Browsing by Author "Ilic, Predrag (57207790079)"

A phalloplasty is a complex genital reconstruction procedure of creating a neophallus. Several techniques to create a neophallus are described, based on different vascularized flaps, and each of them has its advantages and drawbacks. The aim of this study is to present musculocutaneous latissimus dorsi (MLD) flap as a viable option for total phalloplasty, with an interest in clinical outcomes and complications. A comprehensive literature review of all available reports about MLD flap phalloplasty was made. The following keywords were used on PubMed: latissimus dorsi musculocutaneous/myocutaneous free flap and phalloplasty. Research criteria revealed five articles and the results of 182 patients were analyzed. A total number of the patients, indications, operative technique, follow-up period, postoperative results, and complications were presented. In conclusion, MLD free flap presents a good choice for phalloplasty providing sufficient amount of tissue for safe implantation of penile prosthesis and successful penetrative sexual intercourse. The erogenous sensitivity is preserved with clitoris or glans penis incorporated into the base of the neophallus, and voiding in a standing position is achievable after urethral reconstruction. The main drawback is the lack of tactile sensation of the neophallus and the significant advantage is a well-concealed donor site. © 2020, The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature.

AIM: To evaluate the effectiveness of laser fenestration of intravesical ureterocele in prevention of vesicoureteral reflux. MATERIAL AND METHODS: The result of intravesical ureterocele holmium laser fenestration (LF) was retrospectively analyzed in 29 neonatal patients (mean age 8.1 days, range 3-28) in comparison with 38 neonates (mean age 9.6 days, range 5-28) treated with electrosurgical incision (ES). Patients’ records were reviewed for preoperative findings, endoscopic procedure description and postoperative outcomes. RESULTS: Vesicoureteral reflux (VUR) was found in two patients (5.6%) in LF and in 25 patients (65.8%) in ES group after six months (P=0.000). The patients with VUR in LF group had reflux grade III. In ES group six patients (15.8%) had reflux grade III, ten (26.3%) grade IV and nine (23.7%) grade V. DISCUSSION: In our study we found that de novo VUR is several times more common in patients treated with electro-surgical incision. This is the main difference between two described endoscopic procedures. Although this is a relatively new surgical technique, and other authors had similar results, which implies the importance of laser fenestration in the prevention of VUR in neonates with ureterocele. CONCLUSION: The occurrence of VUR is significantly lower in neonatal patients treated with holmium-laser fenestration, compared to standard electrosurgical incision, although both techniques are highly effective in relieving the obstruction. Since the use of this technique reduces the incidence of VUR, the need for subsequent surgery is lower in patients treated with holmium-laser. © 2023, Edizioni Luigi Pozzi. All rights reserved.