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.
In front of the serious deterioration of the elements of the environment, new convictions arose the need to integrate into the global environmental concerns as being one and the issue of shared responsibility and the impact of this conviction, the evolution of the environment protection law in many countries, including Algeria. Due to the multiplicity of perceptions about the environmental result of multiple scientific disciplines, the legislative concept emerged to protect the environment, which includes prevention and rational management and conservation and restoration and repair.
Environmental planning for the various governments and countries aims to avert disasters and achieve the
... Show MoreThe game of volleyball is one of the competitive team games that took the lead in terms of its spread in the world, and the game of volleyball relies on basic skills as an important base on which this game is built to advance in the level of performance Performance and among these skills the skill of spiking and blocking wall, the research aims to identify the extent of the relationship of decision-making to the performance of spiking and blocking in volleyball for junior players. The sample was chosen from volleyball players for the Junior Specialized School of Sulaikh Sports Club / Baghdad Governorate for the season 2020 The researcher used the descriptive approach, and the research community was composed of (101) players. The two
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