use of transverse rotational pedicle flap for the treatment of midpenile and proximal hypospadias in circumcised patients

To evaluate the use of transverse rotational pedicle flap for the treatment of midpenile and proximal hypospadias in circumcised patients. The transverse penile rotational pedicled flap, was performed on 20 circumcised patients with midpenile and proximal hypospadias with chordae. Of the 20 circumcised boys, 10 had midpenile and 10 had penoscrotal hypospadias, after excision of the chordae. Mean age of patients is 4.7 years, mean follow up period is 1 year. Cosmetic results were good. Complications were urethrocutaneous fistula in 3 patients [15%] and meatal stenosis in 2 patients [10%]. The modified technique as shown in our procedure reduces the fistula rate. Thus, we recommend the use of transverse island rotational penile pedicled flaps for the treatment of midpenile and proximal hypospadias with chordae in circumcise patients

Horton divine technique in the surgical management of Peyronie's disease

Peyronie's disease [plastic induration of the penis] is a well-recognized clinical problem affecting middle age and older men. Patients usually present with complaints of painful erection, curvature of the penis and poor erection distal to the involved area. Examination of the penile shaft reveals a palpable dense, fibrous plaque involving the tunica albuginea

Objective: Horton Devine procedure for the surgical management of Peyronie's disease had gained popularity. This study was done to evaluate this procedure in correcting penile curvature

Patients and Methods: ten patients having Peyronie's disease were surgically corrected using Horton Devine technique where the fibroses or calcified plaque is removed with tunica albuginea and the tunica is replaced with a free graft of dermis, brought from the lower abdomen, being rich in elastic tissue

Results: complete success with correction of penile curvature, was obtained in 8 cases [80%] as proved by duplex US to the penile blood vessels while in the remaining 2 cases, secondary infection and complete failure of the procedure

Conclusion: Horton De- vine technique is recommended in the surgical management of severe cases of Peronei's disease when the lesion is more than 1 cm as it provides good cosmetic and functional results