Do pediatricians routinely perform genitourinary examinations during well-child visits? A review from a large tertiary pediatric hospital
The male genital examination is a common source of discomfort for the patient and medical provider. Performance of male genital examination is imperative; however, as many treatable diagnoses can be made. Undescended testicles (UDTs), hernias, testicular tumors, and urethral abnormalities are all potentially concerning findings which can be discovered on routine examination.
AbstractPurposeWe compared the outcomes of laparoscopic surgery (LS) with those of open surgery (OS) for unilateral and bilateral pediatric inguinal hernia.MethodsUsing a nationwide claim-based database in Japan, we analyzed data from children younger than 15 years old, who underwent inguinal hernia repair between January 2005 and December 2017. Patient characteristics, incidence of reoperation, postoperative complications, length of hospital stay, and duration of anesthesia were compared between LS and OS for unilateral and bilateral hernia.ResultsAmong 5554 patients, 2057 underwent LS (unilateral 1095, bilateral 96...
Publication date: 13–19 July 2019Source: The Lancet, Volume 394, Issue 10193Author(s): Ankoor Talwar, Abhinav Talwar, Arunabh Talwar
ConclusionGiant inguinoscrotal hernias should be defined and evaluated as a group apart from classical inguinoscrotal hernias. Recurrence and morbidity rates were lower in patients who underwent hernioplasty using Zig maneuver.
Epithelial –mesenchymal transition (EMT) describes rapid changes in cellular phenotype. During EMT, epithelial cells down-modulate cell–cell adhesion, alter polarity, reorganize cytoskeleton, become isolated, motile, and resistant to anoikis. Epithelial breakdown and epithelial cell migration are the key p rocesses involved in the obliteration of processus vaginalis. The great majority of abnormalities are because of nonobliteration or incomplete fusion of PV. We aimed to analyze the quantitative changes of epithelial genes in adult/child patients and their controls to examine differences of the genes is of these hernias.
ConclusionHigh index of clinical suspicion and early intervention saves the patient from extensive bowel resection and other serious complications.
Mucopolysaccharidosis (MPS) I is an autosomal recessive lysosomal storage disorder resulting from a deficiency in the lysosomal enzyme α-l-iduronidase, leading to the accumulation of the glycosaminoglycans (GAGs) dermatan sulfate (DS) and heparan sulfate (HS) in cells throughout the body. The clinical characteristics of MPS I include cognitive impairment (severe form), coarse facial features, corneal clouding, respiratory disorder s, cardiac diseases, hepatomegaly, umbilical and inguinal hernias, skeletal abnormalities, and joint contractures.
Conclusions: All patients had successful abdominal wall closure. Most of the patients had minimal scar of the large hernia repair and the umbilicus was normal looking and well accepted cosmetically.
ConclusionThis preliminary study showed that NAIRS after cauterization of the neck of the hernia sac in infants and children is safe, feasible, reproducible with excellent cosmetic results.
ConclusionThis study suggests that fewer 0 –4-year olds are undergoing inguinal herniotomy, compared with 20 years ago. This is likely due to a change in practice for the management of unilateral symptomatic hernias, from routine bilateral herniotomies, to unilateral surgery. As well as less aggressive surgical intervention for hydroceles in boys.Level of evidenceIII.
CONCLUSION: The affection of testicular vascularity postoperatively is transient and returns to be near to the preoperative values in the late postoperative period (six months postoperatively). Additionally, no significant change in testicular volume postoperatively. PMID: 31091967 [PubMed - as supplied by publisher]