Isolated torsion of the penis: technique and review of the literature

Torsion of the penis is a rather rare condition in which the penis is rotated to one side with different degrees. It is a common condition when associated with other congenital defects of the penis such as hypospadias and epispadias and their variants. The association of chordee and bending of the penis is a common happening. This study in meant to demonstrate a new technique in the treatment of Torsion of the penis. Among the cases admitted to the Paediatric Surgical Unit of the Medical Research Institute and of the Faculty of Medicine-University of Alexandria, 18 cases of isolated torsion were included in this study. These were gathered based on consecutive admission in the period between March 2001 and February 2003. A total of 11 cases were admitted in the Faculty of Medicine Unit, while 7 cases were managed in the Medical Research Institute. The age ranged between 1 and 10 years with a mean of 4.4 years. The cases associated with hypospadias and epispadias were not included in this study. However, some deviation of the isolated cases of torsion included 1 case with chordee, 1 case of lateral bent penis and 2 cases of deficient ventral prepuce. The annual distribution was 6 cases in 2001, 9 cases of deficient ventral prepuce. The annual distribution was 6 cases in 2001, 9 cases in 2002 and 3 cases in 2003, Fifteen out of the 18 cases were showing an anti-clokwise torsion. Simple detorsion under general anaesthesia was the rule using a modification to adjust the shape of the penis after circumcision. This depends on protection of the glans and determination of the ratio between the post-coronal collar and the skin in anticipation. Adequate apposition of the median raphe to the new de-roted shaft is put in consideration. No complications were encountered except in one case, where residual torsion was reported after healing. Another go was necessary to ensure satisfactory detorston

Role of laser [KTP] in airway disorders in pediatric surgery

The aim of this work was to assess the role of laser in airway disorders in pediatric surgery. A prospective study in 10 patients with airway disorders, consecutively admitted to the Pediatric Surgery Center, University of Alexandria between September 1996 and September 1997. We have a laser apparatus [Laserscope] of 2 different wavelengths, the first is 532 of KTP and the second is 1064 of Nd:YAG. The KTP laser irradiation was induced through the bare fiber of different sizes [200 micro m, 400 micro m, 600 micro m]. We define the technique used: either contact or non contact and we define laser parameters as regards, technique [continuous, non contact], pulse interval, pulse duration and power according to the required tissue effect. Laser was used through rigid bronchoscopic video-camera system. General anesthesia was used as a rule either through endotracheal intubation or ventilation through the same stoma of tracheostomized patients. Through the pediatric bronchoscopic procedures done, laser was used in 10 patients of different age varied from 1 day-15 years old age. Twenty laser sessions were applied for 10 patients. The subglottic tracheal stenosis represented the highest incidence. Prolonged intubation was the most common respiratory indication of laser bronchoscopic procedures. Laser may be used alone or in association with other procedures. The most common laser procedure was excision. The complications were reported. The use of laser [KTP] has no substitution in the treatment of some cases of respiratory obstruction