scholarly journals Surgical correction of severe forms of hypospadias in children

2012 ◽  
Vol 93 (2) ◽  
pp. 255-260
Author(s):  
I M Kagantsov
Keyword(s):  
Surgical Correction ◽  
Cosmetic Result ◽  
Medical Institution ◽  
Skin Flaps ◽  
Two Stage ◽  
Optimal Method ◽  
Urethral Plate ◽  
Positive Functional ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty

Aim. To search for an optimal method of surgical correction of proximal forms of hypospadias in children. Methods. During the period between 1998 and 2011 at the department of urology treated were 51 children with severe forms of hypospadias. Of the 51 patients under observation 13 patients had 21 operations performed out of our medical institution, at our hospital the patients underwent 98 operations: 7 types of urethroplasty in 51 patients. Results. The best results were obtained with a tubularized incised plate urethroplasty. After this intervention significantly fewer complications developed compared to the Duplay operation (p 0.001) and the techniques involving skin flaps - the so-called «flap» methods (p 0.05). After many years of applying various techniques for correction of proximal forms of hypospadias, in the author’s arsenal remain three: the tubularized incised plate urethroplasty, the Snodgraft intervention, and the two-stage Bracka operation. All of these operations bring together one key point - urethroplasty is performed from the urethral plate. Conclusion. The formation of the urethra from the urethral plate provides a positive functional and cosmetic result.

scholarly journals Redo hypospadias repair by a single surgeon after failed hypospadias surgeries: Experience from a developing country

2020 ◽  
pp. 17-23
Author(s):  
Md. Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tanvir Kabir Chowdhury
Keyword(s):  
Developing Country ◽  
Complication Rate ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Meatal Stenosis ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty ◽  
Principal Author

Background: Hypospadias surgeries are often complicated with fistulas, meatal stenosis and disruptions. We report our series of redo surgeries for failed primary repairs. Methods: We prospectively observed all the redo hypospadias repairs done by the principal author between 2013 and 2017. Thiersch-Duplayurethroplasty was done if the urethral plate was adequately wide and intact; tubularized incised plate (TIP) urethroplasty was performed if the urethral plate was intact but, narrower than 8 mm; 2 stage procedures were done with oral mucosal graft (OMG) if the urethral plate was deficient or scarred with significant chordee. Result: There was a total of 31 patients. Age ranged from 18 months to 15 years (mean 8.05 ±4.27 years). Sixteen (51.61%) patients underwent only one surgery, 10 (32.26%) patients underwent 2 surgeries, 2 patients (6.45%) underwent 3 surgeries, and 3 patients (9.68%) underwent 4 surgeries prior to presenting to us before our redo surgeries.We had performed TIP urethroplasty in 16 (51.61%) patients, meatal based flap urethroplasty in 12 (38.71%), OMG followed by urethroplasty in 2 (6.45%), and repair of urethra-cutaneous (UC) fistula in 1 (3.23%) patient. Ten (32.26%) Complications occurred in 8 (25.80%) patients. Unsuccessful repair was noted in 03 (9.67%) patients (UC fistula 1, glans dehiscence with UC fistula 1, and glans dehiscence 1). Conclusion: Thiersch-Duplay and TIP repair can be successfully performed in redo hypospadiassurgeries with acceptable complication rate. OMG graft can be reserved for cases with gross scarring of the urethral plate. Keywords: Failed hypospadias repair; Tubularized incised plate urethroplasty; Thiersch-Duplay; Outcome

scholarly journals Hypospadias in toddlers: a multivariable study of prognostic factors in distal to mid-shaft hypospadias and review of literature

2022 ◽  
Vol 5 (1) ◽  
pp. e000225
Author(s):  
M Reza Roshandel ◽  
Tannaz Aghaei Badr ◽  
Fahimeh Kazemi Rashed ◽  
Samantha Salomon ◽  
Seyyed Mohammad Ghahestani ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Factors Affecting ◽  
Tubularized Incised Plate ◽  
Multivariable Regression ◽  
Tubularized Incised Plate Urethroplasty ◽  
Predicting Factor ◽  
Hypospadias Surgery

BackgroundTubularized incised plate urethroplasty is the most common hypospadias repair technique. However, there are unanswered questions and debates about the anatomical prognostic factors affecting the repair outcomes. This study tried to address some of the problems in the studies compromising the results of the current body of literature.MethodsA prospective cohort of 101 males aged 1–3 years undergoing primary distal to mid-shaft hypospadias repair were enrolled in the study. Complications including edema, erection, inadvertent removal of the urethral stent, surgical wound infection, bladder spasm, hematoma, and hemorrhage were evaluated. Studies in the current literature were reviewed to achieve a better perspective for future investigations.ResultsPersistent complications were found in 16 cases (15.8%) including fistula formation, the persistence of chordee, meatal stenosis, glans, and urethral dehiscence. The mean follow-up time was 6.6±3.4 months. In the single-variable analysis, the meatal location, the length and width of the urethral plate, and the reversible acute postoperative events were significantly associated with the complications. Furthermore, fistula formation was associated with acute surgical site infection (p<0.001). However, the multivariable regression study revealed the presurgical meatal location to be the only statistically significant factor (p=0.03). Notably, the glans diameter or glanular groove shape, urethral plate dimensions, or presence of mild chordee were not independently associated with the outcomes (p>0.05).ConclusionsOur study on the toddlers with hypospadias surgery revealed that the location of urethral meatal was the main predicting factor in the development of major complications. Furthermore, the fistula formation at the infected surgical site emphasizes the importance of postsurgical care.

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