scholarly journals RISK FACTORS FOR URETHROCUTANEOUS FISTULAS FORMATION AFTER ONE STAGE HYPOSPADIAS REPAIR

2011 ◽  
Vol 18 (2) ◽  
Author(s):  
Mohammad Fariz ◽  
Arry Rodjani ◽  
Irfan Wahyudi
Keyword(s):  
Hormonal Therapy ◽  
Fistula Formation ◽  
Operation Technique ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
One Stage ◽  
History Of ◽  
Duration Of Operation ◽  
Urogenital Anomalies ◽  
Onlay Island Flap

Objective: To evaluate risk factors that contribute to urethrocutaneous fistulas formation after one stage hypospadias repair. Material & method: A case control study was performed on hypospadias patients that underwent one stage hypospadias repair. We analyzed the correlation of urethrocutaneous fistula formation with patient age, hypospadias classification, chordee severity, other urogenital anomalies, history of hormonal therapy, suture size, duration of operation, type of dressing, type of stent, duration of stenting, and three types of operation technique, which are TIP, Duckett, and Onlay Island Flap. Results: There were 116 patients with mean age 5,7 ± 3,9 years old (4 months – 19 years old). Urethrocutaneous fistula occured in 12 patients (10,3%). From the data analysis, we didn’t find any significant correlation between urethrocutaneous fistula formation and patient’s age (p = 0,426), hypospadias classification (p = 0,695), chordee severity (p = 0,564), other urogenital anomalies (p = 0,964), history of hormonal therapy (p = 0,739), suture size (p = 0,248), duration of operation (p = 0,856), type of dressings (p = 0,580), type of stents (p = 0,600), and duration of stenting (p = 0,796). We also didn’t find any significant correlation between urethrocutaneous fistula formation and operation technique TIP vs Duckett (p = 0,314), and TIP vs Onlay Island Flap (p = 0,644). Conclusion: There were no significant correlation between urethrocutaneous fistula formation and patient age, hypospadias classification, chordee severity, other urogenital anomalies, history of hormonal therapy, suture size, duration of operation, type of dressing, type of stent, and duration of stenting. There were also no significant correlation between urethrocutaneous fistula formation and operation technique TIP vs Duckett, and TIP vs Onlay Island Flap. Keywords: Hypospadias, one stage urethroplasty, urethrocutaneous fistula.

scholarly journals LIMITED URETHERAL MOBILIZATION PROCEDURE (LUMP) FOR DISTAL PENILE HYPOSPADIAS REPAIR, A SINGLE CENTRE RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 9 (5) ◽  
pp. 1335-1343
Author(s):  
Muhammad Riaz-ul-Haq ◽  
◽  
Arslan Raza Wasati ◽  
Mazhar Rafi ◽  
Sohail Jamil ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Postoperative Management ◽  
Fistula Formation ◽  
Paediatric Surgery ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Meatal Stenosis ◽  
Cosmetic Appearance

Background: Distal penile hypospadias is one of the commonest varieties of hypospadias. Different techniques have been mentioned in literature. The success rate is usually assessed by rate of fistula formation and over all cosmetic appearance and functional outcome. Limited Uretheral Mobilization Procedure (LUMP) for distal penile hypospadias is considered a good technique with almost zero fistula rate in some series. As no new urethral tube is constructed there is no risk of fistula. Objective: To evaluate the results of the Limited Urethral Mobilization Procedure (LUMP) for distal hypospadias repair. Methods.It is retrospective analysis of 32 patients aged up to 12 years who were treated with Limited urethral mobilization procedure for distal penile hypospadias in the Department of Paediatric Surgery Jinnah Hospital Lahore from December 2018 to November 2019. All patients were operated under general anesthesia. The urethra proximal to the meatus was mobilized adequately in such a way that it should reach the tip of glans easily without any ventral bending of penis.Then the urethra was placed in the glandular wings and reconstruction of glans was carried out. Dartos flap was also placed to cover the urethra as a safety measure to avoid urethrocutaneous fistula formation. Follow up was done for a period of 3 months with respect to fistula formation, meatal stenosis, retraction , chordee and over all cosmetic appearance. Results: Age range of children was 9 months to 12 years. Operation time ranged from 60-80 minutes. Seven of 32 cases were previously operated for distal penile hypospadias but after disruption of repair meatus was lying at coronal or subcoronal level. They also underwent LUMP. Five cases had minor chordee, it was corrected at the time of uretheral mobilization by simple excision of fiberous tisse in 4 patients while modified Nesbit dorsal placation was done in one. Cosmetically normal looking circumcised penis with slit like meatus was achieved in all.Two cases got superficial wound infection, two had meatal stenosis, one meatal retraction, one ventral chordee and one urethrocutaneous fistula. Conclusion: LUMP for distal penile hypospadias is a simple and effective procedure with minimum complications.There is no chance for development of urethrocutaneous fistula, a major postoperative complication of other surgical techniques for uretheroplasty. Postoperative management is simple and hospital stay is short.

scholarly journals TUBULARIZED INCISED PLATE URETHROPLASTY FOR ONE-STAGE HYPOSPADIA REPAIR IN CHILDREN AT HASAN SADIKIN HOSPITAL BANDUNG

2017 ◽  
Vol 24 (2) ◽  
Author(s):  
Harris Oetama ◽  
Safendra Siregar
Keyword(s):  
Fistula Formation ◽  
Hypospadias Repair ◽  
One Stage ◽  
Tubularized Incised Plate ◽  
Operative Complications ◽  
Highly Effective ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Post Operative Complications

Objective: To determine the outcome of tubularized incised-plate (TIP) urethroplasty for  one stage hypospadia repair in children. Material & methods: A 7-year retrospective experience at Hasan General Sadikin Hospital Bandung on the outcome of tubularized incised plate for one-stage hypospadias repair in children during 2009-2015. Results: A total of 102 children was undergone one stage hypospadias repair with TIP urethroplasty. The mean age was 6.97 years old. As much as 65 (63.72%) children had distal, and 37 (36.28%) children had proximal hypospadia. The mean length of surgery was 112.56 minutes. Post operative complications was rarely found, consisting of 5 (6.32%) children had urethrocutaneus fistula formation and 11 (13.9%) children had haematoma. 4 (10.81%) children with proximal hypospdia and 1 (1.53%) children with distal hypospadia had urethrocutaneus fistula formation. 4 (6.15%) children with distal hypospadia and 7 (18.91%) children with proximal hypospadia had haematoma. Conclusion: Tubularized incised-plate (TIP) urethroplasty for one stage hypospadia repair in children was highly effective with rare complications comparable with recently published study.

scholarly journals Spongioplasty with Dartos Flap Coverage in the Snodgrass Technique of Hypospadias Repair

2020 ◽  
Vol 38 (2) ◽  
pp. 64-67
Author(s):  
Sahadeb Kumar Das ◽  
Kaniz Hasina ◽  
Md Ashraf Ul Huq ◽  
Syed Abdul Adil ◽  
Md Mahbubul Alam ◽  
...  
Keyword(s):  
Prospective Study ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Flap Coverage ◽  
Dartos Flap ◽  
Distal Hypospadias ◽  
A Prospective Study

Objective: The aim of the study is to evaluate the role of spongiosal tissue with dartos flap coverage for preventing Urethrocutaneous Fistula (UCF) formation in the Snodgrass technique. Materials and Methods: It is a prospective study, performed on 35 patients of mid penile and distal hypospadias aged 15 months to 144 months who underwent urethroplasty in the Snodgrass technique using spongiosal tissue and dartos flap for neourethral coverage. Results: Among 35 patients, Age ranged from 15 months to 144 months (mean 85.94 months). Chordee was corrected by penile degloving alone in 11 patients, partial mobilization of urethral plate with spongiosum in 20 patients and 4 patients required dorsal plication. Glans groove was deep in 19 patients, shallow in 13 patients and no groove noticed in 3 patients. Sixteen patients had narrow urethral plate (<8mm) and 19 patients had adequate urethral plate (>8mm). Urethrocutaneous Fistula (UCF) was encountered in five patients (14.28%), meatal stenosis in two patients (5.71%), and partial glanular dehiscence in one patient. Conclusions: Approximation of spongiosal tissue along with dartos flap as the intermediate layer for neourethral coverage reduces fistula formation. J Bangladesh Coll Phys Surg 2020; 38(2): 64-67

scholarly journals THE RELATION OF HYPOSPADIAS TYPES, AGES, AND SURGICAL TECHNIQUES FOR URETHROCUTANEOUS FISTULA COMPLICATION IN CHILD HYPOSPADIAS CASES

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Desy Pratiwi Widjajana ◽  
Septa Surya Wahyudi ◽  
Ika Rahmwati Sutejo
Keyword(s):  
Surgical Technique ◽  
Significant Relationship ◽  
Surgical Techniques ◽  
The Other ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Cross Sectional ◽  
Surgery Technique ◽  
Hypospadias Surgery ◽  
Onlay Island Flap

Objective: To find correlation between hypospadias type, age, and surgical technique for urethrocutaneous fistula in child hypospadias cases. Material & Method: This research was an observational analytic research with cross sectional approach. It was conducted at Bina Sehat Jember Hospital, Paru Jember Hospital, and Bhayangkara Bondowoso Hospital. The research samples were hypospadias patients who had done hypospadias repair with susceptible age from 0 months until 16 years. Result: In this study, was found correlation between type of hypospadias with urethrocutaneous fistula (p=0.03 and r=0.43). And the other hand, this research did not find relationship between age at hypospadias surgery with urethrocutaneous fistula complication (p=0.34 and r=0.3). The results of this study indicate that the incidence of urethrocutanoeus fistula complications in the surgery using TIP technique was greater than Onlay Island Flap technique, but in this study, there was no association between hypospadias surgery technique used with complications of uretrocutanoeus fistula (p=0.3 and r=0.22). Conclusion: In this study, there was a significant relationship between hypospadias type with urethrocutaneous fistula complication with statistically moderate strength and positive correlation direction. This study did not show any significant relationship between age and hypospadias surgery technique with complications of urethrocutanoeous fistula.

scholarly journals PERBEDAAN ANGKA KEJADIAN FISTEL URETROKUTAN PADA PENGGUNAAN KATETER URETRA DAN KATETER SUPRAPUBIK DENGAN STENT SETELAH OPERASI HIPOSPADIA

1970 ◽  
Vol 16 (2) ◽  
Author(s):  
Yacobda H Sigumonrong ◽  
Adi Santoso ◽  
Tarmono Djojodimedjo ◽  
Widodo J P
Keyword(s):  
Urethral Catheter ◽  
Fistula Formation ◽  
Fisher Exact Test ◽  
Suprapubic Catheter ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Significance Level ◽  
Exact Test ◽  
Onlay Technique ◽  
Single Operator

Objectives: To study rate of urethrocutaneous fistula formation associated with usage of indwelling urethral catheter compared to suprapubic catheter with stent after hypospadias repair. Materials and methods: Twenty patients with primary hypospadias of penile shaft and posterior type underwent reconstruction with onlay technique by a single operator. Urinary diversion in 10 patients utilised a urethral catheter, while the remainder used a silicone suprapubic catheter with stent. Results: Seven urethrocutaneous fistula were observed (35%) with 4 fistulas in the group with suprapubic catheter and stent, and 3 fistulas in the group with urethral catheters. Fisher exact test value was 0,001 with significance level of 1,000 (p>0,05). Conclusion: There was no difference in rate of urethrocutaneous fistula with use of urethral catheter and suprapubic catheterisation with stent after hypospadias repair.

Cyanoacrylate Based Products as Interpositioning Substance versus Reintervention Alone for Urethrocutaneous Fistula Repair after Hypospadias

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Abdallah ◽  
A M Tawfeek ◽  
A M W Mohareb
Keyword(s):  
Success Rate ◽  
Surgical Repair ◽  
Fistula Formation ◽  
P Value ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Cyanoacrylate Glue ◽  
Recurrent Fistula ◽  
Significant Difference ◽  
Basis Method

Abstract Background urethrocutaneous fistula (UCF) is still the commonest complication after hypospadias repair. Although recent advances in the surgical procedures of hypospadias repair have reduced the rate of urethrocutaneous fistula formation, it remains a real complication of hypospadias and frustrating problem for surgeons. Aim of the Work evaluation of success and failure rates of using cyanoacrylate based productes as an interpositioning substance in surgical repair of fistula after hypospadias in comparison to the classic surgical repair technique. Patients and Methods this is a prospective, randomized-controled study, conducted on 40 patients from the date of the approval of the study. It is comparing two different modalities for repair of urethrocutaneous fistula that has developed after hypospadias repair. Our study was assigned on a randomized basis method according to a 1:1 ratio and patients underwent either multilayered closure using dartos facial flap or using cyanoacrylate glue as an interpositioning layer before suturing of the dartos flap for the closure of the urethrocutaneous fistula. All cases were divided into 2 equal groups, 20 cases each. The cases were distributed randomly into the two groups. Results the success rate was higher for patients using cyanoacrylate glue as a protective interpositioning layer as 16 patients (80%) were successfully repaired and 4 patients (20%) developed a recurrent fistula. However, there was no statistically significant difference between 2 groups p-value was 0.465. Conclusion there was no statistically significant difference in adding cyanoacrylate glue to multilayered closure of urethrocutaneous fistula after hypospadias repair. However, cyanoacrylates showed that they are a favourable additional protective substance and they resulted in a high success rate without adding any surgical complications.

Clinical and diagnostic aspects of deep infiltrative endometriosis (diagnosis, treatment, recurrence)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 307-313
Author(s):  
Shakhnoza K. Muftaidinova ◽  
Leonid Z. Faizullin ◽  
Vladimir D. Chuprynin ◽  
Nikolai S. Ruseikin ◽  
Tatiana I. Smolnova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hormonal Therapy ◽  
Serum Levels ◽  
Ca 125 ◽  
Prior History ◽  
Deep Endometriosis ◽  
Preoperative Serum ◽  
Peritoneal Endometriosis ◽  
History Of ◽  
Deep Infiltrative Endometriosis

Aim. To analyze the recurrence of endometriosis after surgical treatment of patients with deep endometriosis. Materials and methods. The case histories of 90 patients aged 19 to 45 years were retrospectively analyzed. The study group consisted of 70 endometriosis patients: 20 with peritoneal endometriosis and 50 with deep infiltrative endometriosis (DIЕ). The comparison group included 20 women without endometriosis. There was an in-depth study of anamnestic data in the cohort of patients under study. The results of preoperative laboratory tests, including serum levels of the CA-125 and CA 19-9 oncomarkers, were processed. Results. Analysis of the obtained data showed that about half of the DIE patients (54%) in the main group had a history of surgical interventions for endometriosis. The number of operations was significantly higher in patients compared to the peritoneal endometriosis group (68% vs 20%, respectively; р=0.0012). Two subgroups were formed from the group of women with DIE: patients who had no history of previous surgical treatment for endometriosis and those hospitalized for repeated surgical treatment of endometriosis (patients with recurrent endometriosis). Patients with recurrent endometriosis had a significantly higher incidence of heavy menstruation, pregnancy terminations (abortions), and a high proportion of gastrointestinal diseases. Analysis of the hormonal therapy received in patients with DIE showed that every second patient with relapses (18/53%) after surgical treatment and every third patient without a prior history of surgery (5/31%) received hormonal therapy. Examination of the preoperative serum levels of CA-125 and CA 19-9 serum markers in patients with DIE showed an increase in their serum levels and a correlation with the frequency of endometriosis recurrence and the size of DIE foci. Conclusion. Despite the conservative and surgical treatment of DIE patients, the recurrence rate is still high. At present, there is no satisfactory therapy for all endometriosis patients. Therefore, the development of therapy for the conservative treatment of the disease remains an urgent task.

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