蒋桂勇

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03 9月 2019

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Author : 伤口世界

熟练掌握骨科常见病、多发病的诊治。在急诊手外科、创面早期处理及运动损伤方面有一定的经验。曾赴比利时鲁汶大学进修学习复杂骨折、肩肘外科，发表论文3篇，参编著作2部。博士，主治医师，讲师，毕业于北京协和医学院八年制临床医学专业，自2008年毕业至南方医院创伤骨科工作后，经过骨科系统培训和专科学习。

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K2 Content

Complete diphallia: How to proceed? 2026-09-10 00:00

Antonio Macedo Jr ^a,b , Se´rgio Leite Ottoni ^b , Paula Cartaxo Barros Camilato ^b , Hugo Santiago Crespo Ganchozo ^b , Gilmar Garrone^b , Ricardo de Mattos Marcondes ^b , Marcela Leal da Cruz ^{b, *}

Summary

Introduction

Diphallia is a rare anomaly. It has a range of appearances from a small accessory penile to complete duplication.

Methods

We present a 2 year-old boy with complete penile duplication. The left penile was the largest. NMR (Nuclear Magnetic Resonance) suggested one corporal body for each penile and VCUG (Voiding Cystourethrogram) showed a normal urethra in the right penile and stricture at glandular and mid penile urethra of the left penis. A Y confluence to bulbar urethra was observed confirming only one prostate and bladder.

Results

The cystoscopy through the right penile identified the urethral confluence in the bulbar area. We performed a meatotomy in the left penile to insert the cystoscope and confirmed the blind ending urethra. We decided to remove this penile. The penile was degloved entirely and clamped and took out the corpora at the base.

Discussion

Diphallia can have three presentations: only glans duplication, bifid diphallia and complete diphallia (two corpora cavernosa and a corpus spongiosum for each penile). In our case, each penile presented only one corpora cavernosa and the decision taken was based on urethral patency.

Conclusion

The treatment should always be planned individually whereas associated anomalies with the goal of attaining satisfactory functional and cosmetic.
Can portable ultrasound bladder scanner be applied to young children less than three years old? 2026-09-09 00:00

Minh-Tung Do ^a , Louis Kim ^b , Young Jae Im ^a,b , Kwanjin Park^{a,b, *}

Summary

Introduction The bladder scanner (BS), a portable ultrasound device specialized in bladder volume measurement, has been developed and applied to clinical assessment of postvoid residual urine, which is a requisite in evaluating patients with voiding dysfunction.

However, experiences in the application of the BS to the pediatric population remain limited despite commonly encountered reluctance to catheterization. This prospective observational study aimed to evaluate the correlation and accuracy of the newly developed pediatric module of the BS (BioCon-900) in measuring bladder volume in children 0e6 years.

Materials and methods

This study included 29 patients scheduled to undergo preventive untethering for their spinal dysraphism. When they undergo cystometry for the confirmation of normal neurologic function, bladder volume was measured by BS when recorded volume infusion reached each quartile of the age-adjusted estimated bladder capacity (EBC). The difference (bias) between measured and infused volume was expressed as a percentage of EBC (%EBC). The correlation coefficient and the Bland_Altman plot were obtained to determine the discriminating power and accuracy, respectively. The acceptable limit was set as 30%EBC.

Results

A strong correlation between the measured and infused volume (r = 0.95, P < 0.001) was found for the entire age range. This excellent correlation remained comparable between children less than three years and the older ones. Bladder volume tended to be overestimated, and the mean bias was 33 ± 22.3%EBC, and it became higher with increasing quartiles. The accuracy was acceptable in all ranges of measurement in the older group and first and second quartiles in the younger one.

Discussion

We have first evaluated the potential use of BS in 0_3 years old children and compared the results with 4_6- year-old children in whom the accuracy of BS has been demonstrated. The strong point of our study was the inclusion of data spanning all quartiles of bladder volume. The use of infused volume as reference enabled us to assess the accuracy in a more precise way than the use of ultrasound. Despite the good discriminating power, the accuracy was not acceptable in higher quartiles in the younger group. If the trend of overestimation especially higher volume, could be understood prior to measurement, it would be helpful to assume the real val.

Conclusions

The children’s module in BS showed excellent discriminating power and generally acceptable accuracy in more than four-year-old children. This may lose accuracy in higher quartiles among less than three years old children.
A global view of pediatric urology 2026-09-08 00:00

Catherine R. deVries *

Summary

Over the course of approximately 60 years, the field of pediatric urology has evolved as a convergence of pediatric surgery, urology, and plastic surgery to address congenital anomalies of the urinary tract and genitalia in children. Guide-lines for training and certification are narrowing in high-income countries (HICs) at the same time as the fertility rate is declining and the prevalence of complex genitourinary (GU) conditions is decreasing. In low-and middle-income countries (LMICs), health systems for large populations are currently in a state of stress. Here we briefly review the history of pediatric urology as a surgical subspecialty, identify unmet needs especially in LMICs and place the field in the context of a global surgical ecosystem.

Methods

The English language literature on workforce trends in pediatric urology, pediatric surgery and urology was reviewed as well as development of the emerging field of global surgery. Global surgery looks at the social, economic and political context of health systems as well as unmet clinical need. World trends in fertility rates were reviewed to identify regions of workforce surplus and gaps, supply chain needs, infrastructure and systems strengths and weaknesses.

Results

The proliferation of training programs in pediatric surgery and specialties in high-income countries (HICs) coupled with declining birth rates has led to a saturation of specialists and declining surgical case load. In LMICs, while the birth rate has also been declining, surgical specialization has not progressed. In the lowest income countries, especially in sub-Saharan Africa, training in pediatric surgical specialties and urology is rare. The broad workforce that supports surgical care, such as anesthesia, intensivist pediatrics, radiology, laboratory, and nursing face similar challenges. Supply chains for specialized pediatric urological surgery are weak.

Conclusion

There is an evolving maldistribution of pediatric surgical and pediatric urological workforce globally, with too few practitioners in LMICs and too many in HICs. The high cost of specialized equipment limits access to quality care, and the supply chain for consumables and medication is patchy. In LIC’s, basic community-based infrastructure for health including reliable electricity is lacking. Recent experience with Covid and environmental disasters has highlighted that even in HICs surgical resilience can be challenged. This is an opportunity to consider the state of children’s urological care globally and to build resilience by identifying and addressing strengths and gaps.

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

蒋桂勇

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

蒋桂勇

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