Opposite gender should not be assigned in patients affected by penile agenesis, who are better raised according to their karyotype and hormonal production. Definitive phalloplasty in adults may achieve good results. Nevertheless, this procedure is generally performed in postpubertal boys and it is not easily available everywhere. Therefore, we believe that social and psychological concerns justified this type of phalloplasty as a palliative preliminary procedure in 3 of our patients. In those countries where definitive forearm phalloplasty is not available our method may also be justified in older children (as in 1 of our patients) as an attempt at a definitive procedure.
Seventeen cases of a solitary polyp of posterior urethra in children (ages ranged between 4 months and 12 years) are presented. All patients were treated endoscopically using a 10 Fr. pediatric cystoscope, equipped with a straight ahead lens, and a Bugbee 3 Fr. electrode to fulgurate the stalk of the polyp through the urethra, without meatotomy. No complications or relapses are recorded, which proves the safety and the efficiency of the transurethral endoscopic resection in all pediatric ages. With the exception of one case, the smallest polyp of the series, lost because entirely burnt during the electrocution, all polyps were recuperated and examined histologically. The dimensions of the polyps ranged from 4 mm to 27 mm length. Their shape varied from a long "cordon-like" peduncle to a short stalk, "balloon-like" appendix. The histologic features were similar, the main component was an axis of connective tissue and vessels, surrounded by transitional epithelium, usually described as a fibroepithelial polyp.
The results of the present study define the long-term risk of ESRD in a large population of children with CRF and VUR, and provide some critical information for identifying the prognosis.
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