Yasin AYDOĞMUŞ, Arif AYDIN, Tolga KARAKAN, Mümtaz DADALI, Şahin BAĞBANCI, Mücahit KABAR, Melih SUNAY, Ahmet HASÇİÇEK, Erim ERSOY, R. Cankon GERMİYANOĞLU

Tubularized incised plate urethroplasty results in patients with proximal hypospadias

Objective: To evaluate the results of the patients with primary proximal hypospadias repaired by “tubularized incised plate” urethroplasty (TIPU).Methods: Thirty-three patients who were operated with TIPU technique in our clinic between 2003-2011 for primary hypospadias with proximal penile and penoscrotal meatus were retrospectively evaluated. Evaluation of the success in this study was, “voiding without fistula”.Results: Mean age was 6.82±3.07 (1-13). Fifteen patients (45.4%) had penoscrotal and 18 patients (54.6%) had proximal penil meatus. Postoperative success was evaluated with direct vision of voiding at the time of un-catheterization, 2 weeks and 6 months after un-catheterization. Success rates were 5/15 and 10/18 after the first repair in the level penoscrotal and proximal penil, respectively. Overall success rate was 45.5% after the first repair. Patients with urethral fistula after first repair were undergone second repair, success rates were increased to 9/15 and 16/18 in the levels of penoscrotal and proximal penil, respectively. Overall success rate after second repair was 75.8%.Conclusion: TIPU may be confidently applied for the patients with proximal hypopadias in experienced clinics, if there is not an uretral cordi or/and abnormality in the development of urethral plate.Key words: Proximal, hypospadias, tubularize incised plate urethroplasty

Anahtar Kelimeler:

Proksimal, hipospadyas, tübülarize insize plate üretroplasti

The comparison of Brucella gel agglutination test with other Brucella tests

Objective: In this study, it was aimed to compare the sensitivity of diagnostic tests in patients with a preliminary diagnosis of brucellosis.Methods: We have compared the serological methods, standard tube agglutination test (STA), Coombs Test (CT), Rose Bengal (RBT), and the gel centrifugation test. In patients with a preliminary diagnosis of brucellosis, subjects with a positive test result of RBT has been included in the research and other diagnostic tests STA, CT and Coombs Gel centrifugation tests were performed within the range of same titration.Results: Total 132 patient’s serums were studied. In RBT positive 92 patients’ serums, negative test results were found in 11 with STA, in 9 with CT and in 6 with gel test. While 35 patients were identified to be positive by using Brucella gel test at 1/5120 titer, no positive test results were seen with STA and CT at the same titer. Generally, CT results were one titration below the gel centrifugation test results.Conclusion: In conclusion, RBT and STA were not always adequate to determine the diagnosis of brucellosis. Low titer STA results should be supported by tests such as CT or gel centrifugation and the seroconversion must be monitored. Due to giving fast results, gel centrifugation test can be preferred in diagnosis of Brucellosis.Key words: Brucellosis, gel centrifugation, Coombs test

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Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994;151:464-465.
Guralnick L, al-Shammari A, Williot PE, et al. Outcome of
hypospadias repair using the tubularized, incised plate urethroplasty.
Can J Urol 2000;7:986-991.
Snodgrass W, Koyle M, Manzoni G, et al. Tubularized incised plate hypospadias repair: results of a multicenter experience. J Urol 1996;156:839-841.
Yang SS, Chen SC, Hsieh CH, et al. Reoperative Snodgrass procedure. J Urol 2001;166:2342-2345.
Backus LH, Defelice CA. Hypospadias-then and now. Plast Reconstr Surg Transplant Bull 1960;25:146-160.
King L.R. Hypospadias--a one-stage repair without skin graft based on a new principle: chordee is sometimes produced by the skin alone. J Urol 1970;103:660-662.
Nesbit RM. Operation for correction of distal penile ventral
curvature with or without hypospadias. J Urol 1967;97:720-722.
Sadlowski RW, Belman AB, King LR. Further experience with one-stage hypospadias repair. J Urol 1974;112:677-680.
Kass EJ, Chung K. Glanuloplasty and in situ tubularization of the urethral plate: long-term followup. J Urol 2000;164:991-993.
van Horn AC, Kass EJ. Glanuloplasty and in situ tubularization
of the urethral plate: a simple reliable technique for the majority of boys with hypospadias. J Urol 1995;154:1505-1507.
Bleustein CB., Esposito MP., Soslow, R. A. et al. Mechanism of healing following the Snodgrass repair. J Urol 2001;165:277-279.
Genc A, Taneli C, Gunsar C, et al. Histopathological evaluation
of the urethra after the Snodgrass operation: an experimental
study in rabbits. BJU Int 2002;90:950-952.
Snodgrass WT. Hypospadias. In: McDougal, W. S, Wein A. J, Kavoussi L. R. et al. Campbell-Walsh Urology 10th Edition Review: Elsevier Health Sciences, 2011:3503-3536.
Chen SC, Yang SS, Hsieh CH, et al. Tubularized incised plate urethroplasty for proximal hypospadias. BJU Int 2000;86:1050-1053.
Borer J. G, Bauer S. B, Peters C. A. et al. Tubularized incised
plate urethroplasty: expanded use in primary and repeat surgery for hypospadias. J Urol 2001;165:581-585.
Mustafa M, Wadie BS, Abol-Enein H. Dorsal dartos flap in Snodgrass hypospadias repair: how to use it? Urol Int 2008;81:215-217.
Mustafa M, Wadie B.S, Abol-Enein H. Standard Snodgrass
technique in conjunction with double-layer covering of the
neourethra with dorsal dartos flap is the therapy of first
choice for hypospadias. Int Urol Nephrol 2008;40:573-576.
Braga L H, Pippi Salle, J L Lorenzo A. J. et al. Comparative
analysis of tubularized incised plate versus onlay island flap urethroplasty for penoscrotal hypospadias. J Urol 2007;178:1451-1456.
Snodgrass W, Yucel S. Tubularized incised plate for mid shaft
and proximal hypospadias repair. J Urol 2007;177:698-702.
Zeytun H, Yiğiter M, Salman AB. The comparison of results
of our surgical techniques in the hypospadias treatment; a retrospective study. Dicle Med J 2013;40:269-274.