The advent of totally internal ureteric stents has the potential to reduce hospital stay in paediatric pyeloplasty. Traditionally, discharge from hospital has followed removal of an external trans-anastomotic drain, usually 5 days to a week post-operatively. The use of totally internal catheters negates the need for nursing supervision by removing external attachments that a paediatric patient might inadvertently dislodge. The length of hospital stay for pyeloplasty using a Double-J ureteric stent was compared with our previous method of trans-anastomotic feeding tube nephrostomy drainage. The results show the use of Double-J stenting to be advantageous in paediatric pyeloplasty by decreasing considerably the length of hospital stay. This is clearly of benefit to the patient, who returns to the family setting much earlier. Despite the need for an outpatient endoscopic procedure to remove the stent, savings in treatment costs and improved efficiency of bed use are also achieved.
We report on 3 patients with a midline sinus extending from the skin overlying the pubis to the anterior wall of the bladder. Two sinuses were lined by transitional epithelium. The sinuses were surrounded by bundles of smooth muscle and lacked any inflammatory reaction, which suggests a developmental origin. Possible etiological causes for this unusual congenital anomaly are discussed. We conclude that these sinuses may represent a variant of epispadiac duplication of the urethra.
Perineal hernia is a rare complication of pelvic surgery. Women are more commonly affected, and development of the condition is usually gradual. Although the true incidence of this problem is unknown, few cases are severe enough to require operative repair. We report the experience of one of the authors (E.S.R.H.) in postproctectomy perineal hernia. One case required surgical repair and is presented, with a discussion of the operative management.
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