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At least 649 records · Page 36Linked to original sources
PubMed2000

Circumcision in paediatric surgery using an ultrasound dissection scalpel.

In contrast to electrocautery, the ultrasound dissection scalpel allows tissue dissection and haemostasis to be performed without the danger of thermal tissue damage or burning caused by uncontrolled active current. In a clinical application study performed on 24 boys with an average age of six years, we examined whether the use of this instrument is also practical in a routine operation such as circumcision. It was possible to perform all operations with the ultrasound dissection scalpel (Ultracision, manufactured by Ethicon) by the classic technique without the additional use of electrocautery for haemostasis. Although dissecting speed is slower than with conventional instruments, the fact that simultaneous haemostasis is possible meant that operations could be carried out quickly and with minimal bleeding. There were no perioperative complications such as haemorrhaging or burning. All children were examined postoperatively over an average of 3 weeks (range 1-8 weeks). Wound healing was completely without complications for 22 patients (92%). One patient (4%) suffered a candidal infection in the first postoperative week. One further patient (4%), who was already suffering preoperatively from an extended chronic inflammation of the prepuce, developed pronounced swelling postoperatively. Heavy scarring occurred subsequently in both cases. Our results show that the advantages of the ultrasound dissection scalpel, e.g. gentle tissue dissection with simultaneous haemostasis, can also be used to advantage for a technically simple operation such as circumcision without having to fear the risks of electrocautery.

Child↗
PubMedDate not supplied

Non-retractile foreskin: a single center 13-year experience.

BACKGROUND: Non-retractile foreskin comprise a significant number of referrals by pediatricians and general practitioners to pediatric surgical centers. In attempts to find alternatives to widely practised circumcision, various procedures have been developed over the years in order to relieve the non-fibrotic narrowing of the foreskin. PATIENTS AND METHODS: In a 13-year period from 1984-1997, we treated 2554 patients with non-retractile foreskin at our center. Dorsal relieving incision was the technique of choice and was performed in 2177 patients, circumcision in 73 patients and preputial adhesiolysis was sufficient to retract the foreskin in 284 patients. RESULTS: Satisfactory esthetic results, an extremely low rate of postoperative complications (1.8%) with a recurrence rate of only 0.8% (18 patients) was observed in our series with dorsal relieving incision. CONCLUSIONS: Dorsal relieving incision operation was found to be a less invasive, safe and effective procedure for non-retractile foreskin not affected by extensive secondary scarring. This technique has fewer complications in comparison to circumcision and can be performed as an ambulatory procedure.

Adolescent↗
PubMed2001

[Severe necrotic processes of the penis and scrotum].

Authors summarise the two-decade experience of their department in severe tissue necrosis of penis and scrotum. Presented cases represent a shared field of urology with dermatology, infectology, nephrology and andrology. Tissue necrosis extended to different depth of the penis, from superficial skin and subcutaneous tissues, fascias to the entire organ. Underlying diseases are acute and chronic inflammations, metabolic diseases, vascular lesions. Diagnostic difficulties and therapeutic choices, both conservative and operative, are discussed.

Abscess↗
PubMed1975

Penile cancer.

A retrospective study was made of the case histories of 91 patients with a penile tumor. The tumor histology of 56 patients could be re-evaluated, confirming the diagnosis: epidermoid cancer. Fifty three of these 56 patients were treated more than five years before the retrospective evaluation. Penile carcinoma has not increased in frequency during the last few decades. No correlation could be found between venereal diseases and penile carcinoma, nor between the duration of symptoms before treatment and the development of metastases. Amputation is the treatment of choice. Lymph node dissection must be performed when metastatic disease is suspected. When patients die of tumor, this is caused by metastatic disease, but in about 50 percent of cases the patients can be saved by dissection of positive nodes, preventing a further extension. More than 70 percent of 53 patients have survived for at least five years without evidence of recurrence or metastatic disease including six (out of 11) patients in whom the dissected inguinal lymph nodes showed involvement. In this series of patients cytostatic therapy was not used. Bleomycin is known to have a definite action on these tumors, but only the far future can show if better results are to be expected with a combination of the described therapy with cytostatic drugs.

Adult↗
PubMed1975

[Hazards of electrosurgery].

Burn accidents due to the use of electrosurgical instruments (electrotomy, electrocoagulation) are uncommon but generally serious: explosion of inflammable anaesthetics or antiseptics, local tissue necrosis by an uncontrollable current or coagulation necrosis by a high current. An appropriate use of electrosurgical instruments based on the correct range of indications is the basis for the prevention of accidents.

Amputation, Surgical↗
PubMed2001

[Administration of diprivan during urological surgery in children].

In 56 children, aged from 6 to 14 years, while performing urological operations the narcosis using ketamine was applied and in 43--basing on diprivan and anesthesy with phentanyl. In all the children premedication was conducted using atropine, dimedrol and sibazone. Pain in the vein while diprivan was injected occurred in 6 (14%) of children, involuntary movements--in 16 (37%). While application of diprivan in all the children the mild arterial hypertension was observed, bradycardia was absent on all stages of anesthesy period. The waking up period duration after conduction of anesthesy using ketamine had constituted at average (86.9 +/- 13.1) min, and using diprivan--(35.2 +/- 11.3) min (P < 0.01). Anesthesy basing on diprivan owes significant advantages in comparison with narcosis using ketamine during performance of urological operation in a child.

Adolescent↗
PubMed2002

[Should circumcision be performed in childhood?].

OBJECTIVE: To evaluate prepuce development and retractibility in a group of boys. To point out the value of circumcision and prepucial forced dilation during childhood. METHODS: Prepuce development and retractibility were evaluated in 400 boys ages between 0-16 year old. RESULTS: In boys under 1 year prepuce retractibility (assessed only in children who did not undergo forced dilation previously) was type I (non retractile) in 71.5% whereas type V (completely retractile) was only 5.5%. In adolescent boys type I prepuce was observed in 1 boy only, 1.6%, whereas type V was observed in 82.3%. Furthermore, it was observed that at the time of examination for the study 106 boys who had undergone forced dilation at an earlier age had balano-prepucial adhesions again, which demonstrates that prepuce adheres again to glans penis in many boys after a forced dilation is performed. Only 11 boys were considered in need for circumcision, three of them for prepucial orifice stenosis, which prevented normal micturition, causing a prepucial sac, one case due to a constrictive ring below the prepucial edge that would have prevented ulterior retractability, two cases with repetitive balanopostitis, and five cases secondary to xerosol balanitis, accounting for 2.7% of all examined boys. CONCLUSIONS: Incomplete separation between prepuce and glans penis is normal and common among new-borns, progressing until adolescence to spontaneous separation, at which time it is complete in the majority of boys. Accordingly to the criteria we have sustained for years and present study's findings, circumcision has few indications during childhood, as well as forced prepucial dilation.

Adolescent↗
PubMedDate not supplied

[Condylomatosis].

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Humans↗