#herniasurgeryforchildindelhi

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Phimosis Treatment In Delhi - Dr. Prashant Jain

What is Phimosis?

Phimosis is defined as inability to retract prepuce.

Non retractile foreskins are common among young boys and is a part of normal preputial development. Prepuce of new born is non retractile and at the age of 3 years up to 10% remain non-retractile. It has been seen that 8% of boys at the age of 6 years and 1% at the age of 16 years still had non-retractile foreskin. The foreskin gradually becomes retractile secondary to intermittent erections and keratinization of the inner epithelium. That is most of the prepuce becomes retractile by adulthood.

It is important to understand that most of these phimosis are physiological and does not require any surgical intervention.

What is difference between Pathological and physiological phimosis?

It is important to differentiate true pathological phimosis from physiological phimosis. While physiologic phimosis consists of pliant, unscarred preputial orifice, true pathological phimosis is characterized by contracted white fibrous ring around the preputial orifice.

What is treatment of Phimosis?

Most of the patients with phimosis require only reassurance and preputial hygiene. A short course of topical corticosteroids (0.15 triamcinilone / betamethasone/0.1% mometasone) twice daily for 6-8 wks has success rate of 80-90% in separating preputial adhesions and can be given if child has symptoms of straining and ballooning of prepuce.

The only indication of surgery (circumcision) is pathologic phimosis with scarred prepuce which is a result of recurrent balanitis.

Most of the phimosis are physiological and self correcting by adulthood and does not require any treatment.

TAG- Best Pediatric surgeon in Delhi,  Best Pediatric urologist in Delhi,  Pediatric robotic surgeon in Delhi,  Phimosis Treatment in Delhi

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Hernia surgery for child in delhi, Hydrocele surgery for child in delhi by Dr. Prashant Jain

Hernia and Hydrocele

How to differentiate between Inguinal hernia and hydrocele?

Inguinal hernia is usually a reducible swelling with cry/cough impulse while a hydrocele is a tense cystic, clinically irreducible swelling without any impulse. Transillumination test is not reliable as can be present in both the cases.

Why hydrocele is irreducible swelling?

The pathogenesis of both hernia and hydrocele is same that is persistence of processus vaginalis.

The neck of hydrocele is very narrow and so even if you try to compress the swelling, the fluid from processus vaginalis will not go into the abdominal cavity. The parents will give a characteristic history of swelling being less during morning and then gradually starts increasing in size. While the opening of hernia sac is large enough to allow the free reduction of contents.

For how long one can safely wait in hydrocele?

The hydrocele which are constant in size through out the day time are usually scrotal type hydrocele and are seen in newborns. They are called as non- communicating hydroceles. It is this type of non -communicating hydrocele which tends to resolve spontaneously.

The hydrocele in which parents gives the history of increase and decrease in the size of swelling are called as communicating hydrocele and will require surgery.

The condition can be safely observed till 18mths to 2 years of age as it is harmless. But one should be sure that they are not associated with hernia.

When one should advice for hernia surgery?

Inguinal hernias never go away without surgery. This is a condition in which surgery is advised to be done as early as possible as the risk of hernia getting incarcerated is as high as 30 to 40%. If not tackled in time it can lead to major complications of gut and testis necrosis. Also emergency anesthesia may further increase the risk for the child.

How safe is inguinal hernia surgery in newborns and infants?

Like any other surgery anesthesia have its own risks. As the risk of hernia incarceration is very high especially in newborns, waiting for hernia repair is not a good option once a diagnosis of hernia is made.

The commonest problem of hernia surgery in newborns is postoperative apnea. To minimise this it is usual practice to perform surgery once the child is more than 49 wks of gestational age or weighing more than 2.2 kg. After surgery these patients needs to be monitored in hospital for 24 hrs for risk of postoperative apnea.

What is the surgical procedure done for hernia and hydrocoel?

The surgery in both the conditions is same that is the ligation of patent processus vaginalis called as “HERNIOTOMY”.

Are there any indications for performing bilateral repair in case of a unilateral inguinal hernia?

The risk of hernia manifesting on the contralateral side after unilateral repair is just 10 %. Although the patent processus vaginalis may be present in higher number of cases but it may not manifest as hernia later on. So as per present recommendations bilateral hernia repair is not routinely done in cases of a unilateral inguinal hernia.

Tag : hernia surgery for child in delhi, hydrocele surgery for child in delhi, best pediatric surgeon in delhi

For more information : http://www.pedsurgerydelhi.com/

[drprashantpediatricsurgeon]

How to differentiate between Inguinal hernia and hydrocele?

Inguinal hernia is usually a reducible swelling with cry/cough impulse while a hydrocele is a tense cystic, clinically irreducible swelling without any impulse. Transillumination test is not reliable as can be present in both the cases.

Why hydrocele is irreducible swelling?

The pathogenesis of both hernia and hydrocele is same that is persistence of processus vaginalis.

The neck of hydrocele is very narrow and so even if you try to compress the swelling, the fluid from processus vaginalis will not go into the abdominal cavity. The parents will give a characteristic history of swelling being less during morning and then gradually starts increasing in size. While the opening of hernia sac is large enough to allow the free reduction of contents.

[drprashantpediatricsurgeon]

How to differentiate between Inguinal hernia and hydrocele?

Inguinal hernia is usually a reducible swelling with cry/cough impulse while a hydrocele is a tense cystic, clinically irreducible swelling without any impulse. Transillumination test is not reliable as can be present in both the cases..

Why hydrocele is irreducible swelling?

The pathogenesis of both hernia and hydrocele is same that is persistence of processes vaginal is.

The neck of hydrocele is very narrow and so even if you try to compress the swelling, the fluid from processes vaginal is will not go into the abdominal cavity. The parents will give a characteristic history of swelling being less during morning and then gradually starts increasing in size. While the opening of hernia sac is large enough to allow the free reduction of contents.

[drprashantpediatricsurgeon]

Hernia and Hydrocele - Dr. Prashant Jain

How to differentiate between Inguinal hernia and hydrocele?

Inguinal hernia is usually a reducible swelling with cry/cough impulse while a hydrocele is a tense cystic, clinically irreducible swelling without any impulse. Transillumination test is not reliable as can be present in both the cases..

Why hydrocele is irreducible swelling?

The pathogenesis of both hernia and hydrocele is same that is persistence of processes vaginal is.

The neck of hydrocele is very narrow and so even if you try to compress the swelling, the fluid from processes vaginal is will not go into the abdominal cavity. The parents will give a characteristic history of swelling being less during morning and then gradually starts increasing in size. While the opening of hernia sac is large enough to allow the free reduction of contents.

For how long one can safely wait in hydrocele?

The hydrocele which are constant in size through out the day time are usually scrotal type hydrocele and are seen in newborns. They are called as non- communicating hydroceles. It is this type of non -communicating hydrocele which tends to resolve spontaneously.

The hydrocele in which parents gives the history of increase and decrease in the size of swelling are called as communicating hydrocele and will require surgery.

The condition can be safely observed till 18 months to 2 years of age as it is harmless. But one should be sure that they are not associated with hernia.

When one should advice for hernia surgery?

Inguinal hernias never go away without surgery. This is a condition in which surgery is advised to be done as early as possible as the risk of hernia getting incarcerated is as high as 30 to 40%. If not tackled in time it can lead to major complications of gut and testis necrosis. Also emergency anesthesia may further increase the risk for the child.

How safe is inguinal hernia surgery in newborns and infants?

Like any other surgery anesthesia have its own risks. As the risk of hernia incarceration is very high especially in newborns, waiting for hernia repair is not a good option once a diagnosis of hernia is made.

The commonest problem of hernia surgery in newborns is postoperative apnea. To minimize this it is usual practice to perform surgery once the child is more than 49 wks of gestational age or weighing more than 2.2 kg. After surgery these patients needs to be monitored in hospital for 24 hrs for risk of postoperative apnea.

What is the surgical procedure done for hernia and hydrocoel?

The surgery in both the conditions is same that is the ligation of patent processes vaginal is called as “HERNIOTOMY”.

Are there any indications for performing bilateral repair in case of a unilateral inguinal hernia?

The risk of hernia manifesting on the contra lateral side after unilateral repair is just 10 %. Although the patent processes vaginal is may be present in higher number of cases but it may not manifest as hernia later on. So as per present recommendations bilateral hernia repair is not routinely done in cases of a unilateral inguinal hernia.

TAG- Best pediatric surgeon in Delhi,  Best pediatric urologist in Delhi, Hernia Surgery for child in Delhi,  Pediatric Robotic Surgery in Delhi

[drprashantpediatricsurgeon]

Director and Sr Consultant Pediatric Surgery and Pediatric Urology - Dr. Prashant Jain

Dr. Prashant Jain is a young and dynamic pediatric surgeon and pediatric urologist in Delhi, India. He has been trained in premier institutes, King Edward Memorial Hospital (KEM), Mumbai and Kalawati Saran children’s hospital, New Delhi. He has been a meritorious student throughout his medical career and was gold medalist in his training in pediatric surgery and pediatric urology. He has special expertise and vast experience in pediatric urology and pediatric minimal invasive surgery. He was fortunate to get opportunity to work in Great Ormond Street, London. He has been performing reconstructive surgeries for congenital anomalies with great skills and excellent results. He has successfully treated many previously failed cases of urological anomalies like hypospadias, bladder exstrophy etc. Over the years he has devised his own innovative techniques in several surgical procedures which have won him accolades. He has presented his innovations in various conferences and workshops for which he has received critical acclaim. He has multiple publications in pediatric surgery and pediatric urology in various national and international journals.

Presently he heads the department of pediatric surgery Dr BL Kapur Memorial Hospital, New Delhi. The department of pediatric urology and pediatric surgery in Dr BL Kapur Super speciality hospital, performs all pediatric reconstructive surgeries for complex congenital anomalies and pediatric laparoscopies.

Recently, he had privilege of heading a team of 40 super specialists doctors involved in the surgical separation of conjoined twins (pygopagus) from Nigeria, which involved major and complex genito-urinary reconstructive work. This rare and exclusive work got acknowledged worldwide.

TAG- Best pediatric Surgeon in Delhi, Best pediatric urologist in Delhi, Best pediatric surgeon in India

[drprashantpediatricsurgeon]

Dr. Prashant Jain is a young and dynamic pediatric surgeon and pediatric urologist in Delhi, India. He has been trained in premier institutes, King Edward Memorial Hospital (KEM), Mumbai and Kalawati Saran children’s hospital, New Delhi. He has been a meritorious student throughout his medical career and was gold medalist in his training in pediatric surgery and pediatric urology. He has special expertise and vast experience in pediatric urology and pediatric minimal invasive surgery.