Frequency of Prune Belly Syndrome

Sabtu, 22 Januari 2011
Prune belly syndrome affects 1 per 30,000-40,000 live births. Approximately 3-4% of all prune belly syndrome cases occur in females. Twinning is associated with prune belly syndrome; 4% of all cases are products of twin pregnancies.

Etiology
Prune belly syndrome is associated with trisomy 18 and 21. Patients with prune belly syndrome also have an increased incidence of tetralogy of Fallot (TF) and ventriculoseptal defects.

Pathophysiology
In 1903, Strumme proposed that prune belly syndrome may be caused by in utero bladder obstruction, stating that dilatation of the urinary tract in utero leads to secondary-pressure atrophy of the abdominal wall and the subsequent clinical findings. More recent theories focus on a functional obstruction due to prostatic hypoplasia that leads to a conformational change in the prostatic urethra during voiding, thereby causing obstruction. The most recent theories suggest a transient obstruction at the junction of the glanular and penile urethra. This would explain the high incidence of megalourethra observed in cases of prune belly syndrome.

Prune belly syndrome

Prune belly syndrome is also called Eagle-Barrett syndrome and triad syndrome.

Prune belly syndrome is also called Eagle-Barrett syndrome and triad syndrome. The treatment of prune belly syndrome poses a significant problem to pediatric urologists. Some authors call for conservative management of the urinary tract in boys with prune belly syndrome, while others advocate an aggressive approach, operating on patients aged 10 days. No definitive timing for treatment of prune belly syndrome has been substantiated. Pediatric urologists have observed that boys with prune belly syndrome can present with a spectrum of abnormalities. At one end of the spectrum, the condition may cause severe urogenital and pulmonary problems incompatible with life (resulting in stillbirth); at the other end of the spectrum, the condition may cause few, if any, urological abnormalities that require no treatment other than orchidopexy to correct the undescended testis. The decision to aggressively treat the urinary tract in these children should be based on the clinical presentation and not solely on radiographic appearance. 

Problem
Children with prune belly syndrome can present with myriad renal, ureteral, and urethral abnormalities. Obstruction and/or upper urinary tract dilatation is not unusual in these children. The site of obstruction can vary from as high as the pelviureteral junction to as low as the prostatic membranous urethra.
A lack of abdominal muscles leads to a poor cough mechanism, which, in turn, leads to increased pulmonary secretions. Weak abdominal muscles lead to constipation because of an inability to perform the Valsalva maneuver, which helps push the stool out of the rectum during defecation.
The mortality rate associated with prune belly syndrome is 20%.

testicular trauma

Trauma that injure the penis can be a blunt trauma, sharp trauma, exposure to engine manufacturers, ruptured tunica albuguinea, or strangulation of the penis. In blunt trauma or exposure to machines, if not total amputation occurs, the penis is cleaned and made primary suturing. In the event of total penile amputation) and the distal part can be identified, recommended washed with physiological salt solution and then stored in ice bags, and sent to a referral center. If it still may be replantasi (grafting) are microscopic.  
Penis fracture Fracture penis is rupture the tunica albuginea of the corpus cavernosa penis that occurs when the penis in erection. This rupture can be caused by the patient's own bent during masturbation, bent by her partner, or inadvertently bent during intercourse. As a result of this bent, the penis becomes bent (angulasi) and the resulting hematoma of the penis with the pain. To find out the location of the rupture, the patient should undergo contrast images kavernosografi ie entering into the corpus cavernosa and then note the contrast extravasation out of the tunica albuginea.

Tumor Incidence

The tumor is a neoplastic cell is autonomous in the sense of growing at a pace that is not coordinated with the needs of host and functions that are not dependent on homeostatic control most of the other body cells. The growth of neoplastic cells is usually progressive, which did not reach equilibrium, but more resulted in the addition of cell mass that has the same properties. Neoplasm does not make a favorable host adaptive purpose, but more often harmful.

Tumors can be either malignant or benign, malignant or cancerous tumor occurs because of breeding cells arise and the surrounding tissue (infiltrating) while destroying (destructive), it can spread to other parts of the body and is generally fatal if left unchecked. Benign tumors grow with strict limits and do not infiltrate, but not damage surrounding tissue swell and press the (expansive).

Relative frequency of cancer in several regions in Indonesia are not the same, which are found is the cervix uteri carcinoma, hepatocellular carcinoma, breast carcinoma, lung carcinoma and leukemia. In the last decade has shown that 80-90% of cases of cancer in humans be promoted by environmental factors. In this case, the environment in a broad sense which covers lifestyle, chemicals, physics, or viruses