29th Congress of the Italian Society of Neonatology - Lombardy section | Bergamo, 29-30 January 2016.

This abstract book contains the abstracts presented at the 29th Congress of the Italian Society of Neonatology - Lombardy section | Bergamo, 29-30 January 2016.

Urinary function after Snodgrass repair of distal hypospadias: comparison with the Mathieu repair.

PURPOSE: To evaluate urinary function in patients with distal hypospadias undergoing repair by the tubularized incised-plate urethroplasty (TIP or Snodgrass), compare the results with those in patients treated by the Mathieu technique, and show the potential issues inherent to the evaluation of such results. PATIENTS AND METHODS: A cross-sectional assessment was performed of uncomplicated distal hypospadias operated on during a 3-year period, already toilet trained, and able to void volitionally. Evaluation included clinical assessment urinary symptoms and urinary stream, and uroflowmetry. RESULTS: Out of 83 patients operated on during the study period, 10 (12%) developed complication and 32 were not toilet trained or refused to participate in the study. Median follow-up in the remaining 41 patients included in the study was 20 (3-36) months. None of these patients presented voiding symptoms or urinary stream abnormalities. Uroflowmetry was normal in 30 cases and obstructive in 11 (27%). An obstructive flow pattern was more common in patients undergoing TIP versus Mathieu repair, 8 of 19 (42%) versus 3 of 22 (14%), respectively (P = 0.07). Four TIP cases with an obstructive uroflow pattern were managed conservatively. CONCLUSIONS: Although both the TIP and the Mathieu repair allow good results in terms of urinary function after distal hypospadias repairs, the TIP technique seems more likely to be associated with urine flow pattern abnormalities. The actual clinical relevance of this finding remains ill defined.

Laparoscopic excision of urachal cyst in pediatric age: report of three cases and review of the literature.

OBJECTIVE: To determine the role of laparoscopic surgery in the treatment of pediatric urachal disorders. METHODS: Case reports and a literature review of laparoscopic excision of urachal remnants. RESULTS: In a five-year period, three children were diagnosed with urachal anomalies presenting as abdominal or urinary symptoms, and were treated by laparoscopic surgery. The average age was 8.3 years (range, 4-13),and there were two girls and one boy. Mean operative time was 90 minutes (range, 60-120), and there were nopostoperative complications. The three patients were all discharged by postoperative day four. CONCLUSION: Laparoscopy is an effective and safe minimally invasive technique in the management of pediatricurachal anomalies. It is effective even in cases of infected urachal cysts.

30th Congress of the Italian Society of Neonatology - Lombardy section | Bergamo, 3-4 February 2017.

This abstract book contains the abstracts presented at the 30th Congress of the Italian Society of Neonatology - Lombardy section | Bergamo, 3-4 February 2017.

Lymphography prior to laparoscopic Palomo varicocelectomy to prevent postoperative hydrocele.

BACKGROUND: We report our experience with preoperative lymphography to identify and perioperatively preserve the ligature of the lymphatic vessels to reduce the incidence of postoperative testicular hydrocele in patients undergoing laparoscopic Palomo varicocelectomy for adolescent varicocele. MATERIALS AND METHODS: Twenty-seven consecutive patients with varicocele had preoperative lymphography. The mean age was 13.5 years (range, 8-18 years) and the mean grade of varicocele was III. We performed lymphography with intrascrotal isosulfan blue. The laparoscopic Palomo procedure was successfully carried out in all patients. RESULTS: In 17 patients (63%) we were able to identify and conserve the lymphatic vessels by lymphography. Mean follow-up was 9.5 months (range, 6-24 months). None of the 27 patients had a recurrence. None of the 17 patients with positive lymphography had a testicular hydrocele. One of the 10 remaining patients developed a sizable hydrocele. CONCLUSION: Preoperative lymphography prior to laparoscopic Palomo varicocelectomy is a simple and feasible method for preventing testicular hydrocele. However, the method should be standardized to identify the exact site, the correct level of injection of blue dye, and to determine the optimal time to perform lymphography prior to the procedure.

28th Congress of the Italian Society of Neonatology - Lombardy section | Bergamo, 30-31 January 2015.

This abstract book contains the abstracts presented at the 28th Congress of the Italian Society of Neonatology - Lombardy section | Bergamo, 30-31 January 2015.

Is objective assessment of cosmetic results after distal hypospadias repair superior to subjective assessment?

OBJECTIVE: To evaluate whether systematic scoring of pictures is really superior to subjective evaluation in the assessment of cosmetic results of distal hypospadias surgery, and whether any differences exist in subjective evaluation among the operating surgeon, the parents of the child, and a third party not previously involved in the care of the patient. PATIENTS AND METHODS: Twenty-seven patients undergoing distal hypospadias repair by either the Snodgrass or Mathieu technique were enrolled. Cosmetic results of surgery were scored from 0 to 10 by one of each child's parents and by three surgeons. The latter assessed the results blindly on pictures taken during the outpatient visits; one used a systematic scoring system while the other two including the operating surgeon used subjective scoring. The four scores were compared using the Kendall W coefficient of concordance. RESULTS: Overall, there was excellent concordance among the four observers (P<0.0001). The Snodgrass repair allowed for significantly better cosmetic results overall. CONCLUSION: In distal hypospadias, subjective evaluation of overall penile appearance can be as reliable as an evaluation made using a systematic scoring system. There seems to be excellent concordance among the subjective evaluations of different observers.