A novel technique for repair of mid-penile hypospadias using a preputial skin flap: results of 110 patients

Elmoghazy, Hazem; Hussein, Mohamed; Mohamed, Elnisr Rashed; Badawy, Abdelbasset A.; Alsagheer, Gamal A.; Elhamed, Ahmed Mamdouh Abd

doi:10.1007/s11255-016-1416-7

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…More than 200 different reconstructive methods for urethral stricture disease or congenital absence have been described, with a variety of donor tissues, such as free skin grafts [1], bladder mucosa [2], buccal mucosa [3], and lingual mucosa [4], proving successful for urethral reconstruction. However, in many cases, an adequate amount of donor tissue is not available [5].…”

Section: Introductionmentioning

confidence: 99%

Urethral reconstruction with autologous urine-derived stem cells seeded in three-dimensional porous small intestinal submucosa in a rabbit model

Liu

et al. 2017

Stem Cell Res Ther

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BackgroundUrethral reconstruction is one of the great surgical challenges for urologists. A cell-based tissue-engineered urethra may be an alternative for patients who have complicated long strictures and need urethral reconstruction. Here, we demonstrated the feasibility of using autologous urine-derived stem cells (USCs) seeded on small intestinal submucosa (SIS) to repair a urethral defect in a rabbit model.MethodsAutologous USCs were obtained and characterized, and their capacity to differentiate into urothelial cells (UCs) and smooth muscle cells (SMCs) was tested. Then, USCs were labeled with PKH67, seeded on SIS, and transplanted to repair a urethral defect. The urethral defect model was surgically established in New Zealand white male rabbits. A ventral urethral gap was created, and the urethral mucosa was completely removed, with a mean rabbit penile urethra length of 2 cm. The urethral mucosal defect was repaired with a SIS scaffold (control group: SIS with no USCs; experimental group: autologous USC-seeded SIS; n = 12 for each group). A series of tests, including a retrograde urethrogram, histological analysis, and immunofluorescence, was undertaken 2, 3, 4, and 12 weeks after the operation to evaluate the effect of the autologous USCs on urethral reconstruction.ResultsAutologous USCs could be easily collected and induced to differentiate into UCs and SMCs. In addition, the urethral caliber, speed of urothelial regeneration, content of smooth muscle, and vessel density were significantly improved in the group with autologous USC-seeded SIS. Moreover, inflammatory cell infiltration and fibrosis were found in the control group with only SIS, but not in the experimental autologous USC-seeded SIS group. Furthermore, immunofluorescence staining demonstrated that the transplanted USCs differentiated into UCs and SMCs in vivo.ConclusionsAutologous USCs can be used as an alternative cell source for cell-based tissue engineering for urethral reconstruction.

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Section: Introductionmentioning

confidence: 99%

Urethral reconstruction with autologous urine-derived stem cells seeded in three-dimensional porous small intestinal submucosa in a rabbit model

Liu

et al. 2017

Stem Cell Res Ther

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“…The use of a local preputial skin flap as a neo-urethra is not a new technique for urethroplasty. Several case reports have described the use of this technique for urethroplasty (Elmoghazy et al, 2016). The preputial skin is reversed, so that the epithelium is inside, and the mucosa is outside.…”

Section: Discussionmentioning

confidence: 99%

One-Step Urethroplasty in Recurrent Chordee on Scrotal Hipospadia

Jailani

2020

bioex

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Hypospadia is genitalia externa congenital anomaly in male. Recurrent chordee is one of most complication often happen in hypospadias correction. One-step urethroplasty in recurrent chordee is very challenging due to formed massive fibrosis. Correction surgery goals is to release chordee and moving meatus urethra externa to glans tip, and could be done by one-step or two-step. We report patient, 13 years old boy came with chief complain urinate from scrotal region. Patient was diagnose with scrotal hypospadia. Patient done chordee excision previously, but penis still not straight. Then, we perform one-step urethroplasty rechordee excision with local flap. Patient was follow-up one week postoperative, wound in good condition, and dehiscent wasn’t found. Urinary catheter released after three weeks. Evaluation also done in one month postoperative, and found no fistel. One-step urethroplasty rechordee excision was perform in scrotal hypospadi with local urethroplasty flap technique. Evaluation from beginning until two months postoperative found no fistel and urinate in straight line.

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“…At present, the cure standard of hypospadias is not only satisfying sex life quality and standing micturition, satisfying cosmetic appearance is also very important. The general research thinks [3],a kind of excellent kill for hypospadias repair should be advantageous to protect supply blood of the distal skin flap, guarantees healing and growth of the neourethra, effectively reduces of the operation times and the rate of operation complication, increase the surgical cure rate [4], as well as achieves satisfaction of the function and cosmetic appearance of the penis [5]. Due to the recognition of urethral plate tissue [6], the urethroplasty of using urethral plate has become a common surgical method for hypospadias repair, the TIP surgery method(Tubularized incised plate plasty) is very good at protecting the anatomical and physiological functions of the urethral.…”

Section: Discussionmentioning

confidence: 99%

To Cultivate Neourethra of Autologous for Proximal Hypospadias Repair of No Associated with Severe Chordee

Liu

Zhang

et al. 2018

BJSTR

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Background: Hypospadias is a common congenital disease and the incidence of live birth is about 1/1250~1/1830 [1]. The most typical is ectopic urethra, the ventral curved downwards of penis, and dorsal skin is "hooded". According to the urethral open position, 80% of patients have a distal malpositioning of the meatus that requires a single-stage repair and nearly 20% have a more severe proximal meatus malposition, which may require two to three stage repair operations. The more serious the initial problem, the higher the complication rate, and the more operations the patient is likely to require. The common postoperative complications of hypospadias include urethrocutaneous fistula, urethral stricture (dysuria) and ventral penile curvature. In a large number of reports of surgical treatment of hypospadias, the evaluation indicators are all complications that are easy to find in the early stages. The performance and acceptability are based on short-term observations. As for satisfaction, it is not possible to seek the opinions of the patients. The final assessment of the effect of the operation can only be determined based on their parents' "degree of satisfaction". In view of the incomplete evaluation index of existing treatment effects, many authors proposed the appearance of the penis, penile curvature and urination function as a new index of hypospadias surgery. Research suggests that the preoperative assessment of the severity of hypospadias and the rational choice of surgical methods are important guarantees for the reduction of postoperative complications of hypospadias, and also for the satisfaction of the appearance of the penis and normal sexual function.Surgical operation is the only way to treat hypospadias, but, due to the great reasons, occurrence rates of complications such as the urethral fistula or constriction, reoccurrence of clubbed penis, poor development of penis and poor appearance of penis are still quite high after operation, indicating that the therapeutic effect of operation have relativities with selected the cure technique.Purpose: To describe a new technique which to Cultivate Neourethra of Autologous(CUA) for proximal hypospadias repair. Material and MethodsClinical Material: A total of 287 patients with hypospadias ranged in age from 1 month to 7 years (average 10.5 months), of which 164 patients in the cured group and 123 patients in the control group had proximal hypospadias.Operation Methods: To utilize the urethra plate to reconstruct a neourethral, longitudinal incision of the septum of scrotum and dartos muscle of scrotum, imbedding the ventral prepuce and corpus spongiosum together with the neourethral and dartos muscle of scrotum, stratified the dartos muscle of scrotum and the skin of septum of scrotum and ventral prepuce corresponding suture, the neourethral was cultivated with a good blood supply of the dartos muscle of scrotum. After 6 months, the second-stage surgery will be performed Meatoplasty and Glanuloplastyto correct abnormal ventral curvature of the penis. Resu...

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A novel technique for repair of mid-penile hypospadias using a preputial skin flap: results of 110 patients

Abstract: This study presents a novel technique for mid-penile hypospadias repair using a preputial skin flap with excellent results in terms of short- and long-term outcomes.

Cited by 13 publications

References 27 publications

Urethral reconstruction with autologous urine-derived stem cells seeded in three-dimensional porous small intestinal submucosa in a rabbit model

Urethral reconstruction with autologous urine-derived stem cells seeded in three-dimensional porous small intestinal submucosa in a rabbit model

One-Step Urethroplasty in Recurrent Chordee on Scrotal Hipospadia

To Cultivate Neourethra of Autologous for Proximal Hypospadias Repair of No Associated with Severe Chordee

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