Suture Materials: Do They Affect Fistula and Stricture Rates in Flap Urethroplasties?

<i>Introduction:</i> The effect of suture materials on urethroplasty complications is debated. Indeed, materials with a delayed absorption might either reduce the incidence of fistulas by ensuring a prolonged approximation of neo-urethral edges or increase the risk of urethral strictures due to a prolonged tissue reaction during suture absorption. We retrospectively evaluated the role of suture materials in the complication rate of urethroplasty procedures performed in our institution over a 10-year period. <i>Patients and Methods:</i> Three hundred and thirty-six boys undergoing a flap procedure (parameatal based, preputial tube, or onlay preputial flap) for hypospa…

Enuresi ed ipertiroidismo

Transurethral incision of duplex system ureteroceles in neonates: does it increase the need for secondary surgery in intravesical and ectopic cases?

OBJECTIVE To evaluate the relevance of ureterocele ectopia and associated reflux on the outcome of duplex system ureteroceles (DSU) after neonatal transurethral incision (TUI). PATIENTS AND METHODS The study included 41 neonates with a diagnosis of DSU; the ureterocele was ectopic in 24 (58%). Before TUI, vesico-ureteric reflux (VUR) was present in 13 lower moieties (32%) and seven contralateral ureters (17%). TUI was always performed within the first month of life. The follow-up and management were tailored for each patient from the findings at ultrasonography, voiding cysto-urethrography and renal scintigraphy. Results of intravesical and ectopic DSU were compared using Fisher's exact tes…

INJECTION TECHNIQUE DOES NOT INFLUENCE RESOLUTION RATE IN HIGH-GRADE VESICO-URETERIC REFLUX IN CHILDREN. A SINGLE CENTRE PROSPECTIVE STUDY

One-Trocar,viedo-assisted stripping technique for use in the treatment of large ovarian cysts in infants

Comprehensive laparoscopic approach to paediatric varicocele

CHIRURGIA LAPAROSCOPICA DEL VARICOCELE: STATO DELL'ARTE

Indicazioni al trattamento del reflusso vescico-ureterale in età pediatrica

Release of partial ureteral obstruction (PUO) in the neonatal mouse prevents proximal tubular but not glomerular damage, which is aggravated by congenital nephron loss

Correzione laparoscopica del varicocele di 3° tipo sec.Coolsaet

Correlation between hypertrophy and risk of hypertension in congenital solitary functioning kidney

Purpose: Solitary functioning kidney (SFK) may be associated to hypertrophy, hypertension and chronic kidney disease. We evaluated blood pressure (BP) of children with congenital SFK comparing agenesis to multicystic dysplastic kidney (MCDK) and correlated BP profiles with renal dimensions of affected and contralateral kidney. Methods: We compared 40 patients with MCDK, grouped for either treatment options (A: conservative vs B: nephrectomy) or involution time (A1: before 4 years-of-age vs A2: persistence-of-MCDK), to 10 unilateral agenesis (C). Patients were evaluated with ultrasound, scintigraphy, office-ambulatory BP monitoring. Results: Compensatory hypertrophy was demonstrated in most …

Evolving management of adolescent varicocele

Abstract Objective To review the evolution in indications for treatment and treatment modalities for adolescent varicocele at our centre, and evaluate the impact of varicocelectomy on final outcome. Patients and methods Between 1995 and 2006, we treated 242 left varicoceles. Preoperative assessment included clinical evaluation, measurement of testicular volumes, and colour-Doppler ultrasound (CDUS). A subinguinal varicocelectomy was performed in 124 patients (group A), and a laparoscopic non-artery-sparing Palomo procedure in the remaining 118 (group B). In group B patients, CDUS was also used to investigate the functional anatomy of varicocele, and all the veins found to be refluxing were …

Fetal unilateral urinoma in upper urinary tract obstruction: our experience and review of literature. Does it protect renal function?

Recent Advances in Derivation of Functional Hepatocytes from Placental Stem Cells

Abstract: End-stage liver diseases are one of the leading causes of death in the world. Often orthotopic liver transplantation represents the final therapeutic choice. The limits of this approach are the scarcity of donor livers available, and the many side effects related to the administration of immune suppressants to the patients. Cellular therapy for liver diseases is increasingly being viewed as a promising strategy to provide hepatocytes to replenish the parenchymal cells of the organ. This technique suffers of some important limitations, such as the difficulty in isolating sufficient cell numbers (e.g. when adult or foetal hepatocytes are used for transplantation), the limited viabil…

Unilateral multicystic dysplastic kidney in infants exposed to antiepileptic drugs during pregnancy

Prenatal exposure to antiepileptic drugs (AEDs) increases the risk of major congenital malformations (MCM) in the fetus. AED-related abnormalities include heart and neural tube defects, cleft palate, and urogenital abnormalities. Among the various congenital anomalies of the kidney and urinary tract (CAKUT), multicystic dysplastic kidney (MCDK) disease is one of the most severe expressions. Although prenatal ultrasound (US) examination has increased the prenatal diagnosis of MCDK, the pathogenesis is still unclear. We report on four cases of MCDK in infants of epileptic women treated with AEDs during pregnancy. From October 2003 to June 2006, we observed four infants with unilateral MCDK bo…

Analisi di biomarcatori urinari e tissutali coinvolti nei meccanismi pro- o anti-fibrotici in pazienti con stenosi del giunto pielo-ureterale unilaterale congenita come ulteriore strumento nel management terapeutico.

Stenosi del giunto pielo-ureterale, biomarcatori urinari, fibrosi, funzione renale, matrice extracellulare.

CONGENITAL REDUCTION IN NUMBER OF NEPHRONS IMPAIRS PROXIMAL TUBULAR GROWTH IN THE CONTRALATERAL KIDNEY DURING PARTIAL UNILATERAL URETERAL OBSTRUCTION

PURPOSE To compare the response of the contralateral (CL) kidney during partial unilateral uretaral obstruction (PUO) and from obstruction/release (PUO/Rel) to sham-operated kidneys in both wild-type (WT) mice and mice with 50% reduction of nephron number (Os/+) MATERIAL AND METHODS C57/BL6 WT and mice with oligosyndactylism and 50% reduction of nephron number (Os/+), were subjected to sham operation or PUO in the first 2 days of life. Additional mice underwent release of obstruction at 7 days (PUO-Rel). All kidneys were harvested at 6 weeks (adulthood). Using histomorphometry, glomerular number and area were determined by PAS staining, and proximal tubular (PT) mass and injury to the glome…

THE USE OF DOUBLE DARTOS FLAP VERSUS DORSAL PREPUCE FLAP IN REDUCING FISTULA RATE AFTER TIP URETHROPLASTY

Approccio laparoscopico al testicolo ritenuto intraddominale non palpabile. L'esperienza di 2 centri Chirurgia Pediatrica

Le incongruenze tra cistografia e cistosonografia minzionale influiscono sul trattamento del reflusso vescico ureterale primitivo ?

Surgery of deferential reflux in pediatric varicocele based on preoperative color doppler ultrasound assessment

Stenosi del giunto pielo-ureterale unilaterale congenita: identificazione di biomarcatori, valutazione clinico-strumentale del danno renale e correlazione con il dato istologico.

Stenosi del giunto pielo-ureterale, biomarcatori urinari, fibrosi, funzione renale, matrice extracellulare.

Il management del reflusso vescico-ureterale

Sull'uso dello stent doppio J nel megauretere ostruttivo

Which non palpable testes truly need laparoscopic Fowler-Stephens orchidopexy?

Valutazione del dolore post-operatorio dopo infiltrazione locale e instillazione endoperitoneale di ropivacaina nella chirurgia laparoscopica in età pediatrica.

Clinical diagnosis and evoluation

CONGENITAL UNILATERAL URETEROPELVIC JUNCTION OBSTRUCTION:RENAL DAMAGE EVALUATION AND CORRELATION BETWEEN RENAL BIOPSY AND PRE-POSTOPERATIVE RADIONUCLIDE SCAN

PURPOSE to correlate severity of UPJO with immunohistochemical findings and radionuclide renal scan split function (SF), to obtain indications and timing of surgical correction of congenital UPJO. MATERIAL AND METHODS 21 patients, 57-105 days old, were studied. UPJO was assessed by MAG 3 diuretic renography. Patients underwent biopsy at pyeloplasty. Histological and himmunoistochemical analysis for Bcl-KL, Bcl2, AKT-1, BAD, Bax, AIF, FAS FAS-L, H-TERT, Mib-1 and Nocth2 was performed. TUNEL technique was used to detect apoptotic nuclei. Severity of UPJO was assessed intraoperatively and histologically. Renography was repeated one year after surgery. RESULTS All patients showed half-time wash…

Materiali di sutura: influenzano l'incidenza delle fistole e/o stenosi nell'uretroplastica con uso di lembi?

MONITORAGGIO ECOGRAFICO NEL TRATTAMENTO ENDOSCOPICO PER REFLUSSO VESCICO-URETERALE: QUANDO LA CISTOURETROGRAFIA PUO' ESSERE EVITATA

L'iniezione di polimeri di acido ialuronico/destranomero (Dx/HA) è un'opzione terapeutica efficace e mini-invasiva nel trattamento del reflusso vescico-ureterale.

Uso del flap di muscolo retto nella derivazione continente sec.Mitrofanoff

Approccio laparoscopico al dolore pelvico in età puberale

A Comprehensive Ultrasonographic Assessment of Pediatric and Adolescent Varicocele Can Improve Surgical Results.

<b><i>Purpose:</i></b> Undetected refluxing venous systems could cause persistence/recurrence of varicoceles in patients undergoing varicocelectomy. Color Doppler ultrasound (CDUS) is an important tool in the diagnosis and follow-up of varicocele, and could be successfully used to detect a venous reflux in the iliac-deferential district, usually involved in the recurrence/persistence of varicocele. <b><i>Materials and Methods:</i></b> We compared 2 historical series of patients treated with Palomo laparoscopic varicocelectomy between 1994 and 2018. In group 1, preoperative scrotal CDUS was obtained, while in group 2, additional inguinal CDUS w…

The fate of implant after endoscopic injection of dextranomer/hyaluronic acid in vesicoureteral reflux: time to partial reabsorption and stabilization

Summary Background/introduction Vesicoureteral reflux (VUR) potentially leads to renal damage, scarring, and eventually end-stage renal disease. Endoscopic treatment is well tolerated in children, it has reduced costs, and it effectively prevents urinary tract infections (UTIs), while avoiding long term antibiotics use. Objective With the aim to investigate the time needed to reach the stabilization of the dextranomer/hyaluronic acid (Dx/HA) implants and to identify cut-off heights to ensure the success of the procedure, the authors analyzed ultrasonographic (US) intra-operative appearance of the mounds following endoscopic treatment for VUR and repeated the measurements during serial posto…

The Fate of Nephrons in Congenital Obstructive Nephropathy: Adult Recovery is Limited by Nephron Number

Background: Pediatric chronic kidney disease (CKD) is most often due to congenital anomalies of the kidneys and urinary tract (CAKUT), and obstructive nephropathy is the leading cause. Progression to renal failure, however, is more likely to develop in adulthood than childhood (Wuhl, CJASN 8: 67–74, 2013). Frequently associated with CAKUT, reduced nephron number (NN) at birth is an independent risk factor for adult CKD. Methods: To determine the role of NN in progression of congenital obstructive nephropathy, wild-type (WT) and reduced NN mice (Os/+) were subjected to sham operation or partial unilateral ureteral obstruction (UUO) in the first 2 days of life (prior to completion of nephroge…

Stenosi del giunto pielo-ureterale unilaterale: valutazione del danno renale correlando il dati clinico strumentale con quello istologico ed immunoistochimico

Anastomosi primaria nell'atresia esofagea: risultati del follow-up

Febbre mediterranea familiare: un caso atipico con esordio precoce.

Un nuovo approccio laparoscopico nel trattamento del varicocele di tipo misto (di 3° tipo sec. Coolsaet) nei bambini ed adolescenti

Il ruolo del color doppler nel determinare il trattamento appropriato nel varicocele in bambini ed adolescenti

Coverage of urethroplasty in pediatric hypospadias: Randomized comparison between different flaps

Objectives The use of covering urethroplasty with flaps in hypospadias surgery has been well recommended. Various techniques have been described for flap harvesting. The aim of the present study was to compare the outcome and complication rate of dorsal preputial flaps and ventral dartos flaps. Methods A total of 130 patients were prospectively evaluated from January 2008 to December 2011. Using the tubularized incised plate urethroplasty procedure, urethroplasty was carried out by a single surgeon. Patients were randomly divided in two groups: group A (57 patients), in which a preputial flap was carried out using three different techniques; and group B (73 patients), in which a single or a…

Endoscopic Approach for Urinary Tract Pathologies

Outline the real indications for the endo scopic procedure in pediatric urology. • Describe the instrumentation suitable for the endoscopy. • Describe the most used endoscopic techniques. • Report the results of endoscopic treatment. • Share tips and tricks of how to act endoscopicall

Reverse Rotation of the Kidney associated with vascular anomaly producing ipsilateral ureteropelvic junction obstrution

Congenital reduction in number of nephrons accelerates renal damage, and limits proximal tubular growth response to release of neonatal partial ureteral obstruction

Aim: to analyze the evolution of the response to persistent partial ureteral obstruction (PUO) and obstruction/release (PUO/Rel) in mice with 50% reduction in the number of nephrons from 21 days of age (time of weaning) to 42 days of age (adulthood). Methods: C57/BL6 wild-type (WT) and mice with oligosyndactylism and 50% reduction of nephron number (Os/+), were subjected to sham operation or PUO in the first 2 days of life. Additional mice underwent release of obstruction at 7 days (PUO-Rel). The study was performed in kidneys harvested at 21 and 42 days. Using histomorphometry, glomerular area (GA) was determined by PAS staining, and fractional proximal tubular (PT) mass and intact glomeru…

Fetal meconium psedocyst spontaneosly disappeared after birth. A Case report

Ultrasonographic mound height as predictor of vesicoureteral reflux resolution after endoscopic treatment in children

Purpose: Endoscopic dextranomer/hyaluronic acid copolymer (Dx/HA) injection is a safe and efficacious treatment option for vesicoureteral reflux (VUR) in children. Endoscopic appearance, hydrodistention and amount of injected Dx/HA have been demonstrated not to be reliable predictors of outcome. Aim of this study was to evaluate Dx/HA mounds on ultrasound scans (US) and find out any eventual correlation with reflux resolution. Methods: We selected patients treated with endoscopic injection for moderate to high VUR, renal scaring or repeated infections under antibiotic prophylaxis. Success was defined by absence of VUR at control 3. months after surgery; at 3. months we also measured mound h…

Double-J stent insertion across vesicoureteral junction--is it a valuable initial approach in neonates and infants with severe primary nonrefluxing megaureter?

Abstract Objectives To evaluate the role of double- J stent insertion in perinatally detected primary nonrefluxing megaureters as a method to temporize treatment in patients with impaired renal function or to prevent function loss in patients treated expectantly, but deemed at high risk of deterioration. Methods Two neonates and 8 infants with a ureter greater than 10 mm and an obstructive excretion pattern, including 3 cases with renal function less than 40%, were selected to undergo double- J stent insertion for a 6-month period. Patients underwent surgery if the ureter redilated and the excretion pattern was obstructive at reassessment 3 months after stent removal. Results Stents were pl…

Efficacy of Periportal Infiltration and Intraperitoneal Instillation of Ropivacaine After Laparoscopic Surgery in Children

Postoperative pain is less intense after laparoscopic than after open surgery. However, minimally invasive surgery is not a a pain-free procedure. Many trials have been done in adults using intraperitoneal and/or incisional local anesthetic, but similar studies have not yet been reported in the literature in children. Aim: The aim of this study was to evaluate the analgesic effect of periportal infiltration and intraperitoneal instillation of ropivacaine in children undergoing laparoscopic surgery. Materials and Methods: Thirty patients who underwent laparoscopic surgery were randomly allocated to one of three groups. Group A (n 10) received local infiltration of port sites with 10 mL of ro…

Focus on pediatric and adolescent varicocele: a single institution experience

The aim of this study was to report our long-term diagnostic and surgical outcome during the last 18 years, in paediatric and adolescent management of varicocoele. The present retrospective study enrols 374 patients observed at our institution between 1994 and 2011. Patients were divided into three groups: Group A includes 142 youngsters and adolescents treated with open surgery for left varicocoele, in which a pre-operative CDUS was not performed; Group B includes 65 patients treated with open surgery in which a pre-operative CDUS evaluation was carried out, to assess varicocoele haemodynamic pattern and testicular volume. Group C includes 167 patients treated by laparoscopy and with pre-o…

Significance of enlarged fetal bladder in males. The value of amniotic fluid. When to perform vesicostomy?.

valvole dell'uretra posteriore

Il testo offre allo studente una visione d’insieme dei concetti fondamentali della Chirurgia Pediatrica al fine di favorire l’apprendimento delle caratteristiche cliniche delle varie condizioni morbose, delle basi biologiche dei processi patologici, della diagnosi e del trattamento delle patologie abitualmente osservate nella pratica clinica. L’intento è quello di trattare ogni campo della patologia chirurgica pediatrica in maniera chiara e sintetica, avvalendosi di contenuti aggiornati e di una opportuna iconografia. La caratteristica principale di quest’opera è rappresentata dall’inserimento di cospicue fotografie ottenute durante gli esami diagnostici. Il piano dell’opera è organizzato i…

The hemodynamic approach to evaluating adolescent varicocele

During adolescence, the risk of developing a varicocele increases. Prevalence is less than 1% in boys aged younger than 10 years, but approaches that of the general adult population (about 15%) during puberty. For adolescent males with varicoceles, surgical risk factors have not yet been clearly delineated and clinical severity correlates poorly with prognosis. Fortunately, the widespread use of Doppler ultrasonography is transforming the diagnostic work-up for this demographic. A continuous reflux detected by color Doppler ultrasound (CDUS) is thought to have a negative prognostic value and evidence suggests that a peak retrograde flow above 38 cm per second is a powerful predictor of lack…

SEPARAZIONE VENTRALE ED EXTRAROTAZIONE DEI CORPI CAVERNOSI NELLA CORREZIONE DELL’INCURVAMENTO DELL’ASTA CON O SENZA IPOSPADIA

Posterior One-Trocar-Assisted Pyeloplasty

Introduction Ureteropelvic junction obstruction is the most common pediatric obstructive uropathy. Retroperitoneal lap- aroscopic-assisted dismembered pyeloplasty (OTAP) combines the advantages of a retroperitoneal approach with the high success rate of the open technique. A modification of the OTAP, using a posterior muscle-sparing incision to approach the kidney, is described. Surgical technique With the patient placed in prone position, a transverse 15-mm-long skin incision is made. A 12-mm bal- loon Hasson trocar with operative telescope is inserted after the Gerota’s fascia has been opened. The ureteropelvic junction is exteriorized and a traditional dismembered pyeloplasty is performe…

Complications of trans-anastomotic externalised stents in open pyeloplasty: influence of the method of placement, the duration of stenting, and the associated bladder drainage

To assess the influence of the method for stent placement, the duration of stenting, and the presence of bladder drainage on the complication rate of open pyeloplasty. Patients and methods: Complications were, retrospectively, compared in 228 consecutive open pyeloplasties performed at institution A using a trans-pyelostomic 6-Fr splint/stent for 5 days and no bladder drainage, and 150 consecutive open pyeloplasties performed at institution B using a trans-nephrostomic 6-Fr splint/stent for 9 days plus bladder drainage. Results: Median age at surgery was comparable between groups. The overall complication rate was 13% and was comparable at the two institutions, but for the presence of perio…

Trattamento laparoscopico del varicocele di tipo misto (di 3° tipo sec.coolsaet)

Laparoscopic surgery of deferential reflux in pediatric and adolescent varicocele

BACKGROUND: This study aimed to assess whether deferential reflux in pediatric and adolescent varicocele can be successfully treated laparoscopically. MATERIALS AND METHODS: Since 2001 at our institution, 148 boys were evaluated for a left varicocele. Preoperatively,all the patients underwent ultrasound scan assessment of testicular volume and color-Doppler US (CDUS)to rule out reflux into the internal spermatic vein (ISV), deferential vein, or cremasteric vein. Boys with ISV reflux were treated by laparoscopic transperitoneal Palomo; boys with isolated deferential reflux or associated to ISV reflux were laparoscopically managed adding to the former procedure, coagulation or clipping of ref…

Complicanze associate all'utilizzo dello stent nelle pieloplastiche open. Studio comparativo tra 2 centri.

Varicocele

The Fate of Nephrons in Congenital Obstructive Nephropathy: Adult Recovery is Limited by Nephron Number Despite Early Release of Obstruction

Urinary tract obstruction and reduced nephron number often occur together as a result of maldevelopment of the kidneys and the urinary tract. We determined the role of nephron number on adaptation of the remaining nephrons of mice subjected to neonatal partial unilateral ureteral obstruction followed through adulthood.Wild-type and Os/+ mice (the latter with 50% fewer nephrons) underwent sham operation or partial unilateral ureteral obstruction in the first 2 days of life. Additional mice underwent release of unilateral ureteral obstruction at 7 days. All kidneys were harvested at 3 weeks (weaning) or 6 weeks (adulthood). Glomerular number and area, glomerulotubular junction integrity, prox…

Quality of life improving after propranolol treatment in patients with Infantile Hemangiomas

AbstractInfantile hemangiomas may affect the quality of life (QoL) of patients and their family members, as anxiety and worry may commonly occur in parents, also linked to the social adversion they experience. We underline the beneficial impact of oral propranolol therapy on QoL of patients with infantile hemangiomas (IH) and of their relatives. A specific questionnaire measuring QoL was administered to parents of IH patients at beginning and end of a treatment with oral propranolol. Different aspects were investigated: site of the lesion, age of patients at starting therapy, length of treatment, occurrence of adverse effects and persistence/recurrence of the vascular anomaly. In all cases …

Absorbable suture materials for primary defect closure in congenital diaphragmatic hernia: long term outcome

Displasia multicistica monolaterale in due neonati esposti in utero a farmaci antiepilettici

Valutazione del reflusso gastroeofageo associato ad atresia dell'esofago con fistola distale mediante ph-impedenzometria 24h

Unexpected complication of TIP urethroplasty: the diverticulum of neo-urethra

Approccio laparoscopico al testicolo non palpabile. E' necessaria l'esplorazione "open" nel vanishing testis intracanalicolare?

Varicocele

Il testo offre allo studente una visione d’insieme dei concetti fondamentali della Chirurgia Pediatrica al fine di favorire l’apprendimento delle caratteristiche cliniche delle varie condizioni morbose, delle basi biologiche dei processi patologici, della diagnosi e del trattamento delle patologie abitualmente osservate nella pratica clinica. L’intento è quello di trattare ogni campo della patologia chirurgica pediatrica in maniera chiara e sintetica, avvalendosi di contenuti aggiornati e di una opportuna iconografia. La caratteristica principale di quest’opera è rappresentata dall’inserimento di cospicue fotografie ottenute durante gli esami diagnostici. Il piano dell’opera è organizzato i…

Surgery for urethrocutaneous fistula following hypospadias repair. An overview

Oesophageal pH/impedance monitoring in children treated for oesophageal atresia

Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

Purpose Despite minimal invasiveness and high success rate, guidelines still prescribe voiding Cystourethrogram (VCUG) after endoscopic treatment for vesicoureteral reflux (VUR) in children. The aim of this paper was to analyze whether intraoperative ultrasound (IO-US) could improve surgical accuracy and perioperative counseling, thus potentially decreasing the need for postoperative VCUG. Methods We selected children treated for moderate to high grade VUR, renal scarring or repeated infections under antibiotic prophylaxis from January to December 2015. Endoscopic injection was combined with IO-US to detect optimal needle placement and to guide mound formation. IO-US findings were compared …

Cisti celomica fetale intra-addominale, causa di atresia intestinale

Focus on paediatric and adolescent varicocoele: a single institution experience

Summary The aim of this study was to report our long-term diagnostic and surgical outcome during the last 18 years, in paediatric and adolescent management of varicocoele. The present retrospective study enrols 374 patients observed at our institution between 1994 and 2011. Patients were divided into three groups: Group A includes 142 youngsters and adolescents treated with open surgery for left varicocoele, in which a pre-operative CDUS was not performed; Group B includes 65 patients treated with open surgery in which a pre-operative CDUS evaluation was carried out, to assess varicocoele haemodynamic pattern and testicular volume. Group C includes 167 patients treated by laparoscopy and wi…

Stripping della parete cistica, un'alternativa all'ovariectomia nelle grosse cisti ovariche congenite? A case report.

The role of Doppler ultrasonography in determining the proper surgical approach to the management of varicocele in children and adolescents

In a study from Italy, colour-Doppler ultrasonography was a reliable diagnostic tool in the preoperative assessment of patients with varicocele. The authors also found that it helped to distinguish those who could be treated laparoscopically from those who should be treated by microsurgical subinguinal ligature. OBJECTIVE To investigate whether colour Doppler ultrasonography (CDUS) is a reliable diagnostic tool for selecting patients with varicocele to undergo either laparoscopy or open microsurgical subinguinal ligation. PATIENTS AND METHODS In a 3-year period, 42 boys affected by left varicocele were evaluated before surgery by inguinal and scrotal CDUS. Using this method it was possible …

Reverse rotation of the right kidney associated with vascular anomaly producing ipsilateral ureteropelvic junction obstruction.

Ruolo della laparoscopia nel trattamento della componente deferenziale nel varicocele di tipo misto (3° tipo sec. Coolsaet) nei bambini e negli adolescenti

Comprehensive laparoscopic approach to pediatric varicocele based on preoperative color Doppler ultrasound assessment

Abstract: Background This study aimed to assess whether laparoscopic treatment for any kind of varicocele is possible after preoperative identification of refluxing veins by color Doppler ultrasound (CDUS). Methods At the authors'' institution, 98 patients with a median age of 11.3 years (range, 7.1-16 years) were evaluated for a left varicocele. Preoperatively, all the patients underwent ultrasound scan assessment of testicular volume and CDUS to rule out reflux into the internal spermatic vein (ISV), deferential vein, or cremasteric vein. In all the patients, laparoscopic division of the spermatic artery and veins was performed as close as possible to the internal inguinal ring. The other…

URINARY TRACT OBSTRUCTION AND REDUCED NEPHRON NUMBER: ADAPTATION OF NEPHRONS FOLLOWED THROUGH ADULTHOOD IN A MOUSE MODEL

Congenital urinary tract obstruction , NEPHRON NUMBER, MOUSE MODEL , release of obstruction

Coverage of urethroplasty in pediatric hypospadias: Randomized comparison between different flaps

Early diagnosis of ureteropelvic junction obstruction in a solitary kidney: when to correctly perform pyeloplasty.

Clinical Diagnosis and Evaluation