Efficacy of Magnetic Resonance urography in detecting crossing renal vessels in children with ureteropelvic junction obstruction.

Introduction: An aberrant or accessory crossing renal vessel (CV) leading to the lower pole of the kidney is the most common extrinsic cause of uretero pelvic obstruction(UPJ) obstruction in a child and young adolescent.There is still controversy regarding there functional significance in obstruction Preoperative identification of such vessels may influence surgical management.

Objective: First aim is to determine the value of magnetic resonance (MR) urography in detecting crossing vessels in children with UPJ obstruction,comparing the data with postoperative findings and the second one is to evaluate morphologic and functional parameters in these hydronephrotic kidneys.

Buccal mucosa grafts for repair of stenotic catheterizable continent stoma.

Purpose: Different tubular structures have been used to create cutaneous catheterizable continent urinary stomas. The most common complication is stomal stenosis on the cutaneous end of the tubes. We present a variant of stomal stenosis repair that uses a buccal mucosa graft.

Is it reasonable to treat refractory voiding dysfunction in children with botulinum-A toxin?

Purpose: We present our results with botulinum-A toxin transperineal pelvic floor/external sphincter injection combined with behavioral and biofeedback reeducation in children with voiding dysfunction who had been resistant to previously applied therapies.

Material And Methods: Eight boys and 12 girls between 7 and 12 years old (mean age 9) with recurrent urinary tract infection, an interrupted or fractional voiding pattern and high post-void residual urine in whom behavioral, short biofeedback and alpha-blocker therapies had failed were included in the study. They were treated with botulinum-A toxin at a dose of 50 to 100 U.

Refluxing megaureter for the Mitrofanoff channel using continent extravesical detrusor tunneling procedure.

Purpose: We present a variation on the continent procedure using the refluxing megaureter for the Mitrofanoff channel, and its results.

Materials And Methods: The Mitrofanoff procedure using the refluxing megaureter was performed in 35 patients (valve bladder syndrome 15, neurogenic bladder 10, non-neurogenic bladder 10) between 1995 and 2001. Mean patient age was 5.

[Effect of treatment of lower urinary tract dysfunction on occurrence of urinary tract infections in children with vesicoureteral reflux].

Correlation between lower urinary tract dysfunction, urinary tract infection (UTI) and vesicoureteral reflux (VUR) is complex and well known. The impact of lower urinary tract dysfunction treatment on frequency of UTI in children with VUR was assessed in our study. Lower urinary tract dysfunction was diagnosed in 32 girls and 4 boys; 19 (53%) of them had VUR in 24 kidney units.

'Pseudospongioplasty' in the repair of a urethral diverticulum.

Objectives: To describe a technique for repairing urethral diverticula which includes neourethral reconstruction and increasing the mechanical support of the neourethra.

Patients And Methods: Between February 1995 and May 2000, 267 patients with proximal hypospadias underwent a one-stage penile skin longitudinal flap urethroplasty. The overall postoperative complication rate was 20%; a diverticulum formed in 24 patients (9%) and in all it was repaired.

Classification of prepuce in hypospadias according to morphological abnormalities and their impact on hypospadias repair.

Purpose: We investigated the morphology of the hypospadiac prepuce to develop a classification of different prepuce types in hypospadias. We also assessed the correlation between morphology and vascularization of the prepuce and their impact on results of hypospadias repair.

Materials And Methods: From September 1997 to December 2001, 174 patients 18 months to 24 years old (mean age 49 months) underwent hypospadias surgery.

Enlargement and sculpturing of a small and deformed glans.

Purpose: We present 2 techniques of enhancement and sculpturing of a small and/or deformed glans.

Materials And Methods: The small glans in primary or re-do hypospadias repair was enhanced by longitudinal double-faced island flaps incorporated onto the ventral side of the glans between the glans wings. The deformed glans, of small or normal size (with normal urethra or well functioning neourethra), was enlarged and sculptured by injection of hydrogel.

Vascularization of the hypospadiac prepuce and its impact on hypospadias repair.

Purpose: Only sparse data are available on the blood supply of the hypospadiac prepuce. We investigated the development and course of the preputial blood vessels, and applied the results of this study to surgery for hypospadias.

Materials And Methods: In 157 patients who underwent hypospadias surgery from October 1996 to December 2000 the prepuce was illuminated by a front and back lighting technique using endoscopic cold light and then photographed.