Buck's fascia repair with glanuloplasty in hypospadias surgery: A simple approach with excellent outcome

Baba, Asif Nazir; Wani, Sajad A.; Bhat, Nisar Ahmad; Mufti, Gowhar Nazir; Lone, Tariq Nazir; Nazir, Shaista

doi:10.1016/j.jpurol.2017.06.015

Cited by 18 publications

(16 citation statements)

References 16 publications

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“…It is easily available, tough tissue layer, which does not need extensive dissection or tailoring unlike tunica vaginalis and dartos flaps. Moreover, we found it to be highly effective in reducing the fistula rates which were 2% in our study thus similar to the findings by Baba et al [7]. Holland and Smith [15] attributed fistula and other complications to the adverse configurations of urethral plate.…”

Section: Discussionsupporting

confidence: 91%

“…In our series none of the patients had glanular dehiscence perhaps because minimal wingless glanuloplasty does not interfere with the vascular planes of the glans and also partly because we restricted WGP to glans size of > 14 mm. Baba et al have also produced similar results even though 10% of their patients included proximal hypospadias [7].…”

Section: Discussionmentioning

confidence: 63%

“…The same patient also had a fistula. The incidence of meatal stenosis is thus comparable with the standard TIP repairs [7,17].…”

Section: Discussionmentioning

confidence: 67%

“…However, the quest for most ideal intermediate layer is still on [5,6]. Recently Buck's fascia as an intermediate layer has shown very promising results due to it being a tough tissue layer with high tensile strength [7]. Apart from fistula formation, hypospadias repair may be associated with glanular dehiscence which is a common and significant complication given the fact that such patients typically need a redo procedure [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Outcome of Buck’s fascia repair with wingless glanuloplasty in distal penile hypospadias

et al. 2021

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Background Hypospadias surgery is technically demanding and is often encountered with complications like fistula and glanular dehiscence. To prevent these complications we have instituted Buck’s fascia repair (BFR) with wingless glanuloplasty (WLP) in the cases of distal penile hypospadias (DPH) deemed to be suitable for TIP repair. The aim of this prospective study was to assess the outcome of Buck’s fascia repair (BFR) with minimal wingless glanuloplasty (WGP). Methods This prospective study included 50 patients with coronal, subcoronal and midpenile hypospadias who received a tubularization of incised plate (TIP) repair. The exclusion criteria were glanular hypospadias, Thiersch Duplay repair, proximal penile hypospadias, previous penile surgeries, uncorrectable chordee, glans size < 14 mm, flat glanular groove and preoperative testosterone therapy. Results Over a period of 3 years, 50 patients with mean age of 3.5 ± 0.8 years were recruited for the study. Meatal position was coronal, subcoronal and midpenile in 6, 24 and 20 patients, respectively. Fistula occurred in one patient (2%) and meatal stenosis in one. Straining on micturition was noted in two patients that needed dilatation in postoperative period. None of the patients had glanular dehiscence. Surgeon acceptability of the procedure was good. Cosmetic results were also fair. Conclusion Buck’s fascia repair with Wingless glanuloplasty is a good repair for the distal penile hypospadias. It is effective and is associated with low fistula rates and glanular dehiscence. It is technically simple procedure involving minimal dissection. However, caution should be observed in midpenile hypospadias to avoid tight repair in subcoronal region.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 63%

“…The same patient also had a fistula. The incidence of meatal stenosis is thus comparable with the standard TIP repairs [7,17].…”

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Outcome of Buck’s fascia repair with wingless glanuloplasty in distal penile hypospadias

et al. 2021

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“…The distinguishing feature of our BFIC method is the integration of the anatomy of the BF combined with the glans wings so as to restore the intermediate-layer structure of the penis and provide a strong support for covering the neourethra ( Figures 5D,E ). Baba et al ( 26 ) applied BF as an intermediate layer in distal and proximal hypospadias with no or mild VC, and there was a statistically significant difference in the fistula occurrence (2.5% in the BF group vs. 12.5% in the dartos group), but in the report of Baba, the integrity of the glans wings and BF was interrupted at the coronal level. Herein, we cut the BF close to the edge of the UP, fully freeing both sides of the corpus cavernosus and, thus, achieving a tension-free suture in the middle of the ventrum.…”

Section: Discussionmentioning

confidence: 97%

Using Buck's Fascia as an Integral Covering in Urethroplasty to Restore the Anatomical Structure of the Penis in One-Stage Hypospadias Repair: A Multicenter Chinese Study Comprising 1,386 Surgeries

et al. 2021

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Objectives: The objective of the study is to investigate the feasibility and efficacy of urethroplasty with a Buck's fascia integral-covering technique (BFIC) to wrap and restore the normal anatomical structure of the penis in one-stage hypospadias surgery.Methods: One-stage surgeries for hypospadias management were performed using BFIC from January 2016 to September 2020 at four high-volume medical centers in China. The technique integrates Buck's fascia with glans wings to mobilize and wrap the urethra and restore penile anatomical relationships. The clinical data, postoperative follow-up data, and complications were recorded, and the results were analyzed.Results: A total of 1,386 patients were included in the study: 1,260 cases of primary hypospadias and 126 cases of re-operations; distal in 382 cases (27.6%), mid-shaft in 639 (46.1%), proximal in 365 (26.3%); tubularized incised plate (TIP) in 748 cases, inlay-graft in 124, onlay-graft in 49, Mathieu in 28, free-tube graft urethroplasty in 406, and 31 of hybrid procedures. One thousand one hundred forty-two patients (82.4%) were found to have penile curvature (>10°) after artificial erection and all corrected by dorsal plication/s or transection of the urethra plate (UP) simultaneously. The median followed-up time was 27 months (6–62). A total of 143 (10.3%) complications were recorded: 114 (9.0%) in the primary operations and 29 (23%) in the re-operations, 15 (3.9%) in distal hypospadias, 61 (9.5%) in mid-shaft, and 67 (18.4%) in proximal. The complication rate in UP preservation and transection was 10.1 and 10.8%, respectively. Of all case complications, there were 73 (5.2%) of fistula, 10 (0.6%) of dehiscence, 22 (1.6%) of meatal stenosis, 21 (1.5%) of stricture, 6 (0.7%) of diverticulum, and resident curvature in 11 cases (1.2%). The overall complication rate in TIP and free-tube procedure was 9.8 and 9.9%, respectively, and fistula occurred in primary TIP of 33 cases (4.9%).Conclusions: Buck's fascia with the glans can be used as an integral covering technique in one-stage distal to proximal hypospadias and primary or re-operative hypospadias repair. It is safe, feasible, and effective for the repair of hypospadias.

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Protective Intermediate Layer

Hadidi

2022

Hypospadias Surgery

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Buck's fascia repair with glanuloplasty in hypospadias surgery: A simple approach with excellent outcome

Cited by 18 publications

References 16 publications

Outcome of Buck’s fascia repair with wingless glanuloplasty in distal penile hypospadias

Outcome of Buck’s fascia repair with wingless glanuloplasty in distal penile hypospadias

Using Buck's Fascia as an Integral Covering in Urethroplasty to Restore the Anatomical Structure of the Penis in One-Stage Hypospadias Repair: A Multicenter Chinese Study Comprising 1,386 Surgeries

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