Surgery

We have inserted 20 totally implantable central venous devices in 17 patients with severe metabolic disease over a 43-month span. Patient ages ranged from 2 months to 17 years (mean, 4.2 years). The underlying pathology was Gaucher's disease in six patients, vitamin D-dependent rickets type II in five, propionic acidemia in two, and methylmalonic acidemia, 3-hydroxyl-3-methylglutaryl coenzyme A (CoA) lyase deficiency, fructose 1,6 diphosphatase deficiency, and urea cycle disorder in one child each. There were seven complications (six due to catheter-related infection and one due to occlusion of the system) during a total of 7,278 patient-catheter days. The infection rate was 0.8 per 1,000 days. Six catheters were removed due to complications and two due to completion of treatment. There were no operative complications or deaths. Our experience demonstrates that a totally implantable device may be useful in children with metabolic disease who need long-term venous access. Attenti...

Current evidence-based studies indicate the need to perform orchidopexy for undescended testicles early in life, between the ages of 6 and 12 months. Despite this evidence, we ob-served a significant delay in the actual age that such a procedure is performed in Saudi Arabia. Therefore, we retrospectively examined all of our patients who received an orchi-dopexy, identified their age at the procedure, and, if the procedure was performed after 12 months of age, noted the reason for the delay. We found that the mean age at orchidopexy in our cohort was approximately four and half years old, indicating the need for greater awareness of the recommended time frame for this procedure among health providers and parents of patients.

Current evidence-based studies indicate the need to perform orchidopexy for undescended testicles early in life, between the ages of 6 and 12 months. Despite this evidence, we observed a significant delay in the actual age that such a procedure is performed in Saudi Arabia. Therefore, we retrospectively examined all of our patients who received an orchidopexy, identified their age at the procedure, and, if the procedure was performed after 12 months of age, noted the reason for the delay. We found that the mean age at orchidopexy in our cohort was approximately four and half years old, indicating the need for greater awareness of the recommended time frame for this procedure among health providers and parents of patients.

Address correspondence to Dr. Anil Kapoor, McMaster University, Institute of Urology, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6 Canada ... Saleh Binsaleh, MD,1 Patrick P. Luke, MD,2 Christopher Nguan, MD,2 ... 1Division of Urology, Department of Surgery, ...