Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce

Duan, Shou Xing; Li, Jianhong; Jiang, Xuewu; Zhang, Xuan; Ou, Wenhui; Fu, Maxian; Chen, Kaihong; Zheng, Lei; Shu, Hua

doi:10.3389/fped.2020.00128

Cited by 11 publications

(7 citation statements)

References 23 publications

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“…11 It is still uncertain whether surgical intervention is necessary for patients with partial MIP who have normal urinary and sexual function, and whose daily life is not affected by the condition. 12 However, in light of increased awareness regarding cosmetic appearance, a surgical correction can be offered to the family to prevent late readmission which may result in difficulty in surgery. 2 On the other hand, surgery can safely be offered in patients with a meatal opening close to or below the coronal margin, a deep glans cleft, a broad, splayed-out glans, and urinary difficulty caused by the anomaly.…”

Section: Discussionmentioning

confidence: 99%

Megameatus Intact Prepuce: Families May Find it Diffucult to Give A Consent to Surgery in Non-Severe Cases, and the Surgery Can be More Difficult in Late Presentation

ŞİPAL,

SUÇEKEN

2023

J Reconstr Urol

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We presented rare 8 megameatus intact prepuce (MIP) hypospadias variants and perspectives of families and patients regarding the surgery and our outcomes. Material and Methods: The 8 glanular MIP cases were admitted to our clinic between 2020-2023, aged between 3 to 17. The 6 cases were presented for circumcision, 2 were admitted with self suspicions. A 17-year-old was admitted for abnormal meatal appearance, considering self-awareness in advanced age; an 11-year-old family had suspected an anomaly after circumcision. Meatuses were glanular in 5, coronal in two, and distal penile in one. Mathieu flap techniques for uncircumcised and meatal advancement and glanuloplasty (MAGPI) for circumcised cases were preferred. Results: In four cases, the family declined to have the operation, due to a perceived lack of abnormalities. Two uncircumcised MIP cases were successfully treated using Mathieu flap techniques. The one circumcised glanular MIP was repaired by the MAGPI technique, resulting in late fistula formation. The 17-year-old case was treated with Matheus techniques using prepuce flaps, but ended up with a late fistula formation due to unpreventable erection episodes. Conclusion: MIP ıs a rare hypospadias variant and ıs commonly concealed by the foreskin causing difficulty in detection, delayed diagnosis, sometimes even after circumcision, and may cause families to reject surgical correction due to a perceived lack of abnormalities. However, as it is shown in our series, a lack of preputial tissue or advanced age may negatively impact the operation's success. Families should be informed about the surgical difficulty in late presentation. The Mathieu techniques can be safely applied in non-circumcised MIP cases.

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Section: Discussionmentioning

confidence: 99%

Megameatus Intact Prepuce: Families May Find it Diffucult to Give A Consent to Surgery in Non-Severe Cases, and the Surgery Can be More Difficult in Late Presentation

ŞİPAL,

SUÇEKEN

2023

J Reconstr Urol

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“…TIP procedure could result in an excellent penile performance and a very low complication rate [ 15 ]. The technique is usually used for less than 1 cm urethral plates and patients with minimal to no chordee [ 16 ]. In this patient, favorable clinical results were seen during the two weeks post-operative follow-up.…”

Section: Clinical Discussionmentioning

confidence: 99%

Tubularized incised plate urethroplasty for megameatus intact prepuce hypospadias variant: First reported case in Indonesia

Permana

Djojodimedjo

Renaldo

2021

International Journal of Surgery Case Reports

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Highlights Megameatus intact Prepuce (MIP) is a rare variant of hypospadias. The case has never been previously reported in Indonesia. MIP reconstruction is challenging due to a thin and immobile ventral portion of the urethral meatus tissue. Tubularized Incised Plate (TIP) urethroplasty is able to fulfil adequate outcomes for a MIP hypospadias variant. Telemedicine can be utilized for postoperative care in pediatric urology patients.

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“…The diagnosis and reporting of cases of megameatus intact prepuce (MIP) have cumulatively increased during the last 10 years 1 . This anomaly is diagnosed in 3%–6% of patients with hypospadias.…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis and reporting of cases of megameatus intact prepuce (MIP) have cumulatively increased during the last 10 years. 1 This anomaly is diagnosed in 3%-6% of patients with hypospadias. Almost all the literature defines MIP as a large wide patulous meatus at the subglanular groove, with wide spatulated glans and a deep urethral groove.…”

Section: Introductionmentioning

confidence: 99%

Spectrum and classification of megameatus anomalies

et al. 2023

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Objective To define and classify megameatus anomalies, the parameters of a considerable number of cases were investigated and compared with those of normal children. Methods A total of 1150 normal babies were examined during routine nonmedical circumcision, and another 750 boys referred with hypospadias were examined during the previous 3 years. All patients were evaluated and assessed for the size, location, and configuration of the urinary meatus, and penile length and girth were measured. Children with normal size and location of the meatus were considered control group A, and 42 cases of different forms of megameatus were considered group B. Other penoscrotal, urinary, and general anomalies were examined and investigated accordingly. All data were analyzed by the SPSS 9.0.1 statistical package and compared by paired t tests. Results Forty‐two uncircumcised patients aged from 1 month to 4 years (mean 18 months) were diagnosed with a urinary meatus that engrossed the whole ventral or dorsal aspects of the glans, exceeding half the width of the glans or penile girth with the complete vanishing of the glans closure in most cases. Megameatus is usually associated with the abnormal meatal position as hypospadiac, orthotopic, or epispadic. Additionally, megameatus may be associated with a normally intact or deficient prepuce. Consequently, we had four categories of megameatus, and the intact prepuce orthotopic megameatus subcategory has not been described before. Megameatus was also detected with deficient prepuce, and this was considered a hypospadiac variant. Conclusion Megameatus is diagnosed precisely with penile biometry and is classified into 4 groups: hypospadiac, epispadic, and orthotopic or central, either with or without intact prepuce. This classification is applicable for expansion to other centers.

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Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce

Cited by 11 publications

References 23 publications

Megameatus Intact Prepuce: Families May Find it Diffucult to Give A Consent to Surgery in Non-Severe Cases, and the Surgery Can be More Difficult in Late Presentation

Megameatus Intact Prepuce: Families May Find it Diffucult to Give A Consent to Surgery in Non-Severe Cases, and the Surgery Can be More Difficult in Late Presentation

Tubularized incised plate urethroplasty for megameatus intact prepuce hypospadias variant: First reported case in Indonesia

Spectrum and classification of megameatus anomalies

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