Background: Hypospadias is a common congenital anomaly, affecting approximately 1 of 300 live male births making hypospadias the second most common birth defect in boys after cryptorchidism. There are more than 100 techniques for urethral reconstruction among these techniques the tubularized incised urethral plate (TIP) which was proposed by Snodgrass and has been the most popular technique for the repair of primary hypospadias. The aim of this work is to assess preputioplasty with Snodgrass technique in cases of distal hypospadias without severe chordea in comparison to correction of hypospadias with circumcision in Snodgrass technique regarding to the results and the outcome. Methods: This is a prospective randomized study that included 40 children with distal hypospadias. Our patients were randomized into two groups. Group 1: (20 patients) underwemt Snodgrass technique with preputioplasty .Group 2: (20 patients) underwent Snodgrass technique with circumcision.Results: In the present study, 18 (90%) of parents in group 1 was satisfied from surgery outcomes and 2(10%) weren"t satisfied. the incidence of early complications was 8 (40%) of cases in group 1 while in group 2, was 5 (25%). The incidence of late complications was 4 (20%) cases in group 1 in group 2, was 6 (30%). Conclusion:Preputioplasty with Snodgrass urethroplasty does not increase the urethroplasty complication rate.In addition, we think that it adds an important cosmetic benefit,that is the normal appearance of penis compared with circumcision.

Background: Inguinal hernias are a significant cause of patient morbidity. It is the most common type of hernia, accounting for 75% of all the abdominal wall hernias. Several methods of inguinal hernia repair have been described and have been evolved over time. The Laparoscopic approach for inguinal hernia repair was first reported by Ger, who performed a high ligation of the sac without mesh placement. Total extraperitoneal repair was developed because of concern for possible complications associated with intra-abdominal access, which was required for the transabdominal preperitoneal approach. Laparoscopic total extra peritoneal repair (TEP) of inguinal hernia is associated with less postoperative pain and morbidity than open hernia repair. The TEP method allows access to the preperitoneal space and avoids the need for a peritoneal incision. The study is aimed to evaluate the role of laparoscopic total extra peritoneal hernia repair without mesh fixation in early ambulation, recurrence rate and post-operative chronic groin pain. Methods: This is prospective study, was conducted on 30 patients suffering from inguinal hernia attending General Surgery Department at Benha University Hospital. Results: The mean age of the studied patients was 31 years, with a standard deviation of 6 years. Regarding gender, there was a male predominance; most of the studied patient was males (93.3%). Regarding complaint, about half of the studied patients (53.3%) complained of left inguinal hernia and the other half (46.7%) complained of right inguinal hernia. Less than one-quarter of the patients had DM or hypertension; 20.0% for each. Only 16.7% had a history of a previous operation. Less than one-quarter had a history of cough or constipation; 20.0% and 23.3%, respectively. Prostatic problem was reported by only 6.7% of the studied patients. The mean surgical time was 60 minutes, with a standard deviation of 14 minutes. No conversion to open surgery was reported in the studied patients. Regarding early outcome, less than one-quarter of the patients reported hematoma, groin pain, or seroma; 20.0%, 16.7%, and 6,7%, respectively. No urine retention was reported. Regarding wound state, most of the patients (93.3%) reported clean wound, and only 6.7% reported infected wound. Regarding late outcome, recurrence occurred in only two patients (6.7%). Only 16.7% reported chronic groin pain. Conclusion: TEP inguinal hernia repair performed without mesh fixation is safe, effective procedure with low morbidity and feasible with minimal recurrence rates. Not fixing the mesh avoids possible complications.