- Email: [email protected]
Crypto-hypospadias. A review of 38 cases
578
cluded bleeding from the conduit, ureteroileal stenosis, and uremia with hypertension. In 49 cases, the IVP preoperatively and postoperatively remained normal or improved. Of 63 n o r m a l kidneys preoperatively, 44 remained n o r m a l after diversion, 14 h a d mild pyelonephritic changes, tour had deterioration, and one became nonfunctioning. Six o f nine caliectatic kidneys remained unchanged and three returned to normal. Thirty-eight of 66 kidneys with mild to moderate hydronephrosis improved and 18 remained unchanged. Fifteen of 20 with severe hydronephrosis improved, four remained unchanged, and one deteriorated. In 63 patients with 75~o to 100~o of n o r m a l renal function, there was no change. In eight patients renal function decreased to fair and in four it was poor. In the patients in w h o m preopera~.ive renal function was only fair, a little more than half improved and the rest were unchanged. Based on a 12-mo to 12-yr follow-up, the a u t h o r s feel that ileal conduits have proved to be an extremely satisfactory m e t h o d of urinary diversion. --S. Kim
Urinary Tract Reconstruction Following Ileal Conduit Diversion. S. P. Dretler, W. H. Hendren, and W, F. Leadbetter. J. Urol, 109:217-224 (February), 1973.
This is a report of 11 patients previously undergoing ileal conduit diversion in w h o m the urinary tract was reconstructed using a variety of techniques, including ileal tapering with ileoneocystostomy, ileal tapering with ileoureteral anastomosis, i[eocecal cystoplasty, sigmoid cystoplasty with ureterosigmoid tunneling, ileoneocystostomy with nipple formation, ureteroureteral reanastomosis, and creation of a neourethra with ileocecal cystoplasty. In a follow-up from 14 m o to 11 yr, ten of the 11 reconstructions have been successful. The authors are optimistic that m a n y more patients will be candidates for successful urinary tract rehabilitation.-- S. Kim
The De-epithelialised Overlap Flap Technique in the Repair of Hypespadias. D. Smith. Br. J. Plastic Surg. 26:106-114 (April), 1973.
The a u t h o r describes his m e t h o d of hypospadias repair and reports that 51 cases were successfully treated with only one fistula. At the first stage the ventral chordee is corrected. The prepuce is split and the skin is swung a r o u n d to cover the skin defect on the underside and to provide sufficient skin for the second stage. At
ABSTRACTS
this operation a skin tube is formed for the urethra and it is covered by overlapping skin flaps. The epithelium of the deeper flap is removed over an area 4 5 m m from its edge. Initially perineal urethrostomies were undertaken and then abandoned. In addition to this, he claims other advantages in the operation. The new external orifice is more stable, there is a uniform lumen to the urethra without redundancy, and fistula formation is rare. A. Jolleys
Crypto-Hypospadias. A Review of 38 Cases. W. R. Dickie and C. Sharpe. fir. J. Plastic Surg. 26: 227-234 (July), 1973.
The term " C r y p t o h y p o s p a d i a s " is used to replace the various names, such as congenital short urethra, which have been previously used. The incidence is discussed, and the varieties are described. Abnormalities of the raphe are frequently found and the treatment is discussed. Two operations are described for the correction of the chordee. In the two-stage procedure, the urethra and corpus s p o n g i o s u m are divided just proximal to the corona. The defect is covered with skin moved medially leaving a defect in the urethra, which is repaired at the second stage either by a Denis Browne-type operation or a complete repair. Satisfactory results have been achieved, either with a perineal urethrostomy or an indwelling urethral catheter for drainage. In the one-stage operation, the urethra is left intact, and only the fibrous tissue is removed. The shortage of skin on the ventral aspect is corrected by the normal surgical devices. The one-stage operation can be performed at l yr of age and is being increasingly used. The two-stage operation is reserved for the m o r e difficult cases.--A. Jolleys
A Chromosome Abnormality in Hypospadias Patients. G. Lupo, M. Lupo, C. Magnany, and M. Bergamaschi. Br. J. Plastic Surg. 26:235-237 (July), 1973.
O n e h u n d r e d thirty-four hypospadiac patients have been examined and 109 showed deletion of material from one of the c h r o m o s o m e s in pair 20. This report does not agree with other reported investigations. A. Jolleys
Congenital Atresia of the Uterine Cervix. W. L. Geary and J. C. Weed. Obstet. Gynecol. 42:213217 (August), 1973.
Four cases of uterine cervical atresia are reported, each being noted at adolescence or
cluded bleeding from the conduit, ureteroileal stenosis, and uremia with hypertension. In 49 cases, the IVP preoperatively and postoperatively remained normal or improved. Of 63 n o r m a l kidneys preoperatively, 44 remained n o r m a l after diversion, 14 h a d mild pyelonephritic changes, tour had deterioration, and one became nonfunctioning. Six o f nine caliectatic kidneys remained unchanged and three returned to normal. Thirty-eight of 66 kidneys with mild to moderate hydronephrosis improved and 18 remained unchanged. Fifteen of 20 with severe hydronephrosis improved, four remained unchanged, and one deteriorated. In 63 patients with 75~o to 100~o of n o r m a l renal function, there was no change. In eight patients renal function decreased to fair and in four it was poor. In the patients in w h o m preopera~.ive renal function was only fair, a little more than half improved and the rest were unchanged. Based on a 12-mo to 12-yr follow-up, the a u t h o r s feel that ileal conduits have proved to be an extremely satisfactory m e t h o d of urinary diversion. --S. Kim
Urinary Tract Reconstruction Following Ileal Conduit Diversion. S. P. Dretler, W. H. Hendren, and W, F. Leadbetter. J. Urol, 109:217-224 (February), 1973.
This is a report of 11 patients previously undergoing ileal conduit diversion in w h o m the urinary tract was reconstructed using a variety of techniques, including ileal tapering with ileoneocystostomy, ileal tapering with ileoureteral anastomosis, i[eocecal cystoplasty, sigmoid cystoplasty with ureterosigmoid tunneling, ileoneocystostomy with nipple formation, ureteroureteral reanastomosis, and creation of a neourethra with ileocecal cystoplasty. In a follow-up from 14 m o to 11 yr, ten of the 11 reconstructions have been successful. The authors are optimistic that m a n y more patients will be candidates for successful urinary tract rehabilitation.-- S. Kim
The De-epithelialised Overlap Flap Technique in the Repair of Hypespadias. D. Smith. Br. J. Plastic Surg. 26:106-114 (April), 1973.
The a u t h o r describes his m e t h o d of hypospadias repair and reports that 51 cases were successfully treated with only one fistula. At the first stage the ventral chordee is corrected. The prepuce is split and the skin is swung a r o u n d to cover the skin defect on the underside and to provide sufficient skin for the second stage. At
ABSTRACTS
this operation a skin tube is formed for the urethra and it is covered by overlapping skin flaps. The epithelium of the deeper flap is removed over an area 4 5 m m from its edge. Initially perineal urethrostomies were undertaken and then abandoned. In addition to this, he claims other advantages in the operation. The new external orifice is more stable, there is a uniform lumen to the urethra without redundancy, and fistula formation is rare. A. Jolleys
Crypto-Hypospadias. A Review of 38 Cases. W. R. Dickie and C. Sharpe. fir. J. Plastic Surg. 26: 227-234 (July), 1973.
The term " C r y p t o h y p o s p a d i a s " is used to replace the various names, such as congenital short urethra, which have been previously used. The incidence is discussed, and the varieties are described. Abnormalities of the raphe are frequently found and the treatment is discussed. Two operations are described for the correction of the chordee. In the two-stage procedure, the urethra and corpus s p o n g i o s u m are divided just proximal to the corona. The defect is covered with skin moved medially leaving a defect in the urethra, which is repaired at the second stage either by a Denis Browne-type operation or a complete repair. Satisfactory results have been achieved, either with a perineal urethrostomy or an indwelling urethral catheter for drainage. In the one-stage operation, the urethra is left intact, and only the fibrous tissue is removed. The shortage of skin on the ventral aspect is corrected by the normal surgical devices. The one-stage operation can be performed at l yr of age and is being increasingly used. The two-stage operation is reserved for the m o r e difficult cases.--A. Jolleys
A Chromosome Abnormality in Hypospadias Patients. G. Lupo, M. Lupo, C. Magnany, and M. Bergamaschi. Br. J. Plastic Surg. 26:235-237 (July), 1973.
O n e h u n d r e d thirty-four hypospadiac patients have been examined and 109 showed deletion of material from one of the c h r o m o s o m e s in pair 20. This report does not agree with other reported investigations. A. Jolleys
Congenital Atresia of the Uterine Cervix. W. L. Geary and J. C. Weed. Obstet. Gynecol. 42:213217 (August), 1973.
Four cases of uterine cervical atresia are reported, each being noted at adolescence or