ACL usually affect infants and young children and may present with spectrum of symptoms from an incidental finding to an acute life-threatening abdominal obstruction. Complete excision of the tumor is a safe and effective method in the management of ACL in pediatric population. Surgery is mandatory to avoid potential complications.
Our retrospective review suggests that perineal groove may be an underdiagnosed condition. Most cases resolve spontaneously, but confusion in diagnosis may lead to misdiagnosis or misinterpretation of sexual abuse and unnecessary treatments.
Purpose To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood.Materials and Methods Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism.Results Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment.Bilateral cryptorchidism Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH.Conclusions Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts no definite effect on testicular volume improvement or hormonal levels at 18 years of age.
Cite as: Can Urol Assoc J 2017;11(1-2):E58-9. ttp://dx.doi.org/10.5489/cuaj.3930 Published online January 12, 2107 AbstractOne of the most controversial aspects of hypospadias surgery is the election of an appropriate wound dressing. In fact, there may be as many different types of dressing as there are types of surgical repair. Here, we describe a new, simple method for hypospadias dressing in children that minimizes painful removal. MethodOne of the most controversial aspects of modern hypospadias surgery is the election of an appropriate wound dressing.1 Multiple dressings after hypospadias surgery have been previously reported.2 Dressing prevents postoperative edema and hematoma formation, maintaining the phallus in an upright position. Most dressings are bulky, hard to apply or remove, and may fall off in an active child.3 Commonly used dressings are adherent to the surgical wound, making removal more likely to be painful, especially in young children. 4 All the above-mentioned materials have their own set of advantages and disadvantages. Under these conditions, the use of a self-adherent, soft, silicone-foam dressing that minimizes painful removal is really appropriate for hypospadias surgery. The Mepilex ® Border foam sheet is cut according to the penile length and circumference. The lower border of dressing is split in three flaps for self-adherence to pubic and scrotal area (Fig. 1). The foam dressing need to be rolled into a cylindrical shape, wrapping round the penis and closed on the dorsal aspect with adhesive lateral border (Fig. 2). The top of the dressing must be left open to allow the urinary catheter to come through and to see the colour of the glans during postoperative period. No secondary dressings are necessary. The application of this type of dressing is very simple, with no need for previous skills and without increasing the operation time.The dressing is removed after 5-10 days, depending on the urethroplasty procedure performed. The dressing, being non-adherent in the wound area, is easily peeled off with no need of analgesics and minimal discomfort (Fig. 3). ConclusionSelf-adherent, soft, silicone-foam dressing (Mepilex ® Border) is really accurate for hypospadias surgery in children. It can be easily removed, avoiding harm to the child. E59Hypospadias dressing in childrenCompeting interests: The authors report no competing personal or financial interests.This paper has been peer-reviewed.
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