Biomedical subjects

Sava V Perovic

Publications and source records attributed to Sava V Perovic.

3 recordsLinked to original sources

PubMed2003

Vascularization of the hypospadiac prepuce and its impact on hypospadias repair.

PURPOSE: Only sparse data are available on the blood supply of the hypospadiac prepuce. We investigated the development and course of the preputial blood vessels, and applied the results of this study to surgery for hypospadias. MATERIALS AND METHODS: In 157 patients who underwent hypospadias surgery from October 1996 to December 2000 the prepuce was illuminated by a front and back lighting technique using endoscopic cold light and then photographed. Its blood vessel course and development were schematically presented. In 65 patients in whom the prepuce was not used for urethroplasty or penile body skin reconstruction the specimen was removed and its blood vessels were identified after injection with gelatin and Indian ink. The results of the 2 methods were compared. RESULTS: Based on the predominant blood vessels we classified preputial vascularization in hypospadias cases into groups, including 1-1 blood vessel predominant in 43%, 2-2 blood vessels predominant in 12%, 3-an H-like form with communication between 2 well developed blood vessels in 14% and 4-a net-like form with no predominant blood vessels in 29%. After comparing the results of the illumination technique versus specimen study in the same preputial tissue the illumination method was confirmed to be precise and easy to perform. CONCLUSIONS: Vascularization of the prepuce is crucial for hypospadias repair. Identification with high precision is achieved by the illumination technique. This method helps create the best vascularized flaps, whether longitudinal, oblique or spiral.

Adolescent↗

PubMed2002

Penile surgery and reconstruction.

This review will highlight recent advances in the field of penile reconstructive surgery in the paediatric and adult population. It is based on the work published during the year 2001. Besides the anatomical and histological studies of the penis, major contributions have been described in congenital and acquired penile anomalies. Also, a few new techniques and modifications of old procedures are described in order to improve the final functional and aesthetic outcome. The techniques for penile enlargement present a trend in the new millennium, but are still at the stage of investigation.

Congenital Abnormalities↗

PubMed2002

Bladder autoaugmentation with rectus muscle backing.

PURPOSE: Bladder autoaugmentation is a procedure which includes detrusoromyotomy or detrusorectomy to release intact urothelium which than prolapses and increases bladder capacity and compliance. The prolapsed urothelium is usually covered with de-epithelialized pedicled colonic or gastric patch. We present our initial experience with bladder autoaugmentation using rectus muscle backing. MATERIALS AND METHODS: Between August 1999 and December 2000 autoaugmentation was performed in 4 girls and 3 boys 4 to 11 years old (median age 8). All patients had neurogenic bladder with small capacity and poor compliance. The technique is performed using an extraperitoneal approach through either an inferior midline longitudinal or transverse incision. The procedure is started with a semi-filled bladder to find the right plane and then continues with an almost empty bladder to avoid severe injury of the prolapsed urothelium. Both rectus muscles are dissected from the anterior and posterior sheaths and sutured to detrusor edges. Urothelium is sutured to the muscle at several places to prevent its retraction and shrinkage. Thus, the bladder is fixed and hangs on rectus muscles, that is the anterior abdominal wall. RESULTS: Followup was 10 to 25 months (median 16). Bladder capacity at 6 months postoperatively increased in all patients, and ranged from 162 to 368 ml. (median 266). All patients had clinical improvement, decreased hydronephrosis, no vesicoureteral reflux and better compliance. CONCLUSIONS: Bladder autoaugmentation with rectus muscle backing is a safe and simple procedure. Rectus muscle is a good alternative to other backing materials.

Child↗