ABSTRACT
PURPOSE: The purpose of this study was to examine whether urethroplasty with a turnover flap, as an alternative method of distal hypospadias repair in adolescents, improves the outcome of surgery. MATERIALS AND METHODS: Between January 2004 and December 2013, a total of 38 adolescents (aged 11-17 years) underwent distal hypospadias repair with either the tubularized incised plate (TIP) procedure (n=25) or the turnover flap procedure (n=13). The turnover flap procedure was performed with a proximal, ventral penile flap that was turned over to cover the urethral plate. Patient demographics, perioperative outcomes, complications, and postoperative uroflowmetry in each surgical group were analyzed retrospectively. RESULTS: The patient demographics were similar in the two groups. There were no significant differences in perioperative outcomes between the groups, including mean operative time, duration of hospital stay, and urethral catheterization. The number of patients with at least one complication, including wound dehiscence, urethrocutaneous fistula, meatal stenosis, and urethral stricture, was lower in the turnover flap group (1/13, 7.7%) than in the TIP group (11/25, 44%, p=0.030). The incidence of meatal stenosis was lower in the turnover flap group (0/12, 0%) than in the TIP group (6/25, 24%). In postoperative uroflowmetry, the plateau-shaped curve rate was lower in the turnover flap group (1/12, 8.3%) than in the TIP group (5/19, 26.3%); the peak flow was higher (p=0.030). CONCLUSIONS: The turnover flap procedure is clinically useful for repairing adolescent distal hypospadias because it offers lower complication rates and better functional outcomes than TIP.
Subject(s)
Adolescent , Child , Humans , Male , Follow-Up Studies , Hypospadias/surgery , Plastic Surgery Procedures/methods , Retrospective Studies , Surgical Flaps , Suture Techniques/instrumentation , Time Factors , Treatment Outcome , Urethra/surgery , Urologic Surgical Procedures, Male/methods , Wound HealingABSTRACT
PURPOSE: Prostate biopsy is used to confirm the prostate cancer. Although first biopsy result was benign, repeat biopsy is recommended for the patient who has higher risk of prostate cancer. In this study, we investigated the PSA change ratio (post-biopsy PSA to baseline PSA) whether it could be predictive factor of prostate cancer and helpful when decided to perform repeat biopsy. MATERIALS AND METHODS: 151 patients, first diagnosed as benign, but underwent repeat biopsy due to clinical suspicion of prostate cancer were included. Post-biopsy PSA was checked 60 minutes later after biopsy. PSA change ratio was defined as post-biopsy PSA to baseline PSA. According to results of repeat biopsy, patients were divided into benign group (group A) and cancer groups (group B). Between two group baseline PSA, PSA density, post-biopsy PSA and PSA change ratio were compared, and most effective cut-off value was analyzed using receiver operating characteristic (ROC). RESULTS: 129 men were benign, 22 men were prostate cancer according to results of repeat biopsy. Between two groups, post-biopsy PSA and PSA change ratio were statically significant differences. (p<0.001, <0.001) The effective cut-off value was 3.0, 3.5 and 4.0 according to ROC. At ROC curve, PSA change ratio was statistically significant for diagnosis of prostate cancer. (AUC 0.800, p<0.001). CONCLUSIONS: PSA change ratio is thought be a predictive factor for prostate cancer. If the PSA change ratio was less than 3.0-4.0, repeat biopsy should be considered to confirm the diagnosis.
Subject(s)
Humans , Male , Biopsy , Prostate , Prostate-Specific Antigen , Prostatic Hyperplasia , Prostatic Neoplasms , ROC CurveABSTRACT
PURPOSE: To evaluate the effectiveness of locking compression plate by analyzing the clinical outcomes of open reduction and internal fixation with locking compression plate in the treatment of femur supracondylar fracture. MATERIALS AND METHODS: We reviewed 21 cases of distal femur fractures which were treated with locking compression plate in our hospital from February 2005 to March 2009 and followed up for minimal 1 year. The types of fractures were seven A1, four A2, two A3, six C2, and two C3 according to AO classification. 2 cases were open fractures. The cases were evaluated by the criteria of Schatzker-Lambert. RESULTS: The mean time to union was 14.3 weeks. One delayed union, one refracture were observed, but no nonunion and postoperative infection was observed. The outcomes were excellent in 6 cases, good in 11, fair in 3, and failure in 1 by the criteria of Schatzker-Lambert. The overall results were excellent or good in 17 cases (81.0%). CONCLUSION: In the treatment of femur supracondylar fracture, open reduction and internal fixation with locking compression plate yields good result and locking compression plate is useful choice of fixation option.
Subject(s)
Femur , Fractures, OpenABSTRACT
PURPOSE: We evaluated the degree of femoral and tibial torsion in, and the efficacy of two operative procedures for, resistant idiopathic clubfoot with toe-in gait. MATERIALS AND METHODS: Thirty one feet in 23 patients (average age at the time of revision surgery 4.3 years) were studied. CT was used to determine femoral anteversion and tibial torsion. Two different operative procedures were applied, depending on the degree of toe-in gait: group 1 (10 feet whose toe-in gait was not severe) - soft tissue release, anterior tibial tendon transfer and mid-foot (cuboid closing and cuneiform opening) osteotomy; group 2 (21 feet which had relatively severe toe-in gait) - supramalleolar external rotation osteotomy of the distal tibia (SEROT), along with the same procedure as group 1. Mean follow-up period after revision surgery was 6.3 years. Results were assessed radiologically and clinically with the Dimeglio classification and Clubfoot Assessment Protocol. RESULTS: The mean femoral anteversion and external-tibial torsion of the affected side were increased. Twenty eight of 31 feet (90.3%) demonstrated excellent or good results. In group 2, we obtained 19 excellent (90.5%) and 2 good (9.5%) results. Group 1 had 6 excellent (60%), one good (10%) and 3 fair (30%) results. CONCLUSION: Surgical treatment of the relapsed clubfoot with toe-in gait including soft-tissue release, tendon transfer and mid-foot osteotomy, along with SEROT in cases of severe toe-in gait, is effective in correcting residual clubfoot deformities.
Subject(s)
Humans , Clubfoot , Congenital Abnormalities , Follow-Up Studies , Foot , Gait , Osteotomy , Surgical Procedures, Operative , Tendon Transfer , Tenotomy , TibiaABSTRACT
No abstract available.