A Technique of Anterior Urethroplasty Using the Tunica Albuginea of the Corpora Cavernosa

Objective: To describe a technique of anterior urethroplasty using the tunica albuginea of the corpora cavernosa. Methods: We performed this technique on 99 male patients with anterior urethral stricture with follow-up at 6, 12 and 18 months. We assessed preoperative and postoperative patient satisfaction rate based on symptoms along with preoperative and postoperative urethrograms, urethrosonographies and uroflowmetry and labelled outcomes as good, fair and poor. Results: Good and fair results were considered successful. The overall success rate was 95.9%. In our series of patients, the overall success rate of urethroplasty remained the same at 6 months, but decreased to 94.9% at 12 months and 88.1% at 18 months. Conclusion: These observations show that anterior urethroplasty by using the tunica albuginea of the corpora cavernosa produced satisfactory results and is comparable with the other techniques of urethroplasty. The merits of using the tunica albuginea for urethroplasty are local availability of tissues, so that there is no need to use anatomically and structurally dissimilar distant tissue such as the buccal mucosa, preputial, penile, or scrotal skin or Teflon grafts. It can be used in our area where most of the patients come with dyskeratotic changes in their buccal mucosa

Comprehensive analysis of etiology on the prognosis of urethral strictures

INTRODUCTION: Urethral strictures remain a reconstructive dilemma, due to high incidence of recurrence and less than satisfactory outcomes. Even experienced surgeons following strict surgical principles have not achieved optimal results, leading us to think whether the etiology of strictures dictate the outcome . We evaluated this "cause-effect" relationship highlighting the significance of the etiology on the overall prognosis of urethral strictures. MATERIALS AND METHODS: A total of 302 males with urethral strictures were assessed (both retrospectively and prospectively) over a period of ten years. The preoperative evaluation was performed by retrograde urethrogram, urethrosonogram, and uroflowmetry and categorized, based on etiology: a) as post traumatic, b) post infective, c) iatrogenic or d) unknown. Traumatic strictures were subjected to pelvic X-ray and sub-categorized into grades A, B and C, following the TILE classification. Patients were operated; with tunica albuginea urethroplasty for anterior strictures and U shape prostato-bulbar anastomosis for posterior strictures. RESULTS: Traumatic strictures accounted for 54% of cases. 127 of the 302 patients were treated using Tunica Albuginea Urethroplasty, while U shaped Prostatobulbar Anastomosis was performed on others. Post traumatic strictures had best outcome whereas post infective strictures had the worse outcome. Among strictures following pelvic fractures, TILE grades A and B had a better post operative course as compared to TILE C. Overall complication rate was 13.24%. CONCLUSION: Our study demonstrated that etiology of urethral strictures may play a vital role for the overall prognosis of urethral strictures

Epidemiological and socio-cultural study of burn patients in M. Y. Hospital, Indore, India

Background: Developing countries have a high incidence of burn injuries, creating a formidable public health problem. The exact number of cases is difficult to determine: however in a country like India, with a population of over 1 billion, we would estimate 700,000 to 800,000 burn admissions annually. Objective: The study was done to investigate the epidemiology of various causations and their outcomes in terms of morbidity and mortality. Also, the effect of social stigma and cultural issues associated with burns on the victim and his family was assessed. Materials and Methods: All burn cases (n=412) admitted to the burns unit of M. Y. Hospital, Indore over a period of one year (2005-2006) were investigated. The data regarding sex, age predisposition, geographical origin, mode and nature of injury were obtained by questionnaire-interview with the patient themselves. Clinical assessment was done in the form of depth and extent of injury and complications. In case of mortality, again various factors like age, sex and cause of death were analyzed. The data was analyzed by SPSS 11.0 version. The interrelationship between various factors was studied using multivariate logistic regression analysis. Results: Burns were found more commonly in middle-aged groups. The incidence was more in females as an absolute number (70.3%) as well as when stratified by age. Most burns were domestic, with cooking being the most prevalent activity. Flame (80.3%) was the most common agent. Most of the cases of burn were accidental (67.7%). Moreover, the patients had third degree burn that leads to more mortality in our circumstances. Death occurred in more than one-half (62.3%) of cases with septicaemia and disseminated intravascular coagulation (35.4%) as the leading causes. When using logistic regression analysis, the outcome of the burn injury was significantly associated with degree, depth, extent and mode of injury. Conclusion: This series provides an overview of the most important aspects of burn injuries for hospital and non-hospital healthcare workers. The majority of deep burns are accidental, seen in middle-aged housewives as a result of flame burns, and lead to death. So measures should be taken to provide proper education to prevent these accidents and ensure safety

Epidemiological and socio-cultural study of burn patients in M. Y. Hospital, Indore, India

Background: Developing countries have a high incidence of burn injuries, creating a formidable public health problem. The exact number of cases is difficult to determine: however in a country like India, with a population of over 1 billion, we would estimate 700,000 to 800,000 burn admissions annually. Objective: The study was done to investigate the epidemiology of various causations and their outcomes in terms of morbidity and mortality. Also, the effect of social stigma and cultural issues associated with burns on the victim and his family was assessed. Materials and Methods: All burn cases (n=412) admitted to the burns unit of M. Y. Hospital, Indore over a period of one year (2005-2006) were investigated. The data regarding sex, age predisposition, geographical origin, mode and nature of injury were obtained by questionnaire-interview with the patient themselves. Clinical assessment was done in the form of depth and extent of injury and complications. In case of mortality, again various factors like age, sex and cause of death were analyzed. The data was analyzed by SPSS 11.0 version. The interrelationship between various factors was studied using multivariate logistic regression analysis. Results: Burns were found more commonly in middle-aged groups. The incidence was more in females as an absolute number (70.3%) as well as when stratified by age. Most burns were domestic, with cooking being the most prevalent activity. Flame (80.3%) was the most common agent. Most of the cases of burn were accidental (67.7%). Moreover, the patients had third degree burn that leads to more mortality in our circumstances. Death occurred in more than one-half (62.3%) of cases with septicaemia and disseminated intravascular coagulation (35.4%) as the leading causes. When using logistic regression analysis, the outcome of the burn injury was significantly associated with degree, depth, extent and mode of injury. Conclusion: This series provides an overview of the most important aspects of burn injuries for hospital and non-hospital healthcare workers. The majority of deep burns are accidental, seen in middle-aged housewives as a result of flame burns, and lead to death. So measures should be taken to provide proper education to prevent these accidents and ensure safety