Urethral Extensibility Applied to Urethral Advancement

BACKGROUND: The male urethra in humans has a large capacity to extend under traction. This property is the main principle of the urethral advancement technique. AIM: We aimed to determine the safe limits of urethral mobilization and extensibility for reconstructive surgery of distal to midshaft hypospadias by applying urethral extensibility on the urethral advancement technique. Also, we wanted to evaluate the variable application of the gap-to-urethra (G:U) ratio from a cadaver to a live human body. METHODS: From November 2004 to February 2006, 20 boys aged from 2 to 16 years old underwent repair of midshaft to glanular hypospadias by urethral advancement technique. The ratio of G:U proposed for a safe limit of urethral extensibility (measured from normal, fresh human cadaveric urethras) applied to know if its application can help in decreasing the rate of late complications. The mean follow-up period was 10 months, which ranged from 4 to 16 months. RESULTS: Late complications were as follows: 25% meatal retraction (MR), 15% meatal stenosis (MS), and 5% fistula. Besides, MR and MS late complications associated with urethral mobilization of G:U ratio of less than 73%. CONCLUSION: The more the approximation in the application of the G:U ratio, the less the rate of MS and MR. Besides, urethral mobilization to the base of the penis helps to decrease the frequency of MS and MR. Furthermore, the type of complication, MR or MS, in urethral advancement correlates with the extent of urethral mobilization

Liposuction assisted Brachioplasty, evaluation of its efficacy and safety

Arm deformity after massive body weight loss is a major concern for many people. Brachioplasty procedures to deal with such deformity are various but not without complications. In this study, a comparison between the liposuction assisted brachioplasty and the standard procedure regarding the complications and patients’ satisfaction. All consecutive brachioplasty procedures that were done from Jan of 2017 until Sep of 2019 were reviewed prospective. Two plastic surgery teams in two private hospitals did these operations. Data was collected regarding the complications, duration of surgery and patients’ satisfaction. The total number of cases was 37. Group (1), including 15 patients (40.5%), were operated as liposuction assisted brachioplasty, and group (2), including 22 cases (59.5%), were operated as standard method without liposuction. All the cases were female group (1) average of age 37.19 ± 4 years old and group (2) average of age 38.94 ± 4.9 years old. For the first group, the average body mass index at time of surgery was 25.94 ± 2.4 kg/m2, and the mean average body mass index was 26.99 ± 3 kg for the second group. Aesthetic and functional satisfaction were excellent in 25.5% and 62% of the patients respectively in the first group. On the other hand, in the second group, aesthetic and functional satisfaction were excellent in 9% and 18 % of the patients respectively. liposuction assisted brachioplasty has a lower complications rate than the standard procedure and has better aesthetic and functional satisfaction. No major difference regarding the duration of surgery of both procedures