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.
There is no doubt various of situations for performing a duty , The diversity of stimuli in humans with sensory, unconscious and instinct sensitive systems. Which leads to a diversity of feelings, sensations, emotions and feelings, This therefore requires different types of function linguistic structures indication , Of that linguistic potential that God willing to be unique, In the function of discharging and venting those feelings and emotions that are raised by its various stimuli, which are only needs and psychological and biological purposes require verification and access and gain it. So the language became to embrace the feelings and feelings, needs and purposes. And mirror reflected and binoculars revealing what
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So the importance of this study come from estimating the Cobb-Douglas production function for Al- Mansoor General Company for Engineering industries in Iraq during the period (1989-2001)
To explain the importance which effects the independent variable such as
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There is no doubt that the achievement of the manuscripts of There is no doubt various of situations for performing a duty , The diversity of stimuli in humans with sensory, unconscious and instinct sensitive systems. Which leads to a diversity of feelings, sensations, emotions and feelings, This therefore requires different types of function linguistic structures indication , Of that linguistic potential that God willing to be unique, In the function of discharging and venting those feelings and emotions that are raised by its various stimuli, which are only needs and psychological and biological purposes require verification and access and gain it. S
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Abstract
Personality is one of the most important elements that should be developed in university student. Thus, we have to develop the positive traits and neutralize the negative traits of students as well as we have to pay attention to the level of student achievement at the same time, the researcher designed a scale to measure the traits of study sample. The research come out with a number of recommendations and proposals, the most important of which Enhancing the positive characteristics of university students in order to reach them to the level of mature personality with mental health. Enhancing the positive role of the high level of achievement by motivating the stude
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In this research cloud computing was used in the field of manufacturing to automate the process of selecting G-Code that Computer Numerical Control machine work it, this process was applied by the using of this machine with Radio Frequency Identification and a AWS Cloud services and some of py
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