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.
This paper investigates the experimental response of composite reinforced concrete with GFRP and steel I-sections under limited cycles of repeated load. The practical work included testing four beams. A reference beam, two composite beams with pultruded GFRP I-sections, and a composite beam with a steel I-beam were subjected to repeated loading. The repeated loading test started by loading gradually up to a maximum of 75% of the ultimate static failure load for five loading and unloading cycles. After that, the specimens were reloaded gradually until failure. All test specimens were tested under a three-point load. Experimental results showed that the ductility index increased for the composite beams relative to the refe
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Early detection of eye diseases can forestall visual deficiency and vision loss. There are several types of human eye diseases, for example, diabetic retinopathy, glaucoma, arteriosclerosis, and hypertension. Diabetic retinopathy (DR) which is brought about by diabetes causes the retinal vessels harmed and blood leakage in the retina. Retinal blood vessels have a huge job in the detection and treatment of different retinal diseases. Thus, retinal vasculature extraction is significant to help experts for the finding and treatment of systematic diseases. Accordingly, early detection and consequent treatment are fundamental for influenced patients to protect their vision. The aim of this paper is to detect blood vessels from
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