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
Penile glans amputation is a tragic complication of circumcision. Beyond the psychological trauma parents go through, they have to deal with the lower urinary tract symptoms including acute urine retention their baby ...Penile glans amputation is a tragic complication of circumcision. Beyond the psychological trauma parents go through, they have to deal with the lower urinary tract symptoms including acute urine retention their baby boys suffer due to meatal stenosis from the scaring process that ensues. We report on the cosmetic and functional outcomes in two patients ten years after neo-glans reconstruction following total glans amputation as a complication of circumcision and discuss the lessons learned over the period.展开更多
目的探讨阴茎头隧道技术联合带蒂阴茎皮瓣扩大尿道成形术治疗阴茎头尿道狭窄的临床效果。方法回顾性分析2023年1月至2024年1月就诊于上海交通大学医学院附属仁济医院泌尿外科的21例阴茎头尿道狭窄患者的临床资料,21例患者均为医源性狭窄...目的探讨阴茎头隧道技术联合带蒂阴茎皮瓣扩大尿道成形术治疗阴茎头尿道狭窄的临床效果。方法回顾性分析2023年1月至2024年1月就诊于上海交通大学医学院附属仁济医院泌尿外科的21例阴茎头尿道狭窄患者的临床资料,21例患者均为医源性狭窄(包括前列腺增生手术、经尿道膀胱病损切除术、导尿)。其中,尿道口狭窄9例,舟状窝狭窄12例。术前患者中位狭窄长度为2.00(2.00,3.00)cm,手术前后常规评估最大尿流率(_(max)imum flow rate,Q_(max))、国际前列腺症状评分(International Prostate Symptom Score,IPSS)、国际勃起功能问卷评分(International Index of Erectile Function-5,IIEF-5)。结果术后平均随访时间(8.24±2.17)个月,术后Q_(max)、IPSS分别为为21.00(19.00,26.00)ml/s、(6.86±2.29)分,高于术前6.00(4.50,8.00)ml/s、(17.24±5.68)分,差异有统计学意义(P<0.01);术后IIEF-5为21.00(10.00,22.50)分,与术前21.00(9.00,22.50)分相比,差异无统计学意义(P>0.30)。术后21例患者均无狭窄复发,阴茎头裂开,尿瘘,伤口感染、缺血坏死。结论对于尿道口及舟状窝狭窄患者,保留阴茎头完整性的阴茎头隧道阴茎皮瓣扩大尿道成形术,可实现功能与美观的统一,是疗效相对确切的方法。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.
文摘Penile glans amputation is a tragic complication of circumcision. Beyond the psychological trauma parents go through, they have to deal with the lower urinary tract symptoms including acute urine retention their baby boys suffer due to meatal stenosis from the scaring process that ensues. We report on the cosmetic and functional outcomes in two patients ten years after neo-glans reconstruction following total glans amputation as a complication of circumcision and discuss the lessons learned over the period.
文摘目的探讨阴茎头隧道技术联合带蒂阴茎皮瓣扩大尿道成形术治疗阴茎头尿道狭窄的临床效果。方法回顾性分析2023年1月至2024年1月就诊于上海交通大学医学院附属仁济医院泌尿外科的21例阴茎头尿道狭窄患者的临床资料,21例患者均为医源性狭窄(包括前列腺增生手术、经尿道膀胱病损切除术、导尿)。其中,尿道口狭窄9例,舟状窝狭窄12例。术前患者中位狭窄长度为2.00(2.00,3.00)cm,手术前后常规评估最大尿流率(_(max)imum flow rate,Q_(max))、国际前列腺症状评分(International Prostate Symptom Score,IPSS)、国际勃起功能问卷评分(International Index of Erectile Function-5,IIEF-5)。结果术后平均随访时间(8.24±2.17)个月,术后Q_(max)、IPSS分别为为21.00(19.00,26.00)ml/s、(6.86±2.29)分,高于术前6.00(4.50,8.00)ml/s、(17.24±5.68)分,差异有统计学意义(P<0.01);术后IIEF-5为21.00(10.00,22.50)分,与术前21.00(9.00,22.50)分相比,差异无统计学意义(P>0.30)。术后21例患者均无狭窄复发,阴茎头裂开,尿瘘,伤口感染、缺血坏死。结论对于尿道口及舟状窝狭窄患者,保留阴茎头完整性的阴茎头隧道阴茎皮瓣扩大尿道成形术,可实现功能与美观的统一,是疗效相对确切的方法。
