Repair of distal hypospadius: decision making of a technique

The aim of this study is to evaluate alternative techniques in repair of different types of primary hypospadias, with suggested plan for decision making of suitable technique of repair. A retrospective study of 96 cases of primary distal hypospadias [glandular, coronal, distal penile with and without chordee] were performed over a period of three years, with a minimum follow up of six months. Methods of repar included MAGPI [40], extended MAGPI [12], Mathieu [24], modified Mathieu [4], tubularised uretheral plate [9] and preputial tubed island flap [7]. The results revealed that, MAGPI [40 patients] had no major complications in glandular type and 12.5% complication rate in coronal. Extended MAGPI [12 patients] had complication rate of 37.5% in distal penile. Classic Mathieu [24] had 15% complication rate and modified Mathieu [4 patients] 25% major complication in distal penile with chordee. Tubularised uretheral plate [9 patients] had 22.2% complication rate for coronal and distal penile. Preputial island flap [7] had 28.5% complication rate in distal penile with chordee. Total major complication rate was 15.6%. Best results were obtained from proper technique selection for different types of distal hypospadias. Decision making of proper technique depends on meatal location and variety, presence of chordee, gland configuration [flat or conical], uretheral plate [flat or grooved and/or a seat of chordee] and availability of shaft or preputial skin

Urologic and sexual complications in chronic spinal cord injury patients with its management overview: a review of 500 patients

A total of 500 patients with chronic SCI were studied clinically, radiologically, bacteriologically, urodynamically in a specialized SCI Center, over one year. Medical treatment, different endoscopic procedures [182 patients] and surgical procedures [77 patients] have been performed. The results revealed that hydronephrosis was reported in 100 patients [V-U reflux 65, stricture ureter 20, renal calculi 9, and infravesical obstruction 6]. Renal stones were occurred in 45, bladder stones in 65 and RF in 16 patients. Also, stricture urethera was occurred in 16, uretheral diverticulum in 3, dyssenergia in 60 in UMNL and 15 in LMNL. Urinary scrotal fistula was represented in 19, traumatic hypospadius in one, penile amputation and edema in 4 patients. Erection was preserved in 70% and antegrade ejaculation in 10% of patients. It was concluded that urologic manifestations of SCI are protean. Their management are controversial with wide range of treatments. The main goal in treatment is to control urosepsis and to provide adequate bladder drainage

Ultrastructural and stereological study of the normal human prostate and of benign prostatic hyperplasia

Normal and benign hyperplastic prostatic tissue was [B.P.H.] studied by quantitative and qualitative methods. Stereological techniques together with electron microscopic examination were employed to investigate the stromal and glandular components of the normal human prostate and of B.P.H. Studies on the relative volumetric amount of the 2 major components of the prostate reveal an significant increase in the volume density [Vv] of the stromal part and significant decrease in the Vv of the glandular of the B.P.H, compared to that of the normal prostate. Regarding the fine structure of the smooth muscle cells of the stromal tissue, there is an increase in the organelles in the B.P.H. compared to that of the normal prostate indicating an activation of these cells. However, in B.P.H., the glandular cells seem to be reduced in height and the amount of secretory droplets diminishes, whereas the endoplasmic reticulum, Golgi apparatus and mitochondria do not differ from the normal human prostate. The stereological measurements obtained in this study jointly with the ultrastructural findings have revealed that the human B.P.H. is an a primarily disease of the stromal portion of the prostate