Primary hypospadias repair outcomes: results from a retrospective cohort of 292 children.

PURPOSE: Hypospadias surgery is challenging. Numerous techniques have been described with variable complication rates. The main objectives of our study were to evaluate the urethroplasty complication rate of primary hypospadias repair and to identify risk factors for complications. METHODS: We retrospectively evaluated the outcomes of all patients who underwent primary hypospadias repair in our department between January 2012 and December 2020. Demographic, anatomical, operative, and postoperative data were reported. Univariate and multivariate logistic regression analyses were performed to identify variables associated with complications. Statistical significance was set at p < 0.05. RESULTS: Of 292 patients, 203 (69.5%) had distal hypospadias, 63 (21.6%) had mid-penile hypospadias, and 26 (8.9%) had proximal hypospadias. The mean age at the time of surgery was 22.8 months. Seventy-eight patients (26.7%) had urethroplasty complications. The rate of complications was higher for proximal hypospadias (57.7%), onlay island flap (44.4%), and Koyanagi (75%) procedures. The mean follow-up duration was 29 months. Two predictors of complications were identified by multivariate analysis: catheterization duration and urethroplasty technique. The reoperation rate was 30.5%. CONCLUSION: Urethroplasty complications frequently occur after primary hypospadias repair. The complication rate was higher in proximal hypospadias. Catheterization duration and surgical technique were significant predictors of complications. A longer and more standardized follow-up is needed for a better assessment of hypospadias repair outcomes.

Effect of hydroxyurea exposure before puberty on sperm parameters in males with sickle cell disease.

Sperm parameters are known to be impaired in men with sickle cell disease (SCD). Although treatment with hydroxyurea (HU) has an impact on sperm quality, sperm preservation is impossible before puberty. This study's primary objective was to analyze and compare sperm parameters in male patients with SCD exposed (or not) to HU before puberty. Twenty-six sperm samples from 15 patients (median age, 17 years; range, 16-23) treated with HU during childhood were compared with 46 samples from 23 HU-naïve patients (20 years; 16-24). The median age at HU initiation was 6 years (1-14 years), the median duration of HU treatment was 4 years (0.5-10), and the mean dose of HU was 22.4 ± 3.7 mg/kg per day. Although we observed substantial quantitative and qualitative semen abnormalities in all patients, there were no significant differences in semen volume, sperm concentration, total sperm count, or spermatozoa motility, morphology, and vitality between the HU-exposed and HU-naïve groups. At the time of the semen analysis, 100% of the patients in the HU-exposed group and 52% of the patients in the HU-naïve group received transfusion therapy. The specific effect of HU on spermatogenesis in very young infants and the putative value of transfusion for reversing the toxicity of HU warrant further investigation.

Occupational risk factors associated with lymphoid malignancies in Benin City, Nigeria.

AIM: This study is designed to identify the associated occupations most at risk of developing lymphoid malignancies. PATIENTS AND METHODS: The medical records of all lymphoid malignancy cases seen in University of Benin Teaching Hospital between July 2001 and June 2010 were retrieved from medical record library. The patient's bio-data, occupational, social and past medical history and pathologic subtypes were extracted. RESULTS: A total of 252 patients records with diagnosis of lymphoid malignancies were reviewed in this study. Farmers (20.6%) and students (38.9%) form the majority of the cases seen and both showed statistically significant association with risk of LM (p<0.0001) CONCLUSION: This study revealed that agricultural workers and students in Benin City are at higher risk of developing lymphoid malignancies. Although previous studies have implicated agricultural exposure, the same cannot be said about students. It is therefore recommended that a follow up study should be conducted to ascertain the possible environmental, nutritional, social/lifestyle stressors that put students in Benin City at higher risk of lymphoid malignancies.

[The non-neurogenic neurogenic bladder (Hinman's syndrome) in children: What are pronostic criteria based on a 31 cases multicentric study]. / Critères pronostics du syndrome de Hinman (vessie neurogène non neurogène). Etude multicentrique de 31 cas.

PURPOSE: To identify in children the pejorative estimated criteria of a extreme dysfunctional voiding can leading to a Hinman syndrome. PATIENTS AND METHODS: Retrospective and multicentric study of 31 patients (19 boys and 12 girls), resulting from three universitary medical center (Besancon, Lyon, Nantes), which were divided into three groups according to their evolution: A - forms with a serious uronephrologic outcome. B - intermediate forms with persistent voiding dysfunction. C - forms with uneventful outcome. RESULTS: The initial urologic examination was done, on average, on 6.4 years old children (1-16) and the diagnosis at 12.2 years (1.8-26.9). Eighty-four percent of the patients presented initial urologic symptoms, including 35 % of enuresis and 48 % with large amount of stool in the rectal vault (constipation and encopresis in 93 %). Thirty-five percent undergoing significant familial life stresses. In group A, urinary incontinence was present in 29 %. Sixty-two percent were improved by an intermittent catheterisme and 50 % by anticholinergic drugs solely. In group B, 46 % presented major constipation or encopresis and 60 % an urinary infection. A voiding retraining and an intermittent catheterisme improved 71 and 75 % respectively. In group C, no patient presented initial low urinary infection, encopresis or stool impaction. The boys presented more febrile urinary infection (20 % vs. 8 %), more rectal disorders (encopresis: 31 % vs. 8 %) and less urinary incontinence. In this group voiding retraining improved 67 %. CONCLUSION: The Hinman's syndrome is a serious and unusual outcome of the "dysfunctional elimination syndrome". At diagnosis, the patterns of a pejorative outcome are the male sex, the severe fecal retention, the serious psychological disorders, the delay of diagnosis and treatment.

[Place of the ureteroscopy in the treatment of the children urolithiasis]. / Place de l'urétéroscopie dans le traitement de la lithiase chez l'enfant.

OBJECTIVE: To determine the efficiency and the role of ureteroscopy in the treatment of urolithiasis in children. METHODS: A multicenter retrospective study was conducted between January 2006 and March 2008 in the department of pediatric surgery and urology of Besançon, Lyon and Grenoble. The clinical data of 17 children having benefited from one or more ureteroscopy procedures for urolithiasis were analyzed. These data concerned age, sex, antecedents of metabolic diseases, existence of a malformed uropathy, how the urolithiasis was discovered, therapeutic indications, endoscopic procedures, type of endoscopic treatment for urolithiasis, results and complications. RESULTS: Twenty-six ureteroscopies were carried out for 17 children (eight girls and nine boys) aged between 9 months and 12 years (mean: 5 (1/2) years old) as a first-line treatment or after extracorporeal shock wave lithotripsy. A 6/7,5 Fr semi-rigid ureteroscope was used in all case. Only once, the operator chose a flexible ureteroscope. Lithotripsy was carried out 15 times with YAG Holmium laser, four times with Swiss Lithoclast and six times by simple extraction with a Dormia type basket .A stent probe was left in place after endoscopy for 14 children. The "stone free" rate was 88% with an average hindsight of 11 months. Two incidents without major complication were recorded: a section of the guide by the laser beam and a perforation with extravasation of the contrast agent. CONCLUSION: Ureteroscopy is the first-line treatment in isolated ureteral urolithiasis. On the other hand, LEC remains the treatment of choice for Starghon calculi, since LIC should be offered only in the event of failure of LEC.

Secondary metabolites from Senecio burtonii (Compositae).

A cacalolide derivative named 4alpha-[2'-hydroxymethylacryloxy]-1beta-hydroxy-14-(5-->6) abeo eremophilan-12,8-olide and a shikimic acid derivative named (3'E)-(1alpha)-3-hydroxymethyl-4beta,5alpha-dimethoxycyclohex-2-enyloctadec-3'-enoate along with three known compounds, octacosan-1-ol, 3beta-hydroxyolean-12-en-28-oic acid and 3beta-acetoxyolean-12-en-28-oic acid were isolated from Senecio burtonii. Their structures and relative configurations were established on the basis of spectroscopic analysis.

Sesquiterpene lactones from Crepis cameroonica (Asteraceae).

In addition to one known compound, 3beta,8alpha-dihydroxyguaian-4(15),10(14),11(13)-trien-6,12 olide (8-desacylcynaropicrin) (3), two new sesquiterpene lactones have been isolated from the aerial parts of Crepis cameroonica. By means of spectroscopic analysis, the structures and relative configurations of the new compounds were established as 3beta,9beta-dihydroxyguaian-4(15),10(14),11(13)-trien-6,12 olide (1) and 8alpha-hydroxy-4alpha(13),11beta(15)-tetrahydrozaluzanin C (2). The in vitro antimicrobial spectrum of pure compounds and crude extracts are also reported.

[Superior mesenteric artery syndrome: a cause of vomiting in children. Report of 3 cases]. / Syndrome de l'artère mésentérique supérieure: une cause à évoquer devant des vomissements isolés chez l'enfant. A propos de 3 observations.

Duodenal obstruction by Superior Mesenteric Artery (SMA) is a misdiagnosed vomiting syndrome in children. Several factors are involved, including rapid weight loss, rapid statural growth without weight augmentation. Diagnosis is suspected when an improvement is achieved by ventral decubitus and it is confirmed by plain films of the abdomen, GI study with barium and echography, measuring the aortomesenteric angle (inferior to 25-30 degrees ). Patients must at first be treated conservatively. Surgery is indicated for occlusive episodes with unsuccessful conservative therapy. The authors report 3 cases with different clinical presentation. However, all the patients presented important weight loss and vomiting.

Grinding as a method of meat texture evaluation.

An electric grinder equipped with a torque/speed sensor was used to evaluate maximum grinding torque (T(max)) and total energy (TE) necessary to grind 150 g of uncooked meat. Texture profile analysis (TPA), relaxation and cutting tests were carried out and sample compositions were also determined. The degree of dependence between grinding, TPA, relaxation, cutting parameters and sample composition was checked. Results showed that grinding parameters (T(max) and TE) correlated better with TPA, relaxation and cutting parameters than with composition. In particular correlation coefficient of -0·92, -0·92 and 0·97 were obtained, respectively, between T(max) and relaxation percentage (%R), T(max) and destructuring coefficient at 25% conmpression (De(25)) and between T(max) and maximum cutting force (F(c)).