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.
Most available methods for unit hydrographs (SUH) derivation involve manual, subjective fitting of
a hydrograph through a few data points. The use of probability distributions for the derivation of synthetic
hydrographs had received much attention because of its similarity with unit hydrograph properties. In this
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In this paper, we used maximum likelihood method and the Bayesian method to estimate the shape parameter (θ), and reliability function (R(t)) of the Kumaraswamy distribution with two parameters l , θ (under assuming the exponential distribution, Chi-squared distribution and Erlang-2 type distribution as prior distributions), in addition to that we used method of moments for estimating the parameters of the prior distributions. Bayes
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The interpretatio
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After looking at the books of the first two grammarians, may God have mercy on them and reward them for what they have provided us with the rules of service to the Book of God and service to Arabic, we must highlight some of the things that the grammarians wanted to clarify, which did not come out of what they proved, but we are working on the statement of the issuance of the passport Provisions from the syntactic industry, and whether it is intended to prove a rule is not very added to the statement of speech, and we know that language, any language was the function of understanding; therefore they said: (speech is a useful word that indicates the benefit improves silence on them), and this concept between Grammatical controls and conte
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