Comparison of Hypospadiac and Normal Preputial Vascular Anatomy

Abstract

Understanding the differences between normal and hypospadiac prepuce vascular anatomy is germane to hypospadias surgery. The arterial blood supply of the hypospadiac prepuce is different than normal. A better knowledge of the vascular anatomy of the hypospadiac prepuce may improve the surgical results of hypospadias repair.

The microvessel density of the hypospadiac prepuce in children

“…The vascular anatomy of the prepuce is also proposed as an important factor when choosing the operative technique, and may have an influence on the surgical outcome. A better knowledge of the vascular anatomy of the hypospadiac prepuce may improve the surgical results of hypospadias repair [3].…”

Two-Stage Urethroplasty for Severe Primary Hypospadias

“…Two-stage repair can be indicated in severe primary hypospadias when: (1) severe chordee (greater than 45 degree) is related to urethral tethering (type IV chodee), and sufficient plate transection warrants long segment urethral substitute; (2) genital skin tissue is insufficient for reconstruction; (3) development of the penis is poor with microphallus and underdeveloped glans/groove, and orthotopic meatus is not likely to be created; (4) severe penoscrotal transposition is associated, with its correction the urethroplasty may be threatened; (5) dorsal hood is not suitable for flap transfer and tubularization in that tissue volume is inadequate, unfolding of prepuce hood endangers vascularity or is dissatisfactory and resulted in a highly irregular surface, or vasculature of dorsal skin is of network type (Yucel et al, 2004); (6) poor cosmesis is expected with single-stage repair; (7) surgeon experience of hypospadias correction is immature (Manzoni & Bracka, 2004;Price et al, 2003;Titley & Bracka,1998). The prevalence of hypospadias is high.…”

“…Through a transillumination technique, the prepuce vasculature is recognized and this is of importance in deciding by what manner the prepuce utilized in urethroplasty. Yucel et al (Yucel et al, 2004) classified the arterial vascular anatomy of normal and hypospadiac prepuce as 1 artery predominant, 2 arteries predominant, H-type arching artery and net-like arterial system. They noted that hypospadiac prepuce revealed a net-like arterial system more frequently (50%) and the frequency was higher in more severe hypospadiac prepuce.…”

Histological Analysis of Vascular and Collagen Tissues in the Ventral and Corresponding Dorsal Skin of Mid-Penile Hypospadiac Penis at the Meatal and Coronal Levels: A Comparative Study

“…In another study it was commented that despite the clinical use of urethral plate to form neourethra, its histological characteristics have not been well understood 12 . Another hypospadiologist reviewed the literature regarding histological findings and made the statement that data about the difference in vascularity between hypospadiac and normal penis were lacking 14 . Thus, at present there seems to be a lot of confusions regarding the histological findings of hypospadiac penile skin among the authors who have worked in this field.…”