ABSTRACT
ABSTRACT Introduction To assess the feasibility of vacuum physiotherapy meant to decrease graft contraction and recurrent penile curvature (PC), hence successful tubularization and a straight penis in patients underwent two-stage buccal mucosa graft (BMG) urethroplasty, in proximal hypospadias repair. Material and methods Between January 2014 and July 2018, 59 two-stage BMG urethroplasties performed at our referral center, were included in the study. The parents were counseled to use the vacuum device between the two stages. An internal, self-administered, semiquantitative, non-validated questionnaire was designed to record parent and patient adherence to the vacuum physiotherapy and parent satisfaction. Success rate of graft tubularization, curvature correction rates, and status of early (4 months) postoperative urinary stream were evaluated. Results Of 45/59 (76.3%) who returned the questionnaire, 77.8% followed the recommended physiotherapy protocol using the vacuum device. 93.3% of parents replied that the use of the vacuum was easy or moderately easy. None of the parents interrupted the physiotherapy because of perceived difficulty or intolerability. 100% of parents would have repeated the physiotherapy, if they had to. Overall, success rate of tubularization was 98.3% (58/59), complete curvature correction was achieved in 88.2% (52/59) of patients, and 79.7% (47/59) of patients showed a straight and powerful early post-operative urinary stream. Conclusions Physiotherapy with the vacuum device is safe, easy and practically feasible. Our vacuum physiotherapy protocol had high compliance rate. Vacuum physiotherapy should be considered for further assessment in patients undergoing two stage hypospadias repair using buccal mucosa.
Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Hypospadias/surgery , Urologic Surgical Procedures, Male , Urethra/surgery , Vacuum , Physical Therapy Modalities , Mouth MucosaABSTRACT
Although Tuberculosis (TB) most commonly affects the lungs, any organ or tissue can be involved. In countries with comprehensive diagnostic and reporting systems, extrapulmonary tuberculosis (EPTB) accounts for 20-25% of reported cases. Globally, extrapulmonary cases (without concurrent pulmonary involvement) comprised 14% of notified cases (new and relapse) in 2007. The most common sites of extrapulmonary tuberculosis consist of lymphatic, genitourinary, bone and joint, and central nervous system involvement followed by peritoneal and other abdominal organ involvement. We report a case of a 25 year old male patient who came with multiple discharging sinuses and an urethrocutaneous fistula over the penis treated by a therapeutic trial of Anti-tubercular therapy (ATT).