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
当一个人受伤后,尤其是大面积烧烫伤后,受伤区域的疤痕可能会出现凸起并伴随瘙痒。
严重的瘙痒可以让病人寝食不安,痛苦不堪。那么,疤痕为什么会痒?可以治疗吗?
赫曼关爱健康 中诺医疗
随着医护人员对伤口护理质量及病患生活质量追求的提高,敷料无痛更换及敷料的止痛效果正获得越来越多的重视。以往大家更多的关注敷料更换时的无痛、无二次损伤,随着新型敷料的使用逐渐增多,医护人员也需更加重视敷料贴附时的止痛效果。
导语:高血压、高血脂、高血糖,再加上高尿酸,被这四种慢性病缠上的人,既需要按时服药,吃喝等还要受到诸多限制,可称得上最让人无可奈何了!
送你四张“处方”,趁还来得及,看懂四高、防四高、降四高!
相信很多人都看过《金刚狼》这部电影。
那部电影中,吸引人的不仅仅是狼叔健硕的肌肉和刀锋般的钢爪,还有就是狼叔无论怎么受伤都可以自我修复的能力。
那么现实生活中,疤痕到底可以自我修复吗?
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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