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.
Radiotherapy is the branch of clinical medicine concerned with the application of ionizing radiation in the treatment of disease. And it is used to killing of cancer cells in a tissue using ionizing radiation while keeping the sparing of healthy cells at acceptable level. X-ray beams are used to deposit absorbed dose at depth within a patient at the site of the tumor. The aim of this work is studying the relationship between the depth dose and the field size in water phantom and homogenous actual planning. In our work, the dose distribution at different depths (zero-18 cm) deep at1cm interval treated with field size (10×10 and 20×20) cm2 were studied.
Results show that high similarity between water phantom and actual planning for th
Radiotherapy is the branch of clinical medicine concerned with the application of ionizing radiation in the treatment of disease. And it is used to killing of cancer cells in a tissue using ionizing radiation while keeping the sparing of healthy cells at acceptable level. X-ray beams are used to deposit absorbed dose at depth within a patient at the site of the tumor. The aim of this work is studying the relationship between the depth dose and the field size in water phantom and homogenous actual planning. In our work, the dose distribution at different depths (zero-18 cm) deep at1cm interval treated with field size (10×10 and 20×20) cm2 were studied. Results show that high similarity between water phantom and actual planning for
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The research concerned the study of the railway transport sector in selected countries that sought to raise the efficiency of the railway network and develop it, after realizing the importance of this vital sector, which is a link between it and the rest of the other economic sectors.
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