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ABSTRACTS
Year : 2020  |  Volume : 12  |  Issue : 5  |  Page : 16-17  

Abstract - SUA202 (Pediatric)


Date of Web Publication9-Jun-2020

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DOI: 10.4103/0974-7796.278705

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How to cite this article:
. Abstract - SUA202 (Pediatric) . Urol Ann 2020;12, Suppl S1:16-7

How to cite this URL:
. Abstract - SUA202 (Pediatric) . Urol Ann [serial online] 2020 [cited 2021 Sep 21];12, Suppl S1:16-7. Available from: https://www.urologyannals.com/text.asp?2020/12/5/16/278705


   The effectiveness of laparoscopic management and its outcomes in nonpalpable intra-abdominal testis: A retrospective study from Northern Saudi Arabia Top


Mohammed J. Alenzi, Ziyad Nawaf Aljazi1, Saleh Farouk2, Kasseb Abalawkel3, Abdualaziz Faisal Alrebea4, Bander M. Altaleb5, Fawaz F. Alrashed6

Associate Professor of Urology, Jouf University,1Resident in Prince Miteb Hospital,2specialist in Prince Miteb Hospital,3Resident in Prince Miteb Hospital,4KASH, 5Resident in King Abdulaziz Specialty Hospital,6Assistant Professor, Hail University, Sakaka, Aljouf, The Kingdom of Saudi Arabia

E-mail: [email protected]

Introduction: Cryptorchidism is one of the most common genitourinary anomalies in male children. The untreated undescended testis may result in several complications such as infertility and tumor. In our study, we examined the diagnostic laparoscopy and evaluated the results and effectiveness of laparoscopy in the diagnosis and surgical treatment of undescended testis.

Methodology: This retrospective study was done among 90 children who had undergone laparoscopic management for undescended testes from different hospitals of Aljouf region of northern Saudi Arabia by a non - probability consecutive sampling method. Physical examination, reported investigation results, age at surgery, laparoscopic management and findings, surgical procedures results, post-operation complications were evaluated at a predetermined follow-up period. The children with non-palpable testis only were included in this study.

Results: Of the 90 children, 34 (37.8%) presented with bilateral, while 56 (62.2%) had unilateral non-palpable cryptorchidism [Table 1]. In the present study, we did not come across any intraoperative complications among all the surgery done. The children had mild postoperative pain and could be managed with analgesics. During the follow up visits, there was no complication reported among the children such as infections, hernia and so on.

Conclusion: Our study revealed that the management of non-palpable testis is more effective and without any major complications. Hence, we recommend including the laparoscopic management of non-palpable testis as a primary modality of management including at peripheral hospitals with adequate training for urologists to deal with like these cases.


   Is the endoscopic injection of dextranomer/hyaluronic acid an efficient treatment of bilateral primary high grade vesicoureteral reflux with safe long-term outcome? Top


Fouad Al Kawai, Osama Sarhan

Department of Urology, King Fahad Specialist Hospital, Dammam, Eastern Province, Saudi Arabia

E-mail: [email protected]

Introduction: Endoscopic injection of dextranomer/hyaluronic acid is commonly used treatments for lower grade vesicoureteral reflux (VUR). However, there is a lack of evidence regarding its long term efficacy and safety in patients with primary bilateral high grade VUR. In this study, we present our experience in endoscopic correction of this specific group of patients with long term follow up.

Materials and Methods: This is a retrospective review of all patients with bilateral primary high grade VUR from 2006 to 2014. We excluded patients with low grade VUR, secondary VUR, and patients treated with re-implantation. Medical records reviewed in regards to the age at diagnosis, clinical presentation, antenatal history, grade of VUR, presence of scarring on DMSA, the indication of surgical intervention, surgical approaches, and clinical/radiological outcome.

Results: A total of 67 patients who have bilateral VUR identified in our records, of whom 30 (20 boys and 10 girls) had bilateral primary high grade VUR. The mean age at diagnosis was 7 months. All of them managed by endoscopic injection of dextranomer/hyaluronic acid. In 18 patients, antenatal hydronephrosis with varying degree identified. DMSA scans showed renal scarring in 19 patients (63%), and 3 of them were bilateral. The overall resolution rate after the first endoscopic injection was 60%; only one of them required redo injection. Persistent high grade VUR and downgrade to low grade VUR seen in 11 patients (37 %) and one patient (3%), respectively. No significant postoperative complications occurred, and none required Ureteral reimplantation after a mean follow-up of 8 years. Chronic kidney disease (CKD) developed in 10 patients (33%), 4 of them had no VUR at last follow-up.

Conclusions: Primary bilateral high grade VUR can be managed by endoscopic injection of dextranomer/hyaluronic acid with acceptable resolution rate and efficient long term outcome. Redo injection can be easily done with a high resolution rate.


   The role of ultrasonography in the management of undescended testes Top


Rakan Mohammed Aldarrab, Riyadh Omar Alfuraidi, Raiyan Yousif Almaini1, Hamoud Omar Alqarni1, Tariq Burki, Ahmad Alshammari

Department of Pediatric Urology, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City,1College of Medicine, King Saud Bin Abdulaziz University for Heath Sciences, Riyadh, Saudi Arabia

E-mail: [email protected]

Introduction: Undescended testes is estimated to be present in about 4.5% of newborns and the rate is higher among pre-terms babies.

Many different practitioners may be involved in the initial diagnosis of undescended testes apart from specialized surgeons.

Aim: To assess The sensitivity of ultrasound versus physical examination by an expert in localizing undescended testes.

Results: The study included 780 cases of undescended testes cases referred. Mean age is 22 months (0-140). 40% of which had ultrasound scans done before referal. The findings on physical examination (n=730) and ultrasound (n=316) were compared with the actual operative findings. The unilateral inguinal canal/scrotal neck testes were correctly identified by 69% on physical exam and 40% on ultrasound (p= <0.001 ), while the bilateral ones were correctly identified by 61% and 69% respectively (p=0.13 ). Operative findings of intra-abdominal testes were correctly identified in 59% on physical examination as impalpable and in 42% on ultrasound as intra-abdominal or negative (p= 0.18 ). In those cases which had a unilateral impalpable testis while the other one was inguinal canal/scrotal were correctly identified by 36% on physical examination and 50% on ultrasound (p=0.57 ).

Conclusion: Physical examination was more accurate in localizing inguinal undescended testes when compared with ultrasound. Apart from inguinal undescended testes, No difference was appreciated between physical exam and ultrasonography in localizing undescended testes. Hence, we recommend against performing it.




 

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