Biomedical subjects
Publications and source records attributed to J M Garat.
Our experience with 30 cutaneous transureteroureterostomies performed in children with neurogenic bladders is presented. 14 of them have been followed up for more than 5 years. The procedure is very simple and has a low percentage of immediate and late complications. Some premises to be followed regarding surgical technique in order to obtain the best possible results are emphasized.
The authors report a series of 130 children suffering from urinary lithiasis (essentially between the age of 4 to 6 years) and particularly in boys (2.5 to 1). There were 108 cases of reno-ureteric lithiasis as against 23 vesico-urethral. In 69 cases, pyelocalyceal lithiasis predominated. Thirty per cent of the children had bilateral lithiasis, and 19% of all cases of lithiasis were staghorn calculi. Presenting symptoms : haematuria, diffuse abdominal pain, anuria (6 cases), complete urinary retention (5 cases). Study of these cases failed to indicate whether obstruction of the upper urinary tract (14%) or infection (27%) was the cause or the effect of the lithiasis. Particularly notable were 8 cases of cystinuria (6%), 1 of glycinuria, 1 of hyperoxaluria and 7 of hypercalciuria. At least in Spain, lithiasis in children would appear to be essentially idiopathic. However, 40% of these cases of lithiasis were secondary to obstruction of the excretory tract and/or urinary infection. All types of entero-uroplasty were lithogenic (6 cases). 32% of the children had a proteus infection. Treatment : 14 children were treated medically as against 125 surgically. 70% are free of any recurrence. 7% have a residual lithiasis. The rarity of recurrences and the quality of the results obtained indicate that complete surgical treatment represents the essential feature of the treatment of urinary lithiasis in children.
A clinical report of 5 cases of balanitis xerotica obliterans (BXO) with urethral involvement is presented. Involvement of the urethra in the BXO is emphasized and the fact that this process is often unnoticed, is stressed. The clinical and histological characteristics of this disease are described in its different localizations. Investigations are suggested to diagnose urethral involvement and the suitable therapy is outlined.
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Urethroplasty with free grafting of tubulized vesical mucosa is a method of great interest for the solution of complex hypospadias, especially in multioperated patients. We prefer its use when the penis is erect and there is no redundant dorsal prepuce. We present 13 cases with an evolution that allows us to be optimistic about this technique.
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The present study reports our experience with epididymitis in 18 boys aged 3-16 years. The diagnosis was made at surgical exploration in 12 patients under 10 years. In the remaining 6 patients over 11 years, the diagnosis was made on the clinical and scrotal ultrasound findings. All patients were treated with analgesics, ice bags, scrotal support and antibiotics. Children that consult for scrotal pain should undergo surgical exploration within 6 hours from the onset of pain if imaging by echo Doppler or technetium pernectate is unavailable.
EMLA Topical cream is a mixture of two local anaesthetics of the aminoamides group (lidocaine and prilocaine) with the ability to penetrate healthy skin. Since 1979 it has been used with good results in those countries where it is available, and where it has become a routinely used compound. In urology, it has been used to release is balanopreputial adherences as a skin anaesthetics in ESWL sessions, cauterization of penial injuries, etc. With the aim evaluating the efficacy of this cream in paediatric urology a prospective study was conducted in 15 boys undergoing release of balanopreputial adherences and 5 girls undergoing venous catheterizations. Following topical application of the cream and a 90 min median occlusion time, an 80% efficacy level was observed in both groups. Considering these results, which are similar to those seen in the literature, we believe that this compound is useful for ordinary practice.
OBJECTIVE: Six cases of enlarged utricle are described, with special reference to the clinical, diagnostic and therapeutic aspects. METHODS/RESULTS: Utricular enlargement was suspected or confirmed radiologically in 5 cases and was confirmed by endoscopy in 5 cases. No patient was submitted to surgery. One patient underwent endoscopic removal of a utricular calculus. Prolonged medical treatment was required to maintain 5 patients free from infection. Good results were observed in 5 cases 1-9 years following diagnosis. CONCLUSIONS: Like most of the authors, we advocate treatment only for those cases with marked symptomatology, since children are at a very high risk for iatrogenic complications. Most of the cases, as shown in our series, do not require any treatment.