Introduction:Surgery for revision of cochlear implantation is an unusual but not uncommon occurrence. The purpose of this study was to discuss the major complications of cochlear implantation that we observed in 11 out of 275 patients who underwent cochlear implantation in Khalili Hospital at Shiraz University of Medical Sciences.Materials and Methods:A retrospective analysis of 275 patients who underwent cochlear implantation between 2003 and 2009 was performed. All of the patients were followed for one to five years.Results:Only 11 patients needed to undergo revision surgery or take medication. Out of those, five patients were referred with signs of device failure, all of whom underwent REIMPLANTATION. For the rest of the patients with complications, one patient underwent surgery due to a misplaced electrode, two patients had poor telemetry due to migration of the implant magnet, one patient presented with meningitis that was managed by medical treatment, and two patients presented with a massive scalp hematoma that responded to medical treatment.Conclusions:In our study the most common cause of a need for cochlear REIMPLANTATION was device failure.

Self-mutilations of the external genitals in psychiatric patients is also known as Klingsor syndrome. (1) These patients show a high tendency to repeating self-aggressive actions, especially when their medical therapy is discontinued.(2,3) In 1929, Ehrlich reported the first successful penile REIMPLANTATION of an amputated penis.(4) Although REIMPLANTATION of the amputated penis has a high success rate, there may be some remaining squeals such as skin necrosis and urethral stricture or fistula.(5) We report a case of a macroscopic REIMPLANTATION of an amputated penis…

Background: Amniotic band Band syndrome Syndrome (ABS) is a rare congenital anomaly which may affecting any region of the fetus. Here, we reported a case of ABS involving the upper limbs resulted in amputation, syndactyly, and lymphedema of several fingers. One of the the amputated finger was reimplanted on to the upper back of the fetus between two scapular bone. The finger-like mass had no osseous tissue.

Background/Objectives: To evaluate the child with intermittent ureteral obstruction following antireflux surgery and to introduce a new imaging technique for diagnosis of the socalled “hook” phenomenon, the most serious complication of antireflux surgery. Patients and Methods: Twenty-five children with a history of antireflux surgery who were referred for either persistent urinary tract infection (UTI) or progressive hydronephrosis were included in the study. All the children with signs and symptoms of voiding dysfunction or persistent reflux were excluded. A new imaging technique was devised to evaluate these patients for the presence of “hook phenomenon”, in which a renal ultrasound was performed both on a full bladder and after voiding. If dilatation of the urinary tract was detected on full bladder, and this dilatation decreased dramatically following micturition, then a catheter was passed into the bladder and was filled with normal saline (based on the estimated bladder capacity in order to avoid over-distension). An intravenous urogram and saline cystogram were performed simultaneously. After 20 minutes, 2 abdominal radiographs were obtained on full and emptied bladder, both. Results: On the intravenous urogram, some children showed typical “J- hook-shaped” ureters. In all the cases marked hydronephrosis was noted, with no contrast material seen entering the bladder on the 20 minute radiogram. Upon evacuation of the bladder, both ureters promptly drained into the bladder and the”J-hooking” of the ureters and hydronephrosis resolved. Conclusion: "J- hook phenomenon” is one of the most common causes of hydronephrosis and hydroureter following ureteral re-implantation is intermittent ureteral obstruction from creation of the new ureteral hiatus at an inappropriate site. This complication is frequently misdiagnosed as irreversible uretero-vesical junction obstruction from ischemia or fibrosis. Once the diagnosis of “J- hook” phenomenon is confirmed, early ureteral REIMPLANTATION with creation of a new hiatus is the treatment of choice.

Ureteral anomalies, ectopic ureter being one of them, are of the most important urogenital abnormalities because they directly affect kidney function. Several techniques have been used for treatment of ectopic ureter. The goal of obstruction relief can be achieved by either ureteropyelostomy or common sheath ureteral REIMPLANTATION for a duplicated system, or REIMPLANTATION for a single system. Heminephrectomy and ureteropyelostomy are well described elsewhere, but several technical points deserve emphasis. Laparoscopic procedures putatively offer reduced morbidity due to less postoperative pain, earlier return of gastrointestinal function, earlier discharge, and a quicker return to work. To our knowledge laparoscopic REIMPLANTATION for ectopic ureter has not been reported, yet. We performed laparoscopic ureteral REIMPLANTATION on a 29-year-old man with ectopic ureter.

Purpose: To describe our experience and analyze the outcomes of robot-assisted laparoscopic ureteral REIMPLANTATION (RALUR) and conventional laparoscopic ureteral REIMPLANTATION (LUR) in treating benign distal ureteral stricture (DUS). Material and Methods: Patients who underwent RALUR or LUR for DUS were retrospectively analyzed. All surgeries were performed by transperitoneal approach in a refluxing manner. Baseline characteristics, history of previous abdominal surgery, operative profile and follow-up data were collected and analyzed. Results: Among 68 patients with DUS, 62 were diagnosed with unilateral DUS, including 28 patients underwent RALUR. The mean operative time of the RALUR group was 2. 44 ± . 45 hours, while the mean operative time of the LUR group was 3. 09 ± . 74 hours (P <. 001). The average suturing time of LUR (39. 59 ± 3. 78 min) is about 2 times that of RALUR (20. 04 ± 3. 5 min) (P <. 001). The success rate of the RALUR group and the LUR group were 89. 3% and 82. 4% respectively (P =. 494). In multiple linear regression model, the modality of surgery was the only variable that influences operative time (Beta =-. 964, P <. 001), suturing time (Beta =-1. 899, P <. 001) and hemoglobin decline (Beta =-. 611, P =. 020). Conclusion: Basically, the postoperative outcomes are similar but robotic surgery offers a quicker surgery and anastomosis.