Subcutaneous emphysema (SE) is a condition often causing minimal symptoms, but sometimes it can be severe and even life-threatening. This study is the first great survey about SE. The aim of this study is to classify and evaluate the etiology, signs, symptoms, and management of SE. This retrospective study was performed by reviewing patients who had been diagnosed as having SE in Rasht, between January 2001 and January 2011. We classified the severity of SE in five grades including the (1) base of the neck, (2) all of the neck area, (3) subpectoralis major area, (4) chest wall and all of the neck area, and (5) chest wall, neck, orbit, scalp, abdominal wall, upper limbs, and scrotum. We excluded all patients in grades 1 and 2, because the symptoms and signs were not significant. Statistical analysis was carried out with SPSS 18. We collected 35 cases of SE with the mean age of 53±14.83 (71 % men). The most common cause of SE was pneumothorax with background of COPD and surgery in grade 5, trauma due to rib fracture in grade 4, and iatrogenicity in grade 3. We performed two bilateral 2-cm infraclavicular incisions. In our patients with infraclavicular incisions, expansion of the lung was better, and the patients' appearance improved. Infraclavicular incisions as a simple method for the management of SE can decrease the severity of SE with no cosmetic problem.

Introduction: Bladder stone is more common in developing countries and it is one of the rare diseases affecting children. In recent years, there is an increasing tendency in urologists to have minimal invasive approaches. The aim of this study was to compare the results of surgical bladder stone management in our single tertiary center. Methods: From 159 children younger than 18 years with vesical stones treated during January 2000 to January 2015 in Shohada-e-Tajrish hospital, Tehran, Iran, 146 subjects entered to the study. According to type of intervention, patients stratified to three groups. First group included 80 patients that open cystolithotomy (OCL) was done for them, second group was 39 patients who underwent percutaneous cystolithotomy (PCCL) and third group was 27 patients who treated by transurethral cystolithotripsy with holmium-YAG laser (TULL). Demographic data, hospital stay, operation time, and post operation complications were recorded and comparison were drawn between the three groups. Results: Mean age was 8.3 ± 5.1 years (8.6 ± 5.1, 6 ± 4.2 years for boys and girls, respectively). Mean stone size (MSS) was 2.76 ± 1.07 cm and no significant differences were found between the three groups but it was larger in OCL group. Mean operative time (MOT) was 29.15 ± 7.12 minutes in separate; MOT in TULL was significantly higher than PCCL and OCL respectively (36.3 ± 5.97, 30.54 ± 5.27 and 26.06 ± 6.32 minutes/P = 0.000). Mean hospital stay (MHS) in OCL group was 3.55 ± 1 days that was higher than PCCL and TULL groups significantly (P = 0.000). Conclusion: Based on our study, holmium:YAG lithotripsy has a high success rate, and is a minimally invasive management, therefore it is a safe method for children bladder calculi treatment if proper equipment was available and done by expert hands.

ObjectiveTo evaluate the use of human amniotic membrane allograft to prevent urethrocutaneous fistula after tubularized incised plate repair for redo‐hypospadias and anterior urethral defects.MethodsThis pilot study included 28 patients (mean age 25.3 ± 11 years) with a history of previous failed hypospadia repair, who underwent tubularized incised plate urethroplasty in one session by the same surgical team from April 2016 to April 2019. After the reconstruction of a neourethra and proper hemostasis, a human amniotic membrane allograft – Grafting Scaffold – was used to cover the suture lines.ResultsThe mean follow‐up time was 13.3 ± 4.5 months. Two urethrocutaneous fistulas occurred within the first 2 weeks after the surgery, one of which was caused by the infection of the surgical site. No penile torsion, urethral diverticula, meatal stenosis or glans dehiscence was reported.ConclusionsAmniotic membrane graft provides an applicable, low‐cost, feasible, biodegradable and safe second cover in redo‐hypospadias repairs by tubularized incised plate technique. Its use is technically easy; it has satisfactory cosmetic outcomes and might decrease urethrocutaneous fistula formation.

Results: MOT and SFR were significantly different in 500 Mm laser caliber (P = 0.046, P = 0.029, respectively). There was no remarkable difference between the three groups in this regard. Conclusion: Based upon our data, the clinical potency of the Ho: YAG laser was great in all three fiber calibers. The most important results of this comparison were the significantly higher SFR with increased laser caliber.

Introduction: Renal rhabdomyosarcoma is a rare malignant mesenchymal tumor, representing 1% -3% of all renal malignant tumors. Case Presentation: In the present study, we discussed about a 33-year-old woman with a botryoid type embryonal rhabdomyosarcoma of the left kidney presented with gross hematuria. Conclusions: This very rare tumor in adults should be considered in differential diagnosis among undifferentiated malignant tumors.