Introduction: Penile torsion is a congenital malformation that causes a rotational deformity of the penile shaft. Several techniques have been considered for penile torsion repair. In this study, we described our experience using two separate “V” dartos flaps, which leads to a more satisfying result. Patient and methods: Two young men with severe penile torsion aged 24 and 28 years old were candidates for surgery. During our novel method for penile torsion repair, we degloved the penis and dissected the dartos fascia from the penis shaft, then cut it distally from the sub-coronal region with a longitudinal cut to make two dartos flaps in a “V” shape. With these two flaps, we corrected penile torsion in a more satisfying way without crossing the urethra. Results: Penile torsion and concurrent chordee were completely corrected after surgery. Urine culture was sterile and uroflowmetry indicated a maximal urinary flow of 12 ml/s 3 months after the operation. Both patients were satisfied with ejaculation and their follow-up indicated complete resolution of penile torsion. Conclusions: Penile torsion is a challenging congenital anomaly. We used a two “V” shaped flap passage method to complete penile rotation and chordee correction without performing any plication techniques. Our penile torsion correction procedure resulted in the successful repair of torsion and excellent outcomes. Level of evidence: Not applicable for this multicenter audit.
Background & Objective: Nowadays, partial nephrectomy (PN) has specific indications in renal tumors. There are challenges regarding the remaining and seeding of malignant cells after surgery due to increasing tendency to do laparoscopic PN (LPN) and consequently increased manipulation of the surrounding tumor tissue. The objective of this study was to investigate the frequency of renal capsule invasion (RCI) and perinephric fat infiltration (PFI) in patients with renal cell carcinoma (RCC) who had underwent PN. Methods: Clinical data and pathologic samples of 101 patients who underwent PN and had RCC from 2011 to 2012 were elicited. Sixty one patients underwent LPN and 40 patients underwent open PN (OPN). All pathologic samples were reviewed by an uropathologist. Fuhrman nuclear grade, surgical margin and prevalence of RCI and PFI were also determined. Results: The mean tumor size was 40.7 mm (range: 15mm to 120mm). In all cases, the renal capsule and perinephric fat were left intact. Surgical margin was involved in four cases of LPN. Three patients had recurrence during follow up time (follow up durations were 12, 16, and 24 months for each). The fourth one was expired during 30 months follow up despite performing radical nephrectomy. Conclusions: Based on the results obtained in this study, the probability of RCI and PFI is low and hence manipulating and removing the perinephric fat to achieve better exposure to tumor will not increase the risk of seeding malignant cells.
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