Treatment of the hidden penis in boys

Introduction. “Hidden penis” (HP) is a developmental malformation of the penis characterized by normally developed, but abnormally located cavernous bodies in the surrounding tissues of the symphysis or scrotum, manifested by the visually shortened penis trunk. The most common type is «buried» penis (BP). This pathology requires, as a rule, surgical treatment.Purpose. To assess outcomes of BP treatment with an improved surgical technique.Material and methods. 40 boys, aged from 2 to 16 (average age 9 ± 1.59) and diagnosed with HP, were treated in 2014-2019. BP was diagnosed in 35 children (87.5%), webbed penis (WP) – in five (12.5%). Primary BP was in 18 children (51.4%) and BP in combination with the suprapubic obesity - in 17 patients (48.6%). Two children (5%) were operated after the previous circumcision. Indications for surgery were: congenital primary HP, secondary HP in adolescents with insufficient visualization of the penis, psychological discomfort of the patient and the absence of significant clinical effects after conservative care. The average age of children with primary HP was 3.9 ± 2.48; with secondary HP and pubic obesity - 12 ± 3.84 years. During surgery, circular or circular and ventral midline incisions to the middle of the scrotum were used; they were followed by mobilization of the penis from adhesions, excision of adipose tissue in the bosom, fixation of the pubopenile and penoscrotal angles with a non-absorbable surgical thread. The authors have proposed a new technique for foreskin fixation using 2 ventral and 2 dorsal incisions, through which the skin was sutured to the deep fascia of the penis to prevent its distal slipping.Results. All patients had good anatomical and functional results. The authors describe the developed surgical technique in details; they also make literature review on the discussed problem.Conclusion. In the treatment of HP an improved surgical technique with the additional use of incisions allows you to reliably fix the skin of the foreskin on the trunk of the penis, avoiding its distal displacement.

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Caudal Extension Graft of the Lower Lateral Cartilage: Technique and Aesthetic and Functional Results

Facial Plastic Surgery ◽

10.1055/s-0041-1726025 ◽

2021 ◽

Author(s):

Juliano de Oliveira Sales ◽

Wolfgang Gubisch ◽

Rodrigo Ribeiro Ferreira Duarte ◽

Aline Souza Costa Teixeira Moreno ◽

Felipe Marques de Oliveira ◽

...

Keyword(s):

Patient Satisfaction ◽

Age Groups ◽

Functional Results ◽

First Year ◽

Lateral Cartilage ◽

Lower Lateral Cartilage ◽

Alar Retraction ◽

Outcomes Evaluation ◽

A New Technique ◽

Extension Graft

AbstractHere we describe a new technique to deal with alar retraction, a highly undesirable imperfection of the nose. The procedure involves placing a caudal extension graft below the vestibular portion of the lower lateral cartilage (LLC) after its detachment from the vestibular skin. The graft is fixed to the cartilage and, subsequently, to the vestibular tissue. The present retrospective study included 20 patients, 11 females and 9 males, with a mean age of 28.90 years. Follow-up ranged from 1 to 18 months. Surgery improved alar notching to a smoother dome shape and nostril exposure was reduced in every patient. The caudal extension graft of the LLC contributed to rise in overall patient satisfaction, as revealed by the postoperative increase of the Rhinoplasty Outcomes Evaluation (ROE) mean score from 40.0 to 79.17 (p < 0.0001). It also contributed to and improved functional outcomes, as indicated by the decrease of the Nasal Obstruction Symptom Evaluation (NOSE) mean score from 52.75 to 13.25 (p = 0.0001). Sex did not affect the mean ROE and NOSE scores. Thus, increased patient satisfaction measured by the ROE is present in both sexes and at both age groups but it is better detected in the first year after surgery. Functional improvements analyzed with NOSE are best detected in patients aged ≥ 30 years and in follow-ups of 11 months. The caudal extension graft of the LLC technique described herein effectively and safely corrects alar retraction and the collapse of the nasal valve while filling the soft triangle.

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Midshaft Hypospadias: Review of Surgical Technique

10.2310/uro.11047 ◽

2019 ◽

Author(s):

Erin R. McNamara ◽

Bryan Sack ◽

Alan B. Retik

Keyword(s):

Surgical Technique ◽

Key Words ◽

Common Type ◽

Hypospadias Repair ◽

Urethrocutaneous Fistula ◽

Tubularized Incised Plate ◽

Dartos Flap ◽

Tubularized Incised Plate Urethroplasty ◽

Skin Coverage

Surgical technique for midshaft hypospadias has evolved since the time of Horton and Devine. The most common type of repair that is currently used is the tubularized incised plate urethroplasty, which is a modification of the Thiersch-Duplay hypospadias repair. The authors review the steps of this procedure in detail and discuss troubleshooting for issues that may arise during the repair. Alternatives for chordee correction and skin coverage are reviewed. The authors briefly discuss outcomes and possible complications. In addition, there is a step-by-step video of a midshaft hypospadias repair that highlights the surgical technique. This review contains 9 figures, and 23 references. Key Words: chordee, dartos flap, hypospadias, midshaft hypospadias, surgical technique, tubularized incised plate (TIP), urethrocutaneous fistula, ventral curvature

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Minimally invasive repair of ruptured Achilles tendon

Acta chirurgica iugoslavica ◽

10.2298/aci1501085b ◽

2015 ◽

Vol 62 (1) ◽

pp. 85-88

Author(s):

Nikola Bulatovic ◽

Miroslav Kezunovic ◽

Zarko Dasic ◽

Nikola Fatic

Keyword(s):

Surgical Technique ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Functional Results ◽

Recreational Athletes ◽

Acute Injuries ◽

Clinical Center ◽

Immobility Time ◽

Heel Bone

INTRODUCTION: Achilles tendon rupture usually occurs in recreational athletes of middle age 30-50godina and typical place of the rupture of 3-5 cm above the insertion of the heel bone. Most common in recreational athletes. OBJECTIVE: To view the surgical technique suture the tendon with a guide ?Achillon? the functional outcome of acute injuries. MATERIAL AND METHODS: retrospective analysis included a total of 20 patients treated at the Clinic of Orthopedics and Traumatology, Clinical Center of Montenegro in Podgorica in the 2009-14. They were monitored for 12 months. Diagnosis is based on history, clinical examination Thompson?s Simmond O?Brien test, ECHO and NMR. RESULTS: The average age was 38.8 ?2.79 years 21-52 years. Right in 14 respondents 70%, the left side in 6 30%. There were no complications as: infection, thrombosis, rerupture and embolism. Functional results tables we have shown through specific scores. CONCLUSION: It can be concluded that this procedure provides a simple and quick surgical technique, a small percentage of complications, shorter immobility time and good functional results.

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Application of fascia of the temporal muscle and cartilage of the auricular tragus in myringoplasty in children

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1208408b ◽

2012 ◽

Vol 140 (7-8) ◽

pp. 408-411 ◽

Cited By ~ 1

Author(s):

Ivan Baljosevic ◽

Jovica Milovanovic ◽

Vladan Subarevic ◽

Mladen Novkovic ◽

Katarina Stankovic

Keyword(s):

Surgical Technique ◽

Tympanic Membrane ◽

Statistical Significance ◽

Functional Results ◽

Young Age ◽

Temporal Muscle ◽

Temporal Fascia ◽

Middle Ear Infection ◽

Number Of Patients ◽

And Cartilage

Introduction. Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infection and loss of hearing. Objective. The aim of this study was to analyze the application of different reconstructive materials in surgical technique myringoplasty. Methods. We performed 88 myringoplasties due to auricular tragus perforation in 76 children (aged 4 to 16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and the site of perforation, status of the contra lateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels and postoperative complications were recorded and analyzed. In performing myringoplasty we used fascia of the temporal muscle and cartilage of the auricular tragus. Results. In 43 (48%) patients we used fascia of the temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft success was defined as an intact eardrum at 12 months postoperatively and improvement in the perception of air-bone gap of 10 dB, which we recorded in 73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases with the temporal fascia. Conclusion. Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, except for young age, differences between the two groups did not reach the level of statistical significance.

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Congenital completely buried penis in boys: anatomical basis and surgical technique

BJU International ◽

10.1111/j.1464-410x.2012.11719.x ◽

2013 ◽

Vol 112 (2) ◽

pp. 271-275 ◽

Cited By ~ 10

Author(s):

Xing Liu ◽

Da-wei He ◽

Yi Hua ◽

De-ying Zhang ◽

Guang-hui Wei

Keyword(s):

Surgical Technique ◽

Anatomical Basis ◽

Buried Penis

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The Metabolic Rearrangements of Bariatric Surgery: Focus on Orexin-A and the Adiponectin System

Journal of Clinical Medicine ◽

10.3390/jcm9103327 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3327

Author(s):

Anna Valenzano ◽

Nicola Tartaglia ◽

Antonio Ambrosi ◽

Domenico Tafuri ◽

Marcellino Monda ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Adipose Tissue ◽

Inflammatory Mediator ◽

Feedback Loops ◽

Disease Type ◽

Clinical Effects ◽

Orexin A ◽

Visceral Adipose

The accumulation of adipose tissue represents one of the characteristics of obesity, increasing the risk of developing correlated obesity diseases such as cardiovascular disease, type 2 diabetes, cancer, and immune diseases. Visceral adipose tissue accumulation leads to chronic low inflammation inducing an imbalanced adipokine secretion. Among these adipokines, Adiponectin is an important metabolic and inflammatory mediator. It is also known that adipose tissue is influenced by Orexin-A levels, a neuropeptide produced in the lateral hypothalamus. Adiponectin and Orexin-A are strongly decreased in obesity and are associated with metabolic and inflammatory pathways. The aim of this review was to investigate the involvement of the autonomic nervous system focusing on Adiponectin and Orexin-A after bariatric surgery. After bariatric surgery, Adiponectin and Orexin-A levels are strongly increased independently of weight loss showing that hormone increases are also attributable to a rearrangement of metabolic and inflammatory mediators. The restriction of food intake and malabsorption are not sufficient to clarify the clinical effects of bariatric surgery suggesting the involvement of neuro-hormonal feedback loops and also of mediators such as Adiponectin and Orexin-A.

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Cervical Myelopathy in Rheumatoid Arthritis

Neurology Research International ◽

10.1155/2011/153628 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

N. Mukerji ◽

N. V. Todd

Keyword(s):

Rheumatoid Arthritis ◽

Cervical Spine ◽

Surgical Treatment ◽

Surgical Technique ◽

Neck Pain ◽

Surgical Management ◽

Cervical Myelopathy ◽

Clinical Presentation ◽

Indications For Surgery ◽

Grading Systems

Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common.

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Radial forearm flap plus Flexor Carpi Radialis tendon in Achilles tendon reconstruction: Surgical technique, functional results, and gait analysis

Microsurgery ◽

10.1002/micr.22481 ◽

2015 ◽

Vol 35 (8) ◽

pp. 608-614 ◽

Cited By ~ 8

Author(s):

Marco Innocenti ◽

Massimiliano Tani ◽

Christian Carulli ◽

Serena Ghezzi ◽

Andrea Raspanti ◽

...

Keyword(s):

Surgical Technique ◽

Achilles Tendon ◽

Gait Analysis ◽

Functional Results ◽

Radial Forearm Flap ◽

Tendon Reconstruction ◽

Forearm Flap ◽

Flexor Carpi Radialis ◽

Radial Forearm ◽

Achilles Tendon Reconstruction

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Optimizing Functional Results in Supracricoid Laryngectomy

Otolaryngology ◽

10.1016/s0194-5998(05)80025-7 ◽

1995 ◽

Vol 112 (5) ◽

pp. P27-P28

Author(s):

Gregory S. Weinstein ◽

Ollivier Laccourreye ◽

Daniel Brasnu

Keyword(s):

Surgical Technique ◽

Functional Outcome ◽

Functional Results ◽

Educational Objectives ◽

Supracricoid Laryngectomy

Educational objectives: To understand the surgical technique of supracricoid laryngectomy, its indications, contraindications, and the keys to optimizing functional outcome.

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