The aim of this article is to analyse the long-term results of different surgical techniques for correction of penile deviations in Peyronie＇s disease. Patients who underwent surgery for a penile deviation in Peyroni...The aim of this article is to analyse the long-term results of different surgical techniques for correction of penile deviations in Peyronie＇s disease. Patients who underwent surgery for a penile deviation in Peyronie＇s disease between 1997 and 2007 were included into this study. Cases were retrospectively analysed by chart review. The current situation was evaluated by a 16-item standardized questionnaire addressing penile straightness, sensation, length, sexual function and satisfaction. Ninety patients were contacted with a return rate of 75 （83%） evaluabie questionnaires. Thirty-two patients were operated by shortening techniques （STs） with either Schroeder-Essed （n= 16） or Nesbit （n= 16）. Forty-three were operated by a plaque in-lexcision and defect covering by TachoSil method （TM）. Both groups were similar regarding age （ST 56 years, TM 57 years）, comorbidities, mean preoperative erection hardness score （EHS; 3.1 ST, 3.4 TM） and time of follow-up （total mean, 63 months）. Preoperatively ST patients had significantly less plaques （P〈0.05） and a lower deviation angle in comparison to TM patients （ST 56° versus TM 74°; P〈 0.001）. Still TM patients reported slightly better straightening results, but a significantly lower mean EHS （ST 3.3 versus TM 2.6; P〈0.001） during the follow-up. Satisfaction rates were similar in both groups. In conclusion, both techniques revealed to be safe and sustainable successful in penile straightening with better functional outcome of patients operated by STs.展开更多
BACKGROUND Testicular torsion is an emergent disease in urology,and there has been discussion of the treatment of testicular torsion.Testicular decompression has been established as a critical treatment for testicular...BACKGROUND Testicular torsion is an emergent disease in urology,and there has been discussion of the treatment of testicular torsion.Testicular decompression has been established as a critical treatment for testicular compartment syndrome(TCS),which occurs after detorsion in a patient who is diagnosed with testis torsion.Until now,testicular fasciotomy and incision of tunica albuginea with tunica vaginalis flap(TVF)graft have been suggested for decompression,and some studies about the efficacy of TVF were reported.However,this method is time consuming and needs meticulous technique,so other methods such as orchio-septopexy are suggested.The objective of this clinical case report was to propose new surgical method using collagen fleece(Tachosil®)instead of tunica vagina flap.CASE SUMMARY A 5-year-old boy with scrotal pain visited our hospital 24 h after symptom onset.After history taking,physical examination,and scrotum ultrasonography,he was diagnosed with testis torsion.Emergency surgery was performed after diagnosis.Following the incision of scrotum and fasciotomy,we covered his tunica albuginea with collagen fleece called Tachosil®instead of covering with TVF.CONCLUSION Short-term follow-up showed normal blood flow in testis without a TCS.This is the first case report of using Tachosil®in testicular torsion surgery,and its advantages were already reported in other surgeries like Peyronie’s disease.Our case suggests this new technique is an appropriate method because of its advantages including its cost-effective and time-saving characteristics.The main limitation is the short follow-up,so more studies are needed to provide a high level of evidence about its efficacy and safety.展开更多
Aim of the present study is to investigate the efficacy and safety of TachoSil? to reduce afterbleeding and hematoma following operative treatment of proximal humerus fractures. In a prospective randomized study we in...Aim of the present study is to investigate the efficacy and safety of TachoSil? to reduce afterbleeding and hematoma following operative treatment of proximal humerus fractures. In a prospective randomized study we included a consecutive series of 40 patients with a proximal humeral fracture in this study. All fractures were stabilized surgically with a fixed-angle “Philos plate” from May 2008 through May 2009. All patients were divided in two groups: Group I with plate osteosynthesis without TachoSil, Group II with plate osteosynthesis with TachoSil. For statistical analysis Chi2- Test and U- Test were used. There were 4 perioperative complica- tions in group II and one complication in group I (Chi2-Test: p=0.233). In group II one hardware failure occurred due to osteoporosis requiring revision and reosteosynthesis. Another patient suffered from paralysis of the radial nerve which healed uneventfully. One superficial postopera-tive infection and one superficial hematoma re-quired revision surgery, too. In this group no subfascial hematoma developed. One subfascial hematoma which required no revision occurred in group I. Blood transfusion was required 2 times in group I and 3 times in group II (Chi2-Test: p = 0.549). In sum in group II there was a sig-nificant lower blood loss for the subfascial drain, the region where TachoSil was applied. No ad-verse affects related to TachoSil could be de-tected. TachoSil was found to be safe and effective for reduction of postoperative bleeding following operative treatment of proximal hume-rus fractures. Further studies with larger sample size are required to confirm the efficacy of TachoSil? in orthopedic surgery.展开更多
文摘The aim of this article is to analyse the long-term results of different surgical techniques for correction of penile deviations in Peyronie＇s disease. Patients who underwent surgery for a penile deviation in Peyronie＇s disease between 1997 and 2007 were included into this study. Cases were retrospectively analysed by chart review. The current situation was evaluated by a 16-item standardized questionnaire addressing penile straightness, sensation, length, sexual function and satisfaction. Ninety patients were contacted with a return rate of 75 （83%） evaluabie questionnaires. Thirty-two patients were operated by shortening techniques （STs） with either Schroeder-Essed （n= 16） or Nesbit （n= 16）. Forty-three were operated by a plaque in-lexcision and defect covering by TachoSil method （TM）. Both groups were similar regarding age （ST 56 years, TM 57 years）, comorbidities, mean preoperative erection hardness score （EHS; 3.1 ST, 3.4 TM） and time of follow-up （total mean, 63 months）. Preoperatively ST patients had significantly less plaques （P〈0.05） and a lower deviation angle in comparison to TM patients （ST 56° versus TM 74°; P〈 0.001）. Still TM patients reported slightly better straightening results, but a significantly lower mean EHS （ST 3.3 versus TM 2.6; P〈0.001） during the follow-up. Satisfaction rates were similar in both groups. In conclusion, both techniques revealed to be safe and sustainable successful in penile straightening with better functional outcome of patients operated by STs.
基金Supported by The Soonchunhyang University Research Fund,No.20230029.
文摘BACKGROUND Testicular torsion is an emergent disease in urology,and there has been discussion of the treatment of testicular torsion.Testicular decompression has been established as a critical treatment for testicular compartment syndrome(TCS),which occurs after detorsion in a patient who is diagnosed with testis torsion.Until now,testicular fasciotomy and incision of tunica albuginea with tunica vaginalis flap(TVF)graft have been suggested for decompression,and some studies about the efficacy of TVF were reported.However,this method is time consuming and needs meticulous technique,so other methods such as orchio-septopexy are suggested.The objective of this clinical case report was to propose new surgical method using collagen fleece(Tachosil®)instead of tunica vagina flap.CASE SUMMARY A 5-year-old boy with scrotal pain visited our hospital 24 h after symptom onset.After history taking,physical examination,and scrotum ultrasonography,he was diagnosed with testis torsion.Emergency surgery was performed after diagnosis.Following the incision of scrotum and fasciotomy,we covered his tunica albuginea with collagen fleece called Tachosil®instead of covering with TVF.CONCLUSION Short-term follow-up showed normal blood flow in testis without a TCS.This is the first case report of using Tachosil®in testicular torsion surgery,and its advantages were already reported in other surgeries like Peyronie’s disease.Our case suggests this new technique is an appropriate method because of its advantages including its cost-effective and time-saving characteristics.The main limitation is the short follow-up,so more studies are needed to provide a high level of evidence about its efficacy and safety.
文摘Aim of the present study is to investigate the efficacy and safety of TachoSil? to reduce afterbleeding and hematoma following operative treatment of proximal humerus fractures. In a prospective randomized study we included a consecutive series of 40 patients with a proximal humeral fracture in this study. All fractures were stabilized surgically with a fixed-angle “Philos plate” from May 2008 through May 2009. All patients were divided in two groups: Group I with plate osteosynthesis without TachoSil, Group II with plate osteosynthesis with TachoSil. For statistical analysis Chi2- Test and U- Test were used. There were 4 perioperative complica- tions in group II and one complication in group I (Chi2-Test: p=0.233). In group II one hardware failure occurred due to osteoporosis requiring revision and reosteosynthesis. Another patient suffered from paralysis of the radial nerve which healed uneventfully. One superficial postopera-tive infection and one superficial hematoma re-quired revision surgery, too. In this group no subfascial hematoma developed. One subfascial hematoma which required no revision occurred in group I. Blood transfusion was required 2 times in group I and 3 times in group II (Chi2-Test: p = 0.549). In sum in group II there was a sig-nificant lower blood loss for the subfascial drain, the region where TachoSil was applied. No ad-verse affects related to TachoSil could be de-tected. TachoSil was found to be safe and effective for reduction of postoperative bleeding following operative treatment of proximal hume-rus fractures. Further studies with larger sample size are required to confirm the efficacy of TachoSil? in orthopedic surgery.
