scholarly journals Intermittent Self Dilation – An Option For The Prevention of Urethral Stricture Recurrence After Filliform Follower Urethral Dilation

2018 ◽  
Vol 14 (2) ◽  
pp. 38-40
Author(s):  
N M Shrestha
Keyword(s):  
Urethral Stricture ◽  
Clinical Symptoms ◽  
Urine Test ◽  
Group A ◽  
Prospective Comparative Study ◽  
Foley’S Catheter ◽  
Group B ◽  
Stricture Recurrence ◽  
Urethral Dilation ◽  
Lower Urinary

Background: Urethral stricture and its recurrence is still a major problem in male. Several procedures are present for the treatment of the disease. Lapides introduced the concept of intermittent self dilatation (ISD) which has decreased the incidence of recurrence of urethral stricture if doing properly. The aim of the this study was to report the outcomes of ISD for the treatment of urethral stricture after Filliform follower urethral dilatation (FFUD).Method: This was a prospective comparative study, conducted in the department of surgery, urology unit from March 2013 to February 2016. Total of 49 patients were enrolled and were randomly divided into Group A and Group B. In Group A, all the patients were taught ISD with Nelaton Catheter after FFUD. In group B, all patients underwent only FFUD for urethral stricture. In both groups, Foley's catheter was removed after 2 weeks of FFUD. These patients who had difficulty In passing urine or having lower urinary tract syndrome after removal of catheter, were evaluated for urethral stricture recurrency by clinical symptoms, ultrasonography, urine test for culture and sensitivity, cystoscopy/urethrogram as necessarily.Result: In Group A, 4 patients out of 20(20%)developed urethral stricture recurrency where as in Group B,18 patients out of 23 (78.26%) developed urethral stricture recurrency. Therefore, the rate of urethral stricture recurrence is significantly more in group B than the Group A (p< 0.001).Conclusion: ISD is an effective way for the prevention of urethtral stricture recurrence after FFUD. JNGMC,  Vol. 14 No. 2 December 2016, Page: 38-40

scholarly journals Prospective comparative study of hypospadias surgical repair with and without the use of fibrin sealant

2019 ◽  
Vol 6 (8) ◽  
pp. 2722
Author(s):  
Tamer A. Sultan ◽  
Tamer A. Faktry ◽  
Ahmad Nabil ◽  
Mohammed Z. Shenishn
Keyword(s):  
Comparative Study ◽  
Urethral Stricture ◽  
Fibrin Sealant ◽  
Tertiary Care ◽  
Hypospadias Repair ◽  
Flap Necrosis ◽  
Significant Difference ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B

Background: Hypospadias is the most common congenital malformation of the penis, affecting about 4-6 males per 1000 male births, and ranging in severity from a urethral meatus that is slightly off-center to a meatus in the perineal area, The aim of this study was to evaluate whether the application of fibrin sealant over the suture lines of neo-urethra reduces complications and improve overall outcome in children hypospadias repair.1,2 Methods: It was a prospective comparative study conducted in a tertiary care center (Department of pediatric surgery - Menoufia University), we included the patients age more than 6 months and less than 4 years presented with hypospadias to our department in this study. A total 30 patients of coronal, sub coronal, mid shaft hypospadias and distal hypospadias were studied and were divided into two groups, group (A) 15 cases and group (B) 15 cases. All patients underwent a tabularized incised plate (TIP) repair with a Dartos vascularized pedicle flap to cover the neo-urethra, In group (B) a thin layer of fibrin sealant applied over the suture line of neo-urethra but no sealant was used in group (A).Results: Postoperative surgical complications: urethra cutaneous fistula, flap dehiscence, flap necrosis and urethral stricture were recorded. Urethrocutaneous fistula flap dehiscence and flap necrosis were lower in group (B) patients. There was no significant difference in postoperative urethral stricture between two groups. Conclusions: Use of fibrin sealant in hypospadias repair is safe and can reduce complications.

scholarly journals Role of intermittent self catheterization in prevention of recurrence of stricture urethra following visual internal urethrotomy: a prospective single centre study

2019 ◽  
Vol 6 (4) ◽  
pp. 1093
Author(s):  
Vijaya Kumar R. ◽  
Sachin Dharwadkar ◽  
Chirag Doshi ◽  
Akshey Batta
Keyword(s):  
Treatment Group ◽  
Urethral Stricture ◽  
Intermittent Catheterization ◽  
Control Group ◽  
Internal Urethrotomy ◽  
Stricture Urethra ◽  
Group A ◽  
Group B ◽  
Stricture Recurrence

Background: Stricture urethra is a highly recurrent disease. Various treatment modalities were used to prevent its recurrence post urethrotomy with variable success. The objective of this randomized study was to compare the stricture recurrence after optical internal urethrotomy with and without clean intermittent self catheterization in patients with anterior urethral stricture.Methods: A total of fourty patients aging 20-60 years with urethral stricture of up to 1cm and up to six months duration were selected randomly in to treatment group A (20 patients) control group B (20patients) and all patients were treated with VIU followed with indwelling catheter for 7 days. Patients with traumatic urethral stricture, congenital or malignant strictures were excluded. The treatment group A was taught to perform self clean intermittent catheterization by inserting Nelaton catheter. All patients were followed regularly at 3,6,12 months.Results: 4 (20%) patients in treatment group A had stricture recurrence while 15 (75%) out of 20 patients in control group B developed urethral stricture recurrence. In Group A 2 Patient developed stricture in first 6 months and 2 in next 6 months of follow up while in control group B 10 patients (50%)out of 20 had their recurrence in the first six months of follow-up while 5 (25%) in group B had their recurrence in the next six months of follow-up.Conclusions: Clean self intermittent catheterization is a simple, safe, cost effective and easy to perform procedure for prevention of urethral stricture with good acceptability and compliance.

Prevention of Frey’s Syndrome with the Use of Porcine Dermal Collagen Graft: Retrospective Analysis of 76 “Formal” Parotidectomies for Benign Pathologies

2021 ◽  
pp. 000348942199018
Author(s):  
Kostas Vahtsevanos ◽  
Angelos Chatziavramidis ◽  
Ioannis (Yiannis) Papadiochos ◽  
Georgios Koloutsos ◽  
Anastasios Stefanidis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Frey’S Syndrome ◽  
Randomized Controlled Studies ◽  
Parotid Surgery ◽  
Porcine Dermal Collagen ◽  
Frey's Syndrome ◽  
Dermal Collagen ◽  
Group A ◽  
Group B ◽  
Collagen Graft

Background: Frey’s syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. Methods: We conducted a 20-year retrospective study including the patients who had undergone “formal” (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. Results: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey’s syndrome was found after the use of dermal collagen interpositional barrier ( P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor’s test was positive at an incidence of 59.09% in Group A and 21.87% in Group B ( P = .004, 95% CI). Severe Frey’s syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B ( P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey’s syndrome in the compared groups, Conclusion: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey’s syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.

Modified Lift Versus Cutting Seton for Transphincteric Fistula -Experience at Tertiary Care Hospital

2021 ◽  
Vol 15 (12) ◽  
pp. 3257-3260
Author(s):  
Muhammad Najam Iqbal ◽  
Ashfaq Nasir
Keyword(s):  
Comparative Study ◽  
Anal Incontinence ◽  
Complete Healing ◽  
Fistula Tract ◽  
Fistula Closure ◽  
Fistula In Ano ◽  
Group A ◽  
Prospective Comparative Study ◽  
Cutting Seton ◽  
Group B

Background: Fistula in ano is a common disease which has high recurrence rate and high fecal incontinence rate after surgery. We compared modified LIFT (Ligation of the intersphincteric fistula tract (LIFT) through lateral approach ) with cutting seton for transphincteric fistula. Aim: This study is aimed at which procedure is better with respect to postoperative complications Study design: It was a prospective comparative study. Methods: This was a prospective comparative study from 01-01-2019 to 30-06-2021 which was conducted on 50 patients who presented with transsphincteric fistula in ano (FIA) in surgical ward of Bahawal Victoria Hospital Bahawalpur. Patients were divided into two groups .Patients of Group A underwent modified lift procedure and patients of group B underwent cutting seton procedure. Data was collected on a proforma which included patients’ name ,age ,sex, age group, comorbid disease like diabetes mellitus ,chronic liver disease, cardiovascular disease and chronic renal failure, fistula tract involving less than 50% or more than 50% external sphincter ,procedure done, healing time of wound, complications like recurrence and incontinence. Patients were followed for 6 months for healing rate ,recurrence and incontinence. Data was analysed on spss 22 version Results: In Group A, complete healing (fistula closure without recurrence) was achieved in 20 patients (80%) out of 25. There was no case of anal incontinence after the procedure. 5 (20%) patients experienced recurrence in 6 months . In Group B, complete healing (fistula closure without recurrence) was achieved in 21 patients (84%), in 6 months follow up . 4(16%) patients were diagnosed as a case of anal incontinence. There were 4 (16%) patients with recurrence. Conclusion: Modified LIFT is better in terms of incontinence where as cutting seton is better in terms of recurrence.it is suggested that for high lying fistula modified LIFT is better procedure and for low lying fistula involving less than 50% sphincter cutting seton is better procedure.. Keywords: Modified LIFT (ligation of ineter sphincteric fistula tract) ,Cutting seton , transphincteric fistula.

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

scholarly journals A modification of the Ponseti method for clubfoot management: a prospective comparative study

2021 ◽  
pp. 1-10
Author(s):  
Reda Ali Sheta ◽  
Mohamed El-Sayed ◽  
Hisham Abdel-Ghani ◽  
Sameh Saber ◽  
Amani Salah Eldin Mohammed ◽  
...  
Keyword(s):  
Treatment Method ◽  
Ponseti Method ◽  
Level Of Evidence ◽  
Home Based ◽  
Multicentre Cohort Study ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Multicentre Cohort

Purpose We aimed to compare our parent-based exercise programem’s efficacy with the foot abduction brace (FAB) Ponseti manipulation as a retention programme. Methods We conducted this prospective multicentre cohort study between August 2009 and November 2019. The included children were allocated into one of two groups according to the retention protocol. The Pirani and Laaveg-Ponseti scores were used to assess the feet clinically and functionally. Radiological assessment was performed using standing anteroposterior and lateral radiographs of the feet. We assessed the parents’ satisfaction and adherence to the retention method. SPSS version 25 was used for the statistical analysis. Results A total of 1265 feet in 973 children were included. Group A included 637 feet managed with FAB, while group B included 628 feet managed with our retention programme. All patients were followed up to the age of four years. At the final follow-up, Pirani scores in group A participants were excellent, good and poor in 515, 90, and 32 feet, respectivel, while in group B the scores were excellent, good and poor in 471, 110 and 44 feet, respectively. The mean total score of Laaveg-Ponseti was 87.81 (sd 19.82) in group A and 90.55 (sd 20.71) in group B (p = 0.02). Group B participants showed higher satisfaction with the treatment method (p = 0.011) and more adherence to the treatment (p = 0.013). Conclusion The deformity’s recurrence related to the brace’s non-compliance in the Ponseti method might be reduced by substituting the brace with our home-based daily stretching exercises. Level of Evidence II

scholarly journals O’CONOR (TRANSABDOMINAL) REPAIR: IS IT ALWAYS NECESSARY TO INTERPOSE A FLAP IN SIMPLE VESICO-VAGINAL FISTULA? A COMPARATIVE STUDY

2021 ◽  
Vol 71 (1) ◽  
pp. 347-50
Author(s):  
Qamar Zia ◽  
Asma Rizwan ◽  
Adil Khurshid ◽  
Mudassar Sajjad ◽  
Muhammad Nawaz ◽  
...  
Keyword(s):  
Comparative Study ◽  
Vesicovaginal Fistula ◽  
Armed Forces ◽  
Vaginal Fistula ◽  
Fistulous Opening ◽  
Vesicovaginal Fistulae ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B ◽  
Vesico Vaginal Fistula

Objective: To assess morbidity and success of transabdominal (O’Conor) repair of vesicovaginal fistula with orwithout interposition of flap between vagina and urinary bladder. Study Design: Prospective comparative study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2016 to Jan 2019. Methodology: Fifty five patients were randomized into group A & B by lottery method. An inclusion criterionwas single fistulous opening of ≤3cm. Complex and recurrent fistulae were excluded. Patients in group A underwent O’Conor repair without interpositional flap while in group B vesicovaginal fistulae were repaired with flap interposition. Results: Twenty two patients were randomized in group A while 27 in group B. Mean age of patients was 41.65± 11.93 years. Gynecological and obstetrical surgery was the main cause of fistula. Mean duration of surgerywas 162.7 ± 18.49 minutes. Per-operative ureteric catheterization was done in 9 (16.8%) patients. Seventeen(30.6%) patients had paralytic ileus. There was transient fever in 4 (7.6%) of cases and wound infection was seenin 3 (5.8%) of patients. Mean hospital stay was 3.4 ± 2.3 days. Cystogram was done in 35 (64.5%) of patients before the removal of per-urethral catheter. The overall success rate was 92.9%. Ten (18.2%) of patients developed denovo urgency which was managed conservatively. There was no statistical difference in both groups in terms of morbidity and success. Conclusion: In simple Vesico-vaginal fistulae repair, interposition of flap can be omitted and it does not affect the outcomes in terms of success and morbidity.

“A PROSPECTIVE STUDY: ROLE OF TRACTION ON FOLEY’S CATHETER IN TURP PATIENTS”

2021 ◽  
pp. 27-29
Author(s):  
Prashant Lavania ◽  
Ankush Gupta ◽  
Rahul Chaudhary
Keyword(s):  
Blood Loss ◽  
Early Discharge ◽  
Common Condition ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Foley’S Catheter ◽  
Group B ◽  
A Prospective Study

INTRODUCTION: Benign prostatic hyperplasia (BPH) is the most common condition affecting men those are 50 years of age and above.TURP is still the widely used technique for management of BPH. TURPwith advent of newer technologies in diathermy and visual scope, has turned into a relatively safe one. AIM:To study role of catheter traction on blood loss and complications in patients with TURP. MATERIALS AND METHODS: This study was done among patients of BPH admitted in the Department of Surgery at S.N. Medical College, Agra during the period from January 2019 to February 2020. Total 60 cases were enrolled in the study and divided into two groups. Group A(30 patients) with traction on catheter after TURPand Group B(30 patients) without traction on catheter. DISCUSSION: Blood loss and irrigation uid was signicantly less in the group with traction on foley's catheter. Duration of hospital stay and complications were also lesser in group with traction. CONCLUSION: Traction on foley's catheter post TURP is effective in managing BPH with the merits of higher safety due to less blood loss and early discharge.

Suboccipital and cervical chordomas: the value of aggressive treatment at first presentation of the disease

2002 ◽  
Vol 97 (5) ◽  
pp. 1070-1077 ◽  
Author(s):  
Alexandre Carpentier ◽  
Marc Polivka ◽  
Alexandre Blanquet ◽  
Guillaume Lot ◽  
Bernard George
Keyword(s):  
Clinical Symptoms ◽  
Rank Test ◽  
Aggressive Treatment ◽  
Actuarial Survival ◽  
High Tendency ◽  
Content Type ◽  
Log Rank Test ◽  
Group A ◽  
Group B ◽  
Fine Print

Object. Chordoma is a locally invasive tumor with a high tendency for recurrence for which radical resection is generally recommended. To assess the benefits of aggressive treatment of chordomas, the authors compared results in patients treated aggressively at the first presentation of this disease with results in patients who were similarly treated, but after recurrence. Methods. Among 36 patients with cervical chordomas who were treated at the authors' institution, 22 underwent primary aggressive treatment (Group A) and 14 were treated secondarily after tumor recurrence (Group B). Two cases were excluded from Group A because of unrelated early deaths and three from Group B because of insufficient pre- or postoperative data. Most tumors were located at the suboccipital level and only eight cases at a level below C-2. Radiotherapy and proton therapy were similarly conducted in both groups of patients. The actuarial survival rates were 80 and 65% at 5 and 10 years, respectively, in Group A patients and 50 and 0% at 5 and 10 years, respectively, in Group B patients (p = 0.049, log-rank test). The actuarial recurrence-free rates were 70 and 35% at 5 and 10 years, respectively, in Group A and 0% at 3 years in Group B (p < 0.0001, log-rank test). The numbers of recurrences per year were 0.15 in Group A and 0.62 in Group B (p > 0.05). All other parameters that were analyzed (patient age, delay before diagnosis, clinical symptoms, chondroid type of lesion, and histological features) did not prove to influence prognosis in a statistically significant manner. Conclusions. Aggressive therapy, combining as radical a resection as possible with radiotherapy, seems to improve the prognoses of suboccipital and cervical chordomas when applied at the patient's first presentation with the disease.

scholarly journals A comparative study of intracervical foley’s catheter with oxytocin and vaginal misoprostol for induction of labour

2020 ◽  
Vol 9 (9) ◽  
pp. 3660
Author(s):  
Priyanka . ◽  
Shashi Bala Arya ◽  
Mirdu Sinha ◽  
J. K. Goel
Keyword(s):  
Pregnant Women ◽  
Induction Of Labour ◽  
Labour Induction ◽  
Bishop Score ◽  
Misoprostol Group ◽  
Successful Induction ◽  
Group A ◽  
Vaginal Misoprostol ◽  
Foley’S Catheter ◽  
Group B

Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.

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