ABSTRACT
Background:Hypospadias is one of the commonest congenital anomaly in boys which requires either a single stage repair or staged repair. The success of the procedure depend upon the type, anatomy, experience of the surgeon, method of repair and preoperative hormonal stimulation. Aim: The aim of the study was to evaluate the various preoperative factors responsible for outcome of single stage repair in distal penile, mid penile and proximal penile hypospadias. Methods: There were 48 patients in this observational study which were divided into two groups. Group A comprised of 24 patients with glanular and coronal hypospadias while Group B comprised of 16 patients with distal penile, 5 mid penile and 3 proximal penile types with minimal chordae. All the 24 (50%) patients in group A underwent meatal advancement and glanuloplasty incorporated (MAGPI) repair while in group B 15 (31.25%) patients underwent Tabularized Incised Plate (TIP) repair and 9 (18.75%) patients underwent combined TIP and Mathieu抯 repair. Results: Overall operative success rate observed in the study was 41 (85.41%) patients. In 7 (14.58%) patients urethrocutaneous fistula as a major complication occurred which included 1 patient in Group A and 2 patients with Distal Penile Hypospadias (DPH), 2 patients with Mid Penile Hypospadias (MPH) and 2 patients with Proximal Penile Hypospadias (PPH) in Group B. In 2 (4.16%) patients, mild meatal stenosis was noted which settled with meatal dilatation. Urethrocutaneous fistula (UCF) disappeared in 2 (4.16%) patients on follow up with regular urethral dilatation. Conclusion: MAGPI is the ideal procedure for glanular/coronal hypospadias. For distal penile hypospadias, TIP alone or combined TIP and Mathieu抯 repair gives equally good results. Preoperative testosterone therapy reduces the incidence of complications in a single stage hypospadias repair.
ABSTRACT
Perineal ectopic testis (PET) is a rarity in pediatric surgical practice seen in less than 10% cases of maldescended testis. An eighteen months old boy presented with empty right scrotum and a palpable soft mass in the perineum which on preoperative ultrasonography was consistent with testicular morphology. Orchidopexy was performed by standard operative technique and testis was placed in Dartos Pouch. The case is reported to highlight the importance of examination of ectopic sites in a cryptorchid child and the need for long term follow-up of patient.
ABSTRACT
Fine needle aspiration cytology (FNAC) is of particular relevance in head and neck lesions because of easy assessibility, excellent patient compliance, miminally invasive nature of procedure and helping to avoid surgery in non-neoplastic lesions, inflammatory conditions and also some tumors. The study was conducted on 160 patients presenting with non-thyroidal head and neck swellings. Swellings arising from lymphnodes formed largest group 110 (68.75%) cases, salivary gland origin leisions comprised of 15(9.3%) cases and miscellaneous lesions 35 (21.8%) patients. Aspiration was satisfactory in 153 (95.63%) and unsatisfactory in 7 (4.40%) patients. The cytodiagnostic yield was 147 (91.87%) cases in the study. In 46 patients surgical intervention and histopathological examination (HPE) of the specimen was undertaken. The sensitivity of FNAC compared with HPE where available in diagnosing lymphnode lesions was 83.33%, salivary gland lesions was 100% and miscellaneous swellings was 95.83%. The overall sensitivity in the study in diagnosing non-thyroidal head and neck lesion was 93.47%. No major complication was recorded.
ABSTRACT
A 35 year old multigravida in the 24th week of gestation presented with history of swelling left breast of 2 years duration. The swelling rapidly increased in size during the pregnancy & underwent spontaneous necrosis of skin with fungation & haemorrhage. Fine needle aspiration cytology showed a diagnosis of fibroadenoma. Lumpectomy was performed in the emergency & histopathology of specimen revealed infarction in fibroadenoma. Patient delivered a normal healthy baby and is alright at 6 month follow up.