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MODIFICATION OF TUBULARIZED INCISED PLATE URETHROPLASTY IN HYPOSPADIUS REPAIR FOR PREVENTING FISTULA AND MEATAL STENOSIS.
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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.

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Publication Date
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Journal Name
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A Proposed Training Program for School Leaders in the Sultanate of Oman on the Planning Practices of the Kaufman Model in Light of the Needs and Challenges of Reality
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Wed Jan 24 2018
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FOOD APPLICATIONS FOR OIL AND CHIA SEEDS SALVIA HISPANICA: FOOD APPLICATIONS FOR OIL AND CHIA SEEDS SALVIA HISPANICA
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The extracted oil from the Chia seeds white and black were used in the manufacture of certain foods such as mayonnaise. The results of the sensory evaluation showed that the product was acceptable except for the flavor of white chia seed oil. The seeds were fully used in the manufacture of the nutella. The results of the sensory evaluation were encouraging the use of the extracted oil from the black chia seeds in the production of the nutella except the spread property. Chia seeds were also used in the manufacture of pudding. The results of the sensory evaluation showed an excellent and acceptable product of black chia seeds oil can be obtained, while the white seeds did not receive the acceptance in terms of color and flavor.

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