scholarly journals Penoscrotal Hypospadias, A 4- Year Follow-Up

2021 ◽  
Vol 31 (4) ◽  
pp. 6
Author(s):  
Danu Caraka Alam ◽  
Dodo Wikanto
Keyword(s):  
Congenital Abnormality ◽  
Fistula Repair ◽  
Penis Size ◽  
Penoscrotal Hypospadias

Penoscrotal hypospadias, a severe congenital abnormality, can interfere with urinary, sexual, and aesthetic functions. This paper reports a 2-year follow-up of a penoscrotal hypospadias after urethroplasty using the Koyanagi-Nonomura technique. After surgery, there are some complication of urethrocutaneus fistula and infectio. This patient undergoes urethrocutaneus fistula repair and chateter was inserted into the new urethra which was resulted in normal urination function and penis size.

Extradural cartilage inlay graft in cerebrospinal fluid fistula repair

2010 ◽  
Vol 124 (12) ◽  
pp. 1294-1297 ◽  
Author(s):  
P Thulasi Das ◽  
D Balasubramanian
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Success Rate ◽  
Bony Defect ◽  
Cerebrospinal Fluid Fistula ◽  
Fistula Repair ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Skull Base Defects ◽  
Fluid Fistula

AbstractObjective:To present our experience in managing cerebrospinal fluid rhinorrhoea using the cartilage inlay (underlay) technique to repair skull base defects larger than 4 mm.Study design:Retrospective study involving patients presenting with cerebrospinal fluid rhinorrhoea between 1994 and 2008.Setting:Patients were treated in a tertiary referral centre for nose and sinus diseases. Patients' medical records were reviewed and analysed.Results:A total of 62 patients were operated upon using a cartilage inlay technique to repair bony skull base defects ranging in size from 4 to 20 mm (widest diameter). Of these 62 patients, 16 constituted revisions of earlier procedures undertaken elsewhere. The success rate of the technique was 100 per cent. Patient follow up ranged from six months to 16 years, with a median follow up of 15 months. Three patients had minor post-operative sinus infections; no serious complications were encountered.Conclusion:Extradural cartilage inlay appears to be an effective technique in the management of cerebrospinal fluid rhinorrhoea, especially for large defects and revision procedures. To our knowledge, the described patients represent the largest reported series of cerebrospinal fluid rhinorrhoea cases managed using the cartilage inlay technique. We believe that the crucial factors in our high success rate for cerebrospinal fluid fistula repair are: precise identification of the bony defect; meticulous preparation of the graft bed; careful elevation of the dura; judicious use of just enough graft tissue; and adequate graft support.

scholarly journals High loss to follow-up following obstetric fistula repair surgery in rural Burundi: is there a way forward?

2013 ◽  
Vol 3 (2) ◽  
pp. 113-117 ◽  
Author(s):  
A. Bishinga ◽  
R. Zachariah ◽  
S. Hinderaker ◽  
K. Tayler-Smith ◽  
M. Khogali ◽  
...  
Keyword(s):  
Obstetric Fistula ◽  
Fistula Repair ◽  
Loss To Follow Up ◽  
High Loss

A community-based long-term follow up of women undergoing obstetric fistula repair in rural Ethiopia

2009 ◽  
Vol 116 (9) ◽  
pp. 1258-1264 ◽  
Author(s):  
HS Nielsen ◽  
L Lindberg ◽  
U Nygaard ◽  
H Aytenfisu ◽  
OL Johnston ◽  
...  
Keyword(s):  
Obstetric Fistula ◽  
Fistula Repair ◽  
Community Based ◽  
Rural Ethiopia ◽  
Long Term Follow Up

scholarly journals Thoracoscopic recurrent tracheo-oesophageal fistula repair with mini endostapler: promising solution

2019 ◽  
Vol 12 (5) ◽  
pp. e229365
Author(s):  
Indalecio Cano Novillo ◽  
Belén Aneiros Castro ◽  
Araceli García Vázquez ◽  
Mónica De Miguel Moya
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Oesophageal Atresia ◽  
High Rate ◽  
Common Complication ◽  
Fistula Repair ◽  
Safe Alternative ◽  
Endoscopic Techniques ◽  
Promising Solution

Recurrent tracheo-oesophageal fistula (TOF) is a common complication in children who underwent oesophageal atresia repair. The traditional surgical approach performed either by thoracotomy or cervicotomy is associated with a high rate of morbidity, mortality and new recurrence. In the last decades, endoscopic techniques have emerged as the minimally invasive alternative. However, it seems that the optimal treatment is still unknown. We present a patient with a recurrent TOF who underwent thoracoscopic closure using a 5.8 mm endostapler. The patient was extubated at the end of the procedure, and he started feeding the day after surgery. At 15 months of follow-up, he is asymptomatic. Thoracoscopic closure of TOF using endostaplers seems to be a safe alternative with some possible benefits compared with traditional and endoscopic approach.

scholarly journals Depression after Obstetric Fistula Repair

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Mary Stokes ◽  
Jeffrey Wilkinson ◽  
Prakash Ganesh ◽  
William Nundwe ◽  
Rachel Pope
Keyword(s):  
Mental Health ◽  
Obstetric Fistula ◽  
Age Group ◽  
Fistula Repair ◽  
Symptoms Of Depression ◽  
Persistent Depression ◽  
Continence Status ◽  
Operative Assessment ◽  
Over Time

Aims: To measure depression using the PHQ-9 over time and to identify characteristics associated with persistent depression. Methods: A database of women undergoing obstetric fistula repair was used to examine association of depression with variables such as general demographics, type of obstetric fistula, surgical outcome, and continence status at the time of discharge. Results: 797 patients completed the PHQ-9 upon initial pre-operative assessment. 365 (45.8%) had a PHQ-9 score of 5 or higher, indicating symptoms of depression. Pre-operatively, depression was associated with the 18-34 year old age group and women with no children. Post-operatively, worse incontinence was associated with depression, however, over time depression was rarely found among women returning for follow-up. Conclusions: The decrease of depression seen over time is either due to selection bias or due to improved adjustment to one’s circumstances. Either way, this study underscores the need for ongoing follow-up, perhaps especially for those not presenting. Further studies are needed to assess the mental health of women who do not present for follow-up visits.

Long-Term Follow-up of Unilateral Cleft lip and Palate: Incidence of Speech-Correcting Surgeries and Fistula Formation

2021 ◽  
pp. 105566562110556
Author(s):  
Charlotta Gustafsson ◽  
Arja Heliövaara ◽  
Junnu Leikola
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Primary Repair ◽  
Single Stage ◽  
Velopharyngeal Insufficiency ◽  
Fistula Formation ◽  
Fistula Repair ◽  
Alveolar Bone Grafting

Objective The ideal surgical protocol and technique for primary closure of unilateral cleft lip and palate (UCLP) are unclear, and the development of velopharyngeal insufficiency and fistulae following primary repair is common. This study aimed to determine the long-term surgical burden of care in terms of secondary surgeries, defined as speech-correcting surgeries (SCSs) and fistula repair, in a UCLP population, and to compare outcomes of various surgical protocols. Design Retrospective, single-center review. Participants The study comprised 290 nonsyndromic children with complete UCLP. Different surgical protocols entailing both single-stage and 2-stage approaches were compared, and the surgical outcome was analyzed at the time of alveolar bone grafting (ABG) and post ABG. Results Altogether 110 children (37.9%) underwent secondary surgery by the time of ABG. Of the total population 25.9% (n  =  75) had undergone SCS and 17.2% (n  =  50) had undergone fistula repair. The respective incidences at follow-up (post ABG) were 30.3% (n  =  88) and 18.9% (n  =  55). Median age at ABG was 9.8 years and at follow-up was 16.3 years. No significant difference emerged in terms of secondary surgeries between the techniques and protocols applied at primary repair. However, some differences occurred regarding the location of fistulae; the single-stage procedure had more anterior fistula repairs, particularly connected to a perialveolar fistula. Conclusions Although the outcome differences between the surgical protocols were small, indicating that none of the treatment protocols was clearly superior to another, attention was drawn to the favorable outcomes of the single-stage protocol.

Portal Hypertension in Children an Experience of 33 Cases

1984 ◽  
Vol 29 (1) ◽  
pp. 6-14 ◽  
Author(s):  
A. I. S. Macpherson
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Congenital Abnormality ◽  
Recurrent Bleeding ◽  
Hepatic Disorder ◽  
Long Survival ◽  
One Year ◽  
Hepatic Portal ◽  
Hypertension In Children

The pathology, treatment and progress of 33 children with portal hypertension are reviewed. There were 20 patients with extra-hepatic portal obstruction (EHB) and 13 with intra-hepatic obstruction (IHB). The lesion in all the EHB was a block in the portal vein: in IHB it was a post-hepatitis cirrhosis in two cases and in the others a congenital abnormality. Treatment was surgical in 32 patients. The prognosis in EHB is good and long survival after operation was the rule. In IHB the survival depended upon the type and severity of the hepatic disorder and the incidence of recurrent bleeding. The frequency of recurrent bleeding was found to vary with the operation performed being greatest after splenectomy alone or with devascularisation, and least after lieno-renal anastomosis. The follow-up ranged from one year to more than 28 years.

scholarly journals Stapled Transperineal Fistula Repair of Rectovaginal Fistula: A Preliminary Experience

2018 ◽  
Vol 26 (1) ◽  
pp. 66-71
Author(s):  
Hong-Cheng Lin ◽  
Liang Huang ◽  
Hua-Xian Chen ◽  
Qian Zhou ◽  
Dong-Lin Ren
Keyword(s):  
Rectovaginal Fistula ◽  
Operative Time ◽  
Fistula Repair ◽  
Wexner Score ◽  
Estimated Blood Loss ◽  
Prospective Assessment ◽  
The Mean ◽  
Initial Results ◽  
Prospective Database

Purpose. This study is designed to assess the safety, efficacy, and postoperative outcomes of stapled transperineal repair in management of rectovaginal fistula (RVF). Methods. A prospective database of patients with RVF undergoing stapled transperineal repair between May 2015 and December 2017 was established and studied retrospectively. Results. Seven consecutive RVF patients underwent stapled transperineal repair. The mean operative time was 119 ± 42 minutes. The estimated blood loss during operation was 24 ± 14 mL. Concomitant levatorplasty was performed with 4 patients and sphincteroplasty with 2 patients. Over a median follow-up of 6 months (range 3-33 months), no case was encountered with recurrence. The mean postoperative Wexner score was significantly improved when compared with the preoperative scores (mean preoperative vs postoperative Wexner scores 3 [range 3-4] vs 1 [range 1-2], respectively; P = .01). Conclusions. Stapled transperineal repair of RVF appears safe and effective. The initial results are encouraging, suggesting the need for a more formal prospective assessment of this technique as part of a randomized trial for the management of low- and mid-vaginal fistulas.

scholarly journals Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Valary T. Raup ◽  
Jairam R. Eswara ◽  
Stephen D. Marshall ◽  
Steven B. Brandes
Keyword(s):  
Elderly Patients ◽  
Spermatic Cord ◽  
Muscle Flap ◽  
Fistula Repair ◽  
Gluteal Muscle ◽  
Novel Technique ◽  
Pull Through ◽  
Cord Length ◽  
Interposition Flap

Rectourinary fistulae and urinary-cutaneous fistulae are a rare yet devastating complication. Current options for tissue interposition include rectus, gracilis, or gluteal muscle, omentum, or intestine for use in coloanal pull-through procedures. In elderly patients, testicular interposition flaps may be an excellent tissue option to use when vitalized tissue is necessary to supplement fistula repair. Elderly patients frequently have increased spermatic cord length, potentially offering a longer flap reach than use of a muscle flap. Additionally, mobilizing one of the testicles and developing it through the external inguinal ring may be a less morbid and less costly procedure than harvesting and tunneling a muscle flap. Longer follow-up and further studies are needed to determine the outcomes of this novel technique.

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