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1.
Pediatr Surg Int ; 26(8): 795-800, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20589381

RESUMO

PURPOSE: Though the Müllerian duct anomalies are rare in incidence, their variable age, and mode of presentation makes their management difficult. METHODS: In the last 10 years authors managed 14 patients with different types of Müllerian anomalies. There were eight patients with complete Müllerian agenesis: three of partial Müllerian agenesis, one patient had uterine didelphys with vertical and transverse vaginal septum on left side, one patient had uterine didelphys with cervical agenesis on the right side, one patient had MRKH with anorectal malformation. RESULTS: Patients with complete Müllerian agenesis underwent bowel vaginoplasty, and patients with partial Müllerian agenesis with hydrocolpos underwent pull-through vaginoplasty. Patient of uterine didelphys one with septum underwent septum excision and in another with cervical agenesis, cervix opened and drain kept. In MRKH with vestibular fistula, fistulous opening was kept as vaginal opening and rectum brought down as a neoanus. CONCLUSION: Müllerian duct anomalies can present in any age group and with variable symptoms. Sigmoid colon vaginoplasty is an excellent procedure for complete or partial Müllerian agenesis. Correct evaluation of these patients and proper management is a challenge.


Assuntos
Ductos Paramesonéfricos/anormalidades , Anormalidades Urogenitais/cirurgia , Adolescente , Adulto , Amenorreia/etiologia , Canal Anal/anormalidades , Canal Anal/cirurgia , Colo do Útero/anormalidades , Colo do Útero/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Laparoscopia , Resultado do Tratamento , Útero/anormalidades , Útero/cirurgia , Vagina/anormalidades , Vagina/cirurgia
2.
Pediatr Surg Int ; 25(3): 289-92, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19184054

RESUMO

Fetus in fetu is a rare disorder. Its embryopathogensis and differentiation from teratoma has not been well established. It is a parasitic twin of a diamniotic monozygotic twin. Here we report, two cases of fetus in fetu with review of literature. In case report 1, a 2-year-old boy was referred for asymptomatic lump in abdomen since birth. X-ray showed the mass in the abdomen with some calcification and fluid inside. CT scan reported a heterogenous mass in the retroperitoneum with bony malformation. CT showed presence of three vertebrae in it. After surgically excising the mass and opening the sac it showed presence of trunk and two limbs with one of the limbs having a nail. Histopathology showed presence of GI tract. In case report 2, 4 month female was found to have lump in the abdomen by housemaid while bathing. X-ray showed a soft tissue shadow while ultrasonography revealed cystic mass arising from right kidney. CT suggested cystic mass with calcification not arising from kidney. During exploration whole mass was excised and there was frank fetus inside it. Histopathology confirmed presence of four vertebral bodies with germ layers. Although fetus in fetu is rare condition, correct diagnosis using imaging can be made before surgery. Complete excision is curative.


Assuntos
Doenças em Gêmeos/cirurgia , Doenças Fetais/cirurgia , Feto/anormalidades , Feto/cirurgia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Gravidez , Gêmeos Monozigóticos
3.
Indian J Urol ; 25(2): 272-3, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19672367

RESUMO

Incidence of the undescended testis (UDT) along with hypospadias varies from 6 to 31%. The repair of UDT and hypospadias is rarely done simultaneously. Here we present a novel technique that uses processus vaginalis as vascular cover for neourethra in hyposapdias patients with UDT. We have done urethroplasty and orchiopexy simultaneously. This is the first report of processus vaginalis being used to reinforce the urethra.

4.
Indian J Surg ; 74(2): 184-5, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23542124

RESUMO

Mesenteric cyst is one of the uncommon childhood tumors. Mostly they are asymptomatic. Some of them present with non specific abdominal symptom like chronic abdominal pain very rarely they present as acute abdomen like torsion or intestinal obstruction. We are reporting a very rare presentation of Mesenteric cyst as an irreducible inguinal hernia.

5.
J Indian Assoc Pediatr Surg ; 16(4): 158-9, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22121317

RESUMO

We report a novel surgical technique for correction of dorsal chordee with coronal hypospadias. The bulbar elongation and anastomotic meatoplasty procedure gave an excellent cosmetic and functional outcome.

6.
Urology ; 75(6): 1476-80, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19913889

RESUMO

OBJECTIVES: To find appropriate ureteric substitute in the pediatric age group. METHODS: Retrospective analysis was done from 2003 to 2008 of all patients operated in our hospital who had undergone ureteric replacement. All cases were followed up to find conduit patency, renal function, and any related complication. RESULTS: Ureteric replacement was performed in 5 cases. Age of the patients ranged from 6 months to 9 years. Three cases were of obstructive megaureter; 1 of redo-pyeloplasty and 1 of iatrogenic injury of the ureter. Three patients underwent partial ureteric substitution of the right ureter, and complete replacement of the left ureter with appendix was performed in 1 patient. In 1 case small bowel was used as Monti tube to substitute the ureter. At median follow-up of 23 months (14-66 months) all patients were well except 1 whose kidney function had deteriorated. CONCLUSIONS: We believe that our small series supports that either appendix or small bowel should be considered as Monti's tube for ureteric replacement when confronting with short ureter in pediatric age group.


Assuntos
Apêndice/transplante , Íleo/transplante , Procedimentos de Cirurgia Plástica/métodos , Ureter/patologia , Ureter/cirurgia , Anastomose Cirúrgica/métodos , Criança , Pré-Escolar , Feminino , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Hidronefrose/cirurgia , Lactente , Masculino , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Estudos de Amostragem , Resultado do Tratamento , Ureter/lesões , Obstrução Ureteral/diagnóstico , Obstrução Ureteral/cirurgia , Micção/fisiologia
7.
J Pediatr Surg ; 44(11): 2233-5, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19944240

RESUMO

PURPOSE: An ideal feminizing genitoplasty in aphallia should achieve good cosmesis and capacious vagina in a single-stage repair. Most of the techniques described in the literature are variations of the posterior sagittal approach with staged repair. We describe a single-stage anterior sagittal approach for feminizing genitoplasty in cases of aphallia. MATERIALS AND METHODS: A case of aphallia was operated through an anterior sagittal approach, and a spiral Monti tube of sigmoid colon was used to create a neovagina. Preservation of the skin tag around the urethra and its placement in the perineum gives it the appearance of the clitoris. RESULT: The patient has been observed for 7 months. She is continent and has a satisfactory cosmetic appearance and capacious vagina. CONCLUSION: A single-stage operation through an anterior sagittal approach is a good alternative technique for genital reconstruction in the case of aphallia.


Assuntos
Transtornos do Desenvolvimento Sexual/cirurgia , Pênis/anormalidades , Procedimentos de Cirurgia Plástica/métodos , Anormalidades Múltiplas/cirurgia , Colo Sigmoide/cirurgia , Feminino , Humanos , Masculino , Períneo/cirurgia , Estruturas Criadas Cirurgicamente , Resultado do Tratamento
8.
Indian J Urol ; 25(3): 329-31, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19881125

RESUMO

CONTEXT: The incidence of undescended testis (UDT) along with hypospadias varies from 6 to 31%. The simultaneous repair of UDT and hypospadias is rarely done. Herein, we present a novel technique to use processes vaginalis as a vascular cover for neourethra in a hypospadias patient with UDT. We have done urethroplasty and orchiopexy simultaneously. This is the first report concerning the use of processes vaginalis to reinforce the urethra. AIMS: Simultaneous repair of hypospadias and undescended testis. RESULTS: Both the patients withstood the procedure well. Postoperative period was uneventful. Patients passed urine in single stream without any fistula. CONCLUSIONS: In patients of undescended testis with hypospadias, simultaneous repair with the processes vaginalis flap is an ideal technique with good results. Processes vaginalis is good vascular cover for neourethra.

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