 112 procedures, of which 7 cases were a secondary hypospadias repair.

Pre-bent instruments used in single-port laparoscopic surgery versus conventional laparoscopic surgery: comparative study of performance in a dry lab.

Background: Different types of single-incision laparoscopic surgery (SILS) have become increasingly popular. Although SILS is technically even more challenging than conventional laparoscopy, published data of first clinical series seem to demonstrate the feasibility of these approaches. Various attempts have been made to overcome restrictions due to loss of triangulation in SILS by specially designed SILS-specific instruments.

Ureteric avulsion caused by lumbar exostosis.

A 72-year-old woman sustained a ureteric avulsion following circulatory collapse at home. Urosonographic imaging revealed hydronephrosis at the left kidney, and abdominal emergency computed tomography showed some fluid around it. Left retrograde pyelography proved ureteral disruption at the level of the ureteropelvic junction (UPJ).

Complete removal of the foreskin--why?

Partial circumcision techniques frequently lead, on account of the remaining foreskin, to functional complications and unsatisfactory cosmetic results requiring re-operation. A series of pictures taken from our own sample of patients illustrates the problem. Review of the literature also attests to higher complication rates after partial circumcision.

Difficulties in diagnosis and treatment of 5alpha-reductase type 2 deficiency in a newborn with 46,XY DSD.

Background/aims: Steroid 5alpha-reductase deficiency (MIM*607306) caused by mutations in the SRD5A2 gene is characterized by a predominantly female phenotype at birth and significant virilization at puberty. The undermasculinization at birth results from low dihydrotestosterone (DHT) levels during fetal development as the type 2 isoenzyme activity is reduced. In puberty, when the type 1 isoenzyme activity increases, significant virilization occurs.

Sonographic long-term study: paediatric growth charts for single kidneys.

Aims: To explore the clinical course of children with "single kidney" (defined as either a solitary or single functioning kidney) with reference to renal function (glomerular filtration rate (GFR) and proteinuria), body height and particularly sonomorphological features.

Patients And Methods: This retrospective monocentric study evaluated 119 children with a solitary or single functioning kidney (>90% unilateral function on isotope scan) between 1997 and 2007. Patients were followed for 6.

[Polyhydramnios, prematurity, dystrophy, polyuria, constipation, nephrocalcinosis and renal tumor: presentation of a classic tubulopathy].

Background: A diagnostic workup of a renal mass will rarely lead to the diagnosis of a tubulopathy. We would like to stress the importance of taking a detailed history and of evaluating these findings in the context of the clinical symptoms.

Case Report: A 3 year old boy with a renal mass, diagnosed due to urinary tract infection, was referred to exclude renal malignancy.

[Left flank tumor of fluctuating size in a 5-week-old boy: perirenal urinoma caused by urethral valves].

Background: Flank swelling and pseudotumors of the kidney are unusual manifestations of obstructive uropathies in small children. Our case illustrates typical problems and briefly reviews management options.

Case Report: A 5-week-old boy presented with a large, palpable urinoma due to posterior urethral valves.

Intraoral wound closure with tissue-engineered mucosa: new perspectives for urethra reconstruction with buccal mucosa grafts.

In urethra reconstruction, the creation of a new urethra from a free oral mucosa graft is an established surgical technique. The oral mucosa is removed at the same time that the urethra reconstruction procedure is performed. Depending on the size of graft required, the intraoral wound is closed primarily or left to heal secondarily.

Fetotoxicity and teratogenesis of SWL treatment in the rabbit.

The potential effects of extracorporeal application of shockwaves on an embryo or fetus were explored in an animal model. In experimental Series A, the fetuses of 30 gravid rabbits were exposed to piezoelectrically induced and sonographically guided shockwaves on Day 25 or 20 of gestation under technical conditions corresponding to extracorporeal lithotripsy in humans. Fetotoxicity was examined by abdominal section 24 hours or 9 days later, and immediate/intermediate damage was assessed (resorptions, viability, gross injuries, and microscopic lesions of the target and neighboring fetuses).

Endoscopic treatment of reflux by subureteric collagen injection: critical review of 5 years' experience.

In the past decade, subureteric endoscopic injection of Teflon or collagen has been propagated as a safe and successful treatment for vesicoureteral reflux. In our center, from 1990 through 1995, 118 children and 5 adults with reflux and recurrent urinary tract infections were injected with cross-linked bovine collagen in an open, prospective study. Efficacy and safety were assessed 6 and 12 months after injection, and long-term (> or =3 years) results were available in 78 cases.

Once-daily fleroxacin versus twice-daily ciprofloxacin in the treatment of complicated urinary tract infections.

Purpose: We compared the efficacy and safety of once-daily fleroxacin and twice-daily ciprofloxacin in patients with complicated urinary tract infections.

Materials And Methods: Using a prospective, open, randomized, multicenter study design, 133 patients (67 fleroxacin, 66 ciprofloxacin) were treated with doses of either 200 mg. of fleroxacin once daily or 250 mg.

Ureteral xanthine calculus and aberrant umbilical artery causing ureteral obstruction.

A 30-month-old girl presented with gastrointestinal symptoms and a febrile urinary tract infection. Sonographic and radiographic imaging demonstrated left hydronephrosis due to a radiolucent ureteral stone. Surgical exploration identified an aberrant, patent left umbilical artery causing ureteral obstruction.

Subureteral collagen injection versus antireflux surgery in primary vesico-ureteral reflux grade III.

Unlabelled: Endoscopic subureteral collagen injection (SCIN) was performed in 24 girls and 5 boys (mean/range: 3.2/0.7-12.