Can a graft be placed over a flap in complex hypospadias surgery? An experimental study in rabbits

Mattos, Ricardo Marcondes; Araújo, Sérgio R.R. de; Quitzan, Juliany Gomes; Leslie, Bruno; Bacelar, Herick; Parizi, João Luiz Gomes; Martins, Gustavo Marconi Caetano; Cruz, Marcela Leal da; Macedo, António

doi:10.1590/s1677-5538.ibju.2016.0168

Cited by 6 publications

(2 citation statements)

References 17 publications

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“…Urethral defects were created according to the previously described methods 1617. Briefly, the penis was freed by incising the fold between the ventral penile portion and the anus, facilitating access to the urethra.…”

Section: Methodsmentioning

confidence: 99%

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model

et al. 2019

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Tubularized graft urethroplasty fails largely because of inadequate graft take. Prefabrication of buccal mucosa lined flap has theoretical indications for constructing neourethra with an independent blood supply. The efficacy of using a tissue expander capsule as an induced vascular bed to prefabricate an axial vascularized buccal mucosa-lined flap for tubularized urethral reconstruction in a rabbit model was tested. The experiments were performed in three stages. First, silicone tissue expanders were inserted into the groin to induce vascularized capsule pouch formation. Next, buccal mucosa grafts were transplanted to the newly formed capsular tissue supplied by the axial vessel for buccal mucosa-lined flap prefabrication. Then, circumferential urethral defects were created and repaired by buccal mucosa graft (Group 1), capsule flap (Group 2) and prefabricated capsule buccal mucosa composite flap (Group 3). With retrograde urethrography, no rabbits in Group 1 maintained a wide urethral caliber. In Group 2, the discontinued epithelial layer regenerated at 1 month, and the constructed neourethra narrowed even though the lumen surface formed intact urothelial cells at 3 months. In Group 3, buccal mucosa formed the lining in the neourethra and kept a wide urethral caliber for 3 months. The capsule may serve as an induced vascular bed for buccal mucosa-lined flap prefabrication. The prefabricated buccal mucosa-lined flap may serve as a neourethra flap for circumferential urethral replacement.

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Section: Methodsmentioning

confidence: 99%

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model

et al. 2019

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“…Hence, TIPU has fallen out of favour for STAGED repair in proximal hypospadias. Concerns about a higher risk of urethroplasty failure when combined with a corporal grafting procedure in a single-stage repair have led to this paradigm shift [11][12][13]. In our study, TIPU was performed in carefully selected cases of proximal penile hypospadias with a Glans score of 1 or 2 and a Shaft score of 2 or 3 (mild to moderate chordee).…”

Section: Classical: Ectodermal Ingrowth Theory 2 Newer Two Zipper Hyp...mentioning

confidence: 99%

Outcome of spongioplasty alone as second layer of tubularised incised plate urethroplasty in patients with hypospadias

et al. 2022

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Background Spongioplasty alone or in combination with local tissue flaps can be used as a second layer for the prevention of complications of tubularised incised plate urethroplasty (TIPU) of hypospadias repair. It can be used when wide urethral plate and well-developed robust spongiosum are present. This study aims to review the success rate and complications of TIPU performed utilising spongioplasty alone as a second layer in Type 3 well-developed robust spongiosum. Methods This is a retrospective observational study conducted between January 2015 and December 2019 at a tertiary care centre. A total of 21 patients aged 4–15.4 years with primary hypospadias having a Type 3 well-developed robust spongiosum, Glans score ≤ 2, Meatal score ≤ 4, and Shaft score ≤ 3 underwent TIPU using spongioplasty alone as a second layer. The hospital stay ranged from 10 to 14 days and follow-up from 12 to 36 months. Results Hypospadias was distal in 12 (57.1%), mid in 5 (23.8%), and proximal penile in 4 (19.1%) patients. The mean Glans Meatus Shaft score was 6.1 (G = 1.25, M = 2.95, S = 1.9) with a range of 3–9. An early post-operative complication of preputial oedema and bladder spasm developed in 1 (4.7%) patient each. Meatal stenosis developed in 1 (4.7%) patient. None developed urethrocutaneous fistula. At 3 months all patients had good urinary flow (> 15 ml/s) and good cosmesis. All the patients/parents (in case of minors) were satisfied with the result. Conclusion Spongioplasty alone as the second layer after TIPU for primary penile hypospadias in patients with well-developed robust spongiosal tissue is associated with minimal, easily manageable complications.

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The Surgical Approach to Two-Stage Hypospadias Repair

2022

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Can a graft be placed over a flap in complex hypospadias surgery? An experimental study in rabbits

Cited by 6 publications

References 17 publications

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model

Outcome of spongioplasty alone as second layer of tubularised incised plate urethroplasty in patients with hypospadias

The Surgical Approach to Two-Stage Hypospadias Repair

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