[Urethroplasty and separation of the corpora cavernosa for hypospadias repair]. / Spongioplastie et "déjantage" des corps caverneux. Intérêt dans la correction des hypospadias.

Hypospadias is a frequent malformation and its treatment is not devoid of complications, particularly fistulas. The authors describe the department's surgical technique (modified Duplay technique). Urethroplasty is no longer performed by simple approximation of the urethral plate without dissection. The inferior surface of corpora cavernosa is exposed as far as the lateral border and as far as the summit in the glans, allowing tension-free suture of urethral tissues with a lengthening effect of this intermediate plane. This completes correction of chordee and especially "bucket-handle" glans and protects the reconstructed urethra and proximal urethra. The risk of fistula is therefore reduced (2 cases out of 51). This technical modification can be used to treat all forms of distal hypospadias (glanular, glanulo-preputial, and anterior penile). It has also been used for several cases of more severe hypospadias. These good results must be confirmed in a larger series of patients.

[Vesicoureteric reflux in children: long-term results of endoscopic treatment by Macroplastique injection]. / Reflux vésico-urétéral chez l'enfant: résultats à long terme du traitement endoscopique par injection de Macroplastique.

OBJECTIVE: To evaluate the long-term efficacy (from the fifth year after injection and up to seven years) of endoscopic treatment by Macroplastique implant for vesicoureteric reflux (VUR) in children, sometimes associated with urological malformations or renal complications. The secondary objective was to evaluate the local tolerance of the Macroplastique implant and the development of any local (haematuria, stones, ureteric stasis) or distant complications. MATERIAL AND METHODS: Retrospective analysis of the medical files of 389 patients, representing a total of 590 refluxing ureters treated by Macroplastique injection in eight different centres. RESULTS: With a follow-up of 5 to 7 years, reflux had not recurred in 309 of the 389 cases, i.e. 79.4% of cases and no case of ureteric stricture was observed. CONCLUSION: The good short-term results in terms of correction of reflux by Macroplastique injection and the very low morbidity are maintained with time. It therefore appears legitimate to propose endoscopic treatment of VUR by first-line Macroplastique injection instead of surgical ureteric reimplantation.