Patient reported vaginal laxity, sexual function and stress incontinence improvement following vaginal rejuvenation with fractional carbon dioxide laser.

In this study, we have evaluated the efficiency of fractional carbon dioxide laser in the treatment of vaginal laxity and urinary incontinence. Thirty patients with vaginal laxity, sexual dysfunction and urinary incontinence complaints were treated with fractional carbon dioxide laser. Results were evaluated with patient questionnaires relating to comfort during the procedure and general satisfaction following the procedure. In the survey regarding comfort during the procedure, 90% (n:27) of the patients reported that they were comfortable during the procedure. The survey on the level of general satisfaction six months following the procedure revealed high-moderate level of satisfaction in 86% (n:26) of the patients. 66% (n:20) of the patients reported improved vaginal tightness and 63% (n:19) of the patients reported improvement in the quality of their sexual activity. Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire(PISQ-12) scores six months following the procedure were not significantly different when compared to the scores prior to the procedure. The average of Questionnaire for Urinary Incontinence Diagnosis(QUID) score prior to the procedure and six months following the procedure was 7.5 and 0.9 respectively (p < 0.05). Fractional carbon dioxide laser treatment results in high level of satisfaction and improvement in vaginal laxity, sexual dysfunction and urinary incontinence symptoms in patients with genitourinary syndrome.

Long-term objective results of proximal phalanx fracture treatment.

BACKGROUND: Proximal phalanx fractures are common. In this study, our preferred methods regarding the treatment of proximal phalanx fractures and their long-term objective results are presented. METHODS: Between October 2001 and March 2010, in the Plastic Reconstructive and Aesthetic Surgery Department of Düzce Medical Faculty, we treated 23 patients with 32 proximal phalanx fractures. Stable fractures (n=5) were treated with splints, while unstable fractures (n=27) were stabilized with 1.0 mm percutaneous intramedullary Kirschner wires following open reduction. RESULTS: At follow-ups, ranging from 3 months to 9 years, patients were evaluated with radiologic efficiency, range of motion (ROM), total active movements (TAM), and grip power of the digit. TAM scores of 20 fingers were perfect (≥220° for D2-5, ≥150° for D1), for 7 fingers were good (180- 220° for D2-5, 120-150° for D1), and for 5 fingers were either moderate or poor. No difference was observed between grip strength of broken fingers and that of healthy fingers. As a major complication, non-union occurred in one finger. CONCLUSION: We concluded that Kirschner wire fixation is a reliable and simple method of treating unstable proximal phalangeal fractures, and excellent long-term results can be obtained in suitable cases. In stable proximal phalanx fractures, splints provide sufficient treatment.

Subtotal ear amputation with a very narrow pedicle: a case report and review of the literature.

Total ear amputation is common, and management can necessitate different procedures, especially microsurgical anastomosis. Partial ear amputations supplied by narrow pedicles, however, have been reported rarely. In a subtotally amputated auricle, the chance of survival depends on the vascularization within the pedicle. In our case, the right ear of a 36-year-old male patient was subtotally amputated following a traffic accident, leaving only a 6-mm skin pedicle on the cranial side. The subtotally amputated segment was bleeding from the wound margins. The ear was reattached with primary suture without using microsurgical techniques after optimal debridement. Postoperatively, we administrated dextran 40 for 5 days to improve the microcirculation and increase blood volume and antibiotic to control the infection. No signs of edema, venous congestion or arterial insufficiency were observed immediately after the operation or subsequently. The replanted auricle healed completely with 100% survival, resulting in an essentially normal contour and appearance. This successful result without microvascular anastomoses also points out the anatomical features of the auricular vascular networks.

Vertical mammaplasty for gigantomastia.

A 48-year-old female patient presented with gigantomastia. The sternal notch-nipple distance was 55 cm for the right breast and 50 cm for the left. Vertical mammaplasty based on the superior pedicle was performed. The resected tissue weighed 3400 g for the right breast and 2800 g for the left breast. The outcome was excellent with respect to symmetry, shape, size, residual scars, and sensitivity of the nipple-areola complex. Longer pedicles or larger resections were not found in the literature on vertical mammaplasty applications. In our opinion, by using the vertical mammaplasty technique in gigantomastia it is possible to achieve a well-projecting shape and preserve NAC sensitivity.

Anophthalmia, cleft lip/palate, absent vomer bone, nystagmus, and mental-motor retardation: a new syndrome or Fryns "anophthalmia-plus" syndrome?

OBJECTIVE: We report that a 4-year-old boy presented with right unilateral complete cleft lip and palate, right anophthalmos, left congenital nystagmus, absence of the vomer bone, mental-motor retardation, and normal lymphocyte karyotype (46, XY). METHODS: For reconstruction of the deformities, we performed cleft lip repair by Millard's rotation-advancement technique and planned cleft palate repair. CONCLUSIONS: This combination of cleft lip and palate, anophthalmos, congenital nystagmus, absent vomer bone, and mental-motor retardation has not, to our knowledge, previously been described. We suggest that this represents either another case of the rare Fryns "anophthalmia-plus" syndrome or a new syndrome.