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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
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Increasing confidence in full field modelling and water flood planning for a giant reservoir under primary depletion through Material Balance modelling
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Abstract<p>One of the principle inputs to project economics and all business decisions is a realistic production forecast and a practical and achievable development plan (i.e. waterflood). Particularly this becomes challenging in supergiant oil fields with medium to low lateral connectivity. The main objectives of the Production Forecast and feasibility study for water injection are:</p><p>1- Provide an overview of the total expected production profile, expected wells potential/spare capacity, water breakthrough timing and water cut development over time</p><p>2- Highlight the requirements to maintain performance, suggest the optimum developmen</p> ... Show More
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