Search

Aims: To report the first noninvasive urodynamic screening of lower urinary tract dysfunction (LUTD) in children, adolescents, and young adults with Prader–Willi Syndrome (PWS). Methods: We recruited 37 PWS patients with/without lower urinary tract symptoms (LUTS) from our hospital. Uroflowmetry was performed in 36 patients. In addition, 20 patients underwent postvoid residual urine (PVR) measurement by transabdominal ultrasound. LUTD is defined as abnormal uroflow patterns, low peak flow rate (Qmax), or elevated PVR by age. Videourodynamic study (VUDS) was performed in selected cases. Results: Mean and median age of the patients were 17.7 ± 7.8 years and 16 years. Male to female ratio was 15/22. Two patients were excluded from the following analysis because of voided volume less than or equal to 50 ml. Of the remaining 34 uroflowmetry examination, normal voiding pattern (bell shape) was observed in 22 (64.7%) patients. Abnormal uroflowmetry pattern were obstructive in 6 (17.6%), staccato in 3 (8.8%), intermittent in 2 (5.8%), tower in 1 (2.9%), and plateau in 0 patients. Ten (29.4%) patients had a Qmax less than 15 ml/s. Of 20 patients undergoing PVR tests 10 (50%) had elevated PVR by age (> 6% of estimated bladder volume). In all, 17/34 (50.0%) PWS patients had at least one abnormality of the noninvasive tests. Of the three cases undergoing VUDS all showed detrusor sphincter dyssynergia. Conclusions: Half of PWS patients with/without LUTS had LUTD. Noninvasive study such as uroflowmetry and postvoid residual urine by ultrasound is recommended to all patients with PWS. [ABSTRACT FROM AUTHOR]

Webbed penis may be congenital or acquired in etiology. Treatments are indicated for reasons such as cosmetic concerns and erection pain. This study aims at reviewing the etiology, symptoms, types of surgical correction, and outcomes of webbed penis. We searched Medline/PubMed for "webbed penis" and "inconspicuous penis" from 1956 through 2019. In this study, we discuss the advantages, drawbacks, and outcomes of each surgical method. We also explain the postoperative cosmetic outcomes and complications of the previously proposed surgical methods. Since the isolated congenital webbed penis is uncommon, there is a paucity of large-scale studies for the treatment of webbed penis. A variety of methods are proposed to correct webbed penis, including traditional transverse incision and vertical closure, Z-plasty, V-Y advancement technique, Byars preputial flap method, and other methods. Preoperative design is essential and is based on not only the degree of penoscrotal fusion but also the surgeon's experience and preference of the surgical methods. Some methods call for elaborate skin flaps that may be technically complicated. The immediate outcomes of surgical correction for webbed penis are good. However, studies on long-term cosmetic results and patient satisfaction remain scarce. Hence, surgical correction of the webbed penis generally yields good results. Long-term follow-up of postoperative cosmetic outcomes, patient satisfaction, and the impact of surgery on the psychological development of children are indicated. [ABSTRACT FROM AUTHOR]