[Penile congenital abnormalities]. / Les malformations congénitales du pénis.

INTRODUCTION: Congenital abnormalities of the penis are usually diagnosed at birth and pose aesthetic and functional problems sometimes requiring surgical management. METHODS: A literature review was conducted on Medline considering the articles listed until January 2012. RESULTS: Hypospadias is the most common malformation (1 in 250 boys. Familial forms: 7%). The causes remain hypothetical but the doubling of the incidence in 30 years could be linked to fetal exposure to endocrine disruptors "estrogen-like" used in the food industry in particular. Surgical treatment is usually intended to improve the aesthetic appearance but sometimes, in case of significant curvature or posterior meatus, necessary for normal sexual life and fertility. Other malformations (epispades, buried penis, transpositions, twists and preputial abnormalities) as well as management for functional or aesthetic consequences of these malformations in adulthood require complex surgical care in a specialized environment. CONCLUSION: The improvement of surgical techniques and pediatric anesthesia allows an early and effective specialized surgical approach of penile malformations. Management of sequelae in adulthood must be discussed and requires experience of surgical techniques on pediatric and adult penis.

[Gastrointestinal system duplications in children (19 cases)]. / Les duplications digestives chez l'enfant (à propos de 19 cas).

UNLABELLED: Digestive duplications are a rare condition in children, characterized by an important anatomoclinical polymorphism. Diagnosis suspected on clinics and evoked by radiology, require histological confirmation. PATIENTS AND METHODS: Nineteen children with duplications were managed in our department, from 1989 to 2001: their hospital chart was retrospectively studied. RESULTS: Ten of our patients were less than one year of age, ten were boys and nine were girls. Clinical signs consisted of pain and abdominal mass, with some transit disturbs, and these signs led to ultrasonography and tomodensitometry. In one case alimentary tract duplication was revealed by digestive hemorrhage, leading to scintigraphic study. The digestive duplications were localized on the stomach in one case, the duodenum in two cases, the jejuno-ileum in twelve cases, the colon in two cases, and the rectum in two cases. Five digestive duplications were tubular, with one communicating duplication. All cases benefited from surgical treatment, and resection procedure was chosen according to duplication type and site. Histological study showed eight cases of ectopic mucosa, six ectopic gastric mucosa and two pancreatic ectopic mucosa. CONCLUSION: Diagnosis and surgical precocious treatment of digestive duplications are the only way to warn complications of this benign pathology.

[Treatment of anterior hypospadias: comparison of modified Mathieu and Duplay techniques (report of 840 children)]. / Traitement de l'hypospadias antérieur: comparaison de la technique modifiée de Mathieu au Duplay (à propos de 849 enfants).

PURPOSE: The objective of this study is the comparison of 2 surgical procedures in the treatment of primary anterior hypospadias including the evaluation of short-term and long-term results. PATIENTS AND METHODS: A retrospective study of the results of the modified Mathieu procedure performed in 392 patients presenting with previously untreated anterior hypospadias at one center by the same experienced surgeon is compared with the results of the modified Duplay procedure performed in 457 patients in a second center by a second experienced surgeon, both series spanning a period of 10 years. RESULTS: Follow-up ranged from 21 months to 10 years. Overall, 7 of 392 patients (1.7%) treated by the Mathieu procedure had complications requiring surgery compared to 32 of 457 patients (7%) treated by the Duplay procedure, a difference that is statistically significant (P < 0.05). Patient satisfaction was excellent in both groups and cosmetic results were considered satisfactory by the parents in all 843 patients. CONCLUSION: Both the modified Duplay and the Mathieu techniques are reliable procedures with reproducible results, a minimal risk of fistula formation as well as excellent cosmetic and functional results.

[Appendix-ureteroplasty in a child: report of a case]. / L'urétéro-appendiculoplastie chez l'enfant: à propos d'un cas.

The use of vermiform appendix as a tube to replace right ureteral segment has been reported, rarely in child. Herein is reported a case of right ischemic ureteral stenosis following a reimplantation of the ureter for high grade reflux secondary to posterior urethral valves with only one functioning kidney. A long ureteral defect was bridged successfully by appendix interposition and then reimplanted in the bladder at four years of age. The interest of ureteroappendiculoplasty provides temporary solution to repair long ureteral defect, in spite of uncertain future, especially in childhood.