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A Caldamone

Publications and source records attributed to A Caldamone.

13 recordsLinked to original sources
PubMed2001

A multi-institutional analysis of laparoscopic orchidopexy.

OBJECTIVE: To combine and analyse the results from centres with a large experience of laparoscopy for the impalpable testis with small series, to determine the expected success rate for laparoscopic orchidopexy. METHODS: A questionnaire was distributed to participating paediatric urologists; each contributor retrospectively reviewed the clinical charts for their cases of therapeutic laparoscopy for an impalpable testis, detailing 36 variables for each patient. The data were collated centrally into a computerized database. For inclusion, the testis was intra-abdominal (including 'peeping' at the internal ring) at laparoscopic examination, was not managed through an open approach and did not undergo orchidectomy. Three surgical groups were assessed, with success defined as lack of atrophy and intrascrotal position: group 1, primary laparoscopic orchidopexy; group 2, a one-stage Fowler-Stephens (F-S) orchidopexy; and group 3, a two-stage F-S orchidopexy. RESULTS: Data were gathered from 10 centres in the USA, covering the period 1990-1999; 252 patients representing 310 testes were included and overall, 15.2% were lost to follow-up. There was no significant difference between success rates in the larger and smaller series. Atrophy occurred in 2.2% of 178 testes, 22.2% of 27 testes and 10.3% of 58 testes in groups 1-3, respectively. Testes were not in a satisfactory scrotal position in 0.6%, 7.4% and 1.7% of groups 1-3, respectively. The mean follow-up for each group was 7.7, 8.6 and 20.0 months, respectively. The overall success for all groups was 92.8% (97.2% group 1; 74.1% group 2; 87.9% group 3), with an atrophy rate of 6.1%. CONCLUSION: Laparoscopic orchidopexy for the intra-abdominal testis, in both large and small series, can be expected to have a success rate higher than that historically ascribed to open orchidopexy. Within this series, single-stage F-S laparoscopic orchidopexy resulted in a significantly higher atrophy rate than the two-stage repair. However, when considering both F-S approaches, the laparoscopic approach gave greater success than previously reported for the same open approaches. Despite the weaknesses inherent in a retrospective unrandomized study, we conclude that laparoscopic orchidopexy is, if not the procedure of choice, an acceptable and successful approach to the impalpable undescended testicle.

Child, Preschool↗
PubMed1998

Tubularized incised plate hypospadias repair for proximal hypospadias.

PURPOSE: We report a multicenter experience using tubularized incised plate urethroplasty for proximal hypospadias. MATERIALS AND METHODS: From August 1993 to December 1996 tubularized incised plate urethroplasty was performed in 27 boys 6 months to 3 years old with mid shaft and penoscrotal hypospadias. In 7 other boys complex reconstruction combined the tubularized incised plate technique for the glanular urethra with other repairs for the proximal urethra. RESULTS: Tubularized incised plate surgery created a functional neourethra even in penoscrotal hypospadias. Complications of the primary repair developed in only 3 of 27 patients (11%). No complications were attributed to use of the technique for the glanular urethra in complex repairs. CONCLUSIONS: Tubularized incised plate urethroplasty is a versatile operation that corrects proximal hypospadias defects with few complications and superior cosmetic results.

Child, Preschool↗
PubMed1996

Tubularized incised plate hypospadias repair: results of a multicenter experience.

PURPOSE: We report a multicenter experience using tubularized incised plate urethroplasty to correct distal hypospadias. MATERIALS AND METHODS: A total of 148 patients underwent repair by 6 pediatric urologists at different institutions in the United States and Europe. RESULTS: Tubularized incised plate repair created a functional neourethra with a vertically oriented meatus. Complications, including meatal stenoses and fistulas, occurred in 10 patients (7%). CONCLUSIONS: Tubularized incised plate urethroplasty can be performed in most cases of distal hypospadias. Cosmetic results are superior to those of other popular techniques.

Child↗
PubMed1995

Pediatric renal trauma: special considerations.

Blunt renal injuries are the cause of greater than 90% of renal injuries in children, and the kidney is the most common organ injured in blunt abdominal trauma. A vast majority of these injuries are the result of motor vehicle accidents. Children with congential malformations of the kidney, such a ureteropelvic junction obstruction, have been thought to be at an increased risk for a renal injuries when they sustain blunt abdominal trauma. This premise and the controversy surrounding the evaluation and treatment of renal injuries in children who sustain blunt renal trauma is discussed.

Child↗
PubMed1993

Cystic dysplasia of the testis.

Cystic dysplasia of the testis (CDT) is a rare congenital defect that results in the formation of numerous irregular cystic spaces within the mediastinum testis. We describe a 4-year-old boy with right testicular swelling who underwent orchiectomy for CDT after a preoperative ultrasound examination revealed a multicystic, anechoic lesion. Grossly, the lesion was 2 cm in size and was composed of multiple, irregularly shaped cystic spaces lined by flattened cuboidal epithelium. Immunohistochemical studies revealed that the epithelial cells expressed keratin, vimentin, and epithelial membrane antigen. Both the histologic appearance of the cyst lining and the immunohistochemical profile resembled the epithelium of rete testis. In our review of the literature 10 cases (including this lesion) of CDT have been described. A defect in the connection between the efferent ductules, derived from the mesonephric epithelium, and the rete testis and seminiferous tubules, derived from the gonadal blastema, is currently thought to be the most likely explanation of the pathogenesis of CDT.

Child, Preschool↗
PubMed1989

Enuresis following masturbation in a mentally retarded adolescent.

An unusual presentation of enuresis is described. A mentally retarded adolescent male with normal bladder function wet his bed while awake following masturbation. Initially, this sequence was not apparent to the parents or physicians. A multidisciplinary approach to the symptom helped to define and focus on the circumstances of the symptom itself, allowing for successful intervention.

Adolescent↗
PubMed1989

Cutaneous blood supply of the penis.

Twelve male cadaver specimens were injected with a latex solution to define the cutaneous blood supply of the penis. The cutaneous blood supply of the penile shaft is derived solely from a pair of axial arteries running in the dartos layer. Additional deep perforating arteries from the dorsal penile artery and corporal vessels supply the glans and subcoronal region. An understanding of this anatomy allows one to develop safely a variety of penile skin flaps for difficult reconstructive problems.

Aged↗
PubMed1984

Ureteroceles in children: clinical study and report of 58 cases.

Fifty-eight children with ureteroceles are the subject of this study. The lesions occurred more commonly in females and affected the left urinary transport system predominantly. Ectopic ureterocele was the most common type and virtually always developed on the ureter originating from the upper renal unit of a duplex kidney. There was a high incidence of associated urinary tract obstruction or vesico-ureteral reflux. The most common presenting symptoms were those of urinary infection followed by discovery of an abdominal mass. A characteristic filling defect in the bladder was seen on excretory urogram, and voiding cystourethrography revealed vesicoureteric reflux in 50% of the patients. Management of an infant or child with a ureterocele should begin with appropriate antibiotic treatment if infection is present, followed by excision or drainage of the involved renal segment(s). A pus filled upper pole and ureter may need to be removed or drained urgently in some ill patients. Ureteroceles are often complicated anatomic problems, which should be treated by surgeons who are familiar with the various facets of this congenital malformation.

Age Factors↗