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J Dvorácek

Publications and source records attributed to J Dvorácek.

16 recordsLinked to original sources
PubMed1992

[A single-stage reconstruction in hypospadias using a vascularized preputial flap].

The authors submit an account of their experience with a modern method of reconstruction of hypospadias connected with the chorda. In 31 boys (10 months to 15 years) they used for reconstruction of the urethra a flap from the prepuce with a preserved vascular stalk, as described by Duckett. In the majority they transferred a double flap ("double face") where the outer sheath of the prepuce was used to cover the ventral side of the penis. In three boys the authors performed their own modification of this plastic operation. Complications developed in 12 boys (38.7%): stricture of the proximal anastomosis of the urethra (6), stricture of the meatus (1), necrosis of the skin cover (4), dehiscence (1). An open operation had to be made in the last five patients (16.1%). In all children excellent functional and aesthetic results were achieved. The above plastic operation is indicated in penile and penoscrotal hypospadias with chorda. It is a single stage operation. Due to the use of vascularized tissue and the microsurgical technique it is possible to perform a definite reconstruction of the external genitalia already by the age of one year.

Adolescent↗
PubMed1989

[The morphology of reflux nephropathy and some forms of obstructive nephropathy].

There were investigated 42 nephrectomy and heminephrectomy specimens with proved vesicoureteral reflux and 113 specimens of various forms of obstructive nephropathy (17 cases of primary obstructive megaureter, 50 cases of pyeloureteral junction stenosis and 12 tumorous, 16 iatrogenic and 18 stone obstructions of the ureter). Macroscopic and microscopic findings and the distribution of immunohistologically determined Tamm-Horsfall protein were estimated. The comparison revealed that despite of some differences there are in some case many similarities on the histological level caused by common sharing of main pathogenetic and etiologic factors i.e. intrarenal reflux and/or urinary tract infection. The most difficult differential diagnostic problems may arise mainly in the group of primary obstructive megaureter and in some patients with the stenosis of pyeloureteral junction. In dubious cases macroscopic picture and clinical data have to be thoroughly evaluated.

Humans↗
PubMed1989

Secondary megaureters in children: results of treatment.

Treatment results of 74 secondary megaureters in 48 children (25 males and 23 females with one segmental and 73 total megaureters) are presented. The left side prevailed over the right one (ratio 1.4:1.0); the lesion was bilateral in 54%. Forty-two children (88%) were treated surgically. Eleven megaureters (15%) were modelled. and 2 megaureters had to be reoperated. The follow-up period ranged between 7 months and 9.5 years. Urinary infection was reduced from 80 to 54%, chronical renal failure was reduced from 65 to 54%, and the occurrence of arterial hypertension remained unchanged. Excellent results were achieved in 27%, they were satisfactory in 60% and poor in 13% of the megaureters.

Adolescent↗
PubMed1987

[Results of surgical therapy of vesico-ureteral reflux in childhood].

During 8 years in the department of paediatric urology of the Clinic of Urology of the Charles University Prague 267 children with a vesicoureteral reflux (VUR) aged between 6 months and 15 years were operated. The sex ratio girls to boys was 4.5 to 1.0. At 89% an infection of the urinary tract was simultaneously present. On an average first symptoms appeared at the age of 3 1/2 years. The operative therapy was performed at the of 6. 221 children with 340 reflux units underwent an after examination 3 to 12 months after operation. Most frequent were the degrees of reflux II and III with altogether 82%. 255 vesicoureteral refluxes were primary refluxes and 85 secondary ones. 208 reflux ureters were modified after Politano-Leadbetter, 105 modified after Gil-Vernet, 17 were treated in form of a pyeloureter anastomosis and 10 by means of nephroureterectomy. A persisting post-operative infection of the urinary tract was existing in 14.5% after 3 months and in 8.8% after 1 year. Implantation stenoses appeared in 2.4% and were successfully reoperated. Altogether the healing of the reflux was successful in 96.4%. An early operative therapy and in refluxes of second and third degree the modified method according Gil-Vernet are recommended.

Child↗
PubMed1986

Renal changes in vesicoureteral reflux--human reflux nephropathy.

25 nephrectomized kidneys of patients with vesicoureteral reflux (VUR) were examined during the period 1977 to 1985. In 13 cases, VUR was associated with other anomalies of the urinary tract. 14 patients were children aged 6 months to 15 years. The oldest of the 11 adult patients was 50 years old. Macroscopically the kidneys were mostly small with focal scarring of the renal parenchyma and dilatation of the corresponding calices. Histologically 5 children presented active pyelonephritis and 7 children atrophic chronic pyelonephritis. In adults there were 2 cases of atrophic chronic pyelonephritis and in the remaining 9 cases there was extensive segmental scarring characteristic of Ask-Upmark kidney. Two boys with VUR in association with a posterior urethral valve presented different changes, indicative of early intrauterine damage with arrest of differentiation. The morphologic changes in all other cases formed a broad essentially continuous succession of changes and should be seen as different developmental stages of chronic pyelonephritis of early childhood, Ask-Upmark kidney being the ultimate consequence. Despite a characteristic clinical picture and certain peculiar morphological features, there is no uniform and pathognomic picture of renal changes in reflux nephropathy. All our cases presented with urinary tract infection or a history of it and we regard them only as a specific pathogenetically determined form of child chronic pyelonephritis.

Adolescent↗
PubMed1986

[Megaureter].

Explore the source record for details and available documents.

Dilatation, Pathologic↗