Detection of Meatal Stenosis with Uroflowmetry in Cases of Distal Hypospadias that are Operated with the TIPU Technique

Objective: Meatal stenosis after hypospadias surgery causes difficulty in urination and intermittent cessation in urinary stream at the early postoperative period. Increasing the duration of catheterization, meatotomy, and meatal revision surgeries are among the procedures applied for meatal stenosis. If the diagnosis of meatal stenosis is made at an earlier stage, it is easier to manage it, especially in the younger age group. We aimed to determine whether the uroflowmetry technique can be a guide for detecting and following meatal stenosis. Material and Methods: Forty-one cases with distal hypospadias operated with the Tubularized Incised Plate Urethroplasty (TIPU) technique were involved in this study. At the postoperative 1st month, all the patients with or without complaints of meatal stenosis had uroflowmetries with an effort to provide an objective data for diagnosing stenosis at the early stages. The results of uroflowmetries were compared with the clinical signs of meatal stenosis. Results: The average maximum flow rate was found to be 11.3 mL/s (6.7–31.6), and the average voided quantity of urine was detected as 181.7 mL/s (71–283) as result of uroflowmetry. Ureteral stenosis was clinically diagnosed in three patients with intermittent urination, prolonged urination with poor flow, and with difficulty in starting urination. All patients were found to be similar. The uroflowmetry results were parallel to the clinical outcome in all patients. Conclusion: In the early stages, uroflowmetry can assist clinical observation as a non-invasive method. In addition, it makes it possible to perform earlier therapeutic interventions

Extradigital glomus tumor revisited: Painful subcutaneous nodules located in various parts of the body

Background: Glomus tumor is a common lesion of the subungual area of the hand fingers. However, glomus tumors located outside the hand region are rare and the diagnosis is often difficult due to their low incidence and lack of distinct clinical features in the physical examination. The presented article contains five cases of extradigital glomus tumors with a short review of the literature. Patients and Methods: Five cases of extradigital glomus tumor were included in the study. All lesions were purple colored subcutaneous nodules with sharp pain by digital palpation. All lesions were examined with ultrasound imaging were operated under local anesthesia using loupe magnification. Results: Among five patients, only one patient was female with a mean age of 35. Two lesions were located at the arm region, two at the crural region and one at the sternal area. The smallest nodule was 0.5 cm and the biggest lesion was 2 cm in diameter. In all the cases, the early postoperative period was uneventful without any surgical complication or acute recurrence. The postoperative 1 st year examination of all patients revealed complete resolution of the pain and no recurrence was encountered. Conclusions: Glomus tumor should be kept in mind in the differential diagnosis of all painful subcutaneous lesions especially for those with purple reflection on the skin surface. In this manner, patients with extradigital glomus tumors may be diagnosed earlier and unnecessary and wrong treatments may be prevented

Applications of triangular glanular flap in hypospadias repairs for different purposes

WOS: 000329857200008PubMed ID: 23639333Hypospadias is a congenital anomaly of the penis with an ectopic, ventrally-placed meatus due to insufficient development of the anterior urethra. Tubularisation of glanular flaps without plate incision is performed with addition of a triangular flap in order to move the meatus more distally and avoid meatal stenosis. Subcoronally, mid-shaft, and coronally placed 41 hypospadias cases were treated with the tubularisation of the glanular flaps without incision of the urethral plate, a technique similar to TIP technique. Triangular flaps were added at the most distal end of one of the glanular flaps in all cases for different purposes. A medially-based triangular flap was elevated at the distal end of the right-sided longitudinal flap to carry the last suture more distally. The flap increased meatal diameter and carried the last suture more distally. No meatal stenosis was observed for an average of 18.02 (12-30) months. The final localisation of the meatus was satisfactory in all patients. Meatal stenosis, demonstrated after hypospadias repair, is a challenge for both the surgeon and the patient. A distal triangular glanular flap is planned to avoid this challenge. Besides, it helps to carry the meatus more distally. Promising results support the use of the glanular flap while longer follow-up is required for better evaluation

Effect of nitrergic system on colonic motility in a rat model of irritable bowel syndrome

Aim: The aim of this study is to investigate whether nitric oxide (NO)-mediated colonic motility was altered in rat irritable bowel syndrome (IBS) model, using different isoforms of NO-synthase (NOS) inhibitors

A Diagnostic and Therapeutic Algorithm for Impacted Teeth for Plastic Surgeons: Outcomes of 242 Extracted Teeth

Objective: Impacted teeth are important for plastic surgeons that frequently perform maxillofacial operations because of their tendency to affect dental occlusion, and thus, cephalometric results. Moreover, severe complications are also caused by the tooth and its surgical removal. In this study, retrospective analysis of 242 extracted teeth and 24 extracted roots was performed and an algorithmic approach to different types and the localizations of impacted teeth was presented. Possible complications and salvage procedures were also discussed. Material and Methods: A retrospective analysis of 128 patients who underwent impacted teeth removal surgery between 2013 and 2015 was performed. Mean age was 26 years (Range: 18–42 years), and the female to male ratio was 39/89. Sixteen of the patients were operated under regional nerve block, whereas the remaining were operated under general anesthesia. In 107 patients, the whole tooth was removed, whereas the residual root of the tooth was removed in 21 patients. In 89 patients, bone interventions like the creation of bone window or peridental milling to loosen the tooth were needed, whereas only oral mucosal incisions were performed in the remaining patients. Results: The most common onset symptom was localized pain, and the most common complications were swelling and edema. The most common extracted tooth was the mandibular 3rd molar. Lower lip hypoesthesia, which was continued up to eight months, was encountered in six patients who underwent mandibular 3rd molar extraction. Conclusion: In our opinion, a wide range of possible complications secondary to impacted teeth surgery makes them important for plastic surgeons who are more experienced than other disciplines, and learning teeth extraction is essential to learn in plastic surgery specialty training