Glandular Groove Research Articles

Separation of the glanular part of the urethral plate, mobilization of the distal part of the neourethra, and creation of the glanular groove: a new modification of second-stage Thiersch-Duplay urethroplasty in proximal hypospadias repair.

To evaluate the effect of separation of the glanular part of the urethral plate from the underlying glans penis with creation of a glanular groove for free accommodation of the neourethra as a new modification of Thiersch-Duplay urethroplasty in proximal hypospadias repair. Between January 2016 and January 2022, 35 patients with proximal hypospadias underwent a modified Thiersch-Duplay two-stage procedure. The glanular portion of the urethral plate was either separated from the underlying glanular tissue or discarded if found scared with mobilization of the distal portion of the neourethra to reach the tip of the glans penis. In all patients, a few millimeter of glanular tissue is excised to create a glanular groove in which the neourethra is embedded freely. 35 patients were involved in this study. The patient's age at the time of operation ranged from 18months to 10years (median 3.7years). The mean follow-up period was 15.7months (ranging from 12 to 18months). Two patients developed urethrocutaneous fistula; while, none of the patients had meatal stenosis, urethral stricture, or meatal retraction. All patients have a slit-like meatus at the tip of the penis and a good cosmetic conical shape glans appearance. We believe that in Thiersch-Duplay urethroplasty, separation of the urethral plat from the underlying glanular tissue and creation of good glandular groove to accommodate the neourethra is associated with adequate glanular closure and minimization of post-operative meatal stenosis, glanular dehiscence, and meatal retraction.

TIPU outcomes for hypospadias treatment and predictive factors causing urethrocutaneous fistula and external urethral meatus stenosis in TIPU: Clinical study.

Our aim is to present patient outcomes for the TIPU method, currently mostly used for distal and sometimes proximal hypospadias treatment, and to identify predictive factors for the most commonly encountered complications of this surgery of urethrocutaneous fistula and urethral meatus stenosis. TIPU is a versatile, reliable, cosmetic and functionally successful surgical method mainly used for distal hypospadias patients but also in recent times for some proximal hypospadias patients. The main complications are urethrocutaneous fistula, urethral meatus stenosis, glans dehiscence and urethral meatus dehiscence. The pre-operative anatomic features of patients were assessed with the glans-meatus-shaft (GMS) scoring. Post-operative assessment of surgical outcomes was performed with the hypospadias objective scoring evaluation (HOSE). The mean total urethrocutaneous fistula and meatal stenosis development rates were 20 (12.3%) and 25 (15.4%). Both complications were found to be significantly high among hypospadias patients with narrow urethral plate, flat glandular groove and small glans (p<.001). Multivariate binary logistic regression analysis found urethral plate, glandular groove and glans shape were predictive factors for fistula and stenosis development.

Tubularized incised plate urethroplasty (Snodgrass procedure) for distal penile hypospadias: A regional center experience

Objective: Tubularized incised plate (TIP) urethroplasty has rapidly become the procedure of choice for repair of distal penile hypospadias (DPH) at most of the centers throughout the world. We did some modifications in the original technique to improve the outcome. In this article, the technique of TIP urethroplasty is discussed and literature is reviewed. Materials and Methods: TIP urethroplasty was performed in 250 new cases of DPH from January 2005 to December 2015 in our institute. We included only primary DPH with typical characteristics including stenotic meatus, deep glandular groove, wide urethral plate distally and in middle, and adequate size penis. We did some modification in the original Snodgrass repair to improve our outcome. Neourethra was covered with vascularized pedicled dartos flap from the inner prepuce. Patients were followed up for a mean of 12 months. Results: Age range of the patients varied between 3 and 11 years with majority of them [235 (94%)] below 9 years; 50 (20%) patients had mild-to-moderate chordee, which was corrected by degloving of the penis. We did not require tunica albuginea plication to correct chordee because it was only skin chordee. The mean age of children was 6 years. Mean duration of surgery was 50 min (45–60 min). Postoperative hospital stay was 10 days. Overall complication rate, requiring specific intervention, was 13.2%. Major complications occurred in 30 (13.2%), urethrocutaneous fistula in 15 (6%), meatal stenosis in five (2%), complete dehiscence in three (1.2%), glanular dehiscence in five (2%), and proximal stricture in five (2%) patients. Functional results as judged by the urinary stream were good in 225 (90%) patients. An excellent cosmetic result was seen in 215 (86%) patients. Conclusion: TIP urethroplasty with dartos flap cover is a simple, single-stage procedure for DPH with excellent cosmetic and functional results and is associated with minimal complications. Finally, some of our modifications in the original technique can improve the outcome.

Tubularized proximally-incised plate in distal/midshaft hypospadias repair.

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25th percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

Immunolocalization of Intermediate Filaments and Laminin in the Oviduct of the Immature and Mature Japanese Quail (Coturnix coturnix japonica)

This study describes the distribution of vimentin, desmin, smooth muscle actin (SMA) and laminin in the oviduct of the immature and mature Japanese quail. The cytoskeletal proteins vimentin, desmin and SMA have been shown to be involved in cellular support, differentiation, migration and contractility. Laminin is a major component of basement membranes. Luminal epithelia in the infundibular and magnal regions of immature and mature birds exhibited strong vimentin immunoreactivity. Luminal epithelial cells exhibiting strong vimentin immunoreactivity were present in the isthmus and shell gland regions of only mature quails. Infundibular glandular grooves displayed strong vimentin immunostaining. In contrast, the glandular epithelia of the magnum, isthmus and shell gland were vimentin immunonegative. Fibroblasts and vascular endothelial cells in the lamina propria of the oviductal regions studied exhibited strong vimentin immunostaining. Smooth muscle cells forming the tunica muscularis and vascular tunica media displayed strong desmin and SMA immunostaining. Strong laminin immunostaining was demonstrated in the basement membranes associated with smooth muscle cells, as well as in the basement membranes underlying the luminal and glandular epithelia. In conclusion, this study has shown that the immunolocalization of desmin, SMA and laminin in the oviduct of the Japanese quail is similar to that in the domestic fowl. However, differences in the immunoexpression of vimentin in the LE of the two avian species were shown to exist. In addition, the study has shown that the immunolocalization of vimentin in the Japanese quail varies depending on the oviductal region, as well as the developmental stage of the oviduct.

An Immunohistochemical Study of the Oviduct in the Domestic Fowl (Gallus domesticus)

This study describes the distribution of vimentin, desmin, smooth muscle actin (SMA) and laminin in the oviduct of the laying domestic fowl. Vimentin immunostaining was localised in the luminal epithelium of the infundibulum, magnum, magnum-isthmus junction and isthmus. The luminal epithelium of the shell gland regions displayed weak vimentin immunostaining. Vimentin immunostaining was demonstrated in the glandular grooves of the tubular infundibular region. In contrast, gland cells in the magnum, isthmus and shell gland regions were vimentin immunonegative. Fibroblasts and vascular endothelial cells in the lamina propria of the oviductal regions studied exhibited vimentin immunostaining. Strong desmin and SMA immunostaining were present in the smooth muscle cells of the tunica muscularis and vascular tunica media. In this study, basement membranes underlying the luminal and glandular epithelia were immunopositive for laminin. In addition, basement membranes associated with smooth muscle cells exhibited laminin immunostaining. The results of the study indicate that the immunolocalisation of desmin, SMA and laminin in the oviduct of the domestic fowl is similar to that in the mammalian uterus. The immunolocalisation of vimentin in the domestic fowl varies depending on the oviductal region.

Scanning Electron Microscopy of the Oviductal Mucosa Apposing the Hen Ovum

The surface patterns of the chicken hen oviductal mucosa apposing an ovum were examined by scanning electron microscopy. The distended infundibular mucosa consisted of folds that were separated by interfold spaces of similar width and longitudinal orientation. The epithelium, which lined the base of the interfold spaces, was nonciliated and appeared to correspond to the glandular grooves, which are the sites of sperm storage in the infundibulum. The presence of an ovum in the magnum or isthmus resulted in the flattening of the mucosal folds and occlusion of the oviductal lumen. The uterine mucosa was slightly compressed when apposed to an egg and wide interfold spaces were evident.

Histochemical studies of the development of alkaline and acid phosphatase activities in the ovary and oviduct of the fowl (Gallus domesticus).

Alkaline and acid phosphatase activities were studied in the ovary and oviducts of pullets from the age of 2-32 weeks. Adult fowls were similarly studied. Alkaline phosphatase activity was present only in the glandular grooves and crypts of the immature oviducts. Alkaline phosphatase activity appeared at the pits of epithelial evaginations as glandular formation commenced. The young, non-secreting glands also showed the enzyme activity. But in the mature oviduct, alkaline phosphatase activity was confined to only the uterovaginal glands or sperm host glands and the epithelium of the vagina. In the ovary, alkaline phosphatase activity in the theca interna increased as the diameter of the follicles increased. Acid phosphatase activity was not present in the ovary, but in the oviduct, the enzyme activity was present in the uterine (shell gland) glands and in the uterovaginal epithelium and glands (sperm host glands). Alkaline phosphatase activity in the ovarian follicles and in the immature oviduct is thought to be related to histodifferentiation of these structures.

Modified Mathieu’s surgical procedure for distal penile hypospadias—our institutional experience

Aims and Objective: This study was carried out to show modified Mathieu’s procedure to reduce the rate of complications of Mathieu’s procedure for the repair of primary distal hypospadias. Settings and Design: Prospective study. Materials and Methods: This study was carried out in the Department of Paediatric Surgery from March 2012 to March 2016. Children between 3 and 12 years were included in the study. We managed 40 patients with primary distal hypospadias. Those who had previous repair, chordee were excluded from the study. After a detailed history, local examination was performed with reference to the site and shape of meatus, glandular groove, penile size, and presence of chordee. Modified Mathieu’s was performed in 40 patients. On follow-up, the patients were examined for the position and the shape of the meatus, urinary stream, urethrocutaneous fistula, and stricture formation. Statistical Analysis Used: Done. Results: The mean age of the presentation was 7.5 ± 2.68 years (range 3–12 years). The mean operative time was 52.37 ± 5.42 min in modified Mathieu’s repair. Complications after surgery were urethrocutaneous fistula in one (2.5%), glandular disruption in 2 (5%), meatal stenosis in zero, wound infection in zero cases in modified Mathieu’s repair. The shape of meatus was near to rounded in all patients who had undergone modified Mathieu’s repair, which was accepted by parents cosmetically and with urinary stream in our study. Conclusion: The modified Mathieu’s repair is significantly faster with less complication in spite of having round-shaped meatus, which was cosmetically and with good urinary stream accepted by parents in our study.

サルボウとカリガネエガイの足糸の解剖學的構造

The byssus gland of Anadara subcrenata is a single thread with a somewhat dilated end (Fig. 1) and composed of 10-30 single long compressed tubules at the root. The tubules are nearly in parallel with each other (Fig. 2) and arranged radially in U-shape in cross section (Fig. 3) and do not anastomose one another at the proximal ends and their distal ends are gathered together into an opening at the conical process (Fig. 2, C) which is located in the byssus pit (P). When the adult of Anadara, measuring 30-40mm in length, is placed in the aquarium, it casts away the byssus and attaches itself to the substratum with a newly formed byssus. The new byssus is secreted from conical process which reaches at first the substratum to fix the end fo byssus over there and then contracts into the byssus pit in stretching the byssus substance so as to from a thick thread. The byssus of Barbatia obtusoides is thick lamellar in shape (Fig. 5) and is secreted from the numerous deep long glandular grooves, running parallel in longitudinal direction of foot (Fig. 6), anastomosing sometimes at the proximal ends. The glandular grooves are gathered together in one groove on each side and united into one on the byssus ridge (C). The byssus of Barbatia is so much well developed as it may withstand a heavy beach-comber in the cleft of rock between tide marks.