Revisted Blocksom vesicostomy: Operative steps

Posterior urethral valves (PUVs) are the most common cause of infravesical outflow obstruction in boys. Vesicostomy is considered in selective cases of PUV as an initial temporary procedure. The most commonly followed procedure is the one described by Blocksom. The procedure is simple and easy to perform. We revisited this procedure and describe the operative steps

Dorsal inlay inner preputial graft for primary hypospadias repair

Background: The most commonly performed operation to repair distal hypospadias is the Tubularised incised plate (TIP) repair. The key step is midline incision of the urethral plate, which widens a narrow plate and converts a flat into a deep plate groove, ensuring a vertical, slit neomeatus and a normal-calibre neourethra. At times in cases of proximal hypospadias, the urethral plate is very narrow and needs to be augmented or substituted for further tubularisation. We report our experience with primary single stage dorsal inlay urethroplasty using preputial skin grafts. Patients and Methods: Children with proximal hypospadias with a narrow urethral plate formed the study group. Children needing transection of the urethral plate, having undergone circumcision/hypospadias repair previously or having an inadequate prepuce was excluded. Results: Twelve children with a mean age of 48.83 months underwent primary dorsal inlay preputial graft urethroplasty for proximal hypospadias with a very narrow urethral plate. At an average follow-up of 42.16 months, 2 (16.66%) children had a breakdown of ventral shaft skin. None of the children had meatal stenosis, and none of these 12 children developed urethrocutaneous fistula. Conclusion: Primary dorsal inlay inner preputial graft urethroplasty successfully fulfills all traditional hypospadias repair criteria. It offers a viable, safe, rapid and easy option in the management of proximal hypospadias with a narrow urethral plate

Laparoscopic Mitrofanoff continent catheterisable stoma in children with spina bifida

Background: In 1980, Mitrofanoff described the creation of an appendicovesicostomy for continent urinary diversion. This procedure greatly facilitates clean intermittent catheterisation in patients with neurogenic bladder. The purpose of our study was to determine the clinical efficacy of the laparoscopic Mitrofanoff catheterisable stoma for children and adolescents with spina bifida. Materials and Methods: Review of hospital records revealed that 11 children with spina bifida underwent a laparoscopic Mitrofanoff procedure with at least 1-year of follow-up. A four-port transperitoneal laparoscopic approach was used to create a Mitrofanoff appendicovesicostomy. The child was followed-up in the urology clinic at 6 weeks, 3 months, 6 months, 1-year, and then semiannually after that. Questionnaires were administered to determine, from the children′s perspective, the level of satisfaction with catheterisation and the psychosocial implications of catheterisation before and after the creation of the Mitrofanoff continent catheterisable stoma. Results: Of the 11 children, six were female, and five were male. The mean age at presentation to Paediatric urological services was 11 × 3.22 years. Overall the mean operative time was 144.09 × 17.00 min. Mean estimated blood loss was 37.36 × 11.44 cc. None of the cases needed conversion to open. Patient satisfaction with their catheterisation was measured at 2.18 × 0.98 preoperatively, Post-operatively, this improved to 4.27 × 0.46. Statistical analysis using paired t-test showed significance with P < 001. Conclusions: Laparoscopic Mitrofanoff catheterisable stoma is feasible in children with spina bifida and is associated with reasonable outcome with early recovery, resumption of normal activities and excellent cosmesis

Solar Powered Smart Irrigation System

Agricultural sector is backbone of Indian economy as population increases demand ofwater also increases. Usually lots of water wastage takes place in the land, due to improper method of irrigation. A solar-based smart irrigation system enables user to monitor the relative soil moisture at many different location throughout the field to more precisely scheduled irrigation cycle. By using solar energy, we can save the electrical energy. The sensing system is based on feedback control mechanism with microcontroller unit depending upon the varied requirement of different crops we can irrigate our field

Modified Cantwell-Ransley epispadias repair in children our experience

Introduction: We retrospectively evaluated our experience with modified Cantwell-Ransley epispadias repair at our center to determine the complications and long-term results. Materials and Methods: We retrospectively reviewed the case records of 43 male children with a mean age of 9.13 ± 1.94 years who underwent primary epispadias repair at our center. The results of epispadias repair were assessed by both physical and endoscopic examination. All children who were old enough to opine as well as all parents/guardians were interviewed during the follow-up visits. Results: Urethrocutaneous fistulae occurred in 17.85% (5/28) children of the classic bladder exstrophy group and in 13.33% (2/15) children with penopubic epispadias. Postoperative cystoscopy done 12 weeks after repair revealed a smooth urethral tube in 81.39% (35/43) of children. With the patient in a standing position, the penis was dangling downward or in a horizontal position in 88.37% (38) of children, 85% of the patients ≥18 years of age were satisfied with both the functional and cosmetic outcome, as assessed by short form 36 and 93.02% (40/43) of the patients were continent during the daytime with voided volumes of more than 200 ml. Conclusion: In our experience, Cantwell-Ransley repair creates a functionally and cosmetically acceptable penis and produces a reliably tubularized neourethra with acceptable complication rates

A Review Paper On Automatic Pneumatic Bar Bending Machine

Now a days the world is focusing into automation. Each and every work of human is reduced by a machine, but few areas like construction the usage of machines for bending rods for stirrups which are used to withstand loads in beams and columns are not done by machine because the cost of machine is high and need skilled labors to operate it. In this paper is aimed to do bending operation for stirrups using pneumatic and named as pneumatic rod bending machine. The main objective of our paper is to implement the pneumatic rod bending machine in the construction sites with less cost compared to the existing bending machines, and increasing the productivity of the stirrups. Pneumatic rod bending machine consist of Pneumatic cylinder, Compressor, Hoses, Pulley, Cutting blades, Fixture, Electronic circuits, Switches and wiring .The rod is bent by the Pneumatic cylinder piston with holding the rod in the fixture. The main advantage of our paper is the square shape of the Stirrups is bent continuously without repositioning the rod in the machin

Colovesical fistula managed with single staged corrective surgery

Colovesical fistulae are most commonly associated with diverticulitis. We report a case of colovesical fistula in a 55-year-old male patient presenting with pneumaturia and fecaluria. Patient was treated with single stage resection of fistula, colocolostomy and closure of bladder