Ashley Cruz | Hunter College (original) (raw)
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Papers by Ashley Cruz
Indian Journal of Pediatrics, 2004
Undescended testis or cryptorchidism is a common problem encountered in children. Despite the abu... more Undescended testis or cryptorchidism is a common problem encountered in children. Despite the abundant literature on the pathology and management of undescended testis, it is the subject of numerous misgivings and controversies. The article reviews available literature on the entity and their relevance in clinical practice.
Journal of Urology, 2006
The management of traumatic posterior urethral disruption in children has ranged from primary rea... more The management of traumatic posterior urethral disruption in children has ranged from primary realignment/repair to delayed urethroplasty. The operative approach may be perineal or transpubic; the advocates of either cite comparable outcome. The anatomic considerations in a child differ from the adult and the management is individualized .We present our experience with the perineal/perineal-transpubic approach in the management of traumatic posterior urethral disruptions in ten boys. A preliminary suprapubic cystostomy was followed by a delayed urethroplasty after comprehensive investigations to delineate the pathoanatomy of the disruption. The urethroplasty began with a perineal exposure and progressed to varying extents to achieve a satisfactory urethral anastomosis. Four cases of bulbomembranous disruption were repaired by perineal approach, whereas six cases of prostatomembranous disruption required a perinealtranspubic approach. Permutations of operative techniques (circumurethral mobilization, corporeal separation/urethral rerouting, pubectomy and omentoplasty) were used. The follow-up assessed micturition patterns, urinary continence and penile erections. At a mean follow-up of 5 years (1.5-12 years), all ten boys void in a good stream and are continent. All have normal penile erections, posture and gait. The paper discusses the rationale and outcome of our management.
Indian Journal of Pediatrics, 2001
Objective: Hirschsprung’s disease may be associated with a number of congenital anomalies of whic... more Objective: Hirschsprung’s disease may be associated with a number of congenital anomalies of which Down’s syndrome and intestinal atresias are commonly encountered. The study aimed to assess the impact of rare associated anomalies on the diagnosis and management of Hirschsprung’s disease.Methods: A retrospective review of the clinical presentation, diagnosis and outcome of thirty five consecutive newly diagnosed cases of Hirschsprung’s disease encountered over two years was performed.Results: Besides Down’s syndrome (two), intestinal atresia (one) and pigmentary ocular defects (two), three rare anomalies (Occipital meningocele, Calcific meconium cyst with anal stenosis, Malrotation) were encountered in four of thirty five cases. The clinical features, radiologic anatomy and gross morphology of the bowel were unconventional and the diagnosis was supported by intraoperative acetylcholinesterase staining of biopsies. Though the diagnosis was relatively delayed in these cases, the outcome has been comparable to the rest. The dilemma in their diagnosis and management and their possible pathoembryology is discussed.Conclusion: Awareness of such associations and a specific investigative protocol is imperative for timely diagnosis and minimal morbidity in complex presentations of Hirschsprung’s disease.
Indian Journal of Pediatrics, 2004
Undescended testis or cryptorchidism is a common problem encountered in children. Despite the abu... more Undescended testis or cryptorchidism is a common problem encountered in children. Despite the abundant literature on the pathology and management of undescended testis, it is the subject of numerous misgivings and controversies. The article reviews available literature on the entity and their relevance in clinical practice.
Journal of Urology, 2006
The management of traumatic posterior urethral disruption in children has ranged from primary rea... more The management of traumatic posterior urethral disruption in children has ranged from primary realignment/repair to delayed urethroplasty. The operative approach may be perineal or transpubic; the advocates of either cite comparable outcome. The anatomic considerations in a child differ from the adult and the management is individualized .We present our experience with the perineal/perineal-transpubic approach in the management of traumatic posterior urethral disruptions in ten boys. A preliminary suprapubic cystostomy was followed by a delayed urethroplasty after comprehensive investigations to delineate the pathoanatomy of the disruption. The urethroplasty began with a perineal exposure and progressed to varying extents to achieve a satisfactory urethral anastomosis. Four cases of bulbomembranous disruption were repaired by perineal approach, whereas six cases of prostatomembranous disruption required a perinealtranspubic approach. Permutations of operative techniques (circumurethral mobilization, corporeal separation/urethral rerouting, pubectomy and omentoplasty) were used. The follow-up assessed micturition patterns, urinary continence and penile erections. At a mean follow-up of 5 years (1.5-12 years), all ten boys void in a good stream and are continent. All have normal penile erections, posture and gait. The paper discusses the rationale and outcome of our management.
Indian Journal of Pediatrics, 2001
Objective: Hirschsprung’s disease may be associated with a number of congenital anomalies of whic... more Objective: Hirschsprung’s disease may be associated with a number of congenital anomalies of which Down’s syndrome and intestinal atresias are commonly encountered. The study aimed to assess the impact of rare associated anomalies on the diagnosis and management of Hirschsprung’s disease.Methods: A retrospective review of the clinical presentation, diagnosis and outcome of thirty five consecutive newly diagnosed cases of Hirschsprung’s disease encountered over two years was performed.Results: Besides Down’s syndrome (two), intestinal atresia (one) and pigmentary ocular defects (two), three rare anomalies (Occipital meningocele, Calcific meconium cyst with anal stenosis, Malrotation) were encountered in four of thirty five cases. The clinical features, radiologic anatomy and gross morphology of the bowel were unconventional and the diagnosis was supported by intraoperative acetylcholinesterase staining of biopsies. Though the diagnosis was relatively delayed in these cases, the outcome has been comparable to the rest. The dilemma in their diagnosis and management and their possible pathoembryology is discussed.Conclusion: Awareness of such associations and a specific investigative protocol is imperative for timely diagnosis and minimal morbidity in complex presentations of Hirschsprung’s disease.