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Buccal mucosa onlay grafts for urethral reconstruction in hypospadias repair seem to provide stable long-term results, with complications occurring primarily during the first 12 months postoperatively.

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Nephron sparing surgery for centrally located kidney tumors is technically feasible and associated with an acceptable complication rate. Local tumor control is excellent, and the overall prognosis depends on contralateral disease and metastasis. Benign tumors may be diagnosed and removed without loss of the kidney. By avoiding hemodialysis quality of life is improved.

Objective To investigate the histological and immunohinecrosis and two ulcerations. Conversely, the 10 buccal mucosal grafts had fewer pathological findings stochemical behaviour of free buccal mucosa and fullskin grafts after exposure to urine.(three minimal inflammation and three with scars) and a pronounced similarity on immunoMaterials and methods A buccal mucosal graft and a full-skin graft were freely transferred into the bladder histochemistry. Conclusion The buccal mucosal graft showed signifiof 12 minipigs, after stripping the bladder mucosa. Endoscopic investigations were carried out 2 and 5 cantly fewer adverse histopathological findings after long-term exposure to urine than the full-skin graft months after surgery, and the grafts examined after death at 7 months, both histologically and immunohiand is therefore a preferable material for urethral reconstruction. stochemically.Results Shrinkage of the full-skin graft was apparent Keywords Free-tissue transfer, buccal mucosa, skin graft, urethral reconstruction endoscopically in five cases. Of the nine full-skin grafts, four showed severe inflammatory reactions, two the histological and immunohistochemical pattern of

Objective To report a one‐stage procedure, using a segment of caecum, both to overcome failed previous procedures and for primary vaginal replacement in patients with congenital vaginal aplasia, where primary reconstruction often results in vaginal obstruction and fistula formation. Patients and methods The vagina was reconstructed using a 15‐cm isolated caecal segment placed between the bladder and rectum and anastomosed to the introitus. Between 1985 and 1997 the technique was used in 17 patients (mean age 23 years). Indications included congenital malformations and vaginal loss through anterior exenteration or trauma. Seven of the 17 patients had undergone previous complex reconstructions; four of these had undergone previous fistula formation. Fourteen patients were followed for a mean of 3.6 (1–9) years. The surgical outcome was evaluated using a questionnaire completed by the patients. Results The postoperative course was unremarkable in all patients. Four patients developed an introital stenosis requiring surgical intervention. Two patients were minors at the time of follow‐up, while all the others had had sexual intercourse and reported that they were very satisfied with the functional and cosmetic result. Conclusion In patients in whom previous vaginal reconstruction has failed, the caecal segment should be used to create a neovagina. By considering the patient’s age, the surgeon can optimize the surgical result.

After failure of conservative treatment in patients with neurogenic bladder urinary diversion represents a safe long-term compromise. Daytime and nighttime continence is provided by the Mainz pouch bladder substitution and urinary diversion, while the upper urinary tract is protected by antireflux ureteral implantation.