Background: Medical treatment accomplished good results in the treatment of erectile dysfunction (ED). However, these results were temporary, whereby approximately 80% of the patients experienced drop out. Penile prosthesis insertion is an outstanding treatment for patients with ED who are refectory to medical treatment or those who desired to leave off pharmacotherapy to gain lasting treatment.Objectives: To assess the safety, efficacy, and sexual and psychological satisfaction among patients with ED who were subjected to subcoronal or infrapubic penile prosthesis implantation. Patients and Methods:The present study was a prospective case-control study that was carried out at Al-Azhar University Hospitals through the entire period of 2016 to 2020. Men with ED that did not respond to medical treatment and had vasculogenic impotence based on penile duplex were included in the study. All patients were submitted to clinical evaluation comprised of detailed sexual and urological history, and physical evaluation. All patients were subjected to frequent follow-up assessment visits for six months after the surgery.Results: This study included a total of 18 patients with ED. Out of them, 9 (50%) patients were subjected to the infrapubic approach, while 9 (50%) patients were treated with the subcoronal approach. Three months postoperatively, all men revealed an average penile length at maximum inflation of 13.4 cm (9.3-17.5 cm). This status was continued for six months in which no patient lost his penile length. Among patients treated with the subcoronal approach, one patient developed penile extrusion one and half months post-operatively due to wound dehiscence secondary to uncontrolled DM. As for the infrapubic group, a patient developed superficial infection and wound dehiscence and responded to antibiotic use and secondary suturing. Another case developed a hypertrophic scar. Conclusion:Erectile dysfunction can be safely and effectively treated by implantation of the penile prosthesis by the subcoronal approach. This approach achieved high satisfactory functional, aesthetic, and psychological outcomes relative to the infrapubic approach.
Background: Rhinoplasty is a technically demanding procedure, requiring a comprehensive understanding of the nasal and facial anatomy and carrying out the nasofacial analysis. These factors are critical in determining the operative plan and the most effective technique that manipulates cartilage, bone, and soft tissue. The ultimate aim of rhinoplasty is to satisfy the patients with post-operative aesthetic and functional outcomes.Objective: To assess the long-term functional and aesthetic satisfaction among a sample of Egyptian patients subjected to rhinoplasty. Patients and Methods:This was a prospective cohort study conducted at Al-Azhar University Hospitals from May 2014 to May 2019. Patients aged more than 22 years of both sexes subjected to rhinoplasty, and presented in the outpatient clinics for follow-up were included. Post-operative counseling with the patients about the pre-operative conditions and deformities was done. Patients' satisfaction was assessed using the rhinoplasty outcome evaluation questionnaire.Results: This study included a total of 30 patients. Of them, there was 3 (10%) male and 27 (90%) females with a mean age of 38.1±6.91years. The mean level of Rhinoplasty outcome evaluation questionnaire was 77.1±6.91. Out of the included patients, 17 (56.66%) patients were satisfied with their aesthetic and functional rhinoplasty outcomes and were presented only for follow-up. Of the remaining 13 (43.33%) cases, four (13.3%) cases required secondary correction due to functional problems and complained of headache and difficulty breathing. Two patients were dissatisfied due to partner dissatisfaction that developed significant psychological impact. Conclusion:A considerable proportion of patients were dissatisfied after rhinoplasty. The major contributing factors are related to functional and aesthetic problems, as well as psychological morbidities. Therefore, patients seeking rhinoplasty should be subjected to thoroughly functional and psychological evaluation preoperatively to achieve the desired functional and aesthetic outcomes.
Background: Obesity dysregulates the hypothalamic-pituitary-ovarian axis resulting in ovulatory dysfunction and subsequent infertility. Tumescent liposuction comprised injection of a large volume of lactated Ringer's solution or normal saline, containing super-diluted epinephrine and lignocaine, in the subcutaneous fat. Even though this procedure accomplished accepted results as a body contouring surgery, the association between large-volume liposuction and infertility outcomes was not examined yet.Objectives: To reveal the aesthetic and reproductive outcomes of obese infertile female patients with established underlying hormonal irregularities and submitted to large-volume tumescent liposuction with the use of adrenaline only. Patients and Methods:The present prospective cohort study was conducted at Al-Azhar University Hospitals throughout September 2015 and August 2020. Obese or overweight infertile women within the reproductive age with menstrual irregularities, for at least one year were eligible for inclusion in the present study. These abnormalities were confirmed based on laboratory, and radiological evaluation. The procedure was done under general anesthesia and sterilization with betadine with small stabs in targeted areas. Postoperative pain was assessed using Visual analogue scale (VAS).Results: A total of 18 female patients with established infertility of more than one-year duration were included in this study. Patients were furtherly assorted based on fulfilling Rotterdam criteria into two groups: Group (A) including 10 patients with polycystic ovarian syndrome (PCOS), and group (B) encompassing eight patients without. Clinically, three cases of secondary infertility get pregnant after the procedure, one case get pregnant after eight months and two of them after one year. Furthermore, two cases of primary infertility with PCOS get pregnant after six months and the other after one year. Seven cases of secondary infertility developed dramatic improvement in hormonal profile preparing them for conception without pregnancy. Patients experienced a statistically significant decline in the body mass index (P<0.001, t=61.3). As for patients' satisfaction, 15 (83.33%) gave a 4 or 5 score to their general appearance. This was reflected in the quality of life in which 13 (72.22%) patients were highly satisfied. No patient complained of uncomfortable postoperative pain. Conclusion:Large-volume tumescent liposuction with use of adrenaline only was a safe, effective, and promising procedure in amending the negative reproductive and aesthetic repercussions of obesity among infertile obese women. These findings were associated with satisfactory pregnancy and cosmetic outcomes, which reflected on patients' satisfaction. No patient in our cohort experienced discomfort pain despite xylocaine non-use.
Background: When performing breast reduction surgery, it is very important to preserve the vascularity of tissues, especially of the nipple-areolar complex (NAC). Preoperative ultrasonographic color Doppler imaging is used for determination of major supplier vessels of the nipple-areola complex. Pedicles containing these vessels were designed for reduction mammaplasty.
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