John F. Redman

Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome: Case Report and Review of the Literature

We report a case of the megacystis-microcolon-intestinal hypoperistalsis syndrome and review the literature. Generally, this disease affects female neonates and is usually fatal within the first year of life. All patients have microcolon megacystis, intestinal hypoperistalsis, abdominal distention and dilated small bowel. Although the dilated bowel and urinary tract suggest an obstruction, such is not usually the case and surgical intervention is not always necessary. The abdominal distension results primarily from distension of the urinary tract.

Conservative management of urethral prolapse in female children

Abstract The management usually recommended for urethral prolapse in girls is surgical. Three cases are presented to illustrate and recommend a conservative approach.

The Barcat Balanic Groove Technique for the Repair of Distal Hypospadias

The Barcat balanic groove technique for the repair of distal hypospadias creates a neourethra with a ventral penile skin flap and a ventral glandular flap, both of which are based at the meatus. A series of 105 consecutive patients with distal hypospadias operated on by the same surgeon is presented. The primary complication was fistula formation in 15 per cent of the patients.

A Technique for the Correction of Penoscrotal Fusion

AbstractA simple technique for the surgical correction of penoscrotal fusion is described. The condition probably is more common than the literature would suggest.

Modified Barcat Balanic Groove Technique for Hypospadias Repair: Experience with 295 Cases

PURPOSEnWe reviewed the results of a large series of hypospadias repairs (311) using the modified Barcat balanic groove technique.nnnMATERIALS AND METHODSnAll patients who underwent modified Barcat repair with closure of the divergent corpus spongiosum were included in our study and were seen or contacted for postoperative followup.nnnRESULTSnOf 295 patients available for followup 94% had excellent cosmetic results. The fistula rate after primary repair was 5% for a glanular or coronal meatus and 18% for a penile meatus, and meatal stenosis was rare. After secondary repair complications were common in patients with a penile meatus.nnnCONCLUSIONSnThe Barcat technique allows anatomically superior glans reconstruction in distal hypospadias repair. Fistula rates can be reduced by tissue coverage of the neourethra.

Technique for Atraumatic Scrotal Pouch Orchiopexy in Management of Testicular Torsion

PURPOSEnScrotal pouch orchiopexy without suture fixation will result in strong atraumatic fixation of the testis in the management of undescended testis. We describe a similar technique that is effective in the management of testicular torsion.nnnMATERIALS AND METHODSnA total of 19 scrotal pouch orchiopexies was performed in 11 boys with testicular torsion. Age ranged from 10 to 17 years (mean 14). Orchiopexy was done using a scrotal pouch without transparenchymal suture fixation of the testis. The partial serosal sac was obliterated, placing the testis in a secured extravaginal position.nnnRESULTSnFollowup ranged from 17 to 33 months (mean 25.6). There were no instances of infection, hematoma, wound dehiscence, atrophy or recurrent torsion.nnnCONCLUSIONSnScrotal pouch orchiopexy as described is recommended to prevent torsion of the testis.

Translocation (7;7)(p13;q21) in a Wilms' tumor

Reports of single chromosome aberrations in Wilms tumors are rare, with most tumors being characterized by multiple complex karyotype aberrations. An 11-month-old female patient with Wilms tumor and a derivative chromosome 7 resulting from t(7;7)(p13;q21) as the sole cytogenetic aberration is described.

The ascending (acquired undescended) testis: a phenomenon?

• Administrative issues. • Accommodation arrangements. • Whether or not the trip met an individual preceptor’s educational goals. • Whether a month was a sufficient duration. • How valuable the preceptor found the wetlab sessions (four in total). • What and how many live cases the preceptor saw during the month. • Whether the preceptor has introduced any new procedures since returning to the UK. • Whether or not the preceptor would recommend the same visit to a colleague.

An anterior extraperitoneal incision for donor nephrectomy that spares the rectus abdominis muscle and anterior abdominal wall nerves.

PURPOSEnTo perform open donor nephrectomy with the least amount of body alteration and complication, a short extraperitoneal incision was developed that preserves the ipsilateral rectus abdominis muscle and abdominal branches of the intercostal nerves.nnnMATERIALS AND METHODSnDonor nephrectomy using the new incision was performed in 11 consecutive patients.nnnRESULTSnMorphine was required for pain relief for 1 to 3 days (mean 1.8), patients tolerated diet at 1 to 4 days (mean 2.2) and postoperative stay was 2 to 5 days (mean 3.5). Complications were minimal, consisting of postoperative fever 1 day in duration. A viable kidney was provided for transplantation in each case.nnnCONCLUSIONSnThe extraperitoneal, rectus abdominis muscle and nerve sparing incision resulted in a short course of pain medication, early diet toleration and a short hospital stay.

Pronounced Dilatation of Cowper’s Gland Duct Manifest as a Perineal Mass: A Recommendation for Management

It is generally accepted that large dilatations of Cowpers gland duct presenting as a perineal mass should be managed by perineal excision. Experience with such a case suggests that if the lesion also is visualized endoscopically, transurethral unroofing should be the initial choice of management.