The long-term clinical syndrome that results from PUVs is known as the “valve-bladder syndrome.” Affected patients have large bladder volumes and subsequent overflow incontinence, which occur because bladder compliance and…
The same basic mechanism applies to solutes, such as potassium, calcium, and other salts, the concentrations of which are maintained in very narrow ranges in the extracellular and intracellular spaces….
TREATMENT A patent urachus or superior sinus should be excised using either an open or laparoscopic technique. It is essential to remove all abnormal urachal tissue because there is a…
The developmental abnormality that gives rise to PUVs remains uncertain, at least in part because of the ongoing debate over the precise morphology of this defect. It has been hypothesized,…
TREATMENT The need for surgical intervention depends on the nature and extent of the malformation. If an obstruction is present, it should be excised as soon as possible so as…
With current reconstructive strategies, most patients achieve urinary continence (albeit with clean intermittent catheterization in a significant proportion) and can lead satisfying personal and professional lives. Long-term management, however, must…
Finally, early orchidopexy is recommended in all patients because it often allows them to achieve normal production of sex hormones at puberty. In addition, it greatly facilitates a regular examination…
PATHOGENESIS The embryologic defect underlying the epispadiasexstrophy complex is poorly understood. The most prominent theory argues that the main defect lies in the cloacal membrane, the bilaminar structure consisting of…
Although all patients have hydronephrosis, the degree of renal dysplasia is variable and has important prognostic implications. Those with the most severe renal dysplasia develop the Potter sequence (Plate 2-8)…
The goals of surgical intervention include relief of obstruction, infection, and reflux. The standard options include endoscopic incision of the ureterocele, as well as various open or laparoscopic procedures, such…
