Hypospadias
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This document discusses hypospadias, a congenital anomaly where the urethra opens on the underside of the penis instead of at the tip. It covers the embryology, risk factors, classifications, clinical features, and various surgical treatment options for hypospadias repair. The goals of treatment are to position the urethral meatus at the tip of the penis, correct any penile curvature, and provide adequate skin coverage. Complications can include meatal stenosis, fistula formation, infection, and procedure failure. Careful patient selection and appropriate surgical technique are emphasized to achieve the best outcomes.
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Hypospadias is a congenital anomaly where the opening of the urethra is on the ventral side of the penis rather than at the tip. It occurs in about 1 in 250 male newborns. The document discusses the definition, causes, classification, diagnosis, and surgical techniques for repairing hypospadias. Surgical repair aims to correct penile curvature if present and create a functional urethra in a cosmetically normal position. Complications can include bleeding, meatal stenosis, and impaired healing but early repair from ages 6-12 months has better outcomes.
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This document discusses hypospadias, a congenital defect where the urethral opening is on the underside of the penis. It has an incidence of about 1 in 300 male newborns. The document covers the definition, causes, diagnosis, classification, surgical techniques like single-stage and two-stage procedures, timing of surgery, complications and goals of repairing hypospadias. It analyzes the demographics, procedures and complications from cases at the author's medical center, finding the most common were fistulas, meatal stenosis and neourethral strictures, and emphasizes the high technical difficulty and complication rates of hypospadias surgery.
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This document discusses hypospadias, a congenital anomaly where the urethral opening is on the underside of the penis. It defines hypospadias and describes its features, types, incidence, associated anomalies, investigations, treatment objectives, surgical techniques including single-stage and multi-stage procedures, and potential complications. The goals of treatment are to produce a straight penis, provide a terminal urethral opening near the glans, allow normal urination and potential fertility.
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This document provides an overview of the principles of managing hypospadias. It discusses the history of hypospadias management from the first descriptions by ancient surgeons to modern techniques. It also covers the embryology, incidence, classification, complications and management of hypospadias. The history section outlines key developments in hypospadias repair techniques from the 19th century to present day. It shows how techniques have evolved from early amputation procedures to modern one-stage repairs using local skin flaps or grafts.
Hypospadias ppt.
Hypospadias is a congenital anomaly where the urethral opening is on the underside of the penis. It occurs in about 1 in 300 male births and has some genetic factors. Treatment is through surgical urethroplasty to reconstruct the urethra and correct any curvature. Outcomes include some urinary and sexual dysfunction compared to controls, with more issues for proximal versus distal hypospadias. The goal of surgery is a functional penis with normal appearance.
Hypospadias
This document discusses hypospadias, a congenital abnormality where the opening of the urethra is on the underside of the penis instead of at the tip. It begins with definitions and classifications of hypospadias. It then discusses the incidence, associated anomalies like cryptorchidism and inguinal hernia, role of imaging, timing of repair, anesthesia techniques, hemostasis methods, suture techniques, and dressings used postoperatively. It outlines indications for repair and the use of preoperative hormonal stimulation. It provides an intraoperative algorithm and details techniques for repair of distal, middle, and proximal hypospadias. Finally, it discusses potential complications like bleeding, meatal stenosis
Hypospadias
- Hypospadias is a congenital condition where the urethral opening is on the underside of the penis rather than at the tip. It can range from mild to severe forms.
- The cause is usually unknown but may involve genetic factors or exposure to chemicals during pregnancy. Risk increases with family history, maternal age over 35, or in vitro fertilization.
- Treatment involves surgery to reposition the urethral opening, which is usually done between ages 6-18 months. The goal is to create a normal appearing penis and allow for normal urination and sexual function.
- Surgical techniques vary depending on the severity but aim to lengthen and tubularize the urethra
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Hypospadias is a congenital anomaly where the opening of the urethra is on the ventral side of the penis rather than at the tip. It occurs in about 1 in 250 male newborns. The document discusses the definition, causes, classification, diagnosis, and surgical techniques for repairing hypospadias. Surgical repair aims to correct penile curvature if present and create a functional urethra in a cosmetically normal position. Complications can include bleeding, meatal stenosis, and impaired healing but early repair from ages 6-12 months has better outcomes.
Hypospadias
This document discusses hypospadias, a congenital defect where the urethral opening is on the underside of the penis. It has an incidence of about 1 in 300 male newborns. The document covers the definition, causes, diagnosis, classification, surgical techniques like single-stage and two-stage procedures, timing of surgery, complications and goals of repairing hypospadias. It analyzes the demographics, procedures and complications from cases at the author's medical center, finding the most common were fistulas, meatal stenosis and neourethral strictures, and emphasizes the high technical difficulty and complication rates of hypospadias surgery.
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Hypospadias ppt.
Hypospadias is a congenital anomaly where the urethral opening is on the underside of the penis. It occurs in about 1 in 300 male births and has some genetic factors. Treatment is through surgical urethroplasty to reconstruct the urethra and correct any curvature. Outcomes include some urinary and sexual dysfunction compared to controls, with more issues for proximal versus distal hypospadias. The goal of surgery is a functional penis with normal appearance.
Hypospadias
This document discusses hypospadias, a congenital abnormality where the opening of the urethra is on the underside of the penis instead of at the tip. It begins with definitions and classifications of hypospadias. It then discusses the incidence, associated anomalies like cryptorchidism and inguinal hernia, role of imaging, timing of repair, anesthesia techniques, hemostasis methods, suture techniques, and dressings used postoperatively. It outlines indications for repair and the use of preoperative hormonal stimulation. It provides an intraoperative algorithm and details techniques for repair of distal, middle, and proximal hypospadias. Finally, it discusses potential complications like bleeding, meatal stenosis
Hypospadias
- Hypospadias is a congenital condition where the urethral opening is on the underside of the penis rather than at the tip. It can range from mild to severe forms.
- The cause is usually unknown but may involve genetic factors or exposure to chemicals during pregnancy. Risk increases with family history, maternal age over 35, or in vitro fertilization.
- Treatment involves surgery to reposition the urethral opening, which is usually done between ages 6-18 months. The goal is to create a normal appearing penis and allow for normal urination and sexual function.
- Surgical techniques vary depending on the severity but aim to lengthen and tubularize the urethra
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The document discusses various topics related to hypospadias including:
1) The embryology of penile development and role of androgens and 5α-Reductase.
2) Diagnosis and classification of hypospadias and chordee.
3) Timing of hypospadias surgery, typically between 6-12 months.
4) Preoperative hormonal stimulation to increase penile size for proximal cases.
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Hypospadias is a common birth defect in boys where the urethral opening is located on the underside of the penis rather than at the tip. It occurs when the urethra fails to form properly during fetal development. Treatment involves surgery to reposition the urethral opening, which is usually successful though there is a small risk of complications like fistulas or scar tissue formation. Left untreated, hypospadias can cause urinary issues and impaired sexual function later in life.
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This document provides information about hypospadias, including:
- The embryology of normal penile development and how hypospadias occurs due to abnormal anterior urethral and penile development.
- The clinical features of hypospadias such as an abnormal urethral opening along the ventral penis and abnormal ventral curvature. It can be associated with other genital anomalies.
- The various surgical techniques used to repair hypospadias depending on its location, from distal techniques like MAGPI to techniques for more proximal hypospadias like tubularized island flaps or multistage repairs.
- Post-operative considerations like catheters, dressings and potential
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Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias.
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Hypospadias is a birth defect where the opening of the urethra is on the underside of the penis instead of at the tip. It occurs in around 4 in 1,000 male births. The cause is unknown but may involve deficient androgen stimulation during penis development in the womb. Treatment involves surgery to reposition the urethral opening, with the ideal age being 6-12 months. Surgical techniques vary depending on the location and severity of the hypospadias.
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This document discusses undescended testis (cryptorchidism). It covers the embryology of testicular descent, factors that can affect descent, clinical features of undescended testis, risks of not treating (e.g. infertility, trauma), and surgical techniques for orchiopexy including for unilateral versus bilateral cases. It also briefly discusses hypospadias, including characteristic features and treatment with urethroplasty surgery.
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uronotes2012.blogspot.comembryology and anatomy of hypospadias
Hypospadias is a congenital abnormality where the urethral opening is located on the ventral side of the penis. It occurs due to abnormal development of the urethra during embryogenesis. The urethra normally develops from the urethral groove which deepens between the urethral folds and fuses in the midline to form the urethral tube. In hypospadias, this fusion of folds is impaired, resulting in an abnormal ventral opening of the urethra. The document discusses in detail the normal embryological development of the male urogenital system and the urethra. It also explores various theories regarding the precise origin and development of
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• Greetings from “ Surgical Educator”
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The document discusses various topics related to hypospadias including:
1) The embryology of penile development and role of androgens and 5α-Reductase.
2) Diagnosis and classification of hypospadias and chordee.
3) Timing of hypospadias surgery, typically between 6-12 months.
4) Preoperative hormonal stimulation to increase penile size for proximal cases.
hypospadiais
Hypospadias is a common birth defect in boys where the urethral opening is located on the underside of the penis rather than at the tip. It occurs when the urethra fails to form properly during fetal development. Treatment involves surgery to reposition the urethral opening, which is usually successful though there is a small risk of complications like fistulas or scar tissue formation. Left untreated, hypospadias can cause urinary issues and impaired sexual function later in life.
Hypospadias.ppt
This document provides information about hypospadias, including:
- The embryology of normal penile development and how hypospadias occurs due to abnormal anterior urethral and penile development.
- The clinical features of hypospadias such as an abnormal urethral opening along the ventral penis and abnormal ventral curvature. It can be associated with other genital anomalies.
- The various surgical techniques used to repair hypospadias depending on its location, from distal techniques like MAGPI to techniques for more proximal hypospadias like tubularized island flaps or multistage repairs.
- Post-operative considerations like catheters, dressings and potential
RECTAL PROLAPSE
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Hypospadias
Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias.
The penis may curve down in an infant and the baby may spray while urinating.
urethroplasty
This document discusses urethral stricture disease, including its definition, risk factors, presentation, diagnosis, and various treatment options. It provides details on endoscopic treatments like dilation and urethrotomy, as well as surgical options like urethroplasty repairs using grafts, flaps, and anastomoses. Five case examples are presented and management options discussed. Key points covered include techniques for anastomotic repairs, the use of buccal mucosa grafts, and monitoring after treatment. Current controversies regarding urethroplasty utilization and outcomes are also noted.
Undescended testis
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Hypospadias 3: MAGPI & snod grass (TIP) step by step operative urology series
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for more resources visit:
uronotes2012.blogspot.comembryology and anatomy of hypospadias
Hypospadias is a congenital abnormality where the urethral opening is located on the ventral side of the penis. It occurs due to abnormal development of the urethra during embryogenesis. The urethra normally develops from the urethral groove which deepens between the urethral folds and fuses in the midline to form the urethral tube. In hypospadias, this fusion of folds is impaired, resulting in an abnormal ventral opening of the urethra. The document discusses in detail the normal embryological development of the male urogenital system and the urethra. It also explores various theories regarding the precise origin and development of
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Anorectal malformations refer to anomalies of the rectum and anus that have an incidence of approximately 1 in 5000 live births. They can range from a simple imperforate anus to more complex anomalies associated with genitourinary and pelvic organs. Anorectal malformations are frequently associated with other anomalies as well, such as VACTERL. Surgical treatment depends on the specific defect but may include procedures such as posterior sagittal anorectoplasty. Postoperative nursing care focuses on pain management, maintaining appropriate skin care and drainage, and educating parents on ostomy and wound care.
Open Pyelolithotomy
The document describes surgical procedures for removing kidney stones. It indicates that open surgery is still needed in cases of obstruction, infection, failed lithotripsy, or stones too large for other procedures. It then provides details on instruments, incisions, and techniques for simple pyelolithotomy, coagulum technique, extended pyelolithotomy, and managing stones extending into the ureteropelvic junction. The goal is to remove all stones and debris while minimizing damage to the kidney and ensuring the pelvis can be closed watertight.
Inguinal hernias in pediatrics
Inguinal hernias are the most common operation performed by pediatric surgeons, often presenting in infants during the first year of life. They occur when the processus vaginalis fails to close after descent of the testes in utero. Clinical diagnosis is based on history and physical exam findings of an inguinal bulge or mass. Management involves early surgical repair to prevent incarceration, with open or laparoscopic techniques used depending on surgeon preference and risk factors. Postoperative complications are rare if repaired promptly.
Hypospadias
Hypospadias is a congenital anomaly where the urethral opening is located abnormally on the ventral side of the penis. It occurs due to failed fusion of the urethral folds during gestation, which may be caused by reduced testosterone stimulation due to endocrine or genetic factors. Symptoms include an abnormal ventral meatus, hooded foreskin, and sometimes chordee. Treatment aims to allow normal urination and sexual function through surgical procedures to reposition the urethra, with complications including bleeding, infection, and late issues like strictures. Classification systems divide hypospadias into anterior, middle, and posterior locations to guide appropriate surgical repair techniques.
Posterior urethral valves- Pediatric Surgery
POSTERIOR URETHRAL VALVES- Pediatric Surgery
• Dear viewers,
• Greetings from “ Surgical Educator”
• Today I have uploaded one more video in Pediatric Surgery/Pediatric Urology- “ Posterior Urethral Valves”
• Posterior Urethral Valves is the congenital cause for Bladder Outlet Obstruction, resulting in abnormal development of the kidneys as well as the bladder.
• In this video, I talked about the learning outcomes, introduction, etiopathogenesis, clinical features, investigations, differential diagnosis, treatment, follow-up and prognosis of “ Posterior Urethral Valves”
• I hope you will enjoy the video for its educational value.
• You can watch all my teaching videos in the following links
• surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
• Thank you for watching the video.
Epispadias exstrophy
The document discusses the exstrophy-epispadias complex, which results from abnormal cloacal development. It is caused by failure of the cloacal membrane to be reinforced by mesodermal ingrowth. The complex includes classic bladder exstrophy and other variants. Reconstruction involves bladder, abdominal wall, and urethral closure in newborns. Osteotomies may be required to approximate the pubic bones. Epispadias repair is usually done later, along with bladder neck reconstruction and antireflux procedures to achieve urinary control.
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Intussusception (2)
Intussusception is the telescoping of one part of the intestine into another part and is most common in children under 2 years old. The classic presentation includes intermittent abdominal pain, a sausage-shaped abdominal mass, and currant jelly stools. Ultrasound is the preferred diagnostic method and shows a target or "doughnut" sign. Treatment involves rehydration and antibiotics if infected. Non-operative reduction using hydrostatic or pneumatic pressure is usually attempted first but surgery may be needed if reduction fails or there are signs of perforation or necrosis. With prompt diagnosis and treatment, mortality from intussusception is less than 1%.
necrotizing enterocolitis
Necrotizing enterocolitis is the death of intestinal tissue. It most often affects premature or sick babies.
Cryptorchidism--(Undescended testis)
Commonest cause for empty scrotum is undescended testis. Proper education of physicians and parents regarding timing of surgery is mandatory to avoid serious consequences.
Necrotizing Enterocolitis
Necrotizing enterocolitis (NEC) is a common gastrointestinal emergency in neonates, especially preterm infants. It involves necrosis of the intestinal mucosa associated with inflammation and infection. Risk factors include prematurity, enteral feeding, and intestinal ischemia. Clinically, NEC presents with abdominal and systemic signs. Diagnosis is based on clinical features and radiographic findings like pneumatosis intestinalis. Treatment involves cessation of feeding, antibiotics, and possible surgery for perforation or failure to improve. Prognosis depends on gestational age and severity of disease. Prevention focuses on exclusive breastfeeding when possible.
care of children with Epispadias,hypospadias,ectopia vescica
Hypospadias is a birth defect where the opening of the urethra is on the underside of the penis rather than at the tip. It occurs in around 1 in 250 male births. The cause is unknown but may involve abnormal hormone levels during fetal development. Treatment options range from observation for minor cases to surgery to reposition the urethra opening for more severe cases. Complications can include urinary tract infections and curvature of the penis during erections.
Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) is a devastating intestinal disease that primarily affects premature infants. It has multifactorial causes related to prematurity including rapid feeding advances, hypoxia, and indomethacin use. Clinically, infants may experience feeding intolerance and signs of sepsis. Diagnosis is supported by abdominal x-ray findings such as pneumatosis intestinalis. Management involves stopping feeds, antibiotics, and surgery for perforated or necrotic bowel. Despite treatment, NEC carries high mortality and morbidity rates, including short bowel syndrome.
Neonatal necrotizing enterocolitis
Neonatal necrotizing enterocolitis
NEC is the most common life-threatening emergency of the gastrointestinal tract in the newborn period. The disease is characterized by various degrees of mucosal or transmural necrosis of the intestine. The cause of NEC remains unclear but is most likely multifactorial. The incidence of NEC is 1-5% of infants in neonatal intensive care units (NICUs). Both incidence and case fatality rates increase with decreasing birthweight and gestational age. Because very small, ill preterm infants are particularly susceptible to NEC, a rising incidence may reflect improved survival of this high-risk group of patients.
Clinical Manifestations
Infants with NEC have a variety of signs and symptoms and may have an insidious or sudden catastrophic onset (Table 96-1). The onset of NEC is usually in the 2nd or 3rd week of life but can be as late as 3 mo in VLBW infants. Age of onset is inversely related to gestational age. The 1st signs of impending disease may be nonspecific, including lethargy and temperature instability, or related to gastrointestinal pathology, such as abdominal distention and gastric retention. Obvious bloody stools are seen in 25% of patients. Because of nonspecific signs, sepsis may be suspected before NEC. The spectrum of illness is broad, ranging from mild disease with only guaiac-positive stools to severe illness with bowel perforation, peritonitis, systemic inflammatory response syndrome, shock, and death. Progression may be rapid, but it is unusual for the disease to progress from mild to severe after 72 hr.
Diagnosis
A very high index of suspicion in treating preterm at-risk infants is crucial. Plain abdominal radiographs are essential to make a diagnosis of NEC. The finding of pneumatosis intestinalis (air in the bowel wall) confirms the clinical suspicion of NEC and is diagnostic; 50-75% of patients have pneumatosis when treatment is started (Fig. 96-4). Portal venous gas is a sign of severe disease, and pneumoperitoneum indicates a perforation (Figs. 96-4 and 96-5). Hepatic ultrasonography may detect portal venous gas despite normal abdominal roentgenograms .
Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) is a disease that primarily affects premature infants, where portions of the intestine undergo necrosis and tissue death. It is the most common and lethal gastrointestinal disease affecting premature neonates. A 12-day old premature male infant presented with lethargy, hypothermia, feeding intolerance, bilious vomiting and bloody diarrhea. Physical exam revealed abdominal distension, loops of bowel visible in the abdomen, abdominal wall erythema and absent bowel sounds. NEC ranges from mild cases involving feeding intolerance to severe cases involving intestinal necrosis, perforation and septic shock. Risk factors include prematurity, low birth weight, initiation of feeding and bacterial infection. Diagnosis involves clinical and
Necrotizing Enterocolitis
Necrotizing enterocolitis is an acquired intestinal disease of unknown etiology that commonly affects premature infants. The main risk factors are prematurity, genetic factors, maternal health conditions like cocaine use, medications like indomethacin and dexamethasone, and certain enteral feeding practices. The pathogenesis involves an initial hypoxic-ischemic insult to the intestine combined with microbial factors and an excessive inflammatory response that can lead to necrosis of the intestinal tissue. Timely diagnosis and management are important for improving outcomes.
Hypospadias part 1 introd (step by step oper series)
Hypospadias operations part 1 introd (step by step oper series)
more resources of urology on:
uronotes2012.blogspot.com
Neck mass differential diagnosis
This document discusses the differential diagnosis of neck swellings. It begins by defining a neck mass and differential diagnosis. It then describes the various structures that can cause swellings in the head and neck region, including lymph nodes, salivary glands, and muscles. The document outlines the approach to examining a neck mass, including inspecting for location, size, and color, and palpating for tenderness, size, and mobility. Radiographic investigations like MRI, CT, and ultrasound are discussed. Biopsy methods like fine needle aspiration are also summarized.
Undescended Testis- Cryptorchidism
1. Undescended testis, or cryptorchidism, occurs when one or both testes fail to descend into the scrotum. This is a common genital abnormality in boys.
2. Cryptorchidism increases the risks of infertility and testicular cancer later in life. The failure of testes to descend properly can lead to degeneration of germ cells and impaired sperm production.
3. Treatment involves hormone therapy or surgery to bring the undescended testes into the scrotum. This is done to preserve fertility and reduce cancer risks. Timely treatment is important for normal testicular development.
Intussusception
This document provides information on intussusception in children. It discusses that intussusception is the telescoping of one segment of intestine into another and is most common in children under 1 year old. It can be idiopathic or have a pathological lead point such as Meckel's diverticulum. Diagnosis is usually made clinically or with ultrasound or contrast enema. Treatment involves non-operative reduction with hydrostatic or pneumatic enema, which has a high success rate. Surgery is needed if reduction fails or there are complications like perforation. Prognosis is generally excellent with prompt treatment.
Intussusception
Intussusception is a condition where one part of the bowel slides into the next, blocking fluid and food passage and cutting off blood supply. It most commonly affects children under 2 years old. Symptoms include abdominal pain, vomiting, and bloody stools. Diagnosis is usually via ultrasound or enema x-ray. Treatment involves nonsurgical reduction via air or liquid enema or surgical reduction if complications are present. With treatment, prognosis is excellent though recurrence or complications can sometimes occur.
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Maternal And Paternal Risk Factors For Cryptorchidism And Hypospadias A Case–...
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Similar to Hypospadias
LECTURE 33_HYPOSPADIAS.pptx
Hypospadias is a congenital abnormality where the urethral opening is on the underside of the penis. It occurs in about 1 in 300 male births. The goal of repair surgery is to create a straight penis with a slit-like urethral meatus at the tip of the glans. Multiple surgical techniques exist depending on the location and severity of the hypospadias, with the tubularized incised plate technique being commonly used. Careful tissue handling and tension-free repair are important for success. Complications can include fistula, wound issues, and meatal stenosis.
C0422014020
This document summarizes a study that evaluated using a tunica vaginalis flap as a second layer for tubularized incised plate urethroplasty (Snodgrass method) in reoperation for hypospadias. The study included 23 boys ages 3.5-18 who underwent this procedure for previously failed hypospadias repair. The procedure was successful in 82.3% of boys with one prior operation and 66.6% of boys with two prior operations. Complications occurred in 5 patients. The study concluded this technique is reasonable for hypospadias repair in reoperations when there is insufficient skin, with acceptable cosmetic and complication rates.
Chandigarh marudhara jodhpur trust oration f
This document describes techniques for the single stage repair of male and female epispadias. For male epispadias, the technique involves partial penile disassembly, mobilization of the urethral plate, penile lengthening, and urethroplasty. This provides excellent cosmetic and functional results while avoiding complications of other techniques. For incontinent female epispadias, the technique uses tubularization of the urethral strip and double breasting of the bladder neck to create a new continence zone, achieving dry intervals in previously incontinent patients.
Varicocele
This document discusses varicoceles, which are dilated and tortuous veins in the pampiniform plexus that commonly occur in the left testicle. Varicoceles are a common cause of male infertility and are often treated with varicocelectomy surgery to ligate the veins. The document describes the anatomy, causes, symptoms, grading, investigations, and surgical and non-surgical treatment options for varicoceles.
Imperforate Anus
1. Imperforate anus occurs in approximately 1 in 5,000 births and is more common in males. It is noticed when an infant fails to pass meconium. It occurs when the cloacal membrane fails to rupture, resulting in no anal opening.
2. Imperforate anus can be associated with other birth defects, including vertebral, anal, cardiac, tracheo-esophageal, renal, and limb defects. Lesions can be high or low. High lesions require a colostomy before repair surgery while low lesions can be repaired via a perineal anoplasty.
3. Preoperative assessment includes testing for other anomalies and evaluating for distension, breathing issues
Ano-rectal Malformations copy.pptx
This document describes various types of anorectal malformations in infants. It begins by explaining normal fetal development of the cloaca and how it divides. It then describes the various defects seen in males (rectobladder neck fistula, rectourethral fistula) and females (rectovestibular fistula, cloaca). Signs and associated anomalies are provided. Investigations like ultrasound and X-rays are outlined. Surgical techniques for repair like PSARP are also summarized.
hypospadias and epispadius.pptx
Hypospadias is a congenital defect where the opening of the urethra is on the ventral side of the penis rather than at the tip. It occurs in about 1 in 250 male newborns and is thought to result from arrested penile development leaving a proximal urethral opening. Treatment involves surgical repair to reposition the urethra, which depends on the location and severity of the hypospadias but generally aims to maximize function and cosmetic appearance. Complications can include bleeding, meatal stenosis and fistula formation.
03,04 Embryology & congenital anomalies.pdf
The document summarizes female genital development from the 12th day of fertilization through birth. It describes the development of the internal and external genitalia including the ovaries, fallopian tubes, uterus, cervix, and vagina. It also discusses congenital anomalies that can occur including ambiguous genitalia, hypoplastic organs, fusion defects of the uterus, and unicornuate or rudimentary uteri. Treatment options are provided for some anomalies.
Undescended Testis
Undescended testis, or cryptorchidism, is a common condition in infants where one or both testes fail to descend into the scrotum. It occurs in approximately 3% of term male infants and is more common in premature infants. Left untreated, undescended testis can lead to infertility and an increased risk of testicular cancer. The standard treatment is orchidopexy surgery to bring the testis into the scrotum, which is usually performed between 6-12 months of age. For intra-abdominal undescended testes, a two-stage surgical approach may be used.
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The document provides information about rectal prolapse including its definition, types, classification, causes, clinical features, pathogenesis, differential diagnosis, complications and treatment. It discusses partial (mucosal) prolapse and complete (full thickness) prolapse. For treatment, it describes both medical management and surgical procedures for rectal prolapse including perineal procedures like Delorme's procedure and Altemeier's procedure as well as abdominal procedures like Wells operation and Ripstein sling operation. It also lists several homeopathic medicines commonly indicated in the treatment of rectal prolapse such as Podophyllum, Aesculus, Sulphur, Ferrum metallicum, Ruta, Ignatia, Muriaticum
Billious vomiting
The document discusses several pediatric surgical emergencies including malrotation, pyloric stenosis, intussusception, Meckel's diverticulum, appendicitis, and acute scrotum. It provides details on the presentation, diagnosis, and treatment of each condition. The main takeaway messages are that bilious emesis should be assumed to be malrotation until proven otherwise, appendicitis should always be in the top 3 differential diagnoses for abdominal pain, and acute scrotum requires urgent evaluation and treatment without delay.
Oshiba feminizing genitoplasty
This document discusses different approaches to feminizing genitoplasty in patients with disorders of sex development. It compares early vs late repair, one-stage vs multi-stage procedures, and techniques for clitoroplasty, vaginoplasty, and labioplasty. A team approach is recommended, including careful examination, imaging, and laboratory workup. Surgical goals are to create normal-appearing female genitalia while preserving sexual function and minimizing complications like stenosis. Long-term outcomes include assessing cosmetic results, genital sensitivity, and urological/psychosexual issues.
Case of mrkh with vaginal hypoplasia for vaginoplasty
This document describes a case of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome with vaginal atresia treated with McIndoe's vaginoplasty. A 19-year old woman presented with primary amenorrhea and pain during intercourse. Exams and investigations confirmed MRKH with a unicornuate uterus and vaginal atresia. She underwent a McIndoe's vaginoplasty where a skin graft was harvested from her abdomen and sutured to create a neovagina. Post-operative care included antibiotics and dressing changes. The skin graft took well and a vaginal passage was successfully created.
Vaginal & genitourinary reconstruction
This document provides an overview of vaginal and genitourinary reconstruction techniques. It discusses the embryology and anatomy of the genital tract. It then covers various congenital defects including vaginal agenesis, ambiguous genitalia, and bladder exstrophy. Surgical techniques for vaginal reconstruction include serial dilation, bowel flaps, local flaps, and the McIndoe technique using a skin graft. Acquired defects from cancer or trauma can be addressed with skin grafts or flaps from the vulva, vaginal vault, penis, or scrotum. Goals of reconstruction include wound coverage and restoration of function.
Spinal Anaesthesia. by Dr. Shailendra
Spinal anaesthesia involves injecting local anaesthetic into the cerebrospinal fluid surrounding the spinal cord. A brief history was provided including the discovery of cerebrospinal fluid in the 1700s and the first planned spinal anaesthesia on a human in 1891. Key anatomy was discussed including the levels of the spinal cord and vertebrae. Common local anaesthetics used for spinal anaesthesia like bupivacaine and ropivacaine were listed along with typical dosages. Factors affecting the level of spinal block were summarized.
Hypospadias cripple - Staged reconstruction
Hypospadias is a congenital deformity where the opening of the urethra (the meatus) is sited on the underside (ventral) part of the penis , anywhere from the glans to the perineum.
Hypospadias is one of the most common congenital anomalies in boys, occurring in 1 in 150 to 300 live births
Nsw plastic-nurses
This document discusses different types of skin grafts and flaps used in reconstructive surgery. It provides details on:
1) The differences between grafts and flaps, with grafts being skin only and flaps retaining some underlying tissue and blood supply.
2) The reconstructive ladder ranging from healing by secondary intention to free flaps.
3) The anatomy of skin blood supply from deep vessels to cutaneous perforators and subcutaneous plexuses.
4) Classification and process of take for skin grafts including split thickness and full thickness grafts.
5) Classification of flaps including random flaps based on subdermal plexus, axial flaps based on named vessels
Rectum .pptx
This document provides information about the anatomy, surgical procedures, investigations, staging, and management of rectal carcinoma. It discusses the rectum's blood supply, relations, and surgical anatomy. Rectal carcinoma risk factors include diet, obesity, smoking, and age over 70. Staging includes MRI, CT, and colonoscopy. Management involves local excision for early stages and anterior resection, Hartmann's procedure, or APR for later stages. It may also include radiotherapy, chemotherapy, or palliative stenting.
Varicocele
Varicocele is a dilation and twisting of the veins within the pampiniform plexus that drain the testicles. It is commonly seen in 15-30 year old males and is a cause of infertility in around 40% of infertile males. The left side is more commonly affected due to anatomical factors. Treatment involves surgical ligation of the veins through various approaches like inguinal or retroperitoneal. Other options include embolization or laparoscopy. Surgery is recommended for infertile males with a varicocele to potentially improve semen parameters and fertility chances.
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This study assessed the efficacy of different surgical techniques (open surgery, percutaneous nephrolithotomy [PNL], and retrograde intrarenal surgery [RIRS]) for treating kidney stones. 102 patients undergoing kidney stone surgery were divided into the three treatment groups. The mean stone burden, operative time, length of hospital stay, and residual stone rates were compared between groups. Complications like fever, infection, urine leakage and persistent pain were also assessed. PNL and RIRS had lower stone burdens, shorter operative times, shorter hospital stays, and fewer complications compared to open surgery. PNL and RIRS were found to be safer and more effective treatments for kidney stones than open surgery.
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FOURNIER’S GANGRENE: REVIEW OF 57 CASES IN TERTIARY INSTITUTION
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EVALUATION OF ABSORBABLE AND NON-ABSORBABLE SUTURES IN A COHORT STUDY
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STAPLER HAEMORRHOIDPEXY FOR 3rd & 4th DEGREE HAEMORRHOID OUR EXPERIENCE
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Mass casualty management
1. Mass casualty management involves treating a large number of injured people from a disaster in a short period of time. It requires advance planning and coordination between medical personnel, facilities, and community groups.
2. A mass casualty situation exceeds normal capabilities, so modifications are needed in triage, transportation, treatment approaches, and more to optimize survival rates. The goal is to reduce immediate mortality and morbidity through efficient triage, transport, and focusing resources on life-saving care.
3. Successful management requires flexible disaster plans that can be rapidly implemented through clear communication and teamwork between all involved parties according to their assigned roles.
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The document discusses the history and evolution of endoscopic and laparoscopic surgery from the 1800s to present day. Key developments include the first use of endoscopes in the 1800s, advancements in instrumentation and video technology in the 1900s enabling more complex procedures, and the explosion of laparoscopic surgeries starting in the late 1980s with procedures like laparoscopic cholecystectomy. The future of laparoscopy may include improvements like 3D imaging to enhance the surgical experience.
Complications of laparoscopic surgeries
The document discusses complications that can occur during and after laparoscopic surgeries. Some common complications discussed include:
1. Anaesthetic complications such as inadequate muscle relaxation during the procedure, hyperventilation prior to surgery, and possible air embolism from carbon dioxide used for pneumoperitoneum.
2. Complications due to pneumoperitoneum such as respiratory acidosis, increased pressure on veins, and possible effects on renal function from increased abdominal pressure.
3. Surgical complications such as injuries to organs like the stomach, bowel, bladder from trocars or instruments. Thermal injuries from diathermy are also discussed.
4. Other complications mentioned include bleeding, infections, inc
Indications for breast reconstruction
Breast reconstruction has become an important part of breast cancer treatment to help restore a woman's body image and self-esteem after mastectomy. There are several options for reconstruction, including implants, flaps of tissue from the abdomen, back, or buttocks, or a combination of procedures. Immediate reconstruction at the time of mastectomy has advantages over delayed reconstruction in terms of cosmetic results and psychological impact. Proper patient selection considering health factors and goals is important to achieve a successful surgical outcome and recovery.
Current role of surgery in the management of peptic ulce (1)
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Raipur twins dr.anil haripriya
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- During the surgery, the liver, pancreas and sternum were separated with no reported complications. The twins are now doing fine after the successful operation.
Mandibular reconstruction
The document discusses various techniques for mandibular reconstruction, including non-vascularized bone grafts and vascularized bone flaps. It states that free vascularized bone flaps have become the most popular technique as they heal more rapidly and have less risk of complications compared to non-vascularized grafts. Common types of free flaps used include fibula flaps based on the peroneal artery and iliac crest flaps based on the deep circumflex iliac artery.
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Hydatid Cyst Of Liver
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Buccal Mucosal Cancer
1) Buccal mucosal cancer has a high incidence in India, accounting for around 4% of all cancers. It is predominantly caused by the habit of chewing tobacco and betel quid.
2) Risk factors include various forms of smokeless tobacco used widely in India. Chewing tobacco and keeping a quid in the cheek overnight increases the risk of buccal mucosal cancer.
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Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
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Patellar Instability: Diagnosis Management
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
RESPIRATORY DISEASES by bhavya kelavadiya
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
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- 11. Treatment Plan Prevention of urethral plate , skin & dartos dissection Distal Proximal Glans configuration Meatal quality & location Urethral plate width Assess curvature Dorsal plication if necessary MAGPI GAP/Pyramid Tubularization Snodgrass Assess curvature Dorsal plication if necessary Rarely resect plate Onlay Two stage Bracka two-stage buccal graft
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