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.
Abstract:
Since the railway transport sector is very important in many countries of the world, we have tried through this research to study the production function of this sector and to indicate the level of productivity under which it operates.
It was found through the estimation and analysis of the production function Kub - Duglas that the railway transport sector in Iraq suffers from a decline in the level of productivity, which was reflected in the deterioration of the level of services provided for the transport of passengers and goods. This led to the loss of the sector of importance in supporting the national economy and the reluctance of most passengers an
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... Show MoreRenewal is generally considered an urgent requirement of life, and a section of its continuation, because renewal means that life exists and continues, and just as renewal is in life, renewal is in science, and in this research the issue of renewal in the science of interpretation, and showed through research that renewal in This science was an urgent demand throughout the Islamic ages, as the research showed the necessity of renewal in the material of interpretation, its method and methods, and the researcher presented the opinions of schools about renewal in the interpretation of the Noble Qur’an inferred by living models that refer to their owners.
Amongst the literary writers who used their art to direct the attention towards the issue of woman and her rights in a proper life is the English poet and novelist Thomas Hardy (1840-1928), who has been praised for his “openness to the feminine principle” 1 as Irving Howe put it. Hardy’s wide readings have changed his way of dealing with and thinking about so many critical issues which started to float on the surface of the English society during the mid and late of the 19th century. His readings for a number of writers, who seem of huge impact on his writings as he later admits that – “[his] pages show harmony of view with
... Show MoreThis article aims to establish and evaluate standards for critical equipment and materials in highway projects in Iraq. Delphi technique has been used to analyze, explore, and discover the main criteria and sub-criteria that affect equipment and materials in highway construction projects in Iraq. To determine the correct response to the criteria presented in this study, a program (IBM, SPSS/V25) was used to assess the main criteria and sub-criteria using the mean score (MS) and standard deviation (SD) technique, as well as to check reliability using Cronbach's alpha factor (α). The experts' qualifications and the extent to which the person is ready to commit are both important factors in panel selection. The design of a
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