Trotz verbesserter Technik und technischer Ausstattung liegt die Komplikationsrate bei Hypospadiekorrekturen zwischen 20 und 30%. Verschiedene Aspekte wie Verbandstechnik und andere sind wesentlich für die Prävention von Komplikationen.

The complication rate of hypospadias repair still ranges between 20 and 30%, although operative skills and technical devices have improved. Different aspects like dressing are important for prevention of complications.Early complications are bleeding, hematoma, and infection. Late complications are fistulas, meatal stenosis, partial and complete breakdown, persisting curvature, a hairy urethra, and hypospadias cripples. Detailed preoperative diagnostics are important. There are several operative techniques that can be used for repair including the use of mesh graft or foreign material. Two or multiple stages are often needed. The surgery to correct complications after hypospadias repair is a challenge, which should only be done by an experienced surgeon.

Introduction: Endometriosis in postmenopausal women is rare, especially in the urinary tract. Only a few cases have been described. Case Report: A postmenopausal woman presented with left-sided ureteric obstruction. Intraoperatively an extrinsic endometriosis was found. In contrast to other cases, the patient had no history of endometriosis or estrogen therapy. Conclusion: This rare disease should also be considered in female patients in non-reproductive age with symptoms of unclear hydronephrosis.

INTRODUCTION:Endometriosis in postmenopausal women is rare, especially in the urinary tract. Only a few cases have been described.CASE REPORT:A postmenopausal woman presented with left-sided ureteric obstruction. Intraoperatively an extrinsic endometriosis was found. In contrast to other cases, the patient had no history of endometriosis or estrogen therapy.CONCLUSION:This rare disease should also be considered in female patients in non-reproductive age with symptoms of unclear hydronephrosis.

Manipulationen an der Harnrohre, gleich welcher Art, konnen schwerwiegende Komplikationen zur Folge haben. Die Operationsindikation sollte individuell und sehr sorgfaltig gestellt werden. Die Indikation zur Operation bei rein kosmetisch storenden Hypospadien ist unter dem Aspekt solch folgenschwerer Komplikationen sehr kritisch zu sehen und sollte mit den Eltern dezidiert besprochen werden. Wenn es nach einem Eingriff zu Problemen wie einer Blasenentleerungsstorung kommt, sollte primar eine Entlastung und Diagnostik erfolgen und erst im zweiten Schritt die entsprechende Therapie.

ss Open Acce Oral presentation Efficacy and safety of propiverine in cpomparison to oxybutynin in children with neurogenic detrusor overactivity: an observational study J Nounla*1, U Rolle1, H Madersbacher2, G Murtz3, S Alloussi4, M Beuke5, M Burst6, B Domurath7, T Henne8, I Korner8, A Niedeggen1, J Pannek1, M Schuldt1, H Schulte-Baukloh1, D Schultz-Lampel1, S Siemer1, T Stuckert1, B Willer1, P Bock1 and J Hanisch1

OBJECTIVE:The impact of storage solution composition on graft performance was evaluated following perfusion with either Euro-Collins (EC), low potassium Euro-Collins (rEC), low potassium dextran (LPD) or University of Wisconsin solution (UW) after brief (2 h) and extended ischemia (16 h) in an acute double lung transplantation model in the rat. METHODS:Following flush perfusion and ischemia the lungs were implanted in recipient rats allowing serial assessment of graft pulmonary vascular resistance (PVR) and alveolar arterial oxygen difference (AaDO2) during 120 min of reperfusion. Graft dynamic lung compliance (DLC) was determined by separate ventilation. Final evaluation included weight gain and histology. RESULTS:After extended ischemia LPD provided superior graft function in respect to DLC (repeated measures ANOVA; LPD versus rEC P < 0.05; versus EC P < 0.03; versus UW P < 0.05) and AaDO2 (LPD versus rEC P < 0.04; versus EC P < 0.006). The PVR was significantly lower in LPD versus UW (P < 0.05). At the end of reperfusion the weight increase amounted to 229 +/- 49% in rEC, 207 +/- 22% in EC, 115 +/- 22% in UW and 87 + 17% in LPD (LPD versus rEC P < 0.01, LPD versus EC P < 0.001). The type of preservation solution used had little impact on graft function after 2 h ischemia. CONCLUSIONS:Low potassium dextran provides superior graft function after extended ischemia. After short ischemia the type of preservation solution used in this study had little impact on global lung function.

To determine the importance of static lung inflation during storage, graft, performance was evaluated at different levels of intratracheal pressure and varying. ischemic intervals, Lewis rat lungs were perfused with low-potassium Euro-Collins and stored for 4 or 8 hr either in atelectasis (4 hr: group I; 8 hr: group IV, respectively) or 13 (group II; V) or 26 cmH(2)O of airway pressure (groups III, VI), Following implantation continuous measurement of alveolar-arterial oxygen difference (AaDO(2)*) and pulmonary vascular resistance (PVR) were performed, Separate ventilation allowed assessment of mechanical lung function of the graft, At the end of reperfusion (120 min) weight gain, histology, and phospholipid and protein content in the pulmonary lavage were compared between the groups, Despite significant differences in survival at 4 hr of ischemia graft function did not differ in groups I to III, In contrast, static inflation had a significant impact after 8 hr of ischemia, Lungs stored in. atelectasis (group IV) could not be reperfused and failed immediately, Survival in group V was 83+/-11 versus 107+/-7 min in group VI (P<0.05). Compliance at 80 min was 27+/-3 in group V and 52+/-6 ml/cmH(2)O in group VI (P<0.02). Corresponding values for PVR were 232+/-92 and 112+/-16 mmHg/ml/min, respectively (P<0.05). Less inflation and longer ischemia resulted in a reduction of the large to small phospholipid aggregate ratio and deterioration of surfactant function in the bubble surfactometer, In conclusion, while the amount of static lung inflation may not be critical following short ischemia, the performance of the graft improves significantly with full inflation (26 cmH(2)O) following extended ischemia (8 hr).

BACKGROUND:The high rate of reperfusion injury in clinical lung transplantation mandates significant improvements in lung preservation. Innovations should be validated using standardized and low-cost experimental models.METHODS:The model introduced here is analyzed by comparing global lung function after varying ischemic times (2, 4, 8, 16, and 24 hours). A rat double-lung block is flush-perfused, and the main pulmonary artery and left atrium are connected to the left pulmonary artery and vein of a syngeneic recipient using a T-shaped stent. With pressure side ports and incorporated flow crystals, measurement of vascular resistance and graft oxygenation can be performed. The transplant is ventilated separately, and compliance and resistance are determined.RESULTS:The increase in the ischemic interval from 2 to 24 hours caused an increase in the alveolar arterial oxygen difference from 220 +/- 20 to 600 +/- 34 mm Hg, pulmonary vascular resistance from 198 +/- 76 to 638 +/- 212 mm Hg.mL-1.min-1, and resistance to airflow from 274 +/- 50 to 712 +/- 30 cm H2O/L H2O, and a decrease in pulmonary compliance from 0.4 +/- 0.05 to 0.12 +/- 0.06 mL/cm H2O.CONCLUSIONS:This in situ, syngeneic rat lung transplantation model offers an alternative to large animal models for verification of lung preservation solutions and for modification of donor or recipient treatment regimens.