Preoperative Factors Affecting the Outcome of Single Stage Hypospadias Repair- An Observational Study

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.

Correlation between preoperative axillary ultrasound and histopathology of resected lymph nodes in patients with carcinoma breast

Background: Axillary Ultrasound is an important tool in assessing regional lymph node status in women who are node negative clinically as many of them will prove to have axillary lymph node involvement on histopathology. The aim of the present study was to establish the role of axillary ultrasound in preoperative assessment of lymph node status in women with carcinoma breast and to correlate the findings of axillary ultrasound with the histopathology of resected axillary nodes.Methods: Forty patients (all women) were included in this study and the preoperative axillary ultrasound was done to know the status of axillary lymph nodes and the findings were correlated with histopathological findings of the resected nodes.Results: The sensitivity of axillary ultrasound was found to be 66.67%, specificity was 87.5%, accuracy 75%, positive predictive value (PPV) of 88.89% and negative predictive value of 63.4%.Conclusions: Axillary ultrasound is very important tool in assessing preoperative axillary lymph node status in patients with carcinoma breast. It is also important in assessment after inadequate axillary dissection and for follow up of non-treated axilla.