Aim: To determine the results of early surgical repair in patients who initially report with a penis fracture. Study design: Retrospective Study Place of study & duration: General Surgery Department Hayatabad Medical Complex Peshawar from January 2020 to December 2021. Methodology: 42 patients with penile fractures who presented to the emergency room of the Hayatabad Medical Complex in Peshawar were included in this retrospective analysis. A clinical diagnosis was made. There was no radiological analysis done. All patients had primary suturing for the tunica tear and underwent postoperative monitoring for 4 months. Results: All patients underwent surgery within 24 hours of the injury. The most common cause of injury was sexual intercourse 35(83.3%) followed by 3(7.1%) masturbation, 2(4.8%) rolling over in bed and 2(4.8%) during “routine stretching.” Every patient consistently reported hearing a cracking sound along with a severe pain, erection loss, deformity, discolouration, and edoema. Only 3 patients had blood at the external meatus. No extravasation was detected by ascending urethrography. There were 20(47.6%) proximal injuries, 16(38%) midshaft injuries and 6(14.3%) distal injuries. Conclusion: An acceptable complication rate and satisfactory postoperative results are associated with early surgical intervention for penile fracture. Early diagnosis and surgical intervention are essential for a positive result and minimal complications. Keywords: Penile fracture, Tunica albugenia, corpus cavernosum

OBJECTIVES This study aims to compare the frequency of fecal incontinence and healing rate in patients treated with Open Internal Anal Sphincterotomy (OIAS) and Closed Lateral Internal Anal Sphincterotomy (CLIAS). METHODOLOGY This randomized control trial was carried out in the Department of Surgery Hayatabad Medical Complex, Peshawar Pakistan from Feb 2019 to Feb 2020. Eighty-four patients were assigned to the open method in Group B while eighty-four patients were allocated to the closed method in Group A (using blade 11) through the randomized control trial method. Fecal incontinence and healing rate were observed on the 7 th postoperative day. SPSS 23.0 software was used to analyse the data. RESULTS In group A out of a total of 84 patients, 96% of patients were in category A, 4% of patients were in category B, and no patients were in categories C and D. In group B out of 84 patients, 96% of patients were in category A while 4% patients were in category B and no patients were in category C and D. The total faecal incontinence in Group B (open method) was 21% while total fecal incontinence in Group A (closed method) was only 4% that is a clear dierence between the two groups. In group A (closed method) out of 84 patients, 2 patients (2.38 %) showed delayed healing while 82 patients (97.61 %) showed normal healing. In group B (open method) 7.4% of patients showed delayed healing with a signicance p level of 0.04 while 92.85 showed normal healing. CONCLUSION Fecal incontinence was less in closed Lateral Anal Sphincterotomy due to the use of blade 11 while it was higher in open internal anal sphincterotomy. Similarly, the healing rate was signicantly higher in the closed method while delayed healing was seen in the open method.

Background: Rectal bleeding is considered an important sign of colonic disease, particularly colorectal cancer. Rectal bleeding is considered to be an alarm feature in particular for colorectal cancer that, in tum, is the second- leading cause of cancer death globally. Colonoscopy has been reported recently as cost effective method of evaluating asymptomatic rectal bleeding 14, while rectal bleeding as a diagnostic indicator has been questioned in general practice. Objective: The objective of this study is to determine the frequency of common causes of bleeding per rectum among patients presenting to surgical OPD at tertiary care hospital. Materials and Methods: This descriptive cross sectional study was carried out at Department of General Surgery Hayatabad Medical Complex Peshawar from September 2021 to March 2022. Total of 164 patients with lower GI bleed were included in the study. All patients were enrolled in a consecutive manner and subjected to lower GI proctoscopy, other relevant investigations to detect the cause of GI bleed. Results: Total 164 patients were included. Age ranged between 15-60 years with a mean age of 37.5 years. There were 107(65.2%) male and 57(34.8%) female, with a male to female ratio of 1.9:1. Age distribution was analyzed as 63(38.4%) belongs to age group of 20-30 years, 30(18.3%) in 30-40 years, 26(15.9%) in 40-50 years and 45(27.4%) in age group 50-60 years respectively. On proctoscopy, hemorrhoids were found in 54(32.9%) patients, colitis in 15(9.1%), inflammatory bowel diseases (IBD) in 39(23.8%), ulcerative colitis in 29(17.7%), diverticular diseases in 10(6.1%) and abdominal TB in 17(10.4%). None of the patients had colorectal cancer. Conclusion: Hemorrhoids, inflammatory bowel diseases and ulcerative colitis were common causes of lower gastrointestinal bleed in our population and ulcerative colitis was significantly high in female patients.