OBJECTIVESTo study the occurrence of different anomalies associated with hypospadias and to instruct relevant treatment in clinical practice.

METHODSThree hundred and forty-one cases of hypospadias were investigated, all treated respectively corresponding to their specific anomalies.

RESULTSThe morbidity of associated anomalies in cases of hypospadias was as high as 21.1%. Most of the anomaly cases were undescended testes and inguinal hernia, and the incidence of associated anomalies was related to the degree of hypospadias.

CONCLUSIONSHypospadias is not just a local dysmorphic problem but rather a local manifestation of a systemic disease. It is necessary to take those associated anomalies as a systemic whole and attach enough importance to their clinical treatment.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; complications ; surgery ; Male ; Urogenital Abnormalities ; complications ; surgery ; Urogenital Surgical Procedures ; methods

OBJECTIVETo introduce two methods of laparoscopic varicocelectomy for the treatment of spermatic varicocele.

METHODSForty-five cases of spermatic varicocele were treated by video laparoscopic technique with two or three punch.

RESULTSAll the 45 operations were performed successfully, and no complications occurred during and after the operations.

CONCLUSIONSSpermatic varicocele is one of the most suitable indications for video laparoscopic surgery. The two-punch technique is more advantageous than the three-punch.

Adolescent ; Adult ; Humans ; Laparoscopy ; Male ; Middle Aged ; Urogenital Surgical Procedures ; methods ; Varicocele ; surgery ; Video-Assisted Surgery

OBJECTIVETo evaluate some currently used surgical approaches to the correction of congenital penile curvature.

METHODSSeventy-six patients with congenital penile curvature underwent surgical correction, of whom 67 were accompanied with hypospadias, 5 with epispadias and 4 with normal urethral meatus. The methods for straightening the phallus included 5-week preoperative hCG treatment, complete degloving of penile skin, release of periurethral fibrous bands extending proximally to the meatus, plication of dorsal or ventral tunica albuginea, and embedding of dermis and tunica vaginalis grafts.

RESULTSAll the cases were followed up for 2 months to 2 years, and the mean follow-up time was 9.3 months. Satisfactory phallus straightening was achieved in 67 cases (88%), mild residual chordee remained in 6 (8%), which needed no reoperation for the time being unless warranted by follow-up, and relapse occurred in 3 (4%), which needed further operation.

CONCLUSIONMost cases of congenital penile curvature can be corrected sufficiently with the above methods.

Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Infant ; Male ; Penis ; abnormalities ; Urogenital Abnormalities ; surgery ; Urologic Surgical Procedures, Male ; methods

Symptomatic seminal vesicle cysts (SVCs), especially those of a large size, can be removed by surgical treatments. Currently, open surgeries for SVC are rarely performed due to their extensive surgical trauma, and minimally invasive surgical therapies for treating seminal vesicle cysts are still in the early stages. In addition, relevant studies are mostly confined to case reports. In this study, we retrospectively reviewed 53 patients who had received transperitoneal laparoscopic unroofing or fenestration under seminal vesiculoscopy for SVC in our institution. Both surgeries decreased the cyst volume to a significant extent; however, according to the remnant lesion size after rechecking images, seminal vesiculoscopic fenestration tended to have a higher recurrence than laparoscopic unroofing. Regarding complications, two individuals in the laparoscopic unroofing group experienced ureteral injury and rectal injury, while patients in the fenestration group only had temporary hemospermia, which indicates that fenestration surgery tends to have less severe complications than laparoscopic unroofing. There was no solid evidence confirming semen improvement after these surgical therapies in our study. Future studies with a prospective design, larger sample size, and longer follow-up period are required to verify and further explore our findings.
Adult ; Anesthesia, General ; Cysts/surgery* ; Follow-Up Studies ; Humans ; Laparoscopy/methods* ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Operative Time ; Postoperative Complications/epidemiology* ; Recurrence ; Retrospective Studies ; Seminal Vesicles/surgery* ; Treatment Outcome ; Urogenital Surgical Procedures/methods* ; Young Adult

OBJECTIVETo evaluate the postoperative complications of microscopic and conventional Palomo varicocelectomy in the treatment of varicocele in army personnel.

METHODSA total of 260 army personnel with varicocele were randomized to receive microscopic varicocelectomy (group A, n=130) and conventional Palomo varicocelectomy (group B, n=130). The postoperative recurrence and complications (scrotal edema, testicular pain and testicular atrophy) were compared between the two groups.

RESULTSAfter 1 year of follow-up, the recurrence rates in groups A and B were statistically comparable (5.3% vs 3.8%, P>0.05). The incidences of testicular atrophy and scrotal edema were significantly lower in group A than in group B (0.7% vs 3.1%, P<0.05; 3.1% vs 14.6%, P<0.05), and the rate of testicular pain relief was significantly higher in group A (90.7% vs 67.7%, P<0.05).

CONCLUSIONMicroscopic varicocelectomy can be a good choice in the treatment of varicocele in army personnel.

Adolescent ; Adult ; Groin ; surgery ; Humans ; Male ; Microsurgery ; adverse effects ; methods ; Postoperative Complications ; Treatment Outcome ; Urogenital Surgical Procedures ; adverse effects ; Varicocele ; surgery ; Young Adult

OBJECTIVETo compare the effects and postoperative complications of microscopic varicocelectomy (MV) and laparoscopic varicocelectomy (LV) in the treatment of varicocele.

METHODSWe assigned 72 varicocele patients to two groups of equal number to be treated by MV and LV. We compared the two groups in the semen parameters before and 3 months after surgery, postoperative complications, and pregnancy rates of the patients'wives.

RESULTSThe operative time was significantly longer in the MV than in the LV group (P<0.05). The postoperative hospital stay showed no significant difference between the MV and LV groups ([2.2 +/- 2.7] d vs [2.8 +/- 0.8] d). Sperm concentration, sperm motility and the percentage of grade a + b sperm were significantly increased in both groups after surgery (P<0.05), but with no significant differences between the two. The pregnancy rate was 65.2% in the former and 57.1% in the latter. Postoperative hydrocele occurred in 5 cases in the LV, but none in the MV group. There were no statistically significant differences in recurrence between the two groups (P>0.05).

CONCLUSIONMV is superior to LV for its minimal invasiveness, economical anesthesia, faster recovery and lower rates of postoperative complications and recurrence.

Adolescent ; Adult ; Humans ; Laparoscopy ; Male ; Microsurgery ; Postoperative Complications ; Recurrence ; Testicular Hydrocele ; etiology ; Treatment Outcome ; Urogenital Surgical Procedures ; methods ; Varicocele ; complications ; surgery ; Young Adult

OBJECTIVETo evaluate the endourethral surgery for the complicated urethra stenosis and urethratresia.

METHODSThe endourethral surgery, such as internal urethrotomy transurethral scar electrosectomy or transurethral scar plasmakinetic bipolar electrocautery (PKR) or transurethral laser cicatrectomy, were carried out in 46 cases suffering from the complicated urethra stenosis and urethratresia.

RESULTSThe curative rate in this series being achieved by once and twice or three times'operation were 80.43% (39/46) and 13.04% (6/46) respectively. Three cases of treatment failure were caused by long-segment stricture and urethratresia or severe malposition of the urethral proximal and distal to a narrow-caliber area or post-operation infection. Thirty-nine cases have been followed up for 6 to 84 months. Satisfactory voiding has been achieved in all patients.

CONCLUSIONEndoscopic surgery was believed to be a safe and efficient therapeutic choice for the complicated urethra stenosis and urethratresia. The success of the treatment depends on understanding the length of the stricture before operation, resecting completely the scar tissue with electric or PKR or laser technique during the process, preventing infection and managing appropriately the urethral catheterization after operation.

Adolescent ; Adult ; Aged ; Endoscopy ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Retrospective Studies ; Urethra ; abnormalities ; surgery ; Urethral Obstruction ; surgery ; Urethral Stricture ; surgery ; Urogenital Surgical Procedures ; methods

AIMTo determine if robot-assisted varicocelectomy can be safely and effectively performed when compared to microscopic inguinal varicocelectomy.

METHODSEight patients aged 29.1+/-12.5 years underwent microscopic subinguinal varicocelectomies: seven patients with left-sided repair, and one patient with bilateral repair. Eight patients aged 22.0+/-8.0 years underwent robot-assisted varicocelectomies: seven patients with left-sided repair and one patient with bilateral repair.

RESULTSThe average operative time for microscopic inguinal varicocelectomy was 73.9+/-12.2 min, whereas the robot-assisted technique took 71.1+/-21.1 min. There were no difficulties in identifying and isolating vessels and the vas deferens with robot-assisted subinguinal varicocelectomy. Hand tremor was eliminated using the robotic procedure. Patients who underwent either microscopic or robot-assisted varicocelectomies were able to resume daily activities on the day of surgery and full activities within 2 weeks. There were no complications or recurrences of varicocele.

CONCLUSIONFrom our experience, compared to microscopic surgery, robot-assisted varicocelectomy can be safely and effectively performed, with the added benefit of eliminating hand tremor.

Adolescent ; Adult ; Humans ; Male ; Robotics ; Suture Techniques ; Time Factors ; Treatment Outcome ; Urogenital Surgical Procedures ; instrumentation ; methods ; Varicocele ; surgery ; Vas Deferens ; blood supply

Adult ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Penis/injuries* ; Postoperative Complications/epidemiology* ; Retrospective Studies ; Treatment Outcome ; Urogenital Surgical Procedures/methods* ; Young Adult

We retrospectively reviewed data for 286 patients with varicocele who underwent microsurgical subinguinal varicocelectomy from March 2015 to May 2017 in Shanghai General Hospital (Shanghai, China). In this surgical approach, the testis was delivered, and the gubernacular and external cremasteric veins were stripped. In addition, the spermatic cord was delivered downward with continuous double traction away from the external ring. The remaining procedure was similar to the conventional approach. We followed patients for at least 3 months and evaluated postoperative semen parameters, pain symptoms, and complications. We excluded data for 32 men due to inadequate follow-up (<3 months). Of the remaining 254 patients, 73 had oligoasthenospermia, 121 had nonobstructive azoospermia, and 60 had symptomatic varicoceles. Total progressive sperm counts increased in the oligoasthenospermic patients from a median preoperative value of 9.15 × 10⁶ ml^-1 to 25.33 × 10⁶ ml^-1 (n= 34), and 35.6% (26/73) initially oligoasthenospermic men contributed to unassisted pregnancies. Sperm returned to the ejaculate in 12.4% (15/121) azoospermia patients. In patients with scrotal pain (n = 60), 43 (71.7%) reported complete resolution of pain, 16 (26.7%) reported partial resolution, and 1 (1.7%) reported no change. No patients experienced varicocele recurrence. This double-traction strategy avoids opening the external oblique aponeurosis, and results in less damage and faster recovery. In addition, the stripping strategy eliminates potential damage to the testis caused by the varicose veins. Our results showed that microsurgical subinguinal varicocelectomy using spermatic cord double traction in conjunction with testicular delivery for vein stripping is a safe and effective approach for varicocele repair.
Adolescent ; Adult ; Humans ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Spermatic Cord/surgery* ; Testis/blood supply* ; Treatment Outcome ; Urogenital Surgical Procedures/methods* ; Varicocele/surgery* ; Veins/surgery* ; Young Adult