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11–14 APRIL, 2018, HELSINKI, FINLAND
A new procedure with pyelography and robotic ureterolysis was performed after 15 months because
of persistent colicky pain. Then, in 2017, persistent symptomatic obstruction required further treat-
ment with a robotic uretero-calicostomy.
RESULTS
The patient was discharged on 9
th
post-operative day without any major complications. Nephrostomy
was removed after 3 weeks and JJ stent after 5 weeks. Ultrasound imaging after 8 weeks showed
significant reduction of hydronephrosis. After 7 months she doesn't complain of any symptoms and
the imaging shows conserved renal function and reduction of hydronephrosis.
CONCLUSIONS
Robotic surgery is a safe approach even for the most complex pediatric urological procedures.
Uretero-calicostomy is an uncommon procedure generally used as salvage surgery for failed
pyeloplasties. Even in this difficult situation, the robotic choice has demonstrated its higher capacity
of handling and maneuvring, allowing a satisfactory result.
VD-17 (VS without presentation)
NOVEL TECHNIQUE IN BURIED PENIS RECONSTRUCTION:
COMPLETE EXCISION OF INELASTIC DARTOS
FASCIA WITHOUT ANCHORING EITHER PENOPUBIC
OR PENOSCROTAL JUNCTION
Arry RODJANI, Widi ATMOKO and Irfan WAHYUDI
Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Department of Urology, Cipto
Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, INDONESIA
PURPOSE
Buried penis is a pathology for which several reconstructive techniques are described. We de-
scribed a novel technique and evaluated the efficacy and safety of our technique.
MATERIAL AND METHODS
From June 2009 and February 2015, 28 patients underwent surgical repair of buried penis with our
novel technique in the hands of two surgeon (A.R. and I.W.) who had same principle technique. The
principle of our technique is complete separation of inelastic dartos fascia from the skin and penis
and excision of inelastic dartos fascia until penopubic and penoscrotal region without anchoring
either the penopubic or penoscrotal area. We administered a questionnaire asking questions about
penile size, morphology, and voiding status to evaluate parental satisfaction.
RESULTS
The mean age of patients at the time of operation was 9.50 ± 2.09 years, and the mean duration
of follow-up was 23.27 ± 16.75 months. The mean satisfaction grades for penile size, morphology,
and voiding function were improve (p < 0.05). The mean preoperative satisfaction grade concerning
penile size was 0.82 ± 0.76, and it improved postoperatively to 2.67 ± 0.52 at the last follow-up (p <
0.001). The mean preoperative satisfaction grade for penile morphology was 0.86 ± 0.55, which
improved to 2.12 ± 0.40 at the last follow-up visit (p < 0.001). The mean preoperative satisfaction
grade for voiding function was 1.10 ± 0.72, which improved to 2.94 ± 0.86 at the last follow-up
visit (p < 0.001). There were no complications such as postoperative infection and tissue necrosis.
Edema developed in 2 patients, but resolved spontaneously after 1 month.
CONCLUSIONS
Our method of buried penis correction was found to be technically feasible and safe. It results
in a good cosmetic appearance and excellent postoperative satisfaction rates in terms of size,
morphology, and voiding function.