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.
Research Summary
Praise be to God, Lord of the worlds, and prayers and peace be upon the most honorable of the prophets and messengers, our master Muhammad, and on the good God and his righteous companions.
For the most truthful hadith is the Book of God Almighty, and the best guidance is the guidance of the Prophet, may God bless him and grant him peace. If any)). Our good predecessor took care of collecting what they were able to collect and arrange from the words of the prophecy issued by our master Muhammad, peace and blessings be upon him, and wrote works on them including forms of support, parts, dictionaries, and mosques. About me, if any, in order to re
Treated effluent wastewater is considered an alternative water resource which can provide an important contribution for using it in different purposes, so, the wastewater quality is very important for knowing its suitability for different uses before discharging it into fresh water ecosystems. The wastewater quality index (WWQI) may be considered as a useful and effective tool to assess wastewater quality by indicating one value representing the overall characteristic of the wastewater. It could be used to indicate the suitability of wastewater for different uses in water quality management and decision making. The present study was conducted to evaluate the Al-Diwaniyah sewage treatment plant (STP) effluent quality based on wastewa
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