Side-to-side penoscrotal anastomosis: a reliable technique for repair of recurrent urethrocutaneous fistula in male children

Background: Surgical repair of urethrocutaneous fistulae (UCF) is relatively simple and results are often satisfactory. However, in some cases of UCF, recurrence results despite several attempts at repair. Reports are scanty on the management of such recalcitrant UCF. The aim of the study was to present our experience with recurrent UCF, and describes our technique of side-to-side penoscrotal anastomosis for repair of such fistulae.Methods: This was a 10 years analytical comparative study of the outcome of repair of recurrent UCF in paediatric patients using the simple double layer repair technique, and our technique of anastomosing the penis to the scrotum between 2008 and 2019 in our centre. Data obtained and analysed with SPSS 21 version included the number of previous attempts at repair, number, site and size of UCF, technique of repair, and the incidence of recurrence of UCF.Results: Nineteen patients were studied. Nine had conventional double layer repair of UCF with recurrence in 5 (55.6%). Two of the recurrent cases were added to the remaining 10 patients to make a total of 12 cases who had the staged repair by penoscrotal anastomosis (PSA) and there was no recurrence during the average follow up period of 1 year. P value was <0.05.Conclusions: Findings in this study suggest a superior outcome when the penoscrotal anastomosis is used for repair of recurrent UCF. We think it is better to apply this technique in cases of UCF which the surgeon considers potentially difficult than to wait to have a failed attempt before deploying it.

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A comparative study on effectiveness of mucosal vibration and topical anaesthetic gel in reducing pain during administration of local anaesthetic in paediatric patients.

RGUHS Journal of Dental Sciences ◽

10.26715/rjds.13_1_6 ◽

2021 ◽

Vol 13 ◽

pp. 32-41

Author(s):

Nameeda K S ◽

Fathimath Nihala K ◽

Anagha Saseendran ◽

Priya Nagar ◽

Pallavi Urs

Keyword(s):

Comparative Study ◽

Local Anaesthetic ◽

Pain Perception ◽

Rating Scale ◽

Inferior Alveolar Nerve ◽

Control Group ◽

P Value ◽

Topical Anaesthetic ◽

Paediatric Patients ◽

Group I

Title : A comparative study on effectiveness of mucosal vibration and topical anaesthetic gel in reducing pain during administration of local anaesthetic in paediatric patients. Introduction: Anxiety related to dentistryis not uncommon in paediatric patients. Poor pain control alongside the fear and anxiety might interfere with appropriate dental management. In this study a modified mucosal vibration device is used to modify the pain perception during LA administration. Aim: To compare the effectiveness of topical anaesthetic gel and mucosal vibration during local anaestheticadministration in children in the age group8-11 years using both subjective and objective scalescales for measuring anxiety and pain. Methodology: Thirty children who required inferior alveolar nerve blockanaesthesia for routine dental procedures were included and divided equally into 3 groups Group I- control Group II- topical anaesthetic gel Group III - Mucosal vibrator Pain perception was compared, assessed and analysed during injection using Sound, Eye, Motor (SEM) scale, Doremon cartoon modified Wong Baker Faces Pain Rating Scale, MotuPatlu cartoon modified Venham scale Results: The scores of SEM scale and Doremon pain scale when subjected to statistical analysis gave a p value <0.001. Conclusion: Mucosal vibrator is an easily availablehandyand effective chair sidedevice for pain reduction during administration of local anaesthesia for paediatric patients

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Single-layer versus double-layer intestinal anastomosis: A comparative study

Health Renaissance ◽

10.3126/hren.v13i2.17563 ◽

2017 ◽

Vol 13 (2) ◽

pp. 134-143 ◽

Cited By ~ 1

Author(s):

Tuhin Shah ◽

RK Agarwal ◽

RK Gupta ◽

CS Agrawal ◽

S Khaniya

Keyword(s):

Comparative Study ◽

Double Layer ◽

Intestinal Anastomosis ◽

Single Layer ◽

P Value ◽

Layer Versus ◽

Elective Setting ◽

Prospective Comparative Study ◽

Layer Groups ◽

Mean Time

Background: Intestinal anastomosis is essential to maintain the continuity after resection. There has been constant controversy due to various repair options. Adequate apposition can be achieved by either single- or double-layer anastomosis which may affect the post-operative outcome.Objective: To compare the outcome of single-layer versus double-layer anastomosis of small and large intestine.Method: This prospective comparative study was conducted over a period of 16 months, and included 78 patients who underwent intestinal anastomosis (without diverting stoma) after fulfilling inclusion and exclusion criteria. They were randomized into double-layer and single-layer intestinal anastomosis groups by a computer generated series. Double layer anastomosis was constructed using inner continuous Polyglactin 3-0 and outer interrupted Silk 3-0, while single layer anastomosis was done with interrupted PDS 2-0.Result: The mean age was 39.79±17.78 years. A total of 59% were operated in emergency room while 41% in elective setting. Overall mean time for anastomosis was 31.81±6.03 (21-50) minutes. In double- and single-layer intestinal anastomosis mean time was 34.35±5.80 (26-50) and 29.13±5.08 (21-45) minutes respectively, which was statistically significant (p value < 0.05). Single-layer was completed 5 minutes earlier than double layer anastomosis in average. Clinical anastomotic leak was seen in six (7.7%) patients, three in each group. Eight (10.3%) patients had surgical site infection: 3 in double-layer and 5 in single-layer groups. One (1.3%) mortality was seen, from single-layer anastomosis group.Conclusion: Single-layer anastomosis can be constructed in significantly shorter time with similar complication rate when compared to doublelayer anastomosis.Health Renaissance 2015;13(2): 134-143

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Single Layer Extra-Mucosal Interrupted Anastomoses; Revalidated

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.2-1.59 ◽

2015 ◽

Vol 2 (1) ◽

pp. 22-26

Author(s):

Bilal Khattak ◽

Faiz -Ur- Rahman ◽

Irfan -Ul-Islam Nasir ◽

Muhammad Iftikhar ◽

Imtiaz Ahmad Khattak ◽

...

Keyword(s):

Comparative Study ◽

Double Layer ◽

Intestinal Anastomosis ◽

Single Layer ◽

P Value ◽

Burst Abdomen ◽

Group A ◽

Prospective Comparative Study ◽

Anastomosis Leakage ◽

Group B

Objective:To evaluate the safety regarding anastomotic failure of single layer interrupted extra mucosal intestinal anastomosis in comparison with double layer intestinal anastomosisMethodology:This prospective comparative study was conducted in surgical A unit of Lady reading Hospital Peshawar from 1st June 2007 to 1st February 2008 (8 months).Patients were divided into two groups, each comprising 60 patients. First 60 consecutive patients were included in Group A, for single layer extra mucosal anastomosis while Group B included last 60 consecutive patients for double layer inverting anastomosis (continuous inner and interrupted outer Lambert sutures). All the cases were admitted through OPD and emergency. The safety of two techniques of anastomosis was analyzed by comparing the outcome in terms of complications.Results:In this study, anastomosis leakage occurred only in 4 (3.33%) patients, one (1.67%) in group A and three (5%) in group B with a P-Value 0.138. Mean age of patient in group A was 36.15 years (+/- 6.0 years) and in group B was 33.25 years (+/- 5.5 years).Conclusion:Single layer extra-mucosal anastomosis has least anastomotic leakage and other complication like wound infection, septicemia, and collection and burst abdomen than in patients with double layer investing anastomosis.

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A comparative study of outcome of pyeloplasty in stented and non-stented children

International Surgery Journal ◽

10.18203/2349-2902.isj20191877 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1601

Author(s):

Ashok Kumar Laddha ◽

Eeshansh Khare ◽

Brijesh Kumar Lahoti

Keyword(s):

Postoperative Complications ◽

Comparative Study ◽

Renal Pelvis ◽

Paediatric Surgery ◽

Paediatric Patients ◽

Double J Stent ◽

Stented Group

Background: It is a matter of debate whether to use a stent (double J) or not during pyeloplasty in patients of pelvic ureteric junction obstruction (PUJ obstruction). This study was conducted to assess which technique- stented or non-stented is better for paediatric patients with PUJ obstruction.Methods: 45 paediatric patients aged 0-12 years were included in this prospective comparative simple randomized sample study during the period of June 2015 to August 2017 in paediatric surgery division of department of surgery in M.Y. Hospital, Indore. All patients except one underwent open A-H dismembered pyeloplasty. The parameters used for comparison were renal parenchymal diameter, renal pelvis AP diameter, GFR (by DTPA scan) and rate of complications. Minimum follow up period was 3 months.Results: The M:F ratio was 2:1. Stented children had significant improvement in renal parenchymal diameter (i.e. increase) and GFR (of affected kidney) after pyeloplasty, whereas non-stented children too had improvement in renal parenchymal diameter and GFR (affected kidney) but was not significant. The percentage of postoperative complications were more in non-stented group as compared to stented group.Conclusions: In all paediatric cases with PUJO undergoing A-H pyeloplasty, both stenting and non-stenting have similar results and to place a double J stent should depend on choice of surgeon.

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Cyanoacrylate Based Products as Interpositioning Substance versus Reintervention Alone for Urethrocutaneous Fistula Repair after Hypospadias

QJM ◽

10.1093/qjmed/hcaa070.020 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

H M Abdallah ◽

A M Tawfeek ◽

A M W Mohareb

Keyword(s):

Success Rate ◽

Surgical Repair ◽

Fistula Formation ◽

P Value ◽

Hypospadias Repair ◽

Urethrocutaneous Fistula ◽

Cyanoacrylate Glue ◽

Recurrent Fistula ◽

Significant Difference ◽

Basis Method

Abstract Background urethrocutaneous fistula (UCF) is still the commonest complication after hypospadias repair. Although recent advances in the surgical procedures of hypospadias repair have reduced the rate of urethrocutaneous fistula formation, it remains a real complication of hypospadias and frustrating problem for surgeons. Aim of the Work evaluation of success and failure rates of using cyanoacrylate based productes as an interpositioning substance in surgical repair of fistula after hypospadias in comparison to the classic surgical repair technique. Patients and Methods this is a prospective, randomized-controled study, conducted on 40 patients from the date of the approval of the study. It is comparing two different modalities for repair of urethrocutaneous fistula that has developed after hypospadias repair. Our study was assigned on a randomized basis method according to a 1:1 ratio and patients underwent either multilayered closure using dartos facial flap or using cyanoacrylate glue as an interpositioning layer before suturing of the dartos flap for the closure of the urethrocutaneous fistula. All cases were divided into 2 equal groups, 20 cases each. The cases were distributed randomly into the two groups. Results the success rate was higher for patients using cyanoacrylate glue as a protective interpositioning layer as 16 patients (80%) were successfully repaired and 4 patients (20%) developed a recurrent fistula. However, there was no statistically significant difference between 2 groups p-value was 0.465. Conclusion there was no statistically significant difference in adding cyanoacrylate glue to multilayered closure of urethrocutaneous fistula after hypospadias repair. However, cyanoacrylates showed that they are a favourable additional protective substance and they resulted in a high success rate without adding any surgical complications.

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Comparative Study between Tadalafil versus Tamsulosin versus Halphabarol with Terpenes Mixture as a Medical Expulsive Therapy for Lower Ureteric Stones

QJM ◽

10.1093/qjmed/hcaa070.015 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

K A H Teama ◽

A Y K Abdelsalam ◽

M E A Elmenyawee

Keyword(s):

Urinary Tract ◽

Side Effects ◽

Comparative Study ◽

Ureteral Stones ◽

P Value ◽

Expulsion Rate ◽

Once Daily ◽

Medical Expulsive Therapy ◽

Tract Infections

Abstract Background urolithiasis is a health problem of worldwide importance. Urolithiasis is the third most common urological disease affecting the urinary tract after urinary tract infections and prostatic diseases. Ureteral stones account for 20% of urolithiasis, and 70% of ureteral stones are located in the lower third of the ureter. Ureteric stones have great bearing on the health as well as quality of life of the patient. Aim of the Study to compare the efficacy of tadalafil (a phosphodiesterase-5 inhibitor), tamsulosin (an alpha-1blocker) and halphabarol (Proximol) with terpenes mixture (Rowatinex) as a medical expulsive therapy for lower ureteric stones. Patients and Methods this was a prospective randomized comparative study conducted on 60 patients between the ages of 20 and 40 years and complaining of unilateral single lower ureteric stone less than or equal to 8 mm presented through the outpatient clinics of Urology in Ain Shams University Hospitals and Damanhour Medical National Institute over a period of 10 months (from November 2017 to August 2018). The patients were randomly divided into 3 equal groups: Group A (20 patients were treated by tadalafil 5 mg once daily), Group B (20 patients were treated by tamsulosin 0.4 mg once daily) and Group C (20 patients were treated by Proximol with Rowatinex three times daily). Therapy was given for a maximum of 3 weeks. The patients were followed-up until stone passage or the end of the study period. Results the results of this study indicate that the stone expulsion rate was significantly higher in tadalafil group and tamsulosin group than Proximol with Rowatinex group (75% vs. 75% vs. 40%, P value = 0.030). Also, the mean stone expulsion time was significantly shorter in tadalafil group and tamsulosin group than Proximol with Rowatinex group (10.20 ± 3.91 days vs. 10.80 ± 3.64 days vs. 14.25 ± 3.28 days, P value = 0.046). The number of patients who experienced renal colic episodes, the number of colic episodes and the number of injectable analgesic uses were significantly lower in tadalafil group and tamsulosin group than Proximol with Rowatinex group (P value < 0.05). The number of follow up ureteroscopic procedures was significantly lower in tadalafil group and tamsulosin group than Proximol with Rowatinex group (25% vs. 25% vs. 60%, P value = 0.030). Also, the drugs are safe with mild few side effects. Conclusion PDE5 inhibitors (tadalafil) are equally efficacious to alpha-1 adrenergic antagonists (tamsulosin) in expulsion of lower ureteric stones less than or equal to 8 mm without any serious side effects. Comparing to Proximol with Rowatinex, both tadalafil and tamsulosin increase significantly the stone expulsion rate, decrease significantly the stone expulsion time and provide significant control of renal colicky pain, significantly less analgesic requirements and significantly lower follow up ureteroscopic procedures.

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A comparative study of the efficacy and tolerability of parenteral ceftriaxone and cefotaxime in pediatric population for acute bacillary dysentery in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20182090 ◽

2018 ◽

Vol 7 (6) ◽

pp. 1109

Author(s):

Sagar K. ◽

Shanmukananda P. ◽

Veena D. R. ◽

Shwetha H.

Keyword(s):

Comparative Study ◽

Bacillary Dysentery ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Paediatric Patients ◽

Significant Difference ◽

Group A ◽

Group B ◽

Acute Bacillary Dysentery

Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients.

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State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽

10.1024/0301-1526/a000324 ◽

2014 ◽

Vol 43 (1) ◽

pp. 6-26 ◽

Cited By ~ 12

Author(s):

Fabian Rengier ◽

Philipp Geisbüsch ◽

Paul Schoenhagen ◽

Matthias Müller-Eschner ◽

Rolf Vosshenrich ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Replacement ◽

Surgical Repair ◽

Imaging Modality ◽

Open Surgical Repair ◽

Cross Sectional ◽

Transcatheter Aortic Valve ◽

Cross Sectional Imaging ◽

Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

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