Purpose: Megaprepuce is a congenital penile malformation that includes phimosis and severe ballooning of the internal prepuce. We combined the main technical details of 2 previously reported surgical techniques to simplify the surgical approach. We report the key points of this revisited surgical correction for megaprepuce and the long-term results.Materials and Methods: Penile reconstruction was performed between March 2004 and March 2009 in 26 children 2 to 19 months old (median age 6) with congenital megaprepuce. Surgical repair consisted of limited preputial resection of the phimotic ring, wide dissection of the outer prepuce to the base of the penis, fixation of the proximal outer prepuce to Buck's fascia to create a new penoscrotal junction, and unfurling and wide tailoring of the inner prepuce in the ventral midline to resurface the whole elongated penile shaft. A bladder catheter was left in place for 5 or 6 days. Only patients with at least 6 months of followup were included in analysis.Results: All patients underwent surgery on an outpatient basis. Operative time was between 50 and 85 minutes. Median followup was 17.6 months (range 6 to 59). Two patients had slight dehiscence of the ventral suture, which healed spontaneously without a scar. In 1 patient transient urethral meatal stenosis developed. The final cosmesis result was adequate in all patients.Conclusions: It is possible to correct megaprepuce and achieve an adequate genital aspect with a simple approach of resurfacing the penis with the unfurled, tailored inner prepuce.

Purpose We present our experience in the posterior bladder approach using laparoscopic techniques to place an Artificial Urinary Sphincter (AUS). Material and Methods : From 1990 to 2006. 132 pediatric patients with urinary incontinence underwent artificial urinary sphincter placement. In the last 4 years we used the posterior laparoscopic bladder approach in 8 patients to dissect the bladder neck under direct vision. There were 6 female and 2 male patients with a mean age of 8,7 years (range:3-20) and mean weight of 29,5 kg (range:14-72). The etiology of incontinence in all the patients was myelodysplasia. 3 patients had simultaneous surgical procedures. In 2 cases a laparoscopic Malone procedure was done and in the third we performed a subureteral endoscopic injection of bulking agent. After a complete laparoscopic exposure of the posterior and lateral walls of the bladder neck, a Phannestiel incision was made to place the components of the AUS-800. Results The mean follow up was 23 months (range:3-38). The average surgical time was 188 minutes (range 145-220), mean oral feeding begun at 17,4 hs postop. (range 3-24) and hospital stays from operation until discharge were 1,4 days (range 1-2). We had no intraoperative complications. One patient presented with a bilateral uretero vesical obstruction after the cuff activation that required an extravesical reimplantation. Conclusions The laparoscopic dissection of the bladder neck is safe and secure. It is not technical demanding and it gives the possibility to dissect the posterior wall of the bladder neck under direct vision. The RESULTS in achieving continence are similar to those reported in the literature.

The role of laparoscopy in children with adrenal tumors has not been fully defined because of the low incidence and variability of this condition. We report our experience with laparoscopic adrenal surgery.

You have accessJournal of Urology1 Apr 2008RENAL TRANSPLANTATION WITH LIVE RELATED DONORS IN PEDIATRIC PATIENTS WITH SEVERE LOWER URINARY TRACT DYSFUNCTION AND AUGMENTED BLADDERS Eduardo Ruiz, Juan Moldes, Javier Escalante Cateriano, Francisco de Badiola, Carlos Giuseppucci, Mauricio Urquizo Lino, Carlos Favre, Carlos Giudice, Edurne Ormaechea, and Jorge Ferraris Eduardo RuizEduardo Ruiz More articles by this author , Juan MoldesJuan Moldes More articles by this author , Javier Escalante CaterianoJavier Escalante Cateriano More articles by this author , Francisco de BadiolaFrancisco de Badiola More articles by this author , Carlos GiuseppucciCarlos Giuseppucci More articles by this author , Mauricio Urquizo LinoMauricio Urquizo Lino More articles by this author , Carlos FavreCarlos Favre More articles by this author , Carlos GiudiceCarlos Giudice More articles by this author , Edurne OrmaecheaEdurne Ormaechea More articles by this author , and Jorge FerrarisJorge Ferraris More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(08)61204-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "RENAL TRANSPLANTATION WITH LIVE RELATED DONORS IN PEDIATRIC PATIENTS WITH SEVERE LOWER URINARY TRACT DYSFUNCTION AND AUGMENTED BLADDERS." The Journal of Urology, 179(4S), p. 411 © 2008 by American Urological AssociationFiguresReferencesRelatedDetails Volume 179Issue 4SApril 2008Page: 411 Advertisement Copyright & Permissions© 2008 by American Urological AssociationMetricsAuthor Information Eduardo Ruiz More articles by this author Juan Moldes More articles by this author Javier Escalante Cateriano More articles by this author Francisco de Badiola More articles by this author Carlos Giuseppucci More articles by this author Mauricio Urquizo Lino More articles by this author Carlos Favre More articles by this author Carlos Giudice More articles by this author Edurne Ormaechea More articles by this author Jorge Ferraris More articles by this author Expand All Advertisement PDF downloadLoading ...