Distal penile fasciocutaneous flap for stricture disease of anterior urethra

To develop curative treatment for complex stricture disease involving anterior urethra. Twenty patients with a median age of 35 years with history of repeated optical internal urethrotomies >5 underwent surgery. Stricture site and length were evaluated by Retrograde and Antegrade urethrogram. Stricture calibration was done by retrograde ureteric catheter insertion of variable sizes. Onlay or tubular was flap applied over partial or blind stricture respectively ranging from 5cm to 15cm. The period of follow up was 24 months. Complications like patchy necrosis of penile skin [3] external meatal stenosis [2], Fistula [1] stricture at anastomotic site [1] and post void dribbling [5] were noted. The patient's quality of life improved following surgery. Distal penile fasciocutaneous flap is an effective tool for recurrent stricture disease involving anterior urethra

Surgical removal of nasopharyngeal angiofibroma following super selective embolization [SSE]

Juvenile Nasopharyngeal Angiofibroma is a common clinical entity in Pakistan. Surgery is the treatment of choice in most centers. Radiotherapy is reserved for intracranial extensions only. Intraoperative blood loss associated with the surgical removal of these vascular tumours was brought down to 150-300 c.c. [Au: 200c.c.], follwing Superselective Embolization in this series of 25 cases. Blood transfusion was found to be unnecessary after the initial experience. No complication of embolization was noted in these patients. Two patients have returned with minor recurrence within a period of 24 months after initial surgery. This could be a disadvantage of S.S.E., as the tumour mass may have shrunken and yet a portion may have remained from resection to regrow at a later date