Objective: to evaluate the benefit of coverage of
the urethral repair by dorsal dartos flap as a second
layer for preventing fistula and V like incision on
the tip of the glans for preventing meatal stenosis.
Patients and Methods:
Forty five children included in this study age
ranged ( 11 months – 7 years), they underwent
hypospadias repair between December 2008 to
March 2012, all cases with distal hypospadias,
same technique used for all patients, a combination
of techniques used for reconstruction starting
withtubularized incised plate urethroplasty with deepithelialized
or stripping of the skin from both
sides of U shaped incision surrounding the urethral
plate, adding a V like incision on the top (tip of
glans) of the midline urethral plate incision that
give wide meatus subsequently prevent meatal
stenosis and no need for dilatation after stent
removal, followed by harvesting well vascularized
dartos flap from de-epithelialized preputial skin
and transposing itventrally by buttonholing
maneuver and suturing the flap as a second layer
along the neourthral suture line, finally
approximation of glans , so achieving three layer
closure.
Results :All patients are followed for (6 months-
24 months) mean was 15 months, only two patients
(4.4%) complicated with small fistula at the
subcoronal region at the beginning of the study
operated after 6 months and the fistula closed
successfully. Twenty five cases (55.5%) with
Chordee were completely released with no
recurrence. No dilatation was needed after removal
of stent for neomeatus developed a good stream of
urine with no problems regarding stenosis.
Conclusions: In this study hypospadias repair
should achieve three layer closures by using a
dartosfalp as a second layer to cover neourethral
suture line combined with stripping the skin on the
edge of the U shaped incision to gain secure
closure of the neourethra, which will prevent
fistula formation. We recommend adding a
Vincision on the tip of the glans connected with
midline urethral plate incision to prevent meatal
stenosis.
A novel demountable shear connector for precast steel‐concrete composite bridges is presented. The connector uses high‐strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents slip of bolts within their holes. Moreover, the connector promotes accelerated construction and overcomes typical construction tolerances issues of precast structures. Most importantly, the connector allows bridge disassembly, and therefore, can address different bridge deterioration scenarios with minimum disturbance to traffic flow, i.e. (i) precast deck panels can be rapidly uplifted and replaced; (ii) connectors can be rapidly removed and replaced; and (iii) steel beams can b
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... Show MoreTheligand4-[5-(2-hydoxy-phenyl)- [1,3,4- thiadiazole-2- ylimino methyl]-1,5-dimethyl -2-phenyl-1,2-dihydro-pyrazol-3-one [HL1] is prepared and characterized. It is reacted with poly(vinyl chloride) (PVC) in THF to form the PVC-L compounds ,PVC-L interacted with ions of transition metals to form PVC-L-MII complexes .All prepared compounds are characterized by FTIR spectroscopy, u.v-visible spectroscopy, C.H.N.S. analysis and some of them by 1HNMR
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In this paper the effect of the test method used in PLT in estimation of some mechanical soil properties was distinguished via a series of both test methods applied in a same site. The comparison of
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