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.
In this paper, the deterministic and the stochastic models are proposed to study the interaction of the Coronavirus (COVID-19) with host cells inside the human body. In the deterministic model, the value of the basic reproduction number determines the persistence or extinction of the COVID-19. If , one infected cell will transmit the virus to less than one cell, as a result, the person carrying the Coronavirus will get rid of the disease .If the infected cell will be able to infect all cells that contain ACE receptors. The stochastic model proves that if are sufficiently large then maybe give us ultimate disease extinction although , and this facts also proved by computer simulation.
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... Show MoreReceipt date:6/3/2021 acceptance date:4/5/2021 Publication date:31/31/2021
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The research in the role of variables contact for non-state actors have become more influential in the current of contemporary events, that related with the reality of seeking services and providing all of that in favor of maintaining the social peace, and ensuring its empowerment in order to make peace and stability outcomes as a real fa
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