The state of continence with the laparoscopic technique in high anorectal malformations in this study showed acceptable results but needs bigger series with longer follow-up for a proper evaluation of this technique.
Two doses factor concentrate and gelatin sponge application were generally enough to prevent bleeding after circumcision of severe hemophilia A. Circumcision and low-dose FVIII protocol were not an additional risk for development of high-titer inhibitor.
Background: Persistent cloaca or cloacal anomalies represent a special category of anorectal anomalies affecting the female sex with a reported incidence of about one in 25,000 live birth. The study included 34 cases of cloaca that were managed at our unit between 2003 through 2017. We retrospectively reviewed patients' records that included clinical presentation, investigations, operative data, and follow-up notes. Anatomically, we stratified cloaca into three types according to the level of urogenital confluence. A low confluence (type 1) was defined by being at or below the level of the lower border of pubic symphysis with a short common channel (11 cases). A high confluence (type 3) was defined by being at or above the level of the upper border of pubic symphysis (9 cases). Between the low and high types, we defined an intermediate type (type 2) where the urogenital confluence was behind the mid-portion of pubic symphysis (14 cases). Results: Renal anomalies were common association: solitary kidney in seven, pelvic kidney in two, and urinary tract dilatation (hydroureteronephrosis) in 12 cases. At follow-up, chronic renal insufficiency was detected in seven cases The prognosis for urinary continence was excellent in low confluence (type 1) cloaca. On the other hand, urinary incontinence was common among type 3 (high confluence) cloaca (62.5%). Conclusion: Renal anomalies represent a common association with cloaca and a major cause of morbidity. Efforts should be directed to preserve renal function during the initial management, and to preserve the continence potential following the definitive repair. Level of evidence: This is a case series with no comparison group (level IV).
Background
Undescended testis or cryptorchidism is one of the most common congenital abnormalities of the genitourinary system in young boys, approximately 1-2% of boys at the age of 1 year have undescended testis, the disorder being unilateral in about 90% of cases and bilateral in about 10%.
Aim of the Work
We conducted this prospective study to assess the efficacy and safety of single-incision, transscrotal orchidopexy in children with palpable UDT.
Patients and Methods
A prospective study was adopted to fulfill the purpose of the study. The study was conducted at Pediatric Surgery Department, Ain Shams University Hospitals in Cairo. The included study population was pediatric patients with palpable, inguinal mal-descended testes who attend to Pediatric Surgery Outpatient Clinic, Ain Shams University Hospital till the fulfillment of the sample size.
Results
The most common sites of undescended testis were intracanalicular and scrotal neck regions. The most common postoperative complication was scrotal edema. Mean operating time was 21 minutes. There was no significant difference in the testicular size pre and post operative.
Conclusion
Based on these results, we concluded that the undescended testis represents a common pediatric problem requiring surgical intervention. Trans-scrotal orchidopexy is an effective, less invasive and highly acceptable cosmetically approach for the treatment of palpable undescended testis.
Background: The goal of the surgical management of gastroschisis is to return the bowel into the abdomen without jeopardizing the viscera. Primary fascial closure (PFC) was historically favored due to improved outcomes. Aim of the work: To prospectively analyse the outcomes of primary closure of gastroschisis using Spatulated Umbilical Cord (SUC) technique, and compare with the retrospectively-collected outcomes of patients who underwent PFC.
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