How We Do Buried Penis Reconstruction in Children: A Novel Technique

2018 ◽  
Vol 24 (8) ◽  
pp. 6164-6167
Author(s):  
Widi Atmoko ◽  
Gerhard Renaldi Situmorang ◽  
Irfan Wahyudi ◽  
Arry Rodjani
Keyword(s):  
Complete Separation ◽  
Voiding Function ◽  
Novel Technique ◽  
Good Cosmetic ◽  
Asking Questions ◽  
The Mean ◽  
Time Of Operation ◽  
Satisfaction Rates ◽  
Buried Penis

Buried penis is a pathology for which several reconstructive techniques are described. We described a novel technique involving complete separation of dartos fascia from the skin and penis and excision of dartos fascia until penile fixation to pubic region after complete degloving of penis to eradicate the abnormal attachments of the dartos muscle to the corporal bodies and evaluated the efficacy and safety of our technique. From June 2009 and February 2015, 28 patients underwent surgical repair of buried penis with our novel technique. We administered a questionnaire asking questions about penile size, morphology, and voiding status to evaluate parental satisfaction. The mean age of patients at the time of operation was 9.50±2.09 years, and the mean duration of follow-up was 23.27±16.75 months. The mean satisfaction grades for penile size, morphology, and voiding function were improve (p < 0.05) (Fig. 2). The mean preoperative satisfaction grade concerning penile size was 0.82±0.76, and it improved postoperatively to 2.67±0.52 at the last follow-up (p < 0.001). The mean preoperative satisfaction grade for penile morphology was 0.86 ± 0.55, which improved to 2.12±0.40 at the last follow-up visit (p < 0.001). The mean preoperative satisfaction grade for voiding function was 1.10±0.72, which improved to 2.94±0.86 at the last follow-up visit (p < 0.001). There were no complications such as postoperative infection and tissue necrosis. Edema developed in 2 patients, but resolved spontaneously after 1 month. Our method of buried penis correction was found to be technically feasible and safe. It results in a good cosmetic appearance and excellent postoperative satisfaction rates in terms of size, morphology, and voiding function. Further research is needed to understand its pathophysiology.

scholarly journals Modified three-step procedure to treat buried penis in children without previous surgery: experience in 150 cases

2021 ◽  
Vol 3 (4) ◽  
pp. 25-30
Author(s):  
Hanzhong HE ◽  
Pengfei GAO ◽  
Sunjie SUN ◽  
Gaoyan DENG
Keyword(s):  
Surgical Procedure ◽  
Operative Time ◽  
Previous Surgery ◽  
Cosmetic Results ◽  
Step Procedure ◽  
Good Cosmetic ◽  
History Of ◽  
The Mean ◽  
Buried Penis

[Background] The buried penis has an abnormally smaller and shorter appearance. We performed a modified three-step procedure to correct the buried penis with satisfactory cosmetic results. [Methods] From May 2014 to December 2020, 150 boys, ranging in age from 2 to 7 years old (median age: 3.3 years), underwent this three-step procedure. The chief complaint was a smaller and shorter appearance of the penis. The surgical procedure consisted of three steps: complete degloving through a diamond-shaped penoscrotal incision, circumcision to remove the majority of the inner plate, and anchoring of the penopubic skin to the base of albuginea penis at the 4 and 8 o’clock positions with unabsorbable sutures. [Results] The mean operative time was 50 minutes (range from 40 to 60 minutes). The mean follow-up time was 2.8 years (range from 10 months to 6 years). There were no complications or recurrences. Good cosmetic results were achieved in all boys. [Conclusions] Our modified three-step procedure had good cosmetic results without complications. We recommend this effective surgical procedure for boys with buried penis who have no history of previous surgery.

scholarly journals Comparison of Snodgross and para-meatal based flap technique for hypospadiasis

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Jaffry S A H ◽  
Naveed Iqbal ◽  
Muhammad Nazir ◽  
Khuda Dad Tarrar
Keyword(s):  
Clinical Intervention ◽  
Wound Dehiscence ◽  
University Hospital ◽  
Flap Technique ◽  
External Meatus ◽  
Good Cosmetic ◽  
Watertight Closure ◽  
The Mean ◽  
Complications Rate

Objective: To compare the two surgical procedures Snod gross & parameatal based flap technique for mid & distal penile hypospadias including cosmosis. Study design: Randomized Clinical interventional trail. Place of study: This study was conducted in the Urology Department of Assir Central University Hospital ABHA, KSA and Department of Urology & Renal transplantation, Jinnah Hospital, Lahore from June 2002 to Dec 2004. Material & Methods: Thirty-two patients were selected for this randomized clinical intervention study with mid shaft & distal hypospadias fulfilling the inclusion criteria. Snod Gross and parameatal based flap technique was assigned randomly to patients comprising of two groups of sixteen each. Watertight closure was made with 6/0 vicryl. Tourniquet or 1:10000 epinephrine were used. Follow up at 2 weeks, three months; 6 months post catheter or stent removal and the patient were assessed on criteria of cosmosis, time for surgery and complications associated with the procedure. Results: Th irty-two patients who underwent procedure of Snodgross & parameatal-based flap in the management of mid shaft & distal penile Hypospadias. Age ranged from 2-12 years. The mean age was 5.23+4 years. The presentation of patients was dystocia of external meatus with misdirected stream in sixteen (50%) patients, spraying of urine in six (25%) and narrow stream in 4(13%) patients. Eighteen patients were having distal penile and fourteen were having mid shaft hypospadias. Following Snod grass technique all patients had good cosmetic results without any complication. Following parameatal based flap, one patients (6.3%) develop wound dehiscence, three patients (18.8%) develop urethral fistula, two patients (12.5%) showed metal retrieval and twenty patients showed good cosmosis. In our study, comparison between Snodgross & parameatal-based flap, the success rate was 100% and 62.4% respectively. Conclusions: Success with Snod gross procedure is better with no complications and good cosmosis. Complications rate was 37.6 % in-patient with para-meatal technique.

scholarly journals The Application of Pediatric Ureteroscope for Seminal Vesiculoscopy

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Shulin Guo ◽  
Donghua Xie ◽  
Xiangfei He ◽  
Chuance Du ◽  
Lunfeng Zhu ◽  
...  
Keyword(s):  
Operative Time ◽  
Ejaculatory Duct ◽  
Cure Rate ◽  
Duct Obstruction ◽  
Novel Technique ◽  
Front End ◽  
Prostatic Utricle ◽  
The Mean ◽  
Ejaculatory Duct Obstruction

To describe a novel technique of transurethral seminal vesiculoscopy using a pediatric ureteroscope in the diagnosis and management of persistent hematospermia, a retrospective study was carried out for 20 patients with recurrent hematospermia whom we evaluated and treated using a 6–7.5F (6F front end and 7.5F rear end) pediatric ureteroscope from August 2009 to September 2013. For the 20 patients, the age ranges from 25 to 48 years with a mean age of 36 years. The duration of the hematospermia ranges from 6 to 48 months with a mean duration of 18 months. Transurethral seminal vesiculoscopy was successfully performed in the 20 cases and the mean operative time was 35 min (ranges from 25 to 90 min). Among the 20 patients, 11 patients were found to have seminal vesiculitis, five were with seminal vesicle stone, one was with prostatic utricle stone, one was with prostate cyst, and one was with ejaculatory duct obstruction. The mean follow-up period was 7 months (ranged from 6 to 12 months). Hematospermia in 19 cases disappeared after the surgery and only in one patient the hematospermia recurred 6 months after the surgery. The cure rate was 95%. This study indicated that transurethral seminal vesiculoscopy could be performed easily using a semirigid pediatric ureteroscope with few complications and is an effective therapeutic approach for persistent hematospermia.

scholarly journals BILIARY TRACT INJURY

2006 ◽  
Vol 13 (02) ◽  
pp. 264-268
Author(s):  
ABDUL SATTAR ◽  
SHAUKAT ALI ◽  
SHAZIA BATOOL RANA
Keyword(s):  
Biliary Tract ◽  
Descriptive Study ◽  
Stone Disease ◽  
Short Hospital Stay ◽  
Biliary Leakage ◽  
Early Return ◽  
Good Cosmetic ◽  
One Year ◽  
Time Of Operation

Objective:-To observe the rate of biliary tract injury and to prove theeffectiveness of mini-cholecystectomy in developing countries. Setting:- Department of Surgery, Nishtar Hospital,Multan. Design:- Descriptive study. Duration:- One year, starting from October 2002 to October 2003. Material andmethods: Total 50 patients were treated with mini-cholecystectomy. Follow up for complication was done for the periodof 6 months after procedure. Results: In 50 patients there was no bile duct injury. Biliary peritonitis and strictures wereseen in 2(4%) patients. Patients developed biliary leakage in which drain was not put at the time of operation and onlydrain was put and recovered. Conclusion: Mini-cholecystectomy is relatively economical method for the treatment ofgall stone disease which is associated with less patients discomfort and less incidence of postoperative complications,short hospital stay, good cosmetic results, early return to work, so it should always be preferred to conventionalcholecystectomy.

Novel technique of tetra trephination for elliptical-shaped tectonic patch grafts in peripheral sterile keratolysis

2021 ◽  
pp. 112067212199895
Author(s):  
Rahul Kumar Bafna ◽  
Nidhi Kalra ◽  
Mohamed Ibrahime Asif ◽  
Rinky Agarwal ◽  
Suman Lata ◽  
...  
Keyword(s):  
Successful Outcome ◽  
Full Thickness ◽  
Surgical Time ◽  
Preparation Time ◽  
Time Saving ◽  
Novel Technique ◽  
Patch Graft ◽  
The Mean ◽  
Iris Prolapse

Purpose: To describe a novel technique of tectonic patch grafts for elliptical-shaped peripheral sterile keratolysis with iris prolapse. Methods: We performed a full thickness corneo-scleral patch graft in five eyes of five patients with elliptical-shaped peripheral sterile keratolysis with perforation and iris tissue prolapse. In this technique, four disposable trephines with predetermined diameter were employed to fashion both the host and the donor without any free-hand dissection. An intact anatomical integrity of the globe without the need for any repeat tectonic measures was considered as a successful outcome. Results: The mean age was 34.2 ± 10.2 years (18–45). The mean total surgical time and donor preparation time was 94.4 ± 7.12 min and 7.6 ± 1.14 min, respectively. The intraoperative course was uneventful in all cases and all eyes had a well-maintained corneal integrity till 6 months follow up. Conclusion: We describe a simple, reproducible, and time-saving technique of performing elliptical shaped corneoscleral patch grafts for peripheral corneal perforations with iris prolapse.

scholarly journals Suprapubic Liposuction With a Modified Devine’s Technique for Buried Penis Release in Adults

2020 ◽  
Vol 28 (3) ◽  
pp. 172-178
Author(s):  
Peiyang Zhang ◽  
Baicheng Wang ◽  
Xiaowei Zhang ◽  
Ziqi Song ◽  
Wenjun Bai ◽  
...  
Keyword(s):  
Gold Standard ◽  
Surgical Techniques ◽  
Overweight And Obesity ◽  
P Value ◽  
Average Amount ◽  
Penile Length ◽  
Post Operation ◽  
The Mean ◽  
Buried Penis

Background: With the increasing prevalence of overweight and obesity, adult-acquired buried penis is more common in recent years. Many surgical techniques have been reported. However, none is the gold standard. Objective: To evaluate the safety and efficacy of combining suprapubic liposuction and modified Devine’s technique for penile lengthening in adult patients with buried penis due to obesity Methods: From September 2015 to June 2018, 26 consecutive suitable patients (mean age: 33 ± 5.7 years, mean body mass index: 29 ± 5.4 kg/m2) with a buried penis received suprapubic liposuction and modified Devine’s technique for penis release in our medical centre. A retrospective study was conducted. Their penile length from tip to the skin (flaccid) was measured pre- and post-operatively. The amount of liposuction was also recorded accordingly. Results: The mean length of the follow-up on the 26 patients is 18 ± 7.1 months (range 3-33 months). The average amount of liposuction is 450 ± 90.2 mL. The average penile length measured preoperatively, post-operatively (on table), and 3 months after the operation is 2.9 ± 1.3, 7.4 ± 2.1, and 5.3 ± 1.8 cm, respectively. The post-operative penile length had significantly increased by 4.5 ± 1.6 cm (on table) and 2.4 ± 0.7 cm (3 months post-operation) with a P value <.05. No patient had difficulties in sexual intercourse or urination post-operatively. None of the patients were dissatisfied with their surgical outcomes. Conclusions: The combination of suprapubic liposuction and modified Devine’s technique is a safe and effective method for releasing the buried penis of adults with satisfying outcomes.

scholarly journals A simple novel technique [PUIT] for closure of urethrocutaneous fistula after hypospadias repair: Preliminary results

2005 ◽  
Vol 38 (02) ◽  
pp. 114-118
Author(s):  
M S Awad
Keyword(s):  
Common Complication ◽  
Hypospadias Repair ◽  
Fistula Repair ◽  
Urethrocutaneous Fistula ◽  
Good Opportunity ◽  
Good Cosmetic Outcome ◽  
Novel Technique ◽  
Good Cosmetic ◽  
The Mean ◽  
Incision Technique

ABSTRACTUrethrocutaneous fistula is a common complication of urethroplasty for severe hypospadias, even when a microsurgical technique is applied, the closure of the fistula is a challenging problem. We present a simple surgical procedure, posterior urethral incision technique [PUIT] to close the fistula in our department.Between February 2001 and December 2004 we prospectively evaluated 32 patients, 26 patients with initial hypospadias fistulas and 6 with recurrent fistulas who underwent closure of urethrocutaneous fistula after hypospadias repair. The mean age of patients was 5 years, the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and 2 mm below the fistula opening then re-approximation of the urethral edges using 6/0 vicryl sutures with loop magnification.The timing of fistula repair was between 6 and 13 months after it was formed, all of these were effectively closed except three cases with stricture and fistula. Of these, two were completely relieved after repeated urethral dilatation, three times a week for 2 weeks. The third failed case will need another sitting after 6 months.The posterior midline urethral incision gives a good opportunity for repair without tension with a good cosmetic outcome. This may be done under local anesthesia in adults. The procedure is considered simple rapid and easy to be done for variable fistulas types whatever of its site and the age.

scholarly journals Posterior lumbar dynamic stabilization instead of arthrodesis for symptomatic adjacent-segment degenerative stenosis: description of a novel technique

2016 ◽  
Vol 40 (1) ◽  
pp. E5 ◽  
Author(s):  
Hazem Mashaly ◽  
Erin E. Paschel ◽  
Nicolas K. Khattar ◽  
Ezequiel Goldschmidt ◽  
Peter C. Gerszten
Keyword(s):  
Lumbar Fusion ◽  
Dynamic Stabilization ◽  
Neurogenic Claudication ◽  
Adjacent Segment ◽  
Fusion Surgery ◽  
Instrumented Fusion ◽  
Novel Technique ◽  
The Mean ◽  
Lumbar Dynamic Stabilization

OBJECTIVE The development of symptomatic adjacent-segment disease (ASD) is a well-recognized consequence of lumbar fusion surgery. Extension of a fusion to a diseased segment may only lead to subsequent adjacent-segment degeneration. The authors report the use of a novel technique that uses dynamic stabilization instead of arthrodesis for the surgical treatment of symptomatic ASD following a prior lumbar instrumented fusion. METHODS A cohort of 28 consecutive patients was evaluated who developed symptomatic stenosis immediately adjacent to a previous lumbar instrumented fusion. All patients had symptoms of neurogenic claudication refractory to nonsurgical treatment and were surgically treated with decompression and dynamic stabilization instead of extending the fusion construct using a posterior lumbar dynamic stabilization system. Preoperative symptoms, visual analog scale (VAS) pain scores, and perioperative complications were recorded. Clinical outcome was gauged by comparing VAS scores prior to surgery and at the time of last follow-up. RESULTS The mean follow-up duration was 52 months (range 17–94 months). The mean interval from the time of primary fusion surgery to the dynamic stabilization surgery was 40 months (range 10–96 months). The mean patient age was 51 years (range 29–76 years). There were 19 (68%) men and 9 (32%) women. Twenty-three patients (82%) presented with low-back pain at time of surgery, whereas 24 patients (86%) presented with lower-extremity symptoms only. Twenty-four patients (86%) underwent operations that were performed using single-level dynamic stabilization, 3 patients (11%) were treated at 2 levels, and 1 patient underwent 3-level decompression and dynamic stabilization. The most commonly affected and treated level (46%) was L3–4. The mean preoperative VAS pain score was 8, whereas the mean postoperative score was 3. No patient required surgery for symptomatic degeneration rostral to the level of dynamic stabilization during the follow-up period. CONCLUSIONS The use of posterior lumbar dynamic stabilization may offer a valid and safe option for the management of patients who develop ASD rostral to a previously instrumented arthrodesis. The technique may serve as an alternative to multilevel arthrodesis in this patient population. By implanting a dynamic stabilization device instead of an extension of a rigid construct, this might translate into a reduction in the development of yet another level of ASD.

Laser Capsulorrhaphy for Multidirectional Instability of the Shoulder

2003 ◽  
Vol 31 (1) ◽  
pp. 26-35 ◽  
Author(s):  
Thomas A. Joseph ◽  
James S. Williams ◽  
John J. Brems
Keyword(s):  
Athletic Activity ◽  
Recurrent Instability ◽  
Rating Score ◽  
Simple Shoulder Test ◽  
Multidirectional Instability ◽  
The Mean ◽  
Satisfaction Rates ◽  
Numeric Rating ◽  
Risk Factor For Recurrence

Background Clinical data on the efficacy of laser capsulorrhaphy for the treatment of multidirectional instability of the shoulder are limited. Hypothesis The diagnosis of multidirectional instability includes a spectrum of pathologic symptoms that warrants subclassification; laser capsulorrhaphy alone is not uniformly effective for all subtypes. Study Design Retrospective review of prospectively collected data. Methods Twenty-five shoulders in 21 patients were treated with laser capsulorrhaphy for multidirectional instability. Functional outcomes at a mean duration of 32 months' follow-up (range, 24 to 48 months) were recorded. Results Instability recurred in 60% of patients with congenital multidirectional instability, 17% of patients with acquired multidirectional instability, and 33% of patients with posttraumatic multidirectional instability (overall recurrence rate, 40%). Generalized ligamentous laxity was a risk factor for recurrence. Patient satisfaction rates were 40%, 83%, and 22% for the congenital, acquired, and posttraumatic subgroups. Reasons for dissatisfaction included recurrent instability, persistent pain, and inability to return to athletic activity at desired capacity. The overall mean postoperative Simple Shoulder Test score was 84%. The mean postoperative numeric rating score for pain was 3.3 (10-point scale). Conclusions Laser capsulorrhaphy may be effective for patients with acquired multidirectional instability secondary to repetitive microtrauma but is less predictable in the other subgroups.

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Sign in / Sign up

Export Citation Format

Share Document