Biomedical subjects

Osama Shaeer

Publications and source records attributed to Osama Shaeer.

6 recordsLinked to original sources

PubMed2006

Corporoscopic excavation of the fibrosed corpora cavernosa for penile prosethesis implantation: optical corporotomy and trans-corporeal resection, Shaeer's technique.

INTRODUCTION: Implantation of a penile prosthesis in cases of neglected or resistant ischemic priapism, or delayed re-implantation following prosthesis infection and extraction, is usually a difficult and risky procedure due to fibrosis of the corpora cavernosa. Among the common complications are perforation of the urethra, tunica albuginea, and infection. The complications are usually due to the use of blind force against resistance. AIM: We propose the techniques of Trans-Corporeal Resection and Optical Corporotomy as adjuvant measures for excavating the fibrosed corpora cavernosa under vision, without the use of force against resistance. METHODS: Six patients with diffuse fibrosis of the corpora cavernosa were operated on. The instruments and technique are the same as for optical urethrotomy and transurethral resection. Optical Corporotomy was started with, where the corpora are incised from within. After establishment of a satisfactory passage, Trans-Corporeal Resection followed to scrape the fibrous tissue. Implantation of penile prosthesis was completed as usual. The procedure was performed through 1.5 cm incision in the tunica albuginea. MAIN OUTCOME MEASURES: Length, girth, and straightness in the erect position, as well as the incidence of complications. RESULTS: Operative time was an average of 90 minutes. No difficulty was encountered during the procedure. No complications were noted through 1 year of follow-up. CONCLUSION: Optical Corporotomy and Trans-Corporeal Resection allow for force-free, visually monitored excavation of the fibrosed corpora cavernosa, aiming at safer penile prosthesis implantation.

Erectile Dysfunction↗

PubMed2006

Correction of penile curvature by rotation of the corpora cavernosa: a case report.

AIM: We report on the corporal rotation technique, customized for the management of ventral curvature in patients without hypospadias. METHODS: A male patient with ventral curvature of 90 degrees was operated on. The neurovascular bundle was mobilized for a short distance at the point of maximum curvature. The corpora cavernosa were approximated to each other in the dorsal midline by suturing pairs of longitudinal parallel incisions. To avoid urethral narrowing, minimal dissection was used to develop the groove on either side of the corpus spongiosum, to release it from its attachment to the rotated corpora cavernosa. RESULTS: Full correction of the curvature was achieved, without shortening, erectile dysfunction, or micturition problems. CONCLUSION: Corporal rotation can be applied for the correction of ventral penile curvature in patients with and without hypospadias, without sacrificing penile length.

Adult↗

PubMed2006

Penile girth augmentation using flaps "Shaeer's augmentation phalloplasty": a case report.

INTRODUCTION: Current girth augmentation techniques rely either on liposuction/injection or on the use of dermal fat grafts. These procedures have serious disadvantages, including regression in gained size, deformities, irregular contour, and asymmetry. Ideally, the augmentation technique should ensure durability and symmetry. This case report describes the first application of a flap (superficial circumflex iliac artery island flap) in penile girth augmentation. MATERIALS AND METHODS: The superficial circumflex iliac vessels were identified and the groin flap was elevated from lateral to medial, rotated toward the penis, and tunneled into a penopubic incision. It was wrapped around the penis short of the corpus spongiosum and insinuated under the glans. RESULTS: Six months after surgery, the patient had an erect girth of 19.5 cm and a flaccid girth of 16.5 cm, compared with 11 cm and 7 cm, respectively, before surgery, thus maintaining the intraoperative girth gain. The outer surface felt smooth with no lobulation. The size of the glans was proportionate to the shaft's girth. CONCLUSION: This case report shows that the application of flaps in penile girth augmentation may provide a reliable alternative to the currently applied techniques. Glans flaring promotes the aesthetic results and is applicable with other techniques of penile girth augmentation.

Adult↗

PubMed2006

Minimizing the losses in penile lengthening: "V-Y half-skin half-fat advancement flap" and "T-closure" combined with severing the suspensory ligament.

INTRODUCTION: The technique most commonly used for penile lengthening is the release of the suspensory ligament in combination with an inverted V-Y skin plasty. This technique has drawbacks such as the possibility of reattachment of the penis to the pubis, a hump that forms at the base of the penis, in addition to alteration in the angle of erection. AIM: In this work, we describe a new technique that overrides these drawbacks and minimize the loss of gained length. METHODS: The suspensory ligament was released through a penopubic incision. The caudal flap of the resected ligaments was reflected caudally and sutured to the Buck's fascia. The V flap was incised. The caudal half of the V was deskinned, leaving a cranial skin-covered V flap, and a caudal, rectangular fat flap. The fat flap was pulled into the gap between the base of the penis and the pubis and secured in position by suturing its deep surface and lower edge to the pubis. This maneuver filled up the gap. The V incision was closed as a Y. The penopubic incision was closed as a T shape, to avoid pulling the penis back at skin closure. A stay suture stretched from the glans to the thigh, maintaining the penis in the stretched position. A urinary catheter was inserted. RESULTS: Six months after surgery, there was no loss in the length gained. The angle of erection (as reported by the patient) was similar to that prior to the procedure. The skin incisions left no hump and a faint scar that was not troublesome to the patient. CONCLUSION: "V-Y half-skin half-fat advancement flap" and "T-closure" may improve the results of suspensory ligament release for penile lengthening. The reported techniques minimize the losses compromising length gain, whether in-surgery or following it.

Adult↗

PubMed2006

Methylene blue-guided repair of fractured penis.

INTRODUCTION: Fracture of the penis is a condition where excessive force applied to the long axis of the penis in the erect state results in rupture of the tunica albuginea of the corpus cavernosum. Surgical management can be confusing and time-consuming due to the concealment of the tear in organized blood and edematous tissue, necessitating extensive dissection in friable traumatized tissues, especially if the tear is a small one, or if there are multiple tears. AIM: The present work investigates the value of methylene blue in aiding the localization of tunical and urethral tears in such cases. PATIENTS AND METHODS: Twelve cases with delayed presentation of fracture penis were managed. In six patients, methylene blue was injected into the corpora cavernosa and through the urethral meatus to point out tears. In the other six patients, methylene blue was not used. MAIN OUTCOME MEASURES: Operative time and complication rate. RESULTS: Operative time was considerably less in the group that received methylene blue, and the repair was more straightforward. Complications issued only in the group that did not receive methylene blue considering the extensive lengthy dissection. CONCLUSION: Methylene blue-guided repair for trauma of the penis is an easy, reliable, safe, and fast method for spotting tears in the tunica albuginea of the corpora cavernosa or in the urethra, eliminating the need for unnecessary lengthening.

Adult↗

PubMed2005

Construction of neoglans penis: a new sculpturing technique from rectus abdominis myofascial flap.

INTRODUCTION: Construction of a neoglans penis may be required following glans amputation at circumcision, strangulation by a hair coil, or self-mutilation, among other indications. It may also be combined with phalloplasty to imitate the natural appearance and to support a penile prosthesis. AIM: This is a report on a novel technique of neoglans construction for a patient with an amputated glans penis as a result of circumcision injury. METHODS: A rectus abdominis myofascial flap was used. The flap was designed to be a 12 x 4 cm segment of the infraumbilical portion of the muscle, based on the inferior epigastric vessels. The flap was harvested through a paramedian incision. The penis was partially degloved through a circumferential incision 1 cm below its summit. The distal penile skin was utilized to elongate the urethra, so that the urethral meatus would be at the tip of the neoglans. The flap was reflected and tunneled underneath the mons veneris and alongside the penis, to emerge distal to the summit of the penis. The flap was fashioned into the shape of a glans and secured in place around the neourethra. The impression of a corona was achieved by tucking the proximal edge of the flap to its undersurface. RESULT: Six months following surgery, the patient had a neoglans penis, a corona, and a urethral meatus at the very tip. The neoglans had similar consistency, color, and shape to the normal glans. CONCLUSION: Construction of a neoglans penis is possible using the described sculpturing techniques, with satisfactory cosmetic results.

Adult↗