This study aimed to investigate the curative effect of spiral embedded flap urethroplasty for the treatment of meatal stenosis after penile carcinoma surgery.From January 2015 to January 2021,we used our technique to ...This study aimed to investigate the curative effect of spiral embedded flap urethroplasty for the treatment of meatal stenosis after penile carcinoma surgery.From January 2015 to January 2021,we used our technique to treat strictures of the external urethral orifice in seven patients,including four cases of meatal stenosis after partial penile resection and three cases of meatal stenosis after perineal stoma.All patients had previously undergone repeat urethral dilatation.The patients underwent spiral embedded flap urethroplasty to enlarge the outer urethral opening.The patients'mean age at the time of surgery was 60(range:42-71)years,the mean operative time was 43 min,and the median follow-up period was 18 months.The patients voided well post-operatively,and urinary peak flow rates ranged from 18.3 ml s^(-1)to 30.4 ml s^(-1).All patients were successful with absence of urethral meatus stricture.The present study showed that using spiral embedded flap urethroplasty to treat meatal stenosis after penile carcinoma surgery is an effective surgical technique withgood long-term outcomes.展开更多
Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to ...Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to problems voiding. Aim: To identify the clinical presentations and management of meatal stenosis in Port Harcourt. Materials and Methods: This was a retrospective study of patients who presented with features of meatal stenosis between January 2012 and December 2021. The patients’ history, physical examination findings, investigations and treatment received were analysed. Results: A total of 52 patients with features of meatal stenosis were recruited for the study. The number of patients less than a year old, between a year and 5 years, between 6 and 10 years and greater than 11 years were 8, 12, 28 and 4 respectively. Only 8 patients presented within 6 months of onset of symptoms. The most common symptom was poor urine stream, followed by straining. Meatotomy was the most commonly performed procedure for meatal stenosis 24 (46.15%). The patients were followed up for at least 6 months. Six patients had recurrence after treatment of meatal stenosis. Three patients each had a recurrence following dilatation and meatotomy. No patient had recurrence after meatoplasty. Conclusion: Meatal stenosis is an uncommon complication post circumcision. Patients usually present late to the hospital in our study. Meatoplasty had the best outcome. After treatment of meatal stenosis patients should be followed up for 6 months.展开更多
Objectives:This review aims to evaluate the utility of nonmedicated middle meatal packing compared to no packing on synechia formation up to 12 weeks after endoscopic sinus surgery(ESS)for chronic rhinosinusitis(CRS)....Objectives:This review aims to evaluate the utility of nonmedicated middle meatal packing compared to no packing on synechia formation up to 12 weeks after endoscopic sinus surgery(ESS)for chronic rhinosinusitis(CRS).Methods:We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search was performed on Medline(PubMed),EBSCO CINAHL plus,CENTRAL,and Clinicaltrials.org and included randomized controlled trials in the English language only.We extracted all relevant data and conducted quality assessment using the Cochrane risk of Bias tool(version 2).We also performed the quality assessment of the outcomes using Grading of Recommendations Assessment,Development and Evaluation.Results:Our search identified 390 articles of which four met our eligibility criteria.A total of 139 patients were randomized to receive middle meatal pack in either of the nostrils.At 4 weeks of follow-up,there was no difference in the risk of synechia formation on either the packed side or the unpacked side,with a relative risk(RR)of 0.77(95%confidence interval[CI]:0.48-1.25).Similarly,no difference was seen at either 8-12 weeks of follow-up,with an RR of 0.68(95%CI:0.42-1.20).Nasal congestion was reported to be less on the packed side on the follow-up in one of the trials.Conclusions:Our systematic review,with limited evidence,indicates no difference in synechia formation between the nonmedicated packed and unpacked middle meatus at four and eight or 12 weeks after ESS for CRS.Further studies are required to ascertain the true effect of packing the middle meatus with different materials and its long-term sequelae.展开更多
目的报告5例尿道外口前移阴茎头成形术（meatal advancement and glanuloplasty,MAGPI）治疗儿童尿道下裂的手术方法及疗效。方法对2011年7月-2016年1月就诊于我院小儿外科的5例尿道下裂儿童行MAGPI治疗,分析适合于此术式治疗的尿道下...目的报告5例尿道外口前移阴茎头成形术（meatal advancement and glanuloplasty,MAGPI）治疗儿童尿道下裂的手术方法及疗效。方法对2011年7月-2016年1月就诊于我院小儿外科的5例尿道下裂儿童行MAGPI治疗,分析适合于此术式治疗的尿道下裂的解剖学基础及其实质,由此推论该术式适应证的选择、技术细节及并发症的防治。结果 5例接受MAGPI治疗的患儿年龄1~11岁,平均4.37岁。术前均存在阴茎头发育小、扁平,缺乏锥形外观,均存在不同程度的阴茎下屈畸形。行包皮脱套、阴茎腹侧纤维束带松解后,阴茎下屈畸形纠正3例。余2例阴茎头下屈畸形通过白膜紧缩缝合技术得以纠正。阴茎下屈畸形完全纠正后,尿道外口均位于阴茎头隐窝近端或冠状沟,其中4例尿道外口近端的阴茎尿道及海绵体组织发育完善;1例阴茎尿道呈厚膜状且缺乏海绵体组织,尿道外口位于冠状沟,术后出现冠状沟尿瘘。5例患儿术后阴茎均呈伸直状态,排尿通畅;4例尿道外口位于阴茎头隐窝,1例阴茎头腹侧远端吻合口部分裂开、尿道外口退至隐窝近端冠状沟远端,1例冠状沟尿瘘。结论 MAGPI的适应证为阴茎头尿道发育缺陷,对于尿道外口位于阴茎头或冠状沟、阴茎尿道及海绵体组织发育完善者具有良好的疗效;阴茎尿道发育不完善、尿道外口前移阴茎头成形存在张力者,会出现阴茎头腹侧切口裂开及尿瘘等并发症。展开更多
基金supported by the National Natural Science Foundation of China(No.82100714,No.82170694)the Shanghai Outstanding Academic Leaders Plan(No.17XD1403100)+2 种基金the Natural Science Foundation of Shanghai(No.20ZR1442100)the Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2021QN102)the Program of Shanghai Sixth People's Hospital(No.ynts202004).
文摘This study aimed to investigate the curative effect of spiral embedded flap urethroplasty for the treatment of meatal stenosis after penile carcinoma surgery.From January 2015 to January 2021,we used our technique to treat strictures of the external urethral orifice in seven patients,including four cases of meatal stenosis after partial penile resection and three cases of meatal stenosis after perineal stoma.All patients had previously undergone repeat urethral dilatation.The patients underwent spiral embedded flap urethroplasty to enlarge the outer urethral opening.The patients'mean age at the time of surgery was 60(range:42-71)years,the mean operative time was 43 min,and the median follow-up period was 18 months.The patients voided well post-operatively,and urinary peak flow rates ranged from 18.3 ml s^(-1)to 30.4 ml s^(-1).All patients were successful with absence of urethral meatus stricture.The present study showed that using spiral embedded flap urethroplasty to treat meatal stenosis after penile carcinoma surgery is an effective surgical technique withgood long-term outcomes.
文摘Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to problems voiding. Aim: To identify the clinical presentations and management of meatal stenosis in Port Harcourt. Materials and Methods: This was a retrospective study of patients who presented with features of meatal stenosis between January 2012 and December 2021. The patients’ history, physical examination findings, investigations and treatment received were analysed. Results: A total of 52 patients with features of meatal stenosis were recruited for the study. The number of patients less than a year old, between a year and 5 years, between 6 and 10 years and greater than 11 years were 8, 12, 28 and 4 respectively. Only 8 patients presented within 6 months of onset of symptoms. The most common symptom was poor urine stream, followed by straining. Meatotomy was the most commonly performed procedure for meatal stenosis 24 (46.15%). The patients were followed up for at least 6 months. Six patients had recurrence after treatment of meatal stenosis. Three patients each had a recurrence following dilatation and meatotomy. No patient had recurrence after meatoplasty. Conclusion: Meatal stenosis is an uncommon complication post circumcision. Patients usually present late to the hospital in our study. Meatoplasty had the best outcome. After treatment of meatal stenosis patients should be followed up for 6 months.
文摘Objectives:This review aims to evaluate the utility of nonmedicated middle meatal packing compared to no packing on synechia formation up to 12 weeks after endoscopic sinus surgery(ESS)for chronic rhinosinusitis(CRS).Methods:We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search was performed on Medline(PubMed),EBSCO CINAHL plus,CENTRAL,and Clinicaltrials.org and included randomized controlled trials in the English language only.We extracted all relevant data and conducted quality assessment using the Cochrane risk of Bias tool(version 2).We also performed the quality assessment of the outcomes using Grading of Recommendations Assessment,Development and Evaluation.Results:Our search identified 390 articles of which four met our eligibility criteria.A total of 139 patients were randomized to receive middle meatal pack in either of the nostrils.At 4 weeks of follow-up,there was no difference in the risk of synechia formation on either the packed side or the unpacked side,with a relative risk(RR)of 0.77(95%confidence interval[CI]:0.48-1.25).Similarly,no difference was seen at either 8-12 weeks of follow-up,with an RR of 0.68(95%CI:0.42-1.20).Nasal congestion was reported to be less on the packed side on the follow-up in one of the trials.Conclusions:Our systematic review,with limited evidence,indicates no difference in synechia formation between the nonmedicated packed and unpacked middle meatus at four and eight or 12 weeks after ESS for CRS.Further studies are required to ascertain the true effect of packing the middle meatus with different materials and its long-term sequelae.
