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Objective: The treatment of ano- or rectovaginal fistula is still difficult. The use of the Martius flap is well described as an adjunctive technique in their repair. We report our experience of a modified Martius flap in the management of ano- or rectovaginal fistula., Method: This is a retrospective study of 14 women presenting with an anovaginal (n = 9) or rectovaginal fistula (n = 5). All were treated by a modified Martius graft. The aetiology included Crohn's disease (n = 7), ulcerative colitis (n = 4), radio-induced (n = 1), obstetric (n = 1) and villous tumour (n = 1)., Results: All 14 fistulas healed within the 3 months after surgery. Subsequently, two patients with Crohn's disease required an abdominoperineal resection owing to progressive anal lesions. Two other patients experienced faecal incontinence which improved with functional rehabilitation treatment., Conclusion: A modified Martius flap is a valuable option in the treatment of ano- or rectovaginal fistula. In the case of Crohn's disease, however, the prognosis depends primarily on subsequent clinical evolution of the condition.

We perform a modified Duplay procedure in our department without incision of the urethral plate for correction of distal hypospadias. The objective of this retrospective study was to analyse the long-term functional and aesthetic results of this technique. Strictures are a frequent complication of hypospadias surgery, but their frequency is often underestimated as they can remain asymptomatic. We decided to systematically detect urethral strictures by performing voiding uroflowmetry in all children over the age of 4 years, i.e. toilet trained, operated by Duplay procedure in our department. The results were compared to the standard results in paediatric populations published in the literature. The maximum flow rate was below the 5th percentile in 20% of cases and the average flow rate was abnormal in 30% of cases. Voiding uroflowmetry is a simple, noninvasive method to detect asymptomatic urethral strictures. Uroflowmetry is essential to evaluate the functional results of surgical procedures used for the treatment of hypospadias.

Purpose: Impalpable and undescended testis is a very common preoccupation for specialized pediatric surgery teams. The laparoscopy as the single most accurate modality for diagnosis and localization of impalpable undescended gonad is well established by all authors. However the therapeutic attitude and the technique are still a matter of debate., Material and Methods: A series of 122 boys presenting an impalpable and undescended testis was studied. All the children beneficiated of a primary laparoscopic exploration. During this exploration, when a testis was found, the clamping of the spermatic vessel was made and the final descent took place few months later., Results: In our study the testis was found in 60 cases and the spermatic vessel's clamping assured the descent of a well vascularized testis in about 80% of cases., Conclusion: Clamping the spermatic vessel during the laparoscopic exploration assured, thanks to the development of a supply, a good vascularisation of the testis during its second step descent. Our retrospective study has showed the good reliability of laparoscopic surgery as primary treatment in front of impalpable undescended testicles in comparison to the one-step classical orchiopexy.