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.
This research deals with compound sentences in the German language and how to transform them and transfer them into a main sentence, touching on their functions and characteristics. Actual to nominative, which is a unique feature of the German language, with some diverse examples taken from various sources.This case is distinguished, like other grammatical cases
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The current research illustrates experimentally the effect of series and parallel connection (Z-I Configurations) of flat plate water solar collectors array on the thermal performance of closed loop solar heating system. The study includes the effect of changing the water flow rate on the thermal efficiency. The results show that, the collector's efficiency in series connection is higher than the parallel connection within flow rate level less than (100) ℓ/hr. Moreover, the collector efficiency in parallel connection of (I-Configurations) is more than the (Z- Configurations) with increasing the water flow rate .The maximum daily efficiency for parallel (I-Configurations) and (Z- Configurations) are (55%) and (51%) at w
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The height of VGs relative to the thickness of the boundary layer enables us to study the efficacy of VGs in delaying boundary layer separation. The distance between two VGs also has an effect on the boundary layer if we take into
... Show MoreThis study is a complementary one to an extended series of research work that aims to produce a thermodynamiclly stable asphalt –sulfur blend. Asphalt was physically modified wiht different percentages of asphaltenes , oxidized asphaltenes and then mixed with sulfur as an attempt to obtaine a stable compatible asphalt-sulfur blend. The homogeneneity of asphalt-asphaltenes[oxidized asphaltenes]-sulfur blends were studied microscopically and the results are prsented as photomicrographs. Generally more stable and compatible asphalt-sulfur blends were obtained by this treatment.