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Non-Tensile Tunica Albuginea Plication for the Correction of Penile Curvature
HR Ismail, M Youssef, M Sakr, T Hussein, AM Zahran
African Journal of Urology , 2009,
Abstract: Objective: To evaluate the efficacy of non-tensile tunica albuginea plication (NTTAP) using nonabsorbable sutures for the correction of congenital and acquired penile curvature and to determine the key points for a successful outcome of this procedure. Patients and Methods: From June 2004 to July 2007, 43 patients with penile curvature (35 congenital and 8 secondary to Peyronie’s disease) underwent surgical correction by NTTAP. The indications were difficult or impossible vaginal penetration, and a cosmetically unacceptable penis. For tunica albuginea plication (TAP) we applied the 16 dot procedure using non-absorbable sutures (Tycron 2/0 polyester fiber). Results: After a mean follow-up period of 18 months, successful results with respect to penile straightening, normal erection, penetration and sensation, confirmed both subjectively and objectively, were achieved in all patients. Post-operative penile shortening of less than 1.5 cm was present in 50% of the cases, but did not affect intercourse. Post-operative complications were mild and reversible; they consisted of penile skin necrosis after circumcising incisions and post-operative pain upon nocturnal erection that subsided after a few weeks with the frequent use of ice compresses. The overall satisfaction rate was nearly 100% (35/43 very satisfied and 8/43 satisfied). Conclusion:NTTAP is a simple and effective method for the correction of congenital and acquired penile curvature. The key points for successful outcomes are: clear identification of the line of maximum curvature, adequate pre-operative evaluation, counseling of the patient to set appropriate expectations, and careful discussion of the location of the suture sites. There is no need for mobilization of the urethra or neurovascular bundle, which adds a great advantage to this easy and simple technique. Cutting through the tunica albuginea, which may prevent postoperative erectile dysfunction, is not necessary. A disadvantage of this procedure is that it cannot correct hour-glass deformity.
Penile torsion correction by diagonal corporal plication sutures
Snow, Brent W.;
International braz j urol , 2009, DOI: 10.1590/S1677-55382009000100009
Abstract: penile torsion is commonly encountered. it can be caused by skin and dartos adherence or buck’s fascia attachments. the authors suggest a new surgical approach to solve both problems. if buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is described to effectively solve this problem.
Long-Term Results of Combined Tunica Albuginea Plication and Penile Prosthesis Implantation for Severe Penile Curvature and Erectile Dysfunction  [PDF]
Luigi Cormio,Paolo Massenio,Giuseppe Di Fino,Giuseppe Lucarelli,Vito Mancini,Giuseppe Liuzzi,Giuseppe Carrieri
Case Reports in Urology , 2014, DOI: 10.1155/2014/818623
Abstract: Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile “modelling” over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. 1. Introduction Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy [1]. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile “modelling” over the inflated prosthesis has been introduced as an effective treatment [2–4]. However, this procedure is not effective in all cases and involves a 4% risk of urethral laceration [3]. Tunical incisions, with or without grafting, have been used to correct residual curvatures after penile modelling; however, they involve increased morbidity, particularly in terms of hematoma and infection [5–7]. In 2004, Rahman et al. [8] described a simplified technique for correcting severe penile curvature and erectile dysfunction using combined penile plication and placement of an inflatable penile prosthesis. Herein, we report for the first time the long-term results of a patient we treated with this procedure. 2. Case Report A 60-year-old Caucasian man underwent bilateral nerve-sparing open retropubic radical prostatectomy because of a pT1c Gleason 7 prostate cancer. His preoperative International Index of Erectile Function-5 (IIEF-5) score was 21. Both operative course and postoperative course were uneventful. Final pathology revealed a pT2cN0 prostate cancer Gleason 7 with three positive surgical margins. He therefore received adjuvant radiotherapy. Following such treatments, he noticed a progressive deterioration of his erectile function, despite the use of phosphodiasterase-5 (PDE-5) inhibitors and intracavernous injection (ICI) with prostaglandin E1 (PGE1), with progressive dorsal penile curvature. At three-year follow-up, his prostate specific
Effect of Intra-Abdominal Absorbable Sutures on Surgical Site Infection
Harish Chauhan,Upendra Patel
National Journal of Medical Research , 2012,
Abstract: Purpose: To establish whether the rates of surgical site infection (SSI) in gastrointestinal surgery are affected by the type of intra-abdominal suturing: sutureless, absorbable material (polyglactin: Vicryl), and silk. Methods: We conducted SSI surveillance prospectively in our hospitla. Results: The overall SSI rate was 14.4% (13/90). The SSI rates in the sutureless, Vicryl, and silk groups were 4.8, 14.8, and 16.4%, respectively, without signi cant differ-ences among the groups. In colorectal surgery, the SSI rate in the Vicryl group was 13.9%, which was signi cantly lower than that of the silk group (22.4%; P = 0.034). The incidence of deeper SSIs in the Vicryl group, including deep incisional and organ/space SSIs, was signi cantly lower than that in the silk group (P = 0.04). The SSI rates did not differ among the suture types overall, in gastric surgery, or in appendectomy. Conclusion: Using intra-abdominal absorbable sutures instead of silk sutures may reduce the risk of SSI, but only in colorectal surgery. [National J of Med Res 2012; 2(3.000): 372-375]
No-mesh inguinal hernia repair with continuous absorbable sutures: A dream or reality? (a study of 229 patients)  [cached]
Desarda Mohan
Saudi Journal of Gastroenterology , 2008,
Abstract: Background/Aim: The author has published results from two series based on his new technique of inguinal hernia repair. Interrupted sutures with a nonabsorbable material were used for repairs in both theses series. The author now describes the results of repairs done with continuous absorbable sutures. Materials and Methods: This is a prospective study of 229 patients having 256 hernias operated from December 2003 to December 2006. An undetached strip of the external oblique aponeurosis was sutured between the inguinal ligament and the muscle arch to form the new posterior wall. Continuous sutures were taken with absorbable suture material (Monofilament Polydioxanone Violet). Data of hospital stay, complications, ambulation, recurrences, and pain were recorded. Follow-up was done until June 2007. Results: A total of 224 (97.8%) patients were ambulatory within 6-8 h (mean: 6.42 h) and they attained free ambulation within 18-24 h (mean: 19.26 h). A total of 222 (96.4%) patients returned to work within 6-14 days (mean: 8.62 days) and 209 (91.26%) patients had one-night stays in the hospital. A total of 216 (94.3%) patients had mild pain for 2 days. There were four minor complications, but no recurrence or incidence of chronic groin pain. Patients were followed up for a mean period of 24.28 months (range: 6-42 months). Conclusions: The results of this study correlate well with the author′s previous publications. Continuous suturing saves operative time and one packet of suture material. The dream of every surgeon to give recurrence-free inguinal hernia repair without leaving any foreign body inside the patient may well become a reality in future.
Review of the Surgical Approaches for Peyronie's Disease: Corporeal Plication and Plaque Incision with Grafting  [PDF]
Viet Q. Tran,Dennis H. Kim,Timothy F. Lesser,Sherif R. Aboseif
Advances in Urology , 2008, DOI: 10.1155/2008/263450
Abstract: The understanding and management of Peyronie's disease (PD) has improved but elucidating the exact etiology of the disease has yet to be achieved. In this paper, we review the historical and clinical aspects of PD. We focus on the evolution of surgical management for PD and review recent published articles that compare popular surgical techniques such as plication and plaque incision with vein graft. These two techniques have been reported to be equivalent with respect to patient satisfaction; however, each technique has its own advantages and disadvantages.
Absorbable Versus Silk Sutures for Surgical Treatment of Trachomatous Trichiasis in Ethiopia: A Randomised Controlled Trial  [PDF]
Saul N. Rajak,Esmael Habtamu,Helen A. Weiss,Amir Bedri Kello,Teshome Gebre,Asrat Genet,Robin L. Bailey,David C. W. Mabey,Peng T. Khaw,Clare E. Gilbert,Paul M. Emerson,Matthew J. Burton
PLOS Medicine , 2011, DOI: 10.1371/journal.pmed.1001137
Abstract: Background Trachoma causes blindness through an anatomical abnormality called trichiasis (lashes touching the eye). Trichiasis can recur after corrective surgery. We tested the hypothesis that using absorbable sutures instead of silk sutures might reduce the risk of recurrent disease among patients with major trichiasis in a randomised trial. Methods and Findings 1,300 individuals with major trichiasis from rural villages in the Amhara Region of Ethiopia were recruited and assigned (1:1) by computer-generated randomisation sequence to receive trichiasis surgery using either an absorbable suture (polyglactin-910) or silk sutures (removed at 7–10 days) in an otherwise identical surgical technique. Participants were examined every 6 months for 2 years by clinicians masked to allocation. The primary outcome measure was recurrent trichiasis (≥one lash touching the eye) at 1 year. There was no difference in prevalence of recurrent trichiasis at 1 year (114 [18.2%] in the absorbable suture group versus 120 [19.7%] in the silk suture group; odds ratio = 0.90, 95% CI 0.68–1.20). The two groups also did not differ in terms of corneal opacification, visual acuity, conjunctival inflammation, and surgical complications. Conclusions There was no evidence that use of absorbable polyglactin-910 sutures was associated with a lower prevalence of trichiasis recurrence at 1 year postsurgery than silk sutures. However, from a programmatic perspective, polyglactin-910 offers the major advantage that patients do not have to be seen soon after surgery for suture removal. The postoperative review after surgery using absorbable polyglactin-910 sutures can be delayed for 3–6 months, which might allow us to better determine whether a patient needs additional surgery. Trial registration ClinicalTrials.gov NCT00522860 Please see later in the article for the Editors' Summary
New-Fangled Slowly-Absorbable versus Non-Absorbable Sutures for Abdominal Fascial Closure. Have the Goals towards an Advantageous Suture Been Met?  [PDF]
Georgios Anthimidis, Marios Gregoriou, Thomas Stavrakis, Kalliopi Vasiliadou, Ioannis Lyras, Kostas Ioannidis, George Basdanis
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.46058

Background-Aim: The technique of abdominal closure along with the material to be used is constantly evolving. The aim of the present study is to evaluate differences in midline laparotomy closure with a standard closure technique and new-fangled slow-absorbable versus non-absorbable sutures. Material and Methods: A prospective, comparative study of patients undergoing laparotomy closure with either STARDIOX (Polydioxanone) or STARLENE (Polypropylene) sutures during a 9 month period was performed. Patients were evaluated and compared in terms of surgical site infection, incisional hernia, burst abdomen, and suture sinus formation. Results: A total of 284 patients were included [141 in the STARDIOX (Polydioxanone) group and 143 in the STARLENE (Polypropylene) group]. Sinus formation was not noticed and no palpable knots were reported in both groups. Moreover burst abdomen was never encountered. Incisional hernia rates were similar for both suture materials: n = 6 (4.3%) for the STARDIOX (Polydioxanone) group and n = 5 (3.5%) for the STARLENE (Polypropylene) group. There was not statistically significant relationship between the type of suture that was used and wound infection: n = 5 (3.5%) in the STARDIOX (Polydioxanone) group and n =

Nonabsorbable-Suture-Induced Osteomyelitis: A Case Report and Review of the Literature
Cheng Hong Yeo,Nick C. Russell,Tom Sharpe
Case Reports in Orthopedics , 2012, DOI: 10.1155/2012/381490
Abstract: We are reporting a case of nonabsorbable suture-induced osteomyelitis in patient who had an open rotator cuff repair with nonabsorbable Ethibond anchor suture. Patient in this case presented with very subtle clinical features of osteomyelitis of the left proximal humerus 15 years after initial rotator cuff repair surgery. Literature had shown that deep infection following rotator cuff repairs, although rare, can be easily missed and can cause severe complications. Absorbable suture had been demonstrated to be more superior, in terms of rate of deep infection, as compared to nonabsorbable suture when used in rotator cuff repair surgery. Both absorbable and nonabsorbable suture had been demonstrated to have similar mechanical properties by several different studies. The case demonstrated that initial presentation of deep infection can be subtle and easily missed by clinicians and leads to further complications.
Técnica de plicatura modificada de túnica albugínea para la corrección de la incurvación peneana
Pascual Regueiro,D.; Rodríguez Vela,L.; Gonzalvo Ibarra,A.;
Actas Urológicas Espa?olas , 2006, DOI: 10.4321/S0210-48062006000800006
Abstract: we present our penile curvature treatment experience in peyronie′s disease and cogenital curvature, using a modificated plication technique of the tunica albuginea with prolene? inverted sutures covered with vicryl? ones. the first suture gives security to the plication and the second one hides the first dots avoiding the nonabsorbable sutures bother.
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