Optimal clamping time in meatotomy procedure for children with meatal stenosis: Experience with 120 cases
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Accepted: May 2, 2021
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Authors
Objective: During meatotomy procedure for children with meatal stenosis (MS), a straight clamp used as a hemostat on the ventrum of the meatus before incised with scissors for clamping and holding bleeding from the site of operation. The aim of this study was to evaluate the optimum clamping time for meatotomy in children with MS.
Materials and methods: All the patients with MS between 2014 to 2019 were enrolled in this retrospective study. Patients with uncircumcised penis, traumatic catheterization, any kind of penile abnormality such as hypospadias or penile curvature, and active urinary tract infection (UTI) were excluded. The indication of meatotomy was a pinpoint meatus that develops with dorsal or lateral deflection of the urinary stream and high-velocity urine flow. During meatotomy procedure, clamping time was examined in different groups such as 2, 3, and 4 minutes. The main symptoms of presentation and ultrasonography (US) findings were recorded and compared between groups. To assess the optimum time clamping, postoperative bleeding was noted carefully in all groups. The success rate was recorded at onemonth postoperative follow-up in the clinic.
Results: Of the 120 patients with MS who underwent a meatotomy procedure, there were 40 (33.3%) participants in each group. The main symptoms were painful urination and urine stream deviation that represented in 54 (46%) patients. Bladder wall thickness was the main pre-operation finding in the US which was observed in 67 (55.8%) patients. In comparison between the groups related to clamping time, bleeding was observed and required suturing when clamping was applied for 2 minutes in 4 (3.3%) patients (p = 0.016). With a minimum follow-up of 12 months, no recurrent meatal stenosis was reported.
Conclusions: Clamping time for more than 2 minutes may prevent bleeding during and after meatotomy.
Faisal Ahmed,MD
PERSONAL DETAILS:
Name Faisal Ahmed
Address Department of Urology, ShahidFaghihiHospital Shiraz/ I.R IRAN
Telephone (+967 776089579)
Date of Birth 1.01.1986
Marital Status Married
Nationality Yemeni
Place of Birth IBB, Yemen
Speciality Urology
Current Appointment Urologist
Ibb Medical University
E-Mail fmaaa2006@yahoo.com
Personal Information:
Date of birth: Jun.1.1986
Place of birth: IBB, YEMEN
Gender: Male
Marital status: Married
Spous's name: Afrah Salem
Spous's Job: Student
Children: 3(two son and one daughter)
EDUCATION
Phase
Year
Institution
Degree Awarded
GPA
High school
2003
Al Nahda School, Ibb, Yemen
High School Diploma
91.62%
University
(Under graduation)
2006-2014
Shiraz University of Medical Sciences, School of Medicine
Doctor of Medicine
16.03 out of 20
University
(Post Graduation)
2014-2018
Shiraz University of Medical Sciences, School of Medicine
Degree in Urology Specialty
graduated
Urology Board Degree
(written exam)
2018
Iranian Board of Urology
Passed (105/150)
A
MEDICAL TRAINING & WORK EXPERIENCE
Appointments:
2013-2014 Internship; Namazi Hospital, Faghihi Hospital– Shiraz-Iran
2014-2018 Residency in Urology; Namazi Hospital,Faghihi Hospital and
Ali Asghar Hospital, Shiraz-Iran.
2018- at present time work in Al-thora General hospital (Yemen) as consultant
Training:
2010 1day Clinical reasoning, Shiraz, Iran
2011 2days Workshop on CPCR, Shiraz, Iran
2013 3days Methodology on research, Shiraz, Iran
2014 6days Workshop on EDC (education development center), Shiraz, Iran
2014 2days Research methods, Shiraz, Iran
2015 3days Workshop on medical ethics, Shiraz, Iran
2016 1days Workshop on Legal doctrines and documentation of medical services and prevention of medical errors, Shiraz, Iran
2017 7days Congress on Iranian Urological Association, Shiraz, Iran
Language Skills:
- English: Good in reading, speaking, writing and listening.
- Persian: Fluent in reading, speaking, writing and listening.
- Arabic: Native speaker.
Professional skills:
- Able to perform all usual open, endourologic and pediatric surgeries, alone.
- Able to perform rare urologic surgeries with assistance.
IT Skills:
- Expert in online communications and primary works like MS word, PowerPoint etc.
Interests & Hobbies:
1- Study in urology and religious field.
2- Succor, Swimming.
RESEARCH
WRITED PAPERS
- Penile enhancement using amniotic membrane in a rabbit model.
- Evaluation of proper timing for ventral meatus clamping in meatotomy procedure.
- Evaluation of SDF1 and CXCR4 expression in adipose derived stem cells (ASCs) around prostate in benign and malignant diseases.
- An Investigation of the Pathology Report of Bladder Cancer Patients With Radical Cystectomy in Southern Iran during 2013 and 2018: A Cross-Sectional Study
- Graft and Patient Survival Rate in Kidney Transplantation, and its Associated Factors: A Systematic Review and Meta-analysis in Iran
- Outcome of Ultrasound-guided Percutaneous Nephrolithotomy in Children Under Age of 16: Experience with 40 Cases
- Comparison Among Mini-Percutaneous Nephrolithotomy (M-PCNL) Using Ultrasonography versus Fluoroscopy in Patients Under Age of 18 Years
- Comparison of the Efficacy of Epidural Injection of Methylprednisolone Versus Methylprednisolone and Calcitonin in Patients with lumbosacral Spinal Stenosis: A Randomized Clinical Trial
- IS there any sympathetic skin response (SSR) abnormality in Raynaud phenomenon?
PUBLISHED PAPERS
- Hassanpour A, Ahmed F, Yeganeh BS, Jahromi BN, Makarem A. Spontaneous Rupture of Renal Cell Carcinoma in Pregnancy, Surgical Management With Fetal Preservation: A Case Report. Urology Journal. 2018 Apr 23.
- Ahmed F, Askarpour MR, Eslahi A, Nikbakht HA, Jafari SH, Hassanpour A, Makarem A, Salama H, Ayoub A. The role of ultrasonography in detecting urinary tract calculi compared to CT scan. Research and reports in urology. 2018;10:199.
- Natami M, Makarem A, Ahmed F, Dastgheib N, Zahraei AH. a giant ureteral stone in a 32-year-old man: a case report. International Medical Case Reports Journal. 2019;12:43
- Shirazi M, Rajabalian MB, Noorafshan A, Karbalay-Doust S, Jahanabadi Z, Ahmed F. The comparison of the effect of phenylephrine and epinephrine on penile spongy tissue in rats after experimental hypospadias surgery: a quantitative stereological study. BMC urology. 2019 Dec;19(1):1-6.
- Jahromi SE, Ahmed F, Pourahmad S, Roozbeh J, Najafi I, Ebrahimi V. Predictors of peritoneal dialysis associated peritonitis; application of the zero-inflated negative binomial model. Journal of Nephropathology. 2019 Jul 23;8(4):e36
- Nasrollahi H, Ariafar A, Ahmed F, Mokhtari M, Eslahi A, Ansari M, Chowdhury U. Isolated schwannoma of the urinary bladder: a case report and review of the literature. The Pan African Medical Journal. 2020 Apr 8;35(108).
- SALEHIPOUR M, ANBARDAR M, HAKIMELAHI H, MONSEF A, AHMED F, ADIB A. Incidentally Detected Adrenal Ganglioneuroma in an adult Female with left Adrenal Mass.
- Ariafar A, Zeighami S, Salehipour M, Ahmed F, Shahabi Z, Nikbakht HA. An Investigation of the Pathology Report of Prostate Cancer Patients with Radical Prostatectomy in Southern Iran, during 2013 and 2018: A Cross-sectional Study. Middle East Journal of Cancer. 2020 Jul 29.
- Shirazi M, Aminsharifi A, Ahmed F, Makarem A, Zahraei SA, Asmaarian N. The impact of post-procedural ureteric stent duration on the outcome of retrograde endopyelotomy for management of failed open pyeloplasty in children: a preliminary report. Med J Islam Repub Iran. 2020 (xx);34:x. https://doi.org/10.34171/mjiri.34.x
- Eslahi A, Farpour H, Hosseini A, Ahmed F, Chowdhury U, Nikbakht HA. Evaluation of the Sympathetic Skin Response in Men with Chronic Prostatitis: A Case-Control Study. Res Rep Urol. 2020;12:239-245
- Al-wageeh S, Ahmed F, Nikbakht HA, Al-shami E, Askarpour MR, Chowdhury U. An Investigation of the Histopathological Pattern of Thyroid in Patients Undergoing Thyroid Operations: A Cross-Sectional Study. Open Access Surgery. 2020 Jul 22;13:47-52.
- Ahmed F, Naji M, Al-Hitari A, Amer Q, Al-sagheer M, Chowdhury U. Use of tunica vaginalis graft for repair of traumatic bilateral testicular rupture after gunshot: a case report. The Pan African Medical Journal. 2020 Aug 12;36(268). doi: 10.11604/pamj.2020.36.268.21988
- Al-Wageeh S, Ahmed F, Al-Naggar K, Askarpour MR, Al-Shami E. Use of anterolateral thigh flap for reconstruction of traumatic bilateral hemipelvectomy after major pelvic trauma: a case report. Surg Case Rep. 2020 Oct 1;6(1):247. doi: 10.1186/s40792-020-01009-2. PMID: 33000349.
- Surgical Management of Giant Cervico-Axillo-Thoracic Cystic Hygroma: A Case Report(Accepted in MEJC)
- Ahmed F, Al-wageeh S, Al-shami E, Al-naggar K, Askarpour MR, Naji M. Congenital Isolated Penile Torsion: A Case Report in 2 Brothers. Open Access Surgery. 2020;13:75-78
https://doi.org/10.2147/OAS.S275810
- Ahmed F, Al-Wageeh S, Al-Shami E, Al-Naggar K, Askarpour MR, Naji M. Penile Injury During Ritual Circumcision. Research and Reports in Neonatology. 2020;10:95-99
https://doi.org/10.2147/RRN.S281896
Log book:
*Operations which I have observed only, and I can aid for them.
**Operations which I am fairly expert on them.
***Operations which I am expert on them and I can do them by myself.
- Pediatric urology:
-Urethroplasty and phallic reconstruction for epispadias*
-Bladder neck reconstruction (Yong-Dees-Leadbetter procedure)*
-Excision of large ureterocele***
-One-stage rapair of extrophy-epispadias complex*
-Vesicostomy (Blocksom metod)**
-Closure of vesicostomy**
-Primary closure of the bladder in extrophy-epispadias complex***
-Nephrectomy of pediatric RCC and Wilms' tumor**
-Pyeloplasty (dismembered***, spiral flap***, vertical flap**)
-Ureteroneocystostomy (Cohen***, Polatino-Leadbetter*, Lich***, n Gilvernet**,Glenn-Anderson**, Fish-mouth refluxing for kidney transplantation***)
-Herniotomy***
-Orchiopexy***
-Retroperitoneal varicocelectomy***
-Circumcision and revision of circumcision***
-Ileocystoplasty***
-Ureterocystoplasty***
- Endourology:
-Cystourethroscopy***
-Percutaneous nephrolithotomy***
-TUNA of the prostate*
-TUV of the prostate***
-TUR of the prostate***
-Incision of adult and pediatric ureterocele***
-Percutaneous endopyelotomy***
-Direct vision internal urethrotomy***
-Cystolitholapaxy***
-TUL***
-Percutaneous access to the kidney***
-TUR of the bladder tumor***
-TUR of the ejaculatory ducts***
-TUR of the bladder neck***
-PUV ablation***
-Incision of ureteric stricture***
-Incision of bladder neck contracture***
- Infertility:
-Vasovasostomy***
-Testicular biopsy***
-Vasectomy (NSV method and conventional methods)***
-Exploration of the vasa defrentia for vasography (Is doing in Radiology Department, yet)***
-Varicocelectomy (subinguinal***, inguinal***, retroperitoneal***)
- Kidney, Ureter & retroperitoneum:
-Adrenalectomy for adrenal tumor***
-Drainage of nephric, perinephric and paranephric abcess***
-Nephrolithotomy in the horseshoe kidney***
-Kidney transplantation*
-Transposition of the left renal vein (Nut-Cracker syndrome)*
-Open drainage of huge retroperitoneal recurrent lymphocele***
-Partial nephrectomy of upper moiety***
-Partial nephrectomy for large calyceal diverticulum***
-Partial nephrectpomy for RCC***
-Bilateral nephrectomy of huge ADPCKD (pre-transplantation)***
-Nephrectomy of very huge MCDK***
-Simple nephrolithotomy***
-Anatrophic nephrolithotomy***
-Open drainage of different type of renal cyst***
-Simple pyelolithotomy***
-Extended pyelolithotomy***
-Nephrectomy of XGPN***
-Ureterolithotomy (proximal***, middle***, and distal***)
-Ureteroureterostomy***
-Transureteroureterostomy***
-Ureteral tapering (megaureter)***
-Open retropritoneal biopsy (IRF)***
-Repair of ruptured renal artery (Iiatrogenic)**
-Ureterocalycostomy***
- Reconstructive urology and urinary diversion:
-Male to female transsexual surgery*
-Vaginoplasty using sigmoid colon*
-Reconstruction of ambigouos genitalia and orchiopexy*
-Orthotopic urinary diversion*
-Augmentation cecocystoplasty***
-Augmentation ileocystoplasty***
-Ureterocystoplasty***
-Ureterosigmoidostomy**
-Ileal conduit***
-Ileal reservoir (Kock pouch)**
-Indiana pouch*
-Ileocecal urinary diversion with Mitrofanoff continent stoma***
-Urethroplasty (MAGPI***, Snodgrass or TIP***, Matheiu**, Ducket***, Two-staged*,buccal mucosal graft*)
-Urethroplasty with release of chordee**
-Perineal urethroplasty of urethral distraction injury**
-Transpubic urethroplasty*
- Uro-oncology:
-Radical retropubic prostatectomy**
-Radical cystoprostatectomy***
-Female anterior pelvic exentration***
-Radical nephrectomy***
-Radical nephroureterectomy***
-Male and female urethrectomy for TCC***
-Radical inguinal orchiectomy***
-RPLND***
- Trauma & urology emergencies:
-Orchiopexy for torsion of the spermatic cord***
-Open cystostomy***
-Distal ureteroneocystostomy and psoas hitch (gunshot)**
-Repair of grade III/IV kidney trauma***
-Partial nephrectomy for kidney trauma***
-Nephrectomy of shuttered kidney***
-Repair of penetrating kidney truma (stab wound*** and gunshot***)
-Repair of bladder rupture***
-Primary realignment of posterior urethral rupture***
-Percutaneous cystostomy (with trocath)***
-Repair of the corpora cavernosa (penile fracture)***
-Repair of the urethra and copora cavernosa (shotgun)***
-Repair of tunica albugina of the testis***
-Orchiectomy of shuttered testis***
-Percutaneous drainage of pyonephrosis***
-Nephrectomy of emphysematous pyelonephritis***
- Female urology:
-MMK colposuspention*
-Trans-vaginal tape*
-Trans-obturator tape*
-Pubovaginal facial sling***
-Repair of vesicovaginal fistula***
-Excision of peri-urethral cyst***
-Excision of urethral diverticulum***
-Excision of urethral prolaps**
9- Laparascopic surgery (L.):
-L. Varicocelectomy*
-L. Simple nephrectomy*
-L. Drainage of renal cyst*
-L. Orchiopexy*
-L. Inguinal herniorrhaphy*
-L. Drainage of seminal vesicle cyst*
-L. Adrenalectomy*
-L. Cholecystectomy*
- Bladder & Urethra:
-Partial cystectomy***
-Simple cystectomy***
-Open cystolithotomy***
-Meatoplasty***
-Excision of benign penile mass***
-Urethrolithotomy***
- Prostate & Testes:
-Simple transvesical prostatectomy***
-Simple retropubic prostatectomy***
-Hydrocelectomy***
-Adult orchiopexy***
-Denervatin of the spermatic cord for chronic orchialgia***
-Epidydimectomy for post-vasectomy chronic orchialgia***
-Inntratunical orchiectomy for hormonal ablation***
- Penile surgery:
-Arterialization of deep dorsal vein of the penis*
-Excsion of Peyronie's plaque and dermal graft**
-Distal El-Ghorab spongiocavernosal shunt***
-Correction of chordee (Nesbit and dorsal placation)***
- Miscellaneous:
-Male facial sling*
-Resection of large perineal rhabdomyosarcoma**
-Extensive dranaige of Fornier's gangerene***
-Perineal urethrostomy (BXO)***
14-General surgery:
-Spelenectomy*
-Repair of ruptured IVC (trauma)**
-Adrenalectomy**
-Apendectomy**
-Repair of rectal injury**
-Colostomy*
-Ileostomy*
-Compelete pelvic exentration*
-Inguinal herniorrhaphy and herniotomy***
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