Background: Congenital complex penile curvature (CCPC) is a rare deformity that arises from asymmetry of the corpora cavernosa. Congenital complex penile curvature has two abnormality components: torsion and curvature of the penis either ventral or dorsal.Objectives: Evaluation of one stage correction of CCPC by combination of modified Nesbit's procedure with dorsal dartos flap.Patients and Methods: This prospective study was conducted at Al-Azhar University Hospital in Damietta. Twenty eight patients with CCPC were evaluated and corrected during the period from October 2014 to September 2017. Their mean age was 5.5±2.1years (range 2-9.5 y). The direction of mal-rotation was anticlockwise in 23 patients and clockwise in 5 patients. Fifteen cases have ventral curvature; 8cases have dorsal curvature, while 5 cases have lateral curvature. All cases were treated firstly by modified Nesbit's procedure for correction of chordee, and then dorsal dartos flap was used for correction of penile mal-rotation in one stage.Results: All patients were corrected with high success rate. There were no more than 10° of residual malrotation or binding in all patients. One patient (3.57%) had penile hematoma that treated conservatively. All patients and their parents were satisfied with wonderful cosmetic and functional outcomes with no recurrent mal-rotation or binding. All cases were followed up for a mean follow up period of 9 ± 1.7 months (range 6 -12 m.).
Conclusion:Congenital complex penile curvature can be treated in one-stage surgery with excellent cosmetic and functional outcomes by combination of modified Nesbit's procedure with dorsal dartos flap.
Introduction:The classical way to treat urethral stricture is the direct vision cold knife internal urethrotomy (DVIU). Along with advances in laser technology, laser urethrotomy is widely used, such as neodymium-doped yttrium aluminum garnet, argon, potassium titanyl phosphate, and thulium laser. We aimed to compare thulium laser urethrotomy (TLU) and cold knife visual urethrotomy (CKVU) in terms of short bulbomembranous urethral stricture management.Materials and methods: This prospective interventional study was conducted for 24 months, from January 2018 to January 2020, on 60 patients with primary short bulbo-membranous urethral stricture who came to the
Background. Proximal hypospadias, with significant curvature, is one of the most challenging anomalies. Great diversity and a large number of procedures described over the last 4 decades confirmed the fact that no single procedure has been universally accepted or successful. So, the aim of this study is to evaluate double-faced tubularized preputial flap (DFPF) versus transverse tubularized inner preputial flap (Duckett’s procedure) as regards surgical outcomes, complications rate, and cosmetic results for repair of penoscrotal hypospadias with chordee. Patients and Methods. This was a prospective comparative study on 144 children with primary penoscrotal hypospadias with moderate or severe chordee, conducted at New Damietta and Assuit hospitals, Al-Azhar University, from March 2016 to March 2022. The patients were randomly divided into two equal groups; group A (n = 72) underwent DFPF, and group B (n = 72) underwent Duckett’s procedure. Results. No significant difference was identified as regards demographic data. The follow-up period ranged from 20 to 66 months (mean of 28 months after DFPF and 31 months after Duckett’s repair), and the complication rate was 20.1% (29 of 144 children). There were statistically significant differences between the two groups as regards the urethral stricture, penile rotation, and total complication rate. HOSE score was adopted for assessment of surgical outcomes, urine stream, and cosmetic results. Conclusions. The DFPF technique is feasible and reliable for one-stage repair of penoscrotal hypospadias with chordee and can be considered as a good option as it ensures better surgical and cosmetic outcomes with lower incidence of complications.
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