Rohan G. Bhalla a , Belinda Li b,d, *, Mark C. Adams b , Wallace W. Neblett c , John C. Thomas b
Summary
Objective
To describe our experience with robot-assisted laparoscopic transperitoneal repair of a congenital rectourethral fistula in a pediatric patient with a urethral duplication.
Methods
The patient is a 2-year-old male with a past medical history of Tetralogy of Fallot presenting with a febrile urinary tract infection (UTI). He was diagnosed with urethral duplication and a rectourethral fistula by voiding cystourethrogram (VCUG). The parents were counseled on various options and agreed to proceed with a robotic repair.
Results
Robotic-assisted transperitoneal rectourethral fistula repair was performed. The procedure time was 229 min with an estimated blood loss (EBL) of 15 mL. His postoperative course was unremarkable. At his 2- week follow-up, the urethral catheter was removed and the patient was voiding normally and having normal bowel movements.
Conclusion
Congenital rectourethral fistula with urethral duplication is a rare anomaly with only a few reports in the literature. Pediatric robotic-assisted trans-peritoneal rectourethral fistula repair is a technically feasible approach in infants with minimal morbidity that allows for excellent visualization and avoids open repair.
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, *
Introduction
Diphallia is a rare anomaly. It has a range of appearances from a small accessory penile to complete duplication.
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.
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.
The treatment should always be planned individually whereas associated anomalies with the goal of attaining satisfactory functional and cosmetic.
去疤痕 中诺医疗
在我们的生活之中难免会遇到一些伤害,而有些时候就会留下疤痕。有一些疤长久的留下了,这是非常的难看的。
慢伤前沿 中诺医疗
本文原文作者为美国加州大学戴维斯医学中心伤口护理中心主任Holly Kirkland-Kyhn博士,中文译者为河北省唐县白求恩纪念医院的张瑞红老师,作者详细介绍见文末。
家庭伤口护理指导
促进伤口愈合的方法概述
中国新闻网 中诺医疗
“十人九胃”,指的是10个人当中就有9个人有胃病。吃进去的食物,首先影响的就是胃。胃每天不停运作,一日三餐,消化吸收之后,将未消化完的食物,再传送到肠。如果饮食不慎,吃的东西难以消化,或胃本身出了问题,不能正常消化食物,都会引发胃病。为了健康和美丽,我们要学会保养好自己的胃,那有哪些养胃的食物呢?推荐13种养胃食物,常吃可以养胃护胃。
转载 中诺医疗
对于不少罹患胃肠道疾病和癌症的患者来说,首要的选择不是生或死,而是要不要成为“造口人”,医生不得不切除某些病人的一部分肠体,再将其一端透过腹部开口引出,缝合固定,排泄物将改由这里离开身体。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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