Vojkan Vukadinovic

Publications (7)12.85 Total impact

• Article: Fast-track surgery concepts for congenital urogenital anomalies.

  Marta R Bizic, Marko J Majstorovic, Vojkan Vukadinovic, Gradimir Korac, Zoran Krstic, Zoran Radojicic, Sinisa Ducic, Miroslav L Djordjevic
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  ABSTRACT: To investigate the possibility of fast-track surgery concepts in pediatric urology department as a single center study model of a developing country. The study included 1620 patients surgically treated at the pediatric urology department, from 2009 to 2011. According to the congenital anomalies, all patients were classified in one of four groups: I - testicular anomalies (197 patients); II - external genital anomalies (453); III - upper urinary tract anomalies (801) and IV - associated anomalies (169). We analyzed the total duration of stay in the hospital of all patients among all treating doctors concerning the anomaly. Statistically significant difference in total length of hospitalization of all patients in Group I was noted in Doctors 1 and 5 (F=10.36** for F0.05;5;12=3.11 and F0.01;5;12=5.06), as well as in the Group II (F=17.01** for F0.05;5;12=3.11 and F0.01;5;12=5.06). Statistical analysis was not possible to be performed in groups III and IV because of lack of the patients. Analyzing the length of hospitalization of the patients treated at the urology department, all doctors showed the tendency to shorten the total length of hospitalization in patients of all groups. Majority of the studies carried out on pediatric urology departments in developed countries, showed that over 50% of children were successfully treated using fast-track surgery concept. Modern methods of surgical management and anesthesia allow decrease of hospitalization length, financial savings to the healthcare system and better comfort for patients. KEY WORDS: Children, Fast-track surgery, Hospitalization, Urogenital anomalies.
  Annali italiani di chirurgia 01/2013; 84(1):61-6. · 0.23 Impact Factor
• Article: Epispadias Repair after Failed Surgery in Childhood.

  Miroslav Djordjevic, Vladimir Kojovic, Marta Bizic, Marko Majstorovic, Vojkan Vukadinovic, Gradimir Korac, Zoran Krstic
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  ABSTRACT: Introduction Redo surgery in failed epispadias presents a great challenge. Our aim was to present a radical approach for correction of penile deformities as well as urethral reconstruction in patients after failed epispadias repair.Materials and Methods Between January 2006 and January 2011, 13 patients, aged 13 to 22 years, underwent redo surgery due to failed epispadias repair in childhood. All patients presented with severe dorsal curvature and short urethra. First stage included penile disassembly technique with complete separation of corporal bodies, urethral dissection, and transposition and subtotal glans mobilization. Residual dorsal curvature was corrected by tunical incision and grafting of the defect. Short urethra was dissected and transposed ventrally with opening at the base of the penis. Penile entities were reassembled in normal anatomical relationship. Penile body was covered using available vascularized skin flaps. After 6 months, second stage was performed and included reconstruction of the penile urethra using buccal mucosa graft and scrotal hairless skin flap.Results Follow-up ranged from 12 to 60 months (mean 33 months). Acceptable outcome is achieved in all the patients. Complete penile lengthening and straightening is obtained in 10 out of 13 patients. Mild curvature is noted in three patients without consequences. Satisfactory sexual activity was reported from nine patients. One patient developed fistula that was closed after 4 months, whereas all other patients reported normal voiding with no difficulties.Conclusions Redo surgery of failed epispadias is very demanding procedure. Radical approach in these cases is necessary for complete repair of all penile deformities with satisfactory postoperative outcome.
  European Journal of Pediatric Surgery 11/2012; · 0.81 Impact Factor
• Article: "Hanging" of the buccal mucosal graft for urethral stricture repair after failed hypospadias.

  Miroslav L Djordjevic, Vladimir Kojovic, Marta Bizic, Marko Majstorovic, Vojkan Vukadinovic, Gradimir Korac
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  ABSTRACT: Urethral stricture is the second most common complication of hypospadias repair after urethrocutaneous fistula. Usually more than 1 procedure is needed for correction due to a lack of available tissue after previous repairs. We evaluated 1-stage urethral stricture management after hypospadias repair using a ventral buccal mucosal graft. We describe the importance of graft hanging and coverage. From August 2004 to April 2009, 15 patients 9 to 17 years old underwent urethral stricture repair after failed hypospadias surgery. Mean time after primary surgery was 7.2 years (range 4 to 13). Vascularized periurethral tissue around the stenotic part of the neourethra was dissected. The urethra was opened ventrally and a buccal mucosal graft of appropriate size was inserted to allow urethral augmentation. Using several U stitches the graft was anchored to the surrounding periurethral tissue to prevent its folding and retraction. Recurrent chordee in 12 patients and secondary vesicoureteral reflux in 3 were also corrected at this time. Mean followup was 37 months (range 17 to 73). Successful results were confirmed in all patients by urethrography and uroflowmetry. One urethral fistula was corrected 3 months later by minor surgery. Recurvature did not develop in this group. There was no recurrent reflux in endoscopically treated patients. Ventral buccal mucosal grafting is a simple, safe option for urethral stricture repair. Hanging the graft to periurethral tissue is important for its survival and to prevent postoperative folding and retraction.
  The Journal of urology 06/2011; 185(6 Suppl):2479-82. · 4.02 Impact Factor
• Article: Minimally invasive inguinal technique for the management of duplex ureteric anomaly.

  Zoran Radojicic, Vojkan Vukadinovic, Zeljko Smoljanic, Polina Pavicevic, Sinisa Ducic, Nenad Janic, Aleksandar Janjic, Sava Perovic
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  ABSTRACT: To present outcomes of a minimally invasive inguinal technique for the separation of the distal part of ureters in duplex systems and for the extravesical ureteroneocystostomy of only the pathologically involved ureter. From November 2001 to February 2007, we performed extravesical reimplantation of only the involved ureter in 21 duplex systems, of which 14 were refluxing (megaureters) and seven had obstruction of the ureterovesical junction. The mean (range) age of the patients was 39 (17-59) months. In seven patients, ureterocutaneostomy (of the involved ureter only) was performed first, with reimplantation 3-6 months later, after the diameter of the ureter had decreased, to ensure safe reimplantation. The mean (range) postoperative follow-up was 28 (12-47) months. Postoperative voiding cysto-urethrograms (VCUGs) and magnetic resonance imaging (MRI), showed an absence of vesico-ureteric reflux (VUR) or obstruction in the ureters of the first 10 patients. In the remaining 11 patients, there was no ultrasound detectable dilatation, but symptomatic urinary tract infection developed in two of these patients. Subsequent VCUG and MRI results showed no obstructions or VURs. Our results showed that the minimally invasive inguinal approach to separation of ureters in duplex systems and single ureteroneocystostomy of only the pathologically involved ureter represents a viable treatment option.
  BJU International 03/2011; 108(10):1660-3; discussion 1663-4. · 2.84 Impact Factor
• Article: Combined buccal mucosa graft and dorsal penile skin flap for repair of severe hypospadias.

  Miroslav L Djordjevic, Marko Majstorovic, Dusan Stanojevic, Marta Bizic, Vladimir Kojovic, Vojkan Vukadinovic, Gradimir Korac, Zoran Krstic, Sava V Perovic
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  ABSTRACT: Urethral reconstruction in severe hypospadias presents a great challenge. We have designed a method of combining a longitudinal dorsal island skin flap and buccal mucosa graft to create a neourethra in most severe hypospadias. Between January 2003 and March 2007, 17 patients (aged from 9 to 23 months) underwent severe hypospadias repair (13 penoscrotal and 4 scrotal hypospadias). Short urethral plate was divided in all cases and remaining curvature repaired by dorsal plication. We harvested and fixed a buccal mucosa graft to the ventral side of corpora cavernosa to be the first half of a neourethra. A longitudinal dorsal island skin flap was created and buttonholed ventrally. We sutured it together with the buccal mucosa graft to form the neourethra. We fixed the abundant flap pedicle laterally to cover all suture lines of the neourethra. We performed penile skin reconstruction using available penile skin. The mean (range) follow-up was 25 (7 to 58) months. We achieved satisfactory, functional, and aesthetic results in 14 patients. In 3 cases urethral fistula (2) and distal stricture (1) required secondary treatment. Combined longitudinal island skin flap and buccal mucosa graft could be a good choice for urethral reconstruction in most severe hypospadias repairs.
  Urology 06/2008; 71(5):821-5. · 2.43 Impact Factor
• Article: Omphalocele associated with gastroschisis defect covered with skin.

  Stojan M Zivkovic, Vojkan Vukadinovic
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  ABSTRACT: Omphalocele and gastroschisis are distinct malformations in many aspects. Anatomical and pathologic findings in both conditions are usually typical and very frequent. Unusual clinical presentations of some cases may contribute to clearing up questions about the embryological origins of gastroschisis and omphalocele. We describe a rare case of omphalocele associated with gastroschisis defect covered with skin.
  Journal of Pediatric Surgery 08/2006; 41(7):e31-3. · 1.45 Impact Factor
• Article: Lymphangioma scroti.

  Jelica Vikicevic, Danica Milobratovic, Vojkan Vukadinovic, Zoran Golubovic, Zoran Krstic
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  ABSTRACT: Lymphangiomas are congenital malformations of the lymphatic system. We report a 10-year-old boy with lymphatic malformation of the scrotum, which presented as a multiloculated scrotal mass associated with edema of the left thigh and left cryptorchidism. Histopathologic examination showed scrotal lymphangioma cavernosum. Ultrasonography was of major importance for the preoperative diagnosis and to determine the extent of the scrotal lesion. Scrotal lymphangiomas are very rare. It is important to consider them in boys with a cystic scrotal mass in order to avoid misdiagnosis, improper treatment and recurrences.
  Pediatric Dermatology 24(6):654-6. · 1.07 Impact Factor