A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

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Comparison of Cohen and Lich-Gregoir ureteral reimplantation in the surgical management of primary unilateral vesicoureteral reflux in children

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.4.424 ◽

2020 ◽

Vol 66 (4) ◽

pp. 424-429

Author(s):

Cemil Aydin ◽

Ali Akkoc ◽

Ramazan Topaktas ◽

Aykut Bugra Senturk ◽

Zeynep Banu Aydin ◽

...

Keyword(s):

Hospital Stay ◽

Vesicoureteral Reflux ◽

Operative Time ◽

Significant Risk ◽

Operation Time ◽

Ureteral Reimplantation ◽

Macroscopic Hematuria ◽

Group A ◽

The Mean ◽

Group B

SUMMARY OBJECTIVE Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Various intravesical and extravesical techniques have been described for the surgical correction of VUR. The aim of our study was to compare the results of open intravesical and extravesical procedures for unilateral primary VUR in children. METHODS Between January 2012 and August 2018, 38 children with primary VUR who underwent open ureteral reimplantation surgery were retrospectively reviewed. The Cohen (intravesical) and the Lich-Gregoir (extravesical) approach were grouped as groups A and B, respectively. The groups were compared for age, gender, preoperative reflux grade, presence of lower urinary tract symptoms, operation time, discomfort and pain, analgesic requirements, duration of hematuria, postoperative complications, and hospital stay. All the parameters were statistically compared. RESULTS There were 38 patients in this study. Group A had 18 patients, and group B had 20 patients. The mean operative time was significantly shorter in group B than in group A. The mean hospital stay was also shorter in group B. The urethral foley stay period was 4.7±0.9 days 2±0 days (p = 0.000*), respectively, for group A and B. Macroscopic hematuria was seen in group A. The objective pain scale was worse after intravesical surgery. Analgesic requirements were higher in group A (p =0.131). CONCLUSION Intravesical and extravesical ureteroneocystostomy methods are equally successful and feasible in the treatment of primary unilateral VUR. The Cohen technique is associated with a longer and more painful hospital stay, gross hematuria, and longer operative time, compared to the Lich-Gregoir technique.

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What is the best choice for repair of distal penile hypospadias: The tubularized incised plate urethroplasty or anterior urethral advancement technique?

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699200 ◽

2007 ◽

Vol 40 (02) ◽

pp. 182-188

Author(s):

Mohamed M.S Awad ◽

Adel M Tolba ◽

Khaled M Saad ◽

Zaghlol R Mahmoud ◽

Ahmed Ezzat Rozigque ◽

...

Keyword(s):

Operative Time ◽

Good Choice ◽

Short Operative Time ◽

Tubularized Incised Plate ◽

Significant Difference ◽

Good Cosmetic ◽

Group A ◽

Tubularized Incised Plate Urethroplasty ◽

Fistula Rate ◽

Group B

ABSTRACT Background and Aim: Numerous ingenious methods have been introduced to repair hypospadias with variable results. we tried to evaluate the two techniques, tubularized incised plate urethroplasty (tip) and anterior urethral advancement (aua) for repair of distal hypospadias and choose the best method to treat the distal type of penile hypospadias with the least complications.Materials and methods :A total of 140 boys with distal penile hypospadias were divided into two groups. group a (68 patients) was treated with tip and group b (72 patients) was treated with aua. all the patients had an average age of three years (2-19) with variable meatal sites coronal (44) sub coronal (53) and anterior penile hypospadias (43). there was no significant difference between both groups with respect to the age and meatal sites.Results: The fistula rate in group a was 8.8% versus 1.3% in group b. there was no urethral stricture in both procedures. wound dehiscence did not occur in group a versus one case in group b (1.3%). in group a, 26 cases (38.3%) had mild glanular torsion and five (7.3%) had moderate glanular torsion versus none in group b postoperatively. no postoperative chordee or binding in group a, versus four patients (5.5%) in group b. no significant difference was observed in both groups with respect to meatal stenosis (7.3% versus 5.5% respectively). there was a significant difference between both groups with regard to the operative time in favour of group b. good cosmetic appearance of the glans was achieved in both techniques.Conclusion: Both techniques can treat this anomaly with a high success rate but the modified aua technique appears to be a good choice due to its simplicity, short operative time and less fistula rate with good cosmetic results.

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Comparative study of two different procedures for primary hypospadias repair

International Surgery Journal ◽

10.18203/2349-2902.isj20173162 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2475

Author(s):

Naser R. Tawfiq ◽

Mahmood J. Saood ◽

Mohanad Hamed Abdulla

Keyword(s):

Operative Time ◽

Wound Dehiscence ◽

Cutaneous Fistula ◽

Tubularized Incised Plate ◽

Urinary Stream ◽

Group A ◽

The Mean ◽

Group B ◽

Local Examination

Background: Different modalities of procedures for hypospadial repair have been described in the literature. Data about the outcome of two main different procedure of repair are scares from Iraq. The aim of this study is to compare the results of these two methods of hypospadias repairs. The present study compared two single stage hypospadias repairs, namely, tubularized incised plate (Snodgrass) repair and Mathieu’s repair.Methods: It involved 50 patients diagnosed with penile hypospadias, from March 2011 to April 2015 at the Department of Surgery, Al-Karama Teaching Hospital. After a detailed history, local examination was performed with reference to the site of meatus, shape of glans, and presence of chordee, patients were randomly assigned as Group A of 26 patients in whom Snodgrass repair was accomplished and Group B having 24 patients in whom Mathieu’s repair was performed. On follow-up, the patients were examined for the position of meatus, shape of meatus, urinary stream, urethra-cutaneous fistula, and stricture formation.Results: The results showed that the mean age of presentation was 7±6 years (range 1-13years). The mean operative time was 90±15 (75-105) minutes and 60±15 (45-75) minutes in Snodgrass and Mathieu’s repair respectively. Complications after surgery were urethero-cutaneous fistula in 2(7.69%) and 4 (16.67%), meatal stenosis in 1(3.84%) and 2(8.33%), wound infection in 4(15.38%) and 3(12.5%) cases in Snodgrass repair and Mathieu repair, respectively, wound dehiscence was equal in Snodgrass repair and Mathieu repair.Conclusions: It can be concluded that the cosmetic results were excellent with Snodgrass repair with a normal looking slit like meatus.

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A comparative study to evaluate milligan morgan hemorrhoidectomy versus pile suture method in management of haemorrhoids

International Surgery Journal ◽

10.18203/2349-2902.isj20210381 ◽

2021 ◽

Vol 8 (2) ◽

pp. 664

Author(s):

Aditya . ◽

Kuldeep Raj ◽

P. N. Agarwal ◽

Md Abu Nasar

Keyword(s):

Return To Work ◽

Hospital Stay ◽

Operative Time ◽

Suture Technique ◽

Pain Scores ◽

Early Return ◽

Suture Group ◽

Group A ◽

The Mean ◽

Group B

Background: A pile suture technique was described originally by the Farag in 1978 was better in terms of post- operative pain, bleeding, hospital stay and early return to work which are the distressing effects of conventional Milligan Morgan Hemorrhoidectomy which is well accepted surgical procedure for haemorrhoids. This study is designed to compare the pile suture and Milligan Morgan Hemorrhoidectomy.Methods: After fulfilling the criteria, 60 patients were randomly allocated to the group A (Pile Suture [PS] n -30) and group B (Milligan Morgan Hemorrhoidectomy [MM] n – 30). The techniques were evaluated with respect to the operative time, pain scores, bleeding, hospital stay, return to work, and recurrence.Results: The mean age of patients was 44.33 years and 42.77 years in the pile suture group and MM group respectively. Grade III or IV hemorrhoids were more common in men (i.e., 80% and 60% in the pile suture and MM group, respectively). The mean operative time was shorter in the PS 20.10 minutes versus 51.47 minutes in the MM group (P .001). The bleeding and pain scores were less in the PS. Mean hospital stay was 4 days and 6.6 days in the PS and MM group, respectively. The patients in the pile suture group returned to their routine activities earlier (i.e., within 7.33 days) as compared with 16.87 days in the MM group.Conclusions: Therefore, pile suture method can be considered as less traumatic for the patients and method can be recommended as a safer alternative to Milligan Morgan haemorrhoidectomy.

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Comparison of Early versus Interval Tonsillectomy in Cases of Peritonsillar Abscess

Life and Science ◽

10.37185/lns.1.1.13 ◽

2020 ◽

Vol 1 (1) ◽

pp. 5

Author(s):

Muhammad Ahmed Khan ◽

Attique Ahmed ◽

Muhammad Khan

Keyword(s):

Blood Loss ◽

Operative Time ◽

Operation Time ◽

Peritonsillar Abscess ◽

Military Hospital ◽

Secondary Hemorrhage ◽

Perioperative Blood Loss ◽

Group A ◽

The Mean ◽

Group B

Objective: To compare early versus interval tonsillectomy in cases of peritonsillar abscess.Study Design: Comparative study.Place and Duration of Study: The study was carried out at ENT Department of Combined Military Hospital, Mardan from January 2017 to January 2018.Materials and Methods: A total 50 patients were selected from ENT outpatient department. All the cases were randomly divided into two groups of 25 each. Group A underwent early tonsillectomy after initial incision and drainage, Group B underwent interval tonsillectomy after 6 weeks. Both the groups were compared in terms of perioperative blood loss, operation time, ease of dissection and postoperative complications including pain and hemorrhage. Tonsillectomy was done with bipolar cautery in all the cases.Results: The mean age was 30.22 + 8.25. Out of 50 patients, 42 (84%) were males and 8 (16%) were females. The mean operative time of surgery in group A (early tonsillectomy) was 45.04+5.78 minutes compared to 32.72+4.37 minutes for group B (interval tonsillectomy (p=0.00). Mean post-operative pain in group A was 3.68+2.12 compared to group B where mean score was 3.36+1.93 (p=0.579). There were 3 cases of mild perioperative blood loss, 19 cases of moderate and 3 of severe perioperative blood loss in group A. There were 18 cases of mild perioperative blood loss, 7 cases of moderate and no case of severe perioperative blood loss in group B (p=0.00). Dissection was found to be significantly easier in group B (interval tonsillectomy). There were 7 cases of post-op secondary hemorrhage in group A compared to 3 in group B (p=0.289). All these cases of secondary hemorrhage were managed conservatively.Conclusion: Interval tonsillectomy is a safer procedure as compared to early tonsillectomy in terms of perioperative blood loss, operative time, dissection with almost similar post-op pain and similar risk of post tonsillectomy hemorrhage. How to cite this: Khan MA, Ahmed A, Khan M. Comparison of Early versus Interval Tonsillectomy in Cases of Peritonsillar Abscess. Life and Science. 2020; 1(1): 24-28. doi: https://doi.org/10.37185/L&S.1.1.13

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Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

International Surgery Journal ◽

10.18203/2349-2902.isj20171629 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1726

Author(s):

Anil Reddy Pinate ◽

Mohammad Fazelul Rahman Shoeb ◽

Shiva Kumar C. R.

Keyword(s):

Acute Appendicitis ◽

Hospital Stay ◽

Operative Time ◽

Laparoscopic Group ◽

Laparoscopic Appendicectomy ◽

Open Group ◽

Open Appendicectomy ◽

Group A ◽

The Mean ◽

Group B

Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days. Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.

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Comparative Study Between Outcomes of Tubularized Incised Plate Urethroplasty and Modified Tubularized Incised Plate Urethroplasty in the Management of Distal Hypospadias

Bangladesh Journal of Urology ◽

10.3329/bju.v17i2.49176 ◽

2020 ◽

Vol 17 (2) ◽

pp. 75-81

Author(s):

Ma Salam ◽

M Asaduzzaman ◽

MR Quddus ◽

Amar Chouudhury ◽

Md Faisal Islam ◽

...

Keyword(s):

Functional Outcomes ◽

P 75 ◽

Stricture Urethra ◽

Tubularized Incised Plate ◽

Group A ◽

Tubularized Incised Plate Urethroplasty ◽

Distal Hypospadias ◽

Group 2 ◽

Group B ◽

Primary Management

Objective: To compare the outcomes of tubularized incised plate urethroplasty and modified tubularized incised plate urethroplasty in the primary management of distal hypospadias Materials and Methods: Total 70 patients of age group 2 to 10 years with distal hypospadias were selected for this study from January 2008 to December 2010. They were divided into Group-A (n=35) treated by the tubularized incised plate urethroplasty and Group-B (n=35) treated by the modified tubularized incised plate urethroplasty.The modification was performed by using inner preputial skin on the incised plate before tubularization. All patients were followed up immediately and at 4th, 8th and 12th weeks after operation. Results: The satisfactory cosmetic and functional outcomes were observed in 29 patients (82.85%) of Group-A and all families of Group-B were happy with aesthetic and functional outcomes. Urethrocutaneous fistula developed in 5 patients (14.70%) patients of Group- A and 1 (2.94%) patient in Group-B. Three patients (8.82%) in group-A and one patient (2.94%) in group-B were found to develop meatal stenosis. One patient (2.94%) developed stricture urethra in group A but no patient in group-B developed urethral stricture. Overall complications occurred in 10 patients (29.41%) in Group-A and 2 patients (5.88%) in Group-B. Conclusions: This study demonstrates that modified tubularized incised plate urethroplasty had excellent cosmetic and functional outcomes and fewer complications than that of tubularized incised plate urethroplasty in the primary management of distal hypospadias. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.75-81

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Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v6i1.27070 ◽

2019 ◽

Vol 6 (1) ◽

pp. 8-13

Author(s):

Birendra Kumar Yadav ◽

Robin Bahadur Basnet ◽

Anil Shrestha ◽

Parish Mani Shrestha

Keyword(s):

Hospital Stay ◽

Percutaneous Nephrolithotomy ◽

Urine Culture ◽

Operation Time ◽

Group A ◽

One Year ◽

Group B ◽

Stone Characteristics ◽

Negative Urine Culture ◽

Infective Complications

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture.

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Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

BioMed Research International ◽

10.1155/2019/1491796 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yangjing Lin ◽

Jin Cao ◽

Changgui Zhang ◽

Liu Yang ◽

Xiaojun Duan

Keyword(s):

Achilles Tendon ◽

Recurrence Rate ◽

Operative Time ◽

Achilles Tendon Rupture ◽

Tendon Lengthening ◽

Group A ◽

Achilles Tendon Lengthening ◽

The Mean ◽

Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

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The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

10.53350/pjmhs2115102712 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2712-2714

Author(s):

Muhammad Aamir Jamil ◽

Muhammad Asif ◽

Imran Yousaf ◽

Muhammad Faheem Anwer ◽

Muhammad Waseem Anwar

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Recovery Time ◽

Mesh Repair ◽

Operative Procedure ◽

Total Extraperitoneal ◽

Outcome Comparison ◽

Group A ◽

The Mean ◽

Group B

Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All male and female patients included in this study in both groups. Twelve (48%) of patients were direct inguinal hernia in group A 13(22%) were in group B and 14(56%) patients were in group A and 11(44%) patients were in group B. The mean±SD postoperative hospital stay was 24.48±4.62 in group A and 34.65±12.26 hours in group B (p 0.001). The mean±SD postoperative recovery time in weeks was 2.18±0.43 in group A and 2.90±0.46 weeks in group B (p 0.001). Only 2 (4%) patient had postoperative infection on first week and 4 (8%) patients had infection respectively. No recurrence was seen in group A and only 3% recurrence was in group B. Conclusion: It is concluded that group A had shorter hospital stay, recovery time, postoperative time and less infection rate as compared to group B. In group A 13% patients had severe pain and in group B 25% patients. Keywords: Inguinal Hernia, Total extraperitoneal, Mesh repair.

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