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Resumen Objetivos Presentamos nuestra experiencia inicial utilizando la adrenalectomia laparoscopica robotica en el tratamiento quirurgico de las masas suprarrenales. Material y metodos Entre octubre de 2009 y octubre de 2011 fueron operados en nuestra institucion un total de 18 pacientes (11 mujeres y 7 hombres) con diagnostico de masa tumoral adrenal funcionante o no funcionante. Evaluamos variables quirurgicas, el tiempo de recuperacion intrahospitalario, los hallazgos patologicos y las complicaciones peri y postoperatorias. Resultados La edad media de la poblacion intervenida fue 51,2 anos (rango: 18-81), el promedio de puntuacion ASA 2,11 (rango: 1-4) y el IMC 27,0 (rango: 18,8-36,1). De los 18 pacientes 11 fueron operados del lado izquierdo y 7 del derecho. El tiempo medio de cirugia fue 150 minutos (rango: 84-329) y el sangrado intraoperatorio 121 ml (rango: 10-1.500), con una perdida media de hemoglobina y de hematocrito de 2,11 g/dl y 6,33%, respectivamente. Dos pacientes fueron convertidos a cirugia convencional. Los factores que influyeron en la conversion quirurgica fueron: tamano tumoral (> 10 cm), peso tumoral (> 100 g), feocromocitoma activo y localizacion izquierda del tumor. Se extirparon 7 adenomas corticales funcionantes, 6 tumores suprarrenales metastasicos, 3 feocromocitomas y 2 tumores incidentales. El tamano medio del tumor fue 5,39 cm (rango: 3-15). La mediana de la estancia hospitalaria fue de 6 dias (rango: 4-14). Un total de 5 pacientes presentaron complicaciones perioperatorias. De estos solo uno (5%) tuvo complicaciones mayores (Clavien III). El seguimiento medio fue de 6 meses (rango: 2-24). Conclusiones La tecnologia robotica para la realizacion de adrenalectomias laparoscopicas es una opcion valida para el tratamiento de los tumores suprarrenales. En nuestra experiencia, con una curva de aprendizaje relativamente corta, permite reducir los tiempos de tratamiento hospitalario, asi como las complicaciones intra y postoperatorias, sin afectar los resultados oncologicos y funcionales postoperatorios.

Objectives We present our initial experience using robotic-assisted laparoscopic adrenalectomy in the surgical treatment of adrenal masses. Material and methods A total of 18 patients (11 women and 7 men) diagnosed of a functioning or non-functioning adrenal tumor mass were operated on in our facilities between October 2009 and October 2011. Surgical variables, intra-hospital recovery time, pathological findings and peri- and post-operatory findings were evaluated. Results Mean age of the population intervened was 51.2 years (range 18–81), average ASA score 2.11 (range 1–4) and BMI 27.0 (range 18.8–36.1). Of the 18 patients, 11 were operated on the left side and 7 on the right. Mean surgery time was 150 (range 84–329) min and intra-operatory bleeding 121 (range 10–1500) ml, with a mean loss of hemoglobin and hematocrits of 2.11 g/dl and 6.33%, respectively. Two patients were converted to conventional surgery. The factors influencing surgical conversion were: normal size (>10 cm), tumor weight (>100 g), active pheochromocytoma and left localization of the tumor. Seven functioning cortical adenomas, 6 metastatic adrenal tumors, 3 pheochromocytoma and 2 incidental tumors were excised. Mean tumor size was 5.39 (range 3–15) cm. Median hospital stay was 6 days (range 4–14). Five patients had peri-operatory complication. Of these, only one (5%) had major complications (Clavien III). Mean follow-up was 6 months (range 2–24). Conclusions Robotic technology for laparoscopic adrenalectomies is a valid option for adrenal tumor treatment. In our experience with a relatively short learning curve, it makes it possible to reduce hospital treatment times and the intra- and post-operatory complications, without affecting the oncological and post-operatory functional results.

Die organerhaltende Nierentumorchirurgie ist das Standardverfahren zur operativen Therapie kleiner Raumforderungen der Niere. Ihr kommt bei steigender Lebenserwartung der Patienten und zunehmender Inzidenz von Nierenraumforderungen und zudem steigender Verfugbarkeit und besserer Qualitat der diagnostischen Mittel eine nicht zu unterschatzende onkologische und auch sozialokonomische Bedeutung zu. In vorliegender Ubersichtsarbeit sollen an Hand der aktuellen Literatur die Situation der organerhaltenden Nierenchirurgie vorgestellt, die zur Verfugung stehenden Methoden kritisch betrachtet und ein Ausblick uber mogliche Entwicklungen und notwendige weiterfuhrende Untersuchungen gegeben werden. Die Ergebnisse der vorliegenden Studien kommen zusammenfassend zu dem Schluss, dass die organerhaltende Nierenchirurgie gut untersucht ist und die vorgestellten Operationsmethoden sicher anwendbar sind bei vergleichbaren onkologischen Ergebnissen zur radikalen Nephrektomie. Die Vorteile der organerhaltenden Nierentumorchirurgie liegen in den besseren Langzeitergebnissen fur das Uberleben und die Morbiditat der Patienten. Hier ist vor allem die chronische Niereninsuffizienz zu beachten. Zusammenfassend sollte unserer Meinung nach jeder Nierentumor wenn moglich organerhaltend operiert werden.

Resumen Objetivo Se evalua la presencia de celulas tumorales en el cordon espermatico en pacientes sometidos a exploracion testicular inguinal, con intencion de avalar si la colocacion de una pinza en el mismo resulta necesaria para evitar la diseminacion tumoral. Material y metodos Durante dos anos se realizo exploracion testicular inguinal a 38 pacientes con diagnostico de masa testicular. En todos los pacientes se evaluo la presencia de celulas tumorales en los vasos sanguineos o linfaticos del cordon. Resultados Existio neoplasia testicular en 28 pacientes (20 seminoma, 5 tumor mixto y tres carcinoma embrionario) con una edad promedio de 42 anos (rango 21-82). Fueron T1N0M0 21 casos, T1N1M0 tres, T2N0M0 dos y T2N1M0 dos, respectivamente. Independientemente del estadio y estirpe tumoral, en ninguno de los casos el examen de anatomia patologica evidencio celulas tumorales en los vasos del cordon. Conclusion En nuestra casuistica parece que el gesto quirurgico consistente en colocar una pinza precozmente en el cordon carece de fundamento cientifico. Sin embargo, este estudio tampoco permite afirmar que no realizar esta maniobra durante el procedimiento quirurgico sea oncologicamente seguro. Se establece asi un precedente para realizar estudios con mayor numero de pacientes que permitan corroborar esta observacion, lo que redundara en tecnicas quirurgicas menos traumaticas y seguras que permitan preservar el testiculo y su funcionalidad.

Objective The presence of tumor cells in the spermatic cord was evaluated in patients undergoing inguinal testis study in order to assure if the placement of a clamp in it was necessary to avoid tumor dissemination. Materials and methods Inguinal testis studies were performed over a two-year period in 38 patients diagnosed of testicular mass. The presence of tumor cells in blood vessels or lymph nodes of the cord was evaluated in all of the patients. Results Testicular tumors were found in 28 patients (20 seminoma, 5 mixed tumor and 3 embryonal) with an average age of 42 (range: 21–82) years. There were T1N0M0 21; T1N1M0 3; T2N0M0 2 and T2N1M0 2 cases, respectively. Independently of the stage and tumor lineage, tumor cells in the cord vessels were not observed in any of the cases through the pathology study. Conclusion In our causistics, it seems that the surgical act consisting of the placement of a clamp early in the cord lacks a scientific foundation. However, this study does not make it possible to state that not performing this maneuver during the surgical procedure is oncologically safe. Thus, a precedent is established to perform studies with a larger number of patients who will make it possible to corroborate this observation. This would result in less traumatic and safer surgical techniques that would allow conserving the testis and its functionality.

Objective To present our experience in the treatment of severe stenosis of the external urinary meatus in male children and adults with balanitis xerotic obliterans. Materials and methods A total of 21 patients were operated on in a 5-year period, using the meatoplasty technique of Malone. Mean patient age was 41.7 years (range 7–75). Mean postoperative follow-up was 40.8 months (range 6–54). The surgical procedure consisted in making a small ventral incision of the urethral meatus with an extensive dorsal meatotomy, correcting the esthetic defect of the gland with an inverted V-shaped relieving incision. The postoperative evaluation was performed in every patient by written questionnaire informing about the functional and cosmetic results of the surgical technique. Results No post-surgical complications or recurrences of the urethral stenosis were recorded. A total of 18 patients (85.7%) replied to the post-surgical questionnaire. All were very satisfied with the functional result. Fifteen (83.3%) were also very satisfied with the cosmetic results of the technique. Conclusion The meatoplasty of Malone is a good alternative for the treatment of urethral meatal stenosis. It is an easy and rapid-to-perform technique. It avoids creating a hypospadiac meatus and achieves good postoperative results.

We investigated the importance of patient and tumor characteristics to predict continence, potency, and physical and mental health 1 year after radical prostatectomy.This prospective study included 236 patients who underwent open radical retropubic prostatectomy at a single institution between January 2005 and October 2007. We used validated questionnaires, including the Short Form General Health Survey, the International Index of Erectile Function and the International Consultation of Incontinence Questionnaire, to evaluate postoperative health related quality of life, erectile function and continence, respectively. Questionnaires were completed at months 3, 6 and 12 postoperatively.At 1-year followup 75%, 73%, 75% and 26% of patients had returned to baseline physical health, mental health, continence and potency, respectively. Mental health recovered more slowly than physical health. Preoperative prostate specific antigen less than 20 ng/ml, nerve sparing technique, no intraoperative or postoperative complications, no adjuvant treatment and attendance at a postoperative rehabilitation program were significant factors that positively influenced the outcome in regard to health related quality of life, and postoperative potency and continence (p0.05).Predictors can be used when counseling patients who are preparing themselves for radical retropubic prostatectomy. This study highlights the mental impact of this surgery on these patients. We propose that men should undergo a combined mental and physical counseling program before surgery to predict postoperative health related quality of life, potency and continence after radical retropubic prostatectomy.

Objetivo: Presentamos nuestra experiencia en cistectomía radical robótica informando sobre los resultados quirúrgicos, tanto desde el punto de vista oncológico como funcional. Material y método: Entre enero de 2007 y agosto de 2010 fueron operados en nuestra institución un total de 84 pacientes (70 hombres y 14 mujeres) con diagnóstico histopatológico de cáncer de vejiga invasor no metastásico. Evaluamos variables quirúrgicas, el tiempo de recuperación intrahospitalario, los hallazgos patológicos y las complicaciones peri y postoperatorias. Resultados: La edad media de la población en estudio fue 65,6 años (rango: 28-82). En 62 pacientes se realizó derivación urinaria con ureteroileostomía tipo Wallace, los 22 pacientes restantes recibieron una neovejiga ileal tipo Studer. El tiempo promedio de cirugía fue de 261 minutos (rango: 243-618) y la pérdida promedio de sangre intraoperatoria fue de 298ml (rango 50-2.000). Un 29, 38, 26 y 7% presentaron estadios histopatológicos postoperatorios pT1, pT2, pT3 y pT4, respectivamente. El 15% de los pacientes operados presentó metástasis locales a nivel ganglionar. El número de ganglios linfáticos resecados por procedimiento quirúrgico fue de 14,47 (rango: 1-33). En dos casos (2,4%) se registraron márgenes quirúrgicos positivos. El tiempo promedio de aparición de flatos fue 2,12 días, evacuación intestinal postoperatoria 2,87 y alta médica 17,7(10-33). Un total de 45 pacientes presentaron complicaciones perioperatorias. De estos sólo un 11,9% tuvo complicaciones mayores (Clavien III o mayor) que necesitaron de un tratamiento más invasivo. El tiempo promedio de seguimiento fue de 16,7 meses. Durante ese período 10 pacientes (11%) presentaron recidiva del tumor vesical, de los cuales dos (2,38%) fallecieron. Conclusión: Nuestra experiencia con cistectomía radical robótica en el tratamiento del cáncer de vejiga sugiere que en manos adecuadas este procedimiento proporciona resultados quirúrgicos y patológicos aceptables. Purpose: Radical cystectomy remains the most effective treatment for patients with localized, invasive bladder cancer and recurrent noninvasive disease. We report our experience with 84 consecutive cases of robotic assisted laparoscopic radical cystectomy with regard to perioperative results, pathological outcomes and surgical complications. Materials and methods: A total of 84 consecutive patients (70 male and 14 female) underwent robotic radical cystectomy and urinary diversion at our institution from January 2007 to August 2010 for clinically localized bladder cancer. Outcome measures evaluated included operative variables, hospital recovery, pathological outcomes and complication rate. Results: Mean age of this cohort was 65.5 years (range 28 to 82). Of the patients 62 underwent ileal conduit diversion, 22 received a neobladder. Mean operating room time for all patients was 261min. (range: 243-618min.) and mean surgical blood loss was 298ml (range: 50-2000ml). 29% of the cases were pT1 or less disease, 38% were pT2, 26% and 7% were pT3 and T4 disease respectively, 15% were node positive. Mean number of lymph nodes removed was 15 (range 1 to 33). In 2 cases (2.4%) there was a positive surgical margin. Mean days to flatus were 2.12, bowel movement 2.87 and discharge home 17.7 (range: 10-33). There were 45 postoperative complications with 11.9% having a major complication (Clavien grade 3 or higher). At a mean followup of 16.7 months 10 patients (11%) had disease recurrence and 2 died of disease. Conclusions: Our experience with robotic radical cystectomy for the treatment of bladder cancer suggests that in proper hands this procedure provides acceptable surgical and pathological outcomes.

Lymphoceles represent a common complication following pelvic lymphadenectomy and radical retropubic prostatectomy. Relevant articles published in the last 25 years and our own results based on a prospective study were taken as the basis for a treatment algorithm for lymphoceles after radical prostatectomy.The type of intervention depends on the clinical situation of the patient. Symptomatic lymphoceles can be managed initially by percutaneous aspiration with or without instillation of sclerosing agents. However, lymphocele recurrence rates are high. Symptomatic, sterile lymphoceles appear to be ideally suited for drainage by laparoscopic techniques. This method is effective, usually immediately definitive, results in minimal patient morbidity, and allows for a more rapid recovery. Infected lymphoceles require percutaneous or open surgical drainage. Laparoscopic marsupialization of symptomatic lymphoceles after pelvic lymphadenectomy for prostate cancer appears to be safe and effective. Because of the minimal postoperative morbidity, rapid convalescence, and low recurrence rate, laparoscopic lymphadenectomy should be considered as a first-line treatment for symptomatic, uninfected sterile lymphoceles.

Erfahrungen mit einer neuen Technik zur Beseitigung hochgradiger Meatusstenosen bei Knaben und Mannern mit Lichen sclerosus werden mitgeteilt. In einem 4-Jahres-Zeitraum wurden 21 Patienten mit einem Durchschnittsalter von 41,7 (7–75) Jahren der plastischen Meatotomie nach Malone unterzogen. Das durchschnittliche Follow-up betrug 3,4 Jahre (6 Monate bis 4,1 Jahre). Der Eingriff kombiniert eine sparsame ventrale mit einer tiefen dorsalen Meatotomie und korrigiert die durch den letzten Teilschritt hervorgerufene Faltenbildung der Glans mittels Vernahung einer invertiert V-formigen Glansinzision. Allen Patienten wurde ein Fragebogen zur Beurteilung des funktionellen und kosmetischen Ergebnisses zugestellt. Es traten keine Komplikationen oder Rezidivstenosen auf. Die Fragebogen wurden von 18/21 Patienten beantwortet. Alle waren mit dem funktionellen Ergebnis und 15/18 mit dem kosmetischen Ergebnis zufrieden. Die Technik beseitigt im Kurzzeitverlauf zuverlassig die Stenose. Sie ist einfach und zugig durchfuhrbar, vermeidet einen hypospaden Neomeatus und gewahrleistet gute Ergebnisse.

Objective Prepubertal testicular tumors are fundamentally distinct from their adult counterparts. We reviewed our 10-year, two-institution experience with respect to diagnosis and treatment. Material and methods A retrospective review was performed of all testicular tumors diagnosed between 1996 and 2006 in males younger than 14 years. We analyzed clinical characteristics, diagnostic procedures, treatment methods, histopathologic findings and outcome. Results Of 15 primary testicular tumors, eight (53%) were germ-cell tumors (three teratomas, two yolk sac tumors, one seminoma, one embryonic carcinoma and one choriocarcinoma), four (27%) tumor-like lesions (epidermoid cysts), two (13%) gonadal stromal tumors (a Leydig and a Sertoli cell tumor), and one (7%) gonadoblastoma with gonadal dysgenesis. All boys were presented with a painless scrotal mass and four (27%) of them with elevated tumor markers. Ten cases (66%) were misdiagnosed by urologists preoperatively and presented for treatment of congenital or acquired scrotal disorders. Twelve children (80%) were treated with radical orchiectomy and three (20%) with a testis-sparing procedure. At a mean 4-year follow-up no patient has presented with recurrent tumor in the residual or contralateral testicle. Postoperative physical examination and scrotal ultrasound were obtained in 14 patients at a median follow-up of 48.2 months, and there was no evidence of tumor progression. One boy with a choriocarcinoma (stage IV) died due to distant metastases. Conclusions Benign teratoma and epidermoid cysts were the most common prepubertal testicular tumors. Any suspicion of a testicular tumor warrants an inguinal approach to prevent scrotal violation of the tumor. Our limited experience with testis-sparing procedures supports the current trends that organ-confined surgery should be performed for benign lesions such as teratoma, Leydig cell tumor and epidermoid cysts based on frozen biopsy findings.

Objective: To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them. Design: This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from April 1997 to December 2001. Setting: The medical–surgical ICU of a tertiary-care, university-affiliated hospital in Argentina. Methods: We studied all patients admitted to the ICU using non-impregnated CVCs. Maximal sterile barrier precautions (ie, use of cap, mask, sterile gown, sterile gloves, and large sterile drape), strict handwashing, preparation of the patients' skin with antiseptic solutions, insertion and management of catheters by trained personnel, and continuing quality improvement programs aimed at appropriate insertion and maintenance of catheters were employed. Results: During the study period, 2,525 patients were admitted to the ICU. Eight hundred sixty-eight patients had 1,037 CVCs inserted. The number of CVC-related bloodstream infections (BSIs), acquired in the ICU, was 2.7 per 1,000 CVC-days (13 nosocomial CVC-related BSIs during 4,770 days of CVC use). Microorganisms isolated included methicillin-susceptible Staphylococcus aureus (n = 6), methicillin-resistant S. aureus (n = 2), coagulase-negative methicillin-resistant Staphylococcus (n = 2), Escherichia coli (n = 1), Klebsiella pneumoniae (n = 1), and Enterobacter cloacae (n = 1). Conclusions: A low rate of catheter-related BSI was achieved without antimicrobial-impregnated catheters. The incidence of CVC-associated bacteremias corresponded to the 10th to 20th percentile range of the National Nosocomial Infections Surveillance System hospitals for the same type of ICU.

Nephron-sparing surgery is considered to be the standard surgery for small renal masses. There is a large socioeconomic and oncological relevance in such a decision, especially since tumour incidence as well as average life expectancy increases, also triggered by better diagnostic quality. The present review highlights the current state of nephron sparing-surgery, evaluates different surgical approaches and gives perspectives on the future developments and scientific investigations required. In conclusion, nephron-sparing surgery has been well studied and different approaches have shown high safety profiles with oncological results comparable to those of radical nephrectomy. Nephron -sparing surgery provides decisive advantages in long-term survival and patient morbidity, especially concerning chronic renal failure rates. Therefore, whenever feasible, a renal mass should be considered for nephron-sparing surgery.

PURPOSE:Our first 91 consecutive cases undergoing a robotic assisted cystectomy were analyzed regarding perioperative outcomes, pathological stages and surgical complications. MATERIALS AND METHODS: Between 2007 and 2010 a total of 91 patients (76 male and 15 female), 86 with clinically localized bladder cancer and 5 with non-urothelial tumors underwent a radical robotic assisted cystectomy. We analyzed the perioperative factors, length of hospital stay, pathological outcomes and complication rates. RESULTS: Mean age was 65.6 years (range 28 to 82). Among the 91 patients, 68 were submitted to an ileal conduit and 23 to a neobladder procedure for urinary diversion. Mean operating time was 412 min (range: 243-618 min.) and mean blood loss was 294 mL (range: 50-2000 mL). In 29% of the cases with urothelial carcinoma the T-stage was pT1 or less, 38% were pT2; 26% and 7% were classified as pT3 and pT4, respectively. 14% of cases had lymph node positive disease. Mean number of lymph nodes removed was 15 (range 4 to 33). Positive surgical margins occurred in 2 cases (2.1%). Mean days to flatus were 2.13, bowel movement 2.88 and inpatient stay 18.8 (range: 10-33). There were 45 postoperative complications with 11% major (Clavien grade 3 or higher). At a mean follow-up of 15 months 10 patients had disease recurrence and 6 died of the disease. CONCLUSIONS: Our experience demonstrates that robotic assisted radical cystectomies for the treatment of bladder cancers seems to be very promising regarding surgical and oncological outcomes.

We present our initial experience using robotic-assisted laparoscopic adrenalectomy in the surgical treatment of adrenal masses.A total of 18 patients (11 women and 7 men) diagnosed of a functioning or non-functioning adrenal tumor mass were operated on in our facilities between October 2009 and October 2011. Surgical variables, intra-hospital recovery time, pathological findings and peri- and post-operatory findings were evaluated.Mean age of the population intervened was 51.2 years (range 18-81), average ASA score 2.11 (range 1-4) and BMI 27.0 (range 18.8-36.1). Of the 18 patients, 11 were operated on the left side and 7 on the right. Mean surgery time was 150 (range 84-329) min and intra-operatory bleeding 121 (range 10-1500) ml, with a mean loss of hemoglobin and hematocrits of 2.11g/dl and 6.33%, respectively. Two patients were converted to conventional surgery. The factors influencing surgical conversion were: normal size (10cm), tumor weight (100g.), active pheochromocytoma and left localization of the tumor. Seven functioning cortical adenomas, 6 metastatic adrenal tumors, 3 pheochromocytoma and 2 incidental tumors were excised. Mean tumor size was 5.39 (range 3-15) cm. Median hospital stay was 6 days (range 4-14). Five patients had peri-operatory complication. Of these, only one (5%) had major complications (Clavien III). Mean follow-up was 6 months (range 2-24).Robotic technology for laparoscopic adrenalectomies is a valid option for adrenal tumor treatment. In our experience with a relatively short learning curve, it makes it possible to reduce hospital treatment times and the intra- and post-operatory complications, without affecting the oncological and post-operatory functional results.

Objetivo: Presentar nuestra experiencia en el tratamiento de estenosis severa localizada en el meato uretral en niños y adultos con balanitis xerótica obliterante. Material y métodos: Un total de 21 pacientes con una edad promedio de 41,7 (7-75) años fueron operados en un período de 5 años utilizando la técnica de meatoplastia según Malone. El seguimiento postoperatorio medio fue 40,8 (6-54) meses. El procedimiento quirúrgico consistió en una pequeña incisión ventral del meato uretral seguida por una meatotomía dorsal profunda, corrigiendo el defecto estético a nivel del glande a través de una sutura en «V» invertida. La evaluación postoperatoria fue realizada en todos los pacientes a través de encuesta escrita que informaba de los resultados funcionales y estéticos de la técnica quirúrgica. Resultados: No se registraron complicaciones postoperatorias, ni tampoco recidiva de la estenosis uretral. Dieciocho pacientes (85,7%) respondieron el cuestionario de evaluación postoperatoria, todos muy satisfechos con el resultado funcional conseguido. Quince de ellos (83,3%) refirieron estar también muy satisfechos con el resultado estético de dicha técnica. Conclusión: La meatoplastia según Malone es una buena alternativa para el tratamiento de la estenosis de meato uretral. Es una técnica fácil, que puede realizarse rápidamente. Evita llevar a cabo un meato hipospádico y consigue buenos resultados postoperatorios. Objective: To present our experience in the treatment of severe stenosis of the external urinary meatus in male children and adults with balanitis xerotic obliterans. Materials and Methods: A total of 21 patients were operated on in a 5-year period, using the meatoplasty technique of Malone. Mean patient age was 41.7 years (range 7-75). Mean postoperative follow-up was 40.8 months (range 6-54). The surgical procedure consisted in making a small ventral incision of the urethral meatus with an extensive dorsal meatotomy, correcting the esthetic defect of the gland with an inverted V-shaped relieving incision. The postoperative evaluation was performed in every patient by written questionnaire informing about the functional and cosmetic results of the surgical technique. Results: No post-surgical complications or recurrences of the urethral stenosis were recorded. A total of 18 patients (85.7%) replied to the post-surgical questionnaire. All were very satisfied with the functional result. Fifteen (83.3%) were also very satisfied with the cosmetic results of the technique. Conclusion: The meatoplasty of Malone is a good alternative for the treatment of urethral meatal stenosis. It is an easy and rapid-to-perform technique. It avoids creating a hypospadiac meatus and achieves good postoperative results.

To present our experience in the treatment of severe stenosis of the external urinary meatus in male children and adults with balanitis xerotic obliterans.A total of 21 patients were operated on in a 5-year period, using the meatoplasty technique of Malone. Mean patient age was 41.7 years (range 7-75). Mean postoperative follow-up was 40.8 months (range 6-54). The surgical procedure consisted in making a small ventral incision of the urethral meatus with an extensive dorsal meatotomy, correcting the esthetic defect of the gland with an inverted V-shaped relieving incision. The postoperative evaluation was performed in every patient by written questionnaire informing about the functional and cosmetic results of the surgical technique.No post-surgical complications or recurrences of the urethral stenosis were recorded. A total of 18 patients (85.7%) replied to the post-surgical questionnaire. All were very satisfied with the functional result. Fifteen (83.3%) were also very satisfied with the cosmetic results of the technique.The meatoplasty of Malone is a good alternative for the treatment of urethral meatal stenosis. It is an easy and rapid-to-perform technique. It avoids creating a hypospadiac meatus and achieves good postoperative results.