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    Detection of Meatal Stenosis with Uroflowmetry in Cases of Distal Hypospadias that are Operated with the TIPU Technique
    (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) Guvercin, Emre; Temiz, Gokhan; Cakmakoglu, Cagri; Yesiloglu, Nebil; Faydaci, Gokhan; Filinte, Gaye Taylan; Bozkurt, Mehmet; Akoz, Tayfun
    Objective: Meatal stenosis after hypospadias surgery causes difficulty in urination and intermittent cessation in urinary stream at the early postoperative period. Increasing the duration of catheterization, meatotomy, and meatal revision surgeries are among the procedures applied for meatal stenosis. If the diagnosis of meatal stenosis is made at an earlier stage, it is easier to manage it, especially in the younger age group. We aimed to determine whether the uroflowmetry technique can be a guide for detecting and following meatal stenosis. Material and Methods: Forty-one cases with distal hypospadias operated with the Tubularized Incised Plate Urethroplasty (TIPU) technique were involved in this study. At the postoperative 1st month, all the patients with or without complaints of meatal stenosis had uroflowmetries with an effort to provide an objective data for diagnosing stenosis at the early stages. The results of uroflowmetries were compared with the clinical signs of meatal stenosis. Results: The average maximum flow rate was found to be 11.3 mL/s (6.7-31.6), and the average voided quantity of urine was detected as 181.7 mL/s (71-283) as result of uroflowmetry. Ureteral stenosis was clinically diagnosed in three patients with intermittent urination, prolonged urination with poor flow, and with difficulty in starting urination. All patients were found to be similar. The uroflowmetry results were parallel to the clinical outcome in all patients. Conclusion: In the early stages, uroflowmetry can assist clinical observation as a non-invasive method. In addition, it makes it possible to perform earlier therapeutic interventions.
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    Temporal Facelift: A New Method for Temporal and Mid-face Lifting
    (Lippincott Williams & Wilkins, 2023) Şirinoğlu, Hakan; Guvercin, Emre
    Lifting the temporal and mid-face areas creates a very dynamic change in the facial appearance and different planes of dissection were described before. In this article, a new plane of dissection is described which allows the surgeon to perform a very quick and safe dissection in both the temporal and mid-face regions. Patients were operated on using the presented technique and brow lift, cantopexy, and mid-facelift were performed. The outcome of the surgery was analyzed by the authors from standardized photos before and 6 months after the surgery with measurements of the brow and lateral canthus. The plane of dissection is just over the subgaleal fascia which is actually the sub-superficial musculoaponeurotic system layer in the mid-face. This plane of dissection is easy and quick and creates a very mobile mid-face and temporal flap. Forty female patients were operated using the presented technique with a mean follow-up period of 15 months, the longest follow-up was 26 months. No major complication was encountered in these patients. In 5 patients, transient unilateral frontal branch palsy was encountered. In 1 patient, bilateral temporal area depression was observed 8 months after the surgery and treated with a fat injection under local anesthesia. One patient had alopecia in the temporal suture line which can be covered with hair. Temporal facelift is a versatile method with long-lasting results due to its important features; creating a very mobile flap for suspension dissection area, a large surface for adherence, and numerous sutures sharing the tension on the key sutures. Despite its slightly difficult early healing period, the technique should be kept in mind for the rejuvenation of the periorbital area and mid-face.Level of Evidence: Level I.