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CONGRESS OF THE ESPU
VS-12 (VS without presentation)
THE ARROW TECHNIQUE FOR CONGENITAL
MEGAPREPUCE
Gloria Fatou ROYO GOMES
1
, Romy GANDER
1
, Marino ASENSIO LLORENTE
1
and Manuel LOPEZ PAREDES
2
1) Hospital Vall Hebron, Pediatric Urology Unit. Pediatric Surgery, Barcelona, SPAIN - 2) Hospital Vall Hebron, Pediatric
Surgery, Barcelona, SPAIN
PURPOSE
Congenital megaprepuce (CMP) appears like a buried penis with a wide base. The caractheristics
of CMP are: a stenotic preputial opening that difficults micturiction and consequently enlarged
inner prepuce shaft; an absent penopubic and penoescrotal angles due to abnormal fixation of
the dermis; and a limited penile shaft skin for its reconstruction.In symptomatic patients an early
surgical correction is needed . The purpose of this Video it’s to describe the technical details for the
correction of CMP.
MATERIAL AND METHODS
The arrow technique has been performed in 4 children. An arrow incision was carried out in the
ventral skin; the incision started from the preputial ring and ended in the penoescrotal junction.
Afterwards a total degloving, excision of the redundant prepuce and dartos fascia was performed.
The dermis of the penopubic and penoescrotal angles were fixed to the Buck’s fascia to avoid recur-
rence. The lateral flaps were rotated up to the balanopreputial grove and sutured by Z-plasty fashion
in the ventral shaft. In very large ventral defect a rotational scrotal flaps to the midline were needed.
A Foley bladder catheter and a foam compressive dressing were left for 48 hours.
RESULTS
All patients attained good cosmetical and functionals results, with uneventful course and remain
asymptomatic. No inmediate postoperative complications were collected in these patients.
CONCLUSIONS
The arrow technique for (CMP) is an easy approach and reproducible technique with good func-
tional and cosmetic results.
VS-13 (VS without presentation)
HIGH-PRESSURE BALLOON DILATATION
FOR ORTHOTOPIC URETEROCELE TREATMENT
Alberto PARENTE
1
, Laura BURGOS
2
, Ruben ORTIZ
2
and Jose Maria ANGULO
2
1) Gregorio Marañón University Hospital, Pediatric Surgery, Madrid, SPAIN - 2) Gregorio Marañon University Hospital,
Pediatric Urology, Madrid, SPAIN
PURPOSE
Transurethral puncture or endoscopic unroofing is the most common treatment currently used for
both orthotopic and ectopic ureteroceles. However, incidence of secondary vesicoureteral reflux is
high and usually a subsequent procedure is needed. We present a new technique for treatment of
orthotopic ureterocele.
MATERIAL AND METHODS
We analyzed 9 patients with orthotopic ureterocele (9.7 ± 6.2 months old) treated by dilatation of the
meatus. No patient had vesicoureteral reflux or duplicate system. The indication was pyonephrosis
in 5 children and progressive worsening of hydronephrosis in 4. Dilatation was performed with
a 5 mm high-pressure balloon after inserting a stent through a 0,014´ guidewire.