Pre-operative embolisation of nasopharyngeal angiofibroma

Nasopharyngeal angiofibroma is a highly vascular tumor that predominantly affects male adolescents, and is considered the most common benign tumor originating in the naso- pharynx and although it is benign, it can erode skull bones. [Bremer, 1986 and Maharaj, 1989] This tumor causes massive bleeding during surgery if operated upon without occluding its blood supply. This bleeding may endanger patients life and in most cases large amounts of blood transfusion are needed intraoperatively. This bleeding may lead also to incomplete surgical excision of the tumor. [Maharaj, 1989]. Twenty one patients with nasopharyngeal angiofibroma have been referred to angiography and interventional radiology unit of Ain Shams university hospital, for preoperative embolisation. All cases were embolised successfully and operated upon within two to three days- after embolisation. No single case of severe operative bleeding was met with, and no blood transfusion was needed for any of these cases

Transrectal ultrasonographic guided biopsy in the evaluation of the suspicious prostatic lesions

While many diagnostic clinical, laboratory and imaging modalities have been used to evaluate prostate, distinction between benign and malignant diseases has not been consistently accurate. Recently, transrectal ultrasound guided biopsy started to be used for differentiation between benign and malignant prostatic lesions. During the period from October 1993 to October 1994, 98 patients with suspected prostatic carcinoma were subjected to ultrasound guided transrectal prostatic biopsy. 58 of these patients showed lesions in the peripheral zone, from each two to three tissue cares were obtained, 35 patients with sonographically free peripheral zone were subjected to strategic six random biopsies from different prostatic zones, while the remaining five cases showed cystic lesions which were aspirated with cytological examination of the aspirated fluid and two biopsy cores were taken from the wall of two of them. No significant complication occured to any of our cases and we believe that transrectal prostatic biopsy is a completely safe procedure and considered the most accurate method for diagnosing postatic malignancy

Management of recurrent rectal prolapse using Notaras technique

Twenty one patients with recurrent rectal prolapse were treated via transabdominal rectopexy, using a prolene mesh applied to the back of rectum and fixed to the promontory of sacrum [Notars Technique, 1973]. Seventeen patients [80.9%] passed smooth, nice postoperative period with good satisfactory results postoperatively. Three patients [14.3%] got severe intraabdominal sepsis and the mesh was removed. One patient [4.8%] got recurrence after 3 months, he needed reoperation with resection of the rectosigmoid colon and refixation again. The satisfactory results obtained in the 17 patients [80.9%] encourage the use of this technique in comparison to other techniques and satisfactory postoperative observation and follow-up of patients for two years encourages the use of this technique, we prefer the use of prolene mesh instead of mersilene mesh used by Notaras to avoid severe infection

Emergency treatment of blunt and penetrating injuries of colon

Twenty three patients with traumatic injuries of the colon were received in the emergency departments of Ain Shams University, Abd El-Kader Fahmy and Al Nozha Hospital. 11 patients had blunt trauma [47.8%], 12 patients experienced penetrating trauma [52.2%]. Blunt trauma commonly involved left colon in 9 patients out of 11 patients [81.8%] while penetrating trauma involved right or transverse colon II patients out of 12. [91.6%]. All patients with blunt injuries were treated with Iry repair of the colon. Ten patients with penetrating injuries were treated with primary colonic repair after resection of the affected segment, resection with proximal colostomy was done in two patients with penetrating injuries. Post-operative mortality was 2 patients [1.9%] on top of associated injuries, and postoperative chest infections. Morbidity was very low in patients with blunt injuries of colon, which encourage primary repair of colon in blunt and penetrating trauma

Venous surgery in erectile dysfunction Therapeutic strategy and results

Fifty seven [57] patients with venogenic impotence -were treated from period of 1989 to 1993. Their corporal veno-occlusive functions was evaluated by dynamic infusion cavernosography and cavernosometery [DICC]. Patients were divided into two groups on the basis of the type of venous operation performed. Thirty [30] patients were subjected to dorsal vein ligation with resection of 1.5 cm of deep dorsal vein. While 27 patients were subjected to deep dorsal vein ligation plus ligation of the proximal parts of both corporae The overall success rate in both groups was [38.7%] [22 patients out of 57]. Success rate was more in patients with dorsal vein ligation plus spongiolysis than in patients with dorsal vein ligation plus ligation of crorae. Data obtained in our series suggest that venous surgery should only be offered to a selected group of patients comprising young impotent males with venous leakage

Comparative study between durapeiase penile stent prosthesis and ACU. form penile stent prosthesis in management of erectile dysfunction

27 patients with erectile impotence were treated and followed for 1 year using Duraphase penile prosthesis in 17 patients and Mentor semirigid malleable penile prosthesis in 10 patients. Average age of patients was 56 years. Etiology of erectile dysfunction was vascular in 14 patients, neurogenic in 7 patients and postoperative in 6 patients. Postoperative results were satisfactory in 13 patients with Duraphase penile prosthesis [76.5%], unsatisfactory in 4 patients, especially their partners, while postoperative results were satisfactory in 9 patients out of 10 who were subjected to Mentor penile prosthesis [90%], unsatisfactory only in one patient. Experience of most recent penile prostheses Duraphase and Mentor Acu form is very simple and easy. Both devices function easily can be concealed, and have excellent axial rigidity for intercourse. Bending ability was more in Mentor penile prosthesis than in Duraphase one. Mentor stent was not liable to fracture and proved to be more safe

Ultrasonography and computed tomography in gallbladder tumours

Twenty cases of gall bladder tumours were diagnosed by ultrasound and C.T. at the radiology department of Ain Shams University, during the period from January 1984 to December 1988. They were 4 males and 16 females, with age ranging between 28 - 74 years. They were proved surgically to be benign polyps in 5 cases and carcinoma in 15 cases [14 adenocarcinoma and 1 squamous cell carcinoma]. Both sonography and computed tomography are superior and accurate diagnostic modalities. We found that both techniques are complementary, rather than competitive. However U/S can be considered as an initial screening modality