Vol. 179, No. 4, Supplement, Monday, May 19, 2008 THE JOURNAL OF UROLOGY ® 387 1124 IATROGENIC URETERAL INJURY: CAN ADULT REPAIR TECHNIQUES BE USED FOR PEDIATRIC PATIENTS? Jonathan C Routh*, Matthew K Tollefson, Richard A Ashley, Douglas A Husmann. Rochester, MN. INTRODUCTION AND OBJECTIVE: Iatrogenic ureteral injury in pediatric patients is a rare occurrence with sparse literature available regarding optimal repair techniques. We reviewed our experience in the management of iatrogenic pediatric ureteral injuries, particularly with respect to initial vs. delayed diagnoses. METHODS: All repairs of pediatric iatrogenic ureteral injuries performed by a single surgeon from 1986-2006 were reviewed. RESULTS: Ten injuries were repaired over 20 years. Median age at injury was 12 years (range 7d-14y). Injuries occurred during 4 retroperitoneal tumor resections, 1 partial nephrectomy for ruptured angiomyolipoma, 3 laparoscopic appendectomies/orchidopexies, and 2 ureteroscopies. Diagnosis was immediate in 4 patients, all of whom had a retroperitoneal tumor resected. Median ureteral defect length was 4 cm (range 2-5). All were treated with ureteroneocystostomy (UNC) and by a median of 21 days (range 7-90). Upon recognition, 5 children (83%) were managed by temporary percutaneous nephrostomy tube & 1 (17%) by ureteral stent. Delayed repair was then performed 1-3 months later. In the 5 patients (50%) with laparoscopic/ureteroscopic injuries the median ureteral defect length was 4 cm (range 3-6). All were treated cm proximal ureteral defect after partial nephrectomy for ruptured AML underwent delayed ileal ureter with good results 4 years postop. CONCLUSIONS: Pediatric iatrogenic ureteral injuries are rare in occurrence and may be repaired by both immediate and delayed techniques as the circumstances demand. Standard techniques that are employed in the adult population with similar injuries may be employed in children with the expectation of good long-term results. Source of Funding: None 1125 ENDOSCOPIC URETHROPLASTY UNDER DIRECT VISION WITHOUT EXTERNAL FIXATION WITH A FREE PARTIAL/FULL THICKNESS SKIN GRAFT IN CHILDREN Farooq Hameed*, Javed Aziz, Arif Qureshi. Lahore, Pakistan. INTRODUCTION AND OBJECTIVE: Between 1994 and 2006 endoscopic urethroplasty using full thickness/ partial thickness skin graft was performed in 14 patients with strictures of the bulbomembranous urethra. METHODS: The patients were children injured either during ranged from 1 to 6 years. The follow up ranged from 1 to 13 years (mean 7.6 years). The patient’s age ranged from 6 years to 12 years (mean 9.3 years).Stricture length varied from 0.5 cm to 2 cm (mean 1.2 cm). All had under gone previous open and endoscopic procedures and had redeveloped strictures. A free full thickness or partial thickness graft was raised from penile shaft/ thigh, stitched inside out over a specially designed intraurethral stent. Recipient bed was prepared and graft after 03 weeks. RESULTS: The complications encountered were. Mild transient haematuria (100%). Mild transient dysuria (28.6%). Partial uptake of graft >1/3 (78.6%). Reformation of stricture (57%). Failure of graft to take-up (21.4%).Infection (7.1%). Mild transient stress incontinence (14.3%). Migration of stent (7.1. %) Ancillary procedures voiding through a urethra which in case of these children is not less than 10 Fr. CONCLUSIONS: Our results compare favorably with the classical open procedures. Our technique offers many advantages over It is a simple procedure. It spares potency and sphincter. Carries very low morbidity with minimal dissection and bleeding. The penile skin or split skin graft is hair less. One only needs a single operator. There is minimal operative scarring, it is easily repeatable and costs less. Source of Funding: None 1126 USEFULNESS OF MR FAT-SUPPRESSED T2-WEIGHTED AND DIFFUSION-WEIGHTED IMAGING FOR THE DIAGNOSIS OF NON- PALPABLE TESTES Toshiki Kato*, Yoshiyuki Kojima, Yasuhiro Shibata, Makoto Imura, Kentaro Mizuno, Tetsuji Maruyama, Yutaro Hayashi, Kenjiro Kohri. Nagoya, Japan. INTRODUCTION AND OBJECTIVE: Both conventional magnetic resonance imaging (MRI) and ultrasonography have been performed for children with non-palpable testes, but the accuracy rates of these examinations are not satisfactory. To improve the diagnostic accuracy of non-palpable testes, we employed fat-suppressed T2-weighted imaging (WI), and diffusion-weighted imaging (DWI), molecules to provide tissue contrast, and discuss the usefulness of these examinations. METHODS: Eighteen children (21 non-palpable testes) aged 9 months to 11 years (mean age 32.4 months), who underwent preoperative MRI for the diagnosis of non-palpable testes between February 2006 and October 2007 were enrolled in this study. Not only T1- and T2-WI, but also fat-suppressed T2-WI and DWI were performed RESULTS: Although testes demonstrated a low signal However, it was easier to detect the testes on fat-suppressed T2-WI and DWI because the testes were imaged at a markedly higher signal intensity (Fig. is fat-suppressed T2-WI). Twelve intra-abdominal testes and 1 extra-canalicular testis diagnosed as intra-abdominal testes preoperatively, 11 testes were intra-abdominal testes and only 1 testis was vanishing testis at surgery. One testis diagnosed as an extra-canalicular testis preoperatively was a