Symptomatic corpus spongiosum defect in adolescents and young adults who underwent distal hypospadias repair during childhood.

Introduction And Objective: Several popular surgical techniques have been described for the repair of distal hypospadias; however, the role of repairing the corpus spongiosum was rarely discussed. Herein we review our experience with adolescents who underwent hypospadias repair during childhood. Their main complaints were partially or totally related to spongiosum deficiency, the surgical outcomes are also discussed.

The adolescent glans penis: Functional and aesthetic issues following childhood hypospadias repair.

Introduction: As children with childhood hypospadias repairs transition into adolescence, the function and appearance of the genitalia acquire greater importance. For some, the direction and shape of the urinary stream can be embarrassing if abnormal, and the appearance of the glans penis and meatus are a concern as they develop the capacity for self-awareness.

Objective: Herein, we address the surgical correction and outcomes of urine spraying with or without fistulae, and cosmesis over 12 years.

The contribution of preconditioning hyperbaric oxygen for complex re-operative surgery of bladder exstrophy and epispadias. A case study of 11patients.

Introduction: Multiple surgeries on patients born with bladder exstrophy and epispadias (BEE) especially when complicated by postoperative infections results in varying degrees of scarring of the tissues and decreased vascularity. When further surgery for these patients is contemplated the tissue ischemia may result in poor healing and additional complications. Problem wounds due to arterial insufficiency mainly in diabetic ulcers and following therapeutic radiation are commonly treated with hyperbaric oxygen therapy (HBOT).

Outcome of penile lengthening of adolescents and young adults born with bladder exstrophy and epispadias.

Background: The decreased penile length in patients born with BE results partly from pubic symphysis diastasis and the separation of the corporal bodies, which causes a shortened penis as the corporal length is lost in traversing the distance between the pubic rami. However, in some cases there is an intrinsic penile abnormality and dorsal chordee. Furthermore, multiple surgeries has in some cases, resulted in cutaneous and subcutaneous scarring, which contributed to the problem of the short phallus and dorsal tethering to the abdominal wall (figure).

Fertility and sexuality issues in congenital lifelong urology patients: female aspects.

Purpose: With advances in treatment modalities and medical knowledge, girls with congenital urologic disorders are living well into adulthood. Although, sexual and reproductive function in this population is still poorly understood. The aim is to review existing literature about fertility and sexuality in women with congenital genitourinary disorders, including spina bifida (SB), bladder exstrophy-epispadias complex (BEEC) and congenital adrenal hyperplasia (CAH).

Management of ischemic tissues and skin flaps in Re-Operative and complex hypospadias repair using vasodilators and hyperbaric oxygen.

Introduction: Repeated and multiple surgeries for hypospadias result in varying degrees of scarring and hypovascularity of penile tissues which may result in poor healing and increasing complication rates with each additional repair. Vasodilator agents such as Nitroglycerine (NTG) can be helpful in the immediate postoperative period to improve flap viability. Hyperbaric oxygen therapy (HBOT) has well-established benefits to promote angiogenesis and wound healing.

Fertility and sexuality issues in congenital lifelong urology patients: male aspects.

Purpose: To review existing literature about fertility and sexuality of boys born with complex congenital genitourinary anomalies.

Methods: A Pubmed review was performed in December 2018 to identify the most relevant original manuscripts regarding male complex congenital conditions affecting the urogenital system in male patients including spina bifida (SB), bladder exstrophy-epispadias complex (BEEC) and hypospadias. A comprehensive review was drafted exploring sexual dysfunction from a medical, psychosexual, surgical and reproductive point of view during transition from childhood (or adolescence) to adulthood.

Recurrent chordee in 59 adolescents and young adults following childhood hypospadias repair.

Background: As children transition to adolescence, penile curvature may recur several years, sometimes, decades later. Herein we review our experience with a group of symptomatic patients, their surgical repairs and outcome.

Material & Methods: Reviews were done on the charts of 59 symptomatic adolescents aged 14-21 years who presented with recurrent penile curvature, causing either sexual dysfunction or significant deformity and had undergone surgical correction between 2000 and 2017.

Advances in bladder substitution and creation of neobladders in children.

Cystectomy and urinary bladder substitution are rare in children but may be necessary in some cases of bladder exstrophy, in the setting of malignancy, or in other settings in which the bladder is severely dysfunctional. This article details advances in surgical techniques in creating continent urinary diversions in this specialized pediatric population.

Metanephric Adenoma in the Pediatric Population: Diagnostic Challenges and Follow-up.

Objective: To discuss the presenting features, imaging findings, and recommended management of patients with Metanephric adenoma (MA) focusing on the diagnostic challenges and indications for follow up.

Materials And Methods: In this case report, we present a case of a 10-year-old female with MA who eventually underwent nephron sparing surgery with a partial nephrectomy. We performed a literature review of previous cases of metanephric adenoma and their respective management and follow-up.

Prepuce sparing: Use of Z-plasty for treatment of phimosis and scarred foreskin.

Introduction And Objectives: The desire to preserve the prepuce is often based on cultural norms. Recently, the concept of "genital autonomy" has been invoked to delay circumcision (or any genital altering procedure) until the individual reaches maturity and can make his or her own decision. However, some uncircumcised boys develop one or more episodes of balanitis resulting in scarring of the prepuce and pathologic phimosis which is difficult to treat.

A novel technique to construct a neo-scrotum out of preputial skin for agenesis and underdeveloped scrotum.

Introduction: Congenital scrotal agenesis (CSA) is an extremely rare condition with fewer than 10 cases reported in the literature. These patients are often further complicated by undescended testicles as well as systemic developmental disorders. Herein, we report our experience and an innovative surgical technique for creation of a neo-scrotum in three children.

Management of 220 adolescents and adults with complications of hypospadias repair during childhood.

Objective: The goal of hypospadias repair is to achieve normal voiding and good penile cosmesis with minimal complications. Some urethroplasties deteriorate from childhood to adolescence and late stage failures have been reported. We report our experience with adult patients who have had a previous repair during childhood and present with a late complication.

Resurfacing the Penis of Complex Hypospadias Repair ("Hypospadias Cripples").

Purpose: After the creation of a neourethra in a "hypospadias cripple," resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred and unusable. We reviewed our experience with various strategies to resurface the penis of hypospadias cripples.

Materials And Methods: We retrospectively reviewed the records of 215 patients referred after multiple unsuccessful hypospadias repairs from 1981 to 2014.

Use of human acellular dermal matrix during classic bladder exstrophy repair.

Introduction: The extent of the abdominal wall defect in people with classic bladder exstrophy (CBE) varies, and can be extensive. In this study, human acellular dermis (HAD) was used to bridge the fascial gap, as an alternative to osteotomy, to support a fascial repair of the abdominal wall, and as a filler in selected cases of CBE.

Objective: To demonstrate the efficacy of the employed techniques of using HAD within the bladder exstrophy population.

Split-cuff nipple technique of ureteral reimplantation in children with thick-walled bladders due to posterior urethral valves.

Objective: To describe a novel technique of ureteral reimplantation in patients with thick-walled bladders, which addresses the technical challenges and high failure rates seen in this population.

Methods: From 1997 to 2012, 45 megaureters were reimplanted in 26 children aged 2-11 years. Key surgical modifications included ureteral trough creation within the detrusor, formation of a distal ureteral split-cuff nipple, reliance on transureteroureterostomy (TUU) when the bladder would not support the reimplantation of 2 ureters, performance of psoas vesicopexy, and judicious utilization of ureteral stump augmentation in patients undergoing TUU.

Vesico-ureteric reflux (VUR) management and screening patterns: are paediatric urologists following the 2010 American Urological Association (AUA) guidelines?

Objective: To evaluate the current practice patterns of vesico-ureteric reflux (VUR) management and screening among paediatric urologists and their relationship with the current American Urological Association (AUA) guidelines in managing and treating VUR.

Subjects And Methods: A 17-question survey was sent out to 476 paediatric urologists who are members of the Society for Pediatric Urology (SPU). In all, 133 respondents answered the survey and results were included for all questions.

Practice patterns among pediatric urologists in the use of Deflux® for vesicoureteral reflux: a survey.

Objectives: This study aims to assess pediatric urology practice patterns and factors which influence the use of Deflux(®) in the management of vesicoureteral reflux among pediatric urologists.

Methods: A 11-question survey was sent out to 476 pediatric urologists who are members of the Society for Pediatric Urology.

Results: 23.