Alexander Springer

Medical University of Vienna | MedUni Vienna

Background: Hypospadias affects around 1/200 newborn males. Intrauterine testicular dysfunction may underlie a subset of cases. The long-term endocrine and reproductive outcomes in these men remain largely unknown. Methods: Cross-sectional study in Ghent and Vienna University Hospitals to assess the endocrine and seminal parameters of young adul...

Infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been associated with changes in blood coagulation resulting in increased incidence of venous thromboembolic events and coagulopathy. Moreover, single cases of ischemic priapism have been reported in adult patients with SARS-CoV-2 infection. In this report, we describe t...

There is currently no universally adopted terminology for defining the surface anatomic location of human genitalia. The lack of precision, accuracy, and reliability of terms used by health care providers, in particular pediatric surgeons, is unsatisfactory both for epidemiological research and for high-quality patient care. Consistent use of preci...

Lichen sclerosus (LS) or balanitis xerotica obliterans (BXO) is a chronic atrophic dermatitis involving the anogenital area affecting females more than males. The etiology is unknown, but it is thought to be due to abnormal immune response to a causative factor, leading to inflammation and subsequent sclerosis. The microscopic picture is characteri...

Objective: Being born small for gestational age (SGA) is frequently associated with unexplained disorders of sex development (nonspecific DSD) in boys. Little is known about their future growth, puberty and testicular function. Our objective is to determine the long-term endocrine outcome of boys born SGA who have a nonspecific DSD. Design: Boys...

In this article international trends in surgical practice in girls with congenital adrenal hyperplasia (CAH) are evaluated. All cases that had been classified in the I-CAH/I-DSD registry as 46,XX CAH and who were born prior to 2017 were identified. Centers were approached to obtain information on surgical decision making. Of the 330 included partic...

Background Laparoscopic procedures are usually performed under general anesthesia with a secured airway including endotracheal intubation or supraglottic airways. Aims Prospective study of the feasibility of subumbilical laparoscopic procedures under epidural anesthesia in sedated, spontaneous breathing infants with a natural airway. Methods We c...

Purpose: We assessed the long-term surgical, functional urinary and sexual outcome of adolescent and young adult men who underwent childhood hypospadias repair. Materials and methods: Men born with non-syndromic hypospadias and healthy male controls, aged 16-21 years old, were recruited and their surgical, urinary, sexual functional and aestheti...

Although the outcome of hypospadias surgery requires careful scrutiny, there is little consensus on what clinical outcome parameters should be considered essential as part of routine clinical practice. To understand the extent of variation in reported outcome measures, Pubmed was searched to identify outcomes in boys with hypospadias published in t...

Background The psychosexual outcome in adolescents and young adults (AYA) men born with hypospadias is precarious. However, the factors responsible for impaired outcome in some AYA men have been understudied. Aim To explore the outcome after hypospadias repair in childhood of AYA men aged 16–21 years and examine their opinion and their parents’ op...

Lichen sclerosus (LS) is a chronic inflammatory and atrophic dermatitis of unknown etiology. In boys LS is mainly involving the prepuce, glans, and the distal urethra.

Context Standardized description of external genitalia is needed in the assessment of children with atypical genitalia. Objectives To validate the External Genitalia Score (EGS), to present reference values for preterm and term babies up to 24 months and correlate obtained scores with anogenital distances (AGDs). Design, Setting A European multic...

The treatment and care of individuals who have a Difference of Sex Development (DSD) have been revised over the past two decades and new guidelines have been published. In order to study the impact of treatments and new forms of management in these rare and heterogeneous conditions, standardized assessment procedures across centres are needed. Diag...

Differences of sex development are conditions with discrepancies between chromosomal, gonadal and phenotypic sex. In congenital hypogonadotropic hypogonadism, a lack of gonadotropin activity results primarily in the absence of pubertal development with prenatal sex development being (almost) unaffected in most patients. To expedite progress in the...

Cerebral palsy is a rare condition following injury of the developing brain and including nonprogressive neurological disorders, spasticity, intellectual impairment and others. Boys with cerebral palsy have a high incidence of undescended testis. Although the motives for treatment (infertility, cancer prevention, psychological aspects, testicular t...

Purpose: In severe hypospadias staged repair is commonly used and it is regarded as feasible, safe, and durable. In this article we want to describe the results of a modification of the staged repair: a midline incision of the graft during the second stage. Materials and Methods: This is a consecutive single team (2 surgeons) retrospective series....

The level of connection between health care professionals and people who experience a condition that affects sex development is variable. These people and associated support groups need to be included in discussions about research and healthcare delivery. The aim of this study was to understand the experiences of individuals with disorders of sexua...

Bladder augmentation is a demanding surgical procedure and exclusively offered for selected children and has only a small spectrum of indications. Paediatric bladder voiding dysfunction occurs either on a basis of neurological dysfunction caused by congenital neural tube defects or on a basis of rare congenital anatomic malformations. Neurogenic bl...

Purpose: To determine whether there is a difference in the outcome of renal transplantation (RT) in patients with posterior urethral valves (PUV) and children with non-uropathy related end stage renal disease. Methods: Data were acquired retrospectively. We analyzed possible factors that influence the function of renal allografts and graft survi...

The term differences of sex development (DSDs; also known as disorders of sex development) refers to a heterogeneous group of congenital conditions affecting human sex determination and differentiation. Several reports highlighting suboptimal physical and psychosexual outcomes in individuals who have a DSD led to a radical revision of nomenclature...

Background: The level of connection between health care professionals and people

Objectives: To present the results of simultaneous creation of both Mitrofanoff stoma and Malone antegrade continence stoma (MACE) using simple division of the appendix and a cecal extension method. Methods: Between June 2011 and November 2016 simultaneous Mitrofanoff and MACE was performed in 16 children (12 children - simple division of the ap...

Today, a multiple number of surgical techniques, modifications, and combinations of techniques are used to improve cosmetic and functional outcomes and to minimise the procedure burden for the patient. Nevertheless, controversy exists regarding the ideal management of hypospadias. This update is based on current literature following a systematic re...

Intersex/disorders of sex development advocacy groups and associated health care professionals question the legitimacy of the Council of Europe issue paper, express their worries about its potentially harmful consequences, and urge the Council of Europe to consult more widely with relevant stakeholders.

Introduction: Hypospadias is a common congenital malformation. Surgical repair and management of the long-term consequences require a substantial amount of socioeconomic resources. It is generally accepted that genetic and environmental factors play a major role in the etiology of hypospadias. There have been contradictory reports on rising hyposp...

Hypospadias surgery is challenging. Long-term follow-up beyond puberty is es-sential. Literature is lacking of long-term outcome data. The l-DSD registry (14) and The Dutch Hypospadias Study (13) are international databases for prospective hypospadias patients allocation. Every hypospadias surgeon is encouraged and invited to join such a database f...

Fetal unilateral ureteral obstruction (UUO) triggers complex pathophysiology involving not only the affected organ but also the contralateral kidney, which undergoes evident compensatory changes. We hypothesized that it would be possible to characterize a transcriptomic fingerprint and selected molecular mechanisms for compensatory growth of contra...

Patients with chronic kidney disease (CKD) have a high risk to develop atherosclerosis. The capacity of high-density lipoproteins (HDL) or serum to accept cholesterol from macrophages and the capacity of macrophages to export excess cholesterol are critical for the atheroprotective role of reverse cholesterol transport. HDL cholesterol acceptor cap...

What little data exist as to the optimal timing of hypospadias reconstruction is based on retrospective studies and expert opinion. No data exist as to the optimum timing of hypospadias reconstruction in the extremely small subset of patients with severe hypospadias that merits a disorder of sex development (DSD) diagnoses. Until such data exist, i...

Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous re-evaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includ...

Unlabelled: In recent years, there have been fundamental changes in the understanding of vesicoureteral reflux (VUR). This is reflected by current international guidelines that cover diagnosis, screening, and treatment of VUR. However, literature is still lacking and many questions are unsolved. In this article, we shortly review the important asp...

Context: Aromatase deficiency due to a CYP19A1 defect leads to fetoplacental inability to convert androgens into estrogens. Pregnant mothers experience virilization caused by excess nonaromatized fetal androgens entering the maternal circulation. Biochemical normalization is believed to take place shortly after delivery. Objective: We report pro...

Videocystometrography (VCMG) is the most complex study of urinary tract function, combining as it does conventional pressure flow urodynamics with simultaneous imaging of the lower urinary tract. The commonest indications include the assessment of the neurogenic bladder, urinary incontinence and patients who have undergone reconstruction of the low...

Objective: To show that splinting of the urethral repair with acellular collagen matrix is a safe and useful adjunct in the procedure to manage complex urethrocutaneous fistula. Urethrocutaneous fistula is one of the most common complications of hypospadias surgery. Management of persistent urethrocutaneous fistula is challenging because it is com...

Objective: To evaluate orchidopexy patterns in Austria. Material and methods: All boys with cryptorchidism who underwent orchidopexy (n = 19.998) in Austria between 1993 and 2009 were analyzed using the database Austrian Health Information System at the Austrian Federal Research and Planning Institute for Health Care. Regression models were cons...

To describe a modification of the 2-stage repair using a dorsal split dartos fascia flap, as a well vascularized bed for the graft in the first stage.The 2-stage repair is a commonly used technique in proximal hypospadias or in hypospadias with severe chordee, or in cases with urethral plate of poor or dubious quality. Between 2006 and 2009, 32 pat...

Objective: To determine the attitude of referring pediatricians towards the decision of treatment modalities for undescended testis (UDT) in neurologic impaired boys (NIB). Methods and materials: An online questionnaire was offered to registered pediatricians in Austria and Germany for online completion. Results: 221 male (61.6%) and 138 femal...

Fetal obstructive uropathy is a leading cause of loss of renal function. Characterizing the molecular fingerprint of cellular responses to obstruction in a fetal model of complete unilateral ureteral obstruction may help elucidate the activated mechanisms and suggest new therapeutic interventions. Unilateral ureteral obstruction was created in 3 sh...

Hypospadias is a challenging field of urogenital reconstructive surgery, with different techniques currently being used. Evaluate international trends in hypospadias surgery. Paediatric urologists, paediatric surgeons, urologists, and plastic surgeons worldwide were invited to participate an anonymous online questionnaire (http://www.hypospadias-ce...

We report the findings of voiding cystourethrography in a boy with posterior urethral valves that showed reflux into the epididymis.

Extensive ureteral loss in early childhood is a rare but dramatic event. We present the case of a 6-month-old girl with a iatrogenic extensive pyelo-ureteral loss and solitary kidney. She successfully underwent left ureteral substitution using the appendix vermiformis. Left ureteral reconstruction using the appendix vermiformis is a feasible proced...

Bilateral foetal uropathy is the leading cause of chronic renal failure in childhood. Vesico-amniotic shunting (VAS) is a simple, feasible, and widely used procedure for decompressing the foetal urinary system. We report a case of a boy with bilateral foetal uropathy who underwent VAS at a gestational age of 29 weeks. Vesico-abdominal shunt dislodg...

Guidelines recommend early orchidopexy in cryptorchidism to decrease the risk of infertility and tumor formation. We aimed to asses if a delayed initial presentation for cryptorchidism was due to unawareness of these guidelines or for any other reasons. A short questionnaire exploring timing and referral habits when assessing children with cryptorc...

Zusammenfassung Pränatal auftretende zystisch-hämorrhagische Raumforderungen der Nebenniere sind sehr selten. Die wichtigste Differenzialdiagnose ist das Neuroblastom. Zystische Fehlbildungen und Tumoren der Nebenniere werden auch beim Beckwith-Wiedemann-Syndrom (BWS) beschrieben. Es wird über ein Neugeborenes berichtet, bei dem im 5. Schwangerscha...

Severe intraabdominal bleeding in neonates within 24 hours after birth are an extremely seldom event. In our neonate, the intraabdominal bleeding was diagnosed by the clinical picture and by abdominal ultrasound examination. The etiology for this bleeding was primarily a blunt abdominal trauma as described in most cases of the liver; however, histo...

A male newborn with pentalogy of Cantrell, tetralogy of Fallot, agenesis of the gallbladder, and polysplenia died at 3 days of age. Polysplenia was not previously reported in this association.

A 13-month-old girl with a unilateral renal angiomyolipoma causing severe hypertension is reported. The differential diagnosis of renal masses, a review of the literature, and the diagnostic algorithm for renal masses used at our center are presented.

Einleitung: Bereits 1963 entwickelte Cadwell eine Methode der anorektalen Muskelstimulation mit Hilfe der Elektrostimulation. Bis heute existieren fast ausschließlich Studien bei Erwachsenen in Zusammenhang mit Verletzung des Kontinenzorganes. Bei Neugeborenen, Säuglingen und Kleinkindern, bei denen eine anorektale Fehlbildung operativ korrigiert w...

As surgeons gain more experience with laparoscopy in children, it is becoming apparent that one of the best applications of the technique is for appendicitis. The advantages of laparoscopic appendectomy include a better cosmetic result, particularly in young female patients, a shorter recovery time, and an early return to normal activities. In the...

In order to address the frequency of complications as well as extraordinary cases with relation to the anatomic and pathological course of diseases, European Pediatric Surgical Centers have formed a central database EDBEC (European Databank for Extraordinary Courses). A questionnaire comprising of 26 points addressing the complications and extraord...

Surg Childh Intern 2000; VIII(4):326-327