scholarly journals Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula

2015 ◽  
Vol 3 (1) ◽  
pp. 12-17
Author(s):  
Md Shah Alam Talukder ◽  
Debesh Ch Talukder ◽  
Md Abdullah Al Mahmud ◽  
Mohammed Showkot Ali ◽  
Nadiuzzaman Khan ◽  
...  
Keyword(s):  
Urethrocutaneous Fistula ◽  
Cutaneous Fistula ◽  
Medical College ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Dartos Flap ◽  
Distal Hypospadias ◽  
Group B ◽  
Hypospadias Surgery ◽  
Fistula Prevention

Urethro cutaneous fistula( U-C fistula) is the most common complication of hypospadias surgery. It frequently needs separate surgeries for closure, which bring a great deal of physical and mental agony and monetary involvement of the patient and his family. Many efforts have been invented to prevent the u-c fistula with various degree of success. We would like to see the outcome of “Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula”. This interventional study was performed to see the outcome of preputial dartos reinforced Snodgrass tubularized incised plate urethroplasties in distal hypospadias specially urethrocutaneous fistula prevention. For this purpose 40 patients were selected having distal hypospadias age ranging from 6 months to 11 years admitted in the Department of Pediatric Surgery, Mymensingh Medical College & Hospital during the period of January 2010 to March 2011. Out of 40 patients, 20 were in group-A (preputial dartos flap) and another 20 were included in group - B (without flap). All this patients were followed by perioperative and postoperative care. Few patients developed postoperative pyrexia, wound infection, stent blockage which were treated accordingly leaving minimum morbidity. Both groups of patients were followed up for 3 months after surgery. Present study is probably a better technique to prevent fistulaassociated morbidities in distal Snodgrass TIP urethroplasties.J. Paediatr. Surg. Bangladesh 3(1): 12-17, 2012 (January)

scholarly journals Comparison of Dartos flap and spongioplasty in Snodgrass urethroplasty in distal penile hypospadias

2021 ◽  
Vol 4 (3) ◽  
pp. e000294
Author(s):  
Anju Verma ◽  
Shahid Murtaza ◽  
Vijay Kumar Kundal ◽  
Amita Sen ◽  
Divya Gali
Keyword(s):  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Dartos Flap ◽  
The Difference ◽  
Group B ◽  
Good Cosmesis ◽  
Hypospadias Surgery ◽  
Single Technique

BackgroundHypospadias surgery has been continuously evolving, although there is no single technique which can be said to be perfect and suitable for all types of hypospadias. Tubularized incised plate (TIP) urethroplasty (Snodgrass procedure) is presently the most common surgical procedure performed for distal penile hypospadias (DPH). The aim of this study was to compare the outcome of TIP urethroplasty using Dartos flap (DF) and spongioplasty as second layer in DPH.MethodsA total of 30 patients of DPH were repaired using TIP urethroplasty with DF or spongioplasty as second layer from January 2017 to June 2018. Out of 30 patients, TIP with DF was done in 15 patients (group A) and TIP with spongioplasty was done in the remaining 15 patients (group B). Preoperative mean age and weight were comparable in both groups. Postoperative complications, namely, postoperative edema, residual chordee, urethrocutaneous fistula (UCF), meatal stenosis and final cosmesis, were recorded.ResultsIn both groups, complications included postoperative edema (Gp A-1Gp B-1), residual chordee (Gp A-1, Gp B-1), UCF (Gp A-3, Gp B-4), meatal stenosis (Gp A-1, Gp B-5) and poor cosmesis (Gp A-3, Gp B-4). Wound infection was managed with appropriate antibiotics, and meatal stenosis responded to calibration in five patients.Although it seems that DF has a better outcome clinically, the difference between the two techniques was statistically not significant.ConclusionDF as an additional cover to TIP is associated with an acceptable complication and has good cosmesis compared with spongioplasty; however, the difference is not statistically significant.

scholarly journals A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair

2015 ◽  
Vol 3 (2) ◽  
pp. 65-70
Author(s):  
Abhi Kumar Chakraborty ◽  
Sajal Kumar Majumdar ◽  
Mirza Kamrul Zahid ◽  
Sayed Mahmudur Rahman ◽  
Dipankar Kumar Saha ◽  
...  
Keyword(s):  
Double Layer ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Tubularized Incised Plate ◽  
Superficial Skin ◽  
Group A ◽  
Dartos Flap ◽  
Tubularized Incised Plate Urethroplasty ◽  
Distal Hypospadias ◽  
Group B

Background/purpose: The tubularized incised plate urethroplasty (Snodgrass technique) presents the procedure of choice for distal hypospadias repair. Fistula formation is the most common complication with various rates. Avoiding overlap of suture lines in the Snodgrass repair is critical to minimize fistula formation through second-layer coverage of the neourethra. We compared the outcome of double- layer dartos flaps to flapless procedure in the tubularized incised plate urethroplasty for distal hypospadias repair to assess the effectiveness of dartos flap in this method.Methods: Our study included 28 patients aged upto 12 years who were treated with tubularized incised plate urethroplasty for distal hypospadias in Shaheed Suhrawardy Medical College Hospital from April 2010 to December 2011. They were divided into two groups. Group A (14 patients) had double dartos flap coverings. Group B (14 patients) had no dartos flap covering. The dissected dorsal dartos flap was bisected vertically to form two pedicle wings. Each wing was rotated laterally from either side of the glans to cover the neourethra ventrally in a double-layer fashion.Result: Mean follow up period was 9 months. In Group A, one patient (7%) developed fistula and one (7%) superficial skin necrosis. On the other hand three (21%) patients developed fistula and one patient (7%) meatal stenosis in group B, who were treated with Snodgrass procedure without using dartos flap. All successful repaired hypospadias patients of both groups had a cosmetically normal looking circumcised penis with ventrally slit meatus.Conclusions : Double dartos flaps covering of the neourethra is a simple procedure and could be effective for the prevention of urethrocutaneous fistula after tubularized incised plate urethroplasty.J. Paediatr. Surg. Bangladesh 3(2): 65-70, 2012 (July)

scholarly journals Comparative study of two different procedures for primary hypospadias repair

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.

scholarly journals To Evaluate the Role of Vascularised Dorsal Dartos Flap in Snodgras Urethroplasty

2013 ◽  
Vol 2 (1) ◽  
pp. 31-35
Author(s):  
M Anisuzzaman ◽  
MAB Akan ◽  
R Ara ◽  
MM Hasan ◽  
MN Zaman ◽  
...  
Keyword(s):  
Fistula Formation ◽  
Urethrocutaneous Fistula ◽  
Pedicle Flap ◽  
Number Of Patients ◽  
Postoperative Fistula ◽  
Group A ◽  
Dartos Flap ◽  
Group B ◽  
Interventional Group

Background: Hypospadias is a common congenital anomaly of male urethra. Surgical repair is the only treatment of this defect, but there is no single, universally acceptable technique for its repair . Snodgrass technique is now popular for its low complication rate, shorter operative time, vertically oriented slit like meatus and better cosmetic outcome. Objective: To evaluate the role of vascularized dorsal dartos pedicle flap over the neourethra in terms of postoperative urethrocutaneous fistula formation between two groups of patients of distal penile hypospadias. Methodology: Thirty two patients were included in this study. They were divided in group A and group B on the basis of serial number of patients. Snodgrass urethroplasty was done in group A considered as control and in group B, Snodgrass urethroplasty was done with additional dorsal dartos flap by buttonhole technique considered as interventional group. The outcome of both groups in terms of post operative urethrocutaneous fistula were evaluated. Results: In this study in group A, urethrocutaneous fistula developed in 6 patients out of 16 patients. Among the fistulas, 5 were situated at the coronal level and 1 at the hypospadiac meatus level. In group B, urethrocutaneous fistula developed in 1 patient out of 16 patients and the fistula occurred at the coronal level. In either group, all the fistulas are developed after removal of the catheter. In terms of post operative urethrocutaneous fistula formation in between the two groups, the results were statistically significant. Conclusion: Snodgrass urethroplasty with additional dorsal dartos flap by buttonhole technique have better outcome than without additional dorsal dartos flap in terms of postoperative fistula formation. DOI: http://dx.doi.org/10.3329/jpsb.v2i1.15161 Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 31-35

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

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

Comparative Study Between Clean Intermittent Self-Catheterization (Cisc) and Continuous Indwelling Catheterization (Cidc) in Relieving Acute Refractory Retention of Urine Due to Benign Enlargement of Prostate (Bep)

2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin
Keyword(s):  
Comparative Study ◽  
Acute Urinary Retention ◽  
Bladder Capacity ◽  
Inclusion Criteria ◽  
College Hospital ◽  
Medical College ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Better Than

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

scholarly journals Comparative study between two empirical antibiotic regime in the management of childhood malignancy with fever

2015 ◽  
Vol 5 (2) ◽  
pp. 329-331 ◽  
Author(s):  
Laila Helaly ◽  
Md Zakir Hossain Sarker ◽  
MA Mannan ◽  
Md Tafazzal Hossain ◽  
Shafi Ahmed ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Study Drug ◽  
Successful Outcome ◽  
Medical College ◽  
Pediatric Hematology ◽  
Pediatric Cancer Patients ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Oncology Unit

Objective : The present prospective randomized clinical trial was carried out to assess whether combined cefepime and amikacin as empirical antibiotic therapy was more effective than combined ceftriaxone and gentamicin in the treatment of febrile neutropenic children with malignant diseases.Material & Methods : The study was conducted in the Pediatric Hematology and Oncology unit of BSMMU over a period of 2 years. (From January 2006 to December 2007) Hospitalised pediatric cancer patients who developed febrile neutropenia following chemotherapy or radiotherapy were the study population. A total 64 cases were consecutively included in the study and were randomly assigned to either cefepime & amikacin group (Group- A) or ceftriaxone & gentamicin group (Group-B). The Group-A received cefepime 1500 mg/m2/dose infused over 15 minutes in two divided doses intravenously(IV) while amikacin was administered as thrice daily dose of 200 mg/m2/dose. Patients of Group-B received ceftriaxone 1500 mg/m2/dose in two divided doses and gentamicin 60 mg/m2/dose thrice daily IV. The therapy was continued until absolute neutrophil counts reached >1000 neutrophils/mm3. The treatment outcome was considered successful if fever resolves within 4 days and does not recur within 7 days of completion of therapy. Of the 64 patients, 13 cases were excluded from the final analysis.Results : Bacteria were isolated from culture in only 16.7% of cases Group-A and 9.5% of group-B. Patients E. coli was the most common isolate found in blood specimen (37%). Following intervention, 90% of cefepime & amikacin group and 85.6% of ceftriaxone & gentamicin group improved absolute neutrophil count to >1000/mm3 of blood. Persistence of fever after start of study drug and duration of antibiotic therapy were significantly less in the former group than those in later group (p = 0.049 and p = 0.004 respectively). Only 1 patient of group B had recurrence of infection within 7 days of treatment completion. The mean duration of hospital stay was less in the former group (7.97 ± 2.61 days) than that in the latter group (11.00 ± 3.42 days) (p = 0.06). Evaluation of final outcome shows that majority (86.6%) of cefepime & amikacin group had successful outcome, while majority of ceftriaxone & gentamicin group (81%) failed to resolve infection with continuation of fever for > 4 days.Conclusion : The study concluded that combined cefepime and amikacin is a better option for empirical treatment of fever and neutropenia in children with malignancies than combined ceftriaxone and gentamicin (p<0.001).Northern International Medical College Journal Vol.5(2) 2014: 329-331

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud
Keyword(s):  
Postoperative Pain ◽  
Postoperative Bleeding ◽  
Throat Pain ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Case Surgery ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

scholarly journals Fetal and maternal outcome following expectant management of severe pre-eclampsia remote from term

2017 ◽  
Vol 6 (12) ◽  
pp. 5420
Author(s):  
Deepak A. V. ◽  
Reena R. P. ◽  
Deepa Anirudhan
Keyword(s):  
Expectant Management ◽  
Severe Preeclampsia ◽  
Close Monitoring ◽  
Antenatal Corticosteroids ◽  
Maternal Complications ◽  
Medical College ◽  
Difficult Decision ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Expectant management of severe preeclampsia, remote from term is often a difficult decision. Maternal and foetal complications may occur while trying to achieve a more favourable perinatal outcome. We wanted to find out the foetal and maternal outcomes of expectant management in these women.Methods: A prospective cohort study was conducted at Government Medical College, Thrissur, India between May 2013 and April 2015. Women with severe preeclampsia remote from term, who were admitted, managed expectantly and delivered in our hospital during the study period, were recruited. The study subjects were grouped into: Group A (between 28 weeks and 31 weeks 6 days) and Group B (between 32 weeks and 33 weeks 6 days). A structured proforma was used to collect demographic and clinical details. The maternal and foetal outcomes were noted.Results: There were 4786 deliveries during the study period. Among them 76 (1.58% of total deliveries) women with severe preeclampsia between 28 weeks and 33-week 6 days gestation on expectant management were included in the study. The mean duration of expectant management was 7.92 days in group A (27 women) and 6.67 days in group B (49 women). Most women required termination of pregnancy for foetal distress (36.8%). HELLP syndrome and imminent eclampsia were the maternal complications that occurred. Perinatal loss was significantly more in Group A when compared to Group B.Conclusions: Expectant management of women with severe preeclampsia remote from term, especially between 32weeks and 33weeks 6 days, with antenatal corticosteroids and close monitoring, seems a reasonable option in developing countries.

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