Foreskin retractility following hypospadias repair with preputioplasty – Medium term outcomes

Kallampallil, Jins; Hennayake, Supul

doi:10.1016/j.jpurol.2013.05.022

Cited by 14 publications

(5 citation statements)

References 15 publications

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“…Under these circumstances, the TIP repair is currently the most commonly performed procedure, and this technique leaves the prepuce intact. Similarly, PR could be considered an option also in proximal hypospadias cases amenable to a TIP repair [7,9,11,12]. Nevertheless, such cases accounted for less than 10% of cases undergoing PR in the series we identify (Table 1) and Kallalampalil et al [12] have noted that proximal meatal location increases the risk to end up with a non-retractile prepuce (OR 3.01, 95% CI 1.29e7.04).…”

Section: Pr and Urethroplastymentioning

confidence: 81%

See 1 more Smart Citation

Preputial reconstruction in hypospadias repair

Castagnetti

Bagnara²,

Rigamonti

et al. 2017

Journal of Pediatric Urology

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Section: Pr and Urethroplastymentioning

confidence: 81%

“…Kallampallil et al [12] have reported the only series on preputial retractility after PR associated with HR.…”

Section: Preputial Retractility and Secondary Phimosis After Prmentioning

confidence: 99%

Preputial reconstruction in hypospadias repair

Castagnetti

Bagnara²,

Rigamonti

et al. 2017

Journal of Pediatric Urology

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“…Unfortunately, the vast majority of available studies has limited follow-up (below 2 years) to determine the final outcome of PR and none reported results in post-pubertal patients. Only one study specifically focused on preputial retractility after PR associated with hypospadias repair ( 21 ). After a median follow-up of 2.3 years, the prepuce was retractile in 82% (159/194) of patients, 14% (27/194) were under observation for a tight prepuce, and circumcision had been performed for a secondary phimosis in 4% (8/194) of cases.…”

Section: Discussionmentioning

confidence: 99%

Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

et al. 2016

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IntroductionWe performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair.Materials and MethodsA systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword “hypospadias.” Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected. A meta-analysis of studies comparing PR vs. circumcision was performed for the outcomes “hypospadias fistula formation” and “reoperation rate.”ResultsTwenty studies were identified. Nineteen reported the outcome of PR in 2115 patients. Overall, 95% (2016/2115) of patients undergoing PR had distal hypospadias. The cumulative rate of PR complications was 7.7% (163/2115 patients), including 5.7% (121/2115 patients) preputial dehiscences and 1.5% (35/2117 reported patients) secondary phimoses needing circumcision. A meta-analysis of seven studies comparing patients undergoing PR vs. circumcision showed no increased risk of urethral fistula formation associated with PR, odds ratio (OR) (Mantel–Haenszel, Fixed effect, 95% CI), 1.25 (0.80–1.97). Likewise, two studies comparing the overall reoperation rate did not show an increased risk of reoperation associated with PR, OR (Mantel–Haenszel, Random effect, 95% CI), 1.27 (0.45–3.58).ConclusionPR carries an 8% risk of specific complications (dehiscence of reconstructed prepuce or secondary phimosis needing circumcision), but does not seem to increase the risk of urethroplasty complications, and the overall reoperation rate of hypospadias repair.

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“…Meatal stenosis seems to be due to the use of smaller than appropriate size catheter following UPI and this has not been seen after 2009. Tight foreskin was due to not ensuring that the foreskin was loose enough to facilitate retraction at the end of the procedure [12] and this has not been seen since 2005. Partial or complete foreskin dehiscence is likely to be due to inadequate apposition of the dartos layer between skin and mucosa and less than optimum closure of skin with this stage of the procedure being performed by trainees or due to poor quality of foreskin tissue.…”

Section: Split Spongiosal Correction To Correct the Glans Tiltmentioning

confidence: 99%

The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications

Amila¹,

Tamas²,

Supul³

2022

IJCU

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Introduction There are various techniques described for repair of penile hypospadias. Objective To present the anatomical repair technique and to discuss the lessons learned from this technique over 18 years. Methods All consecutive patients with penile hypospadias who underwent anatomical repair of urethra, spongiosum, bucks and dartos fascia and foreskin by the 3 rd author, with a minimum of 1 year follow up from January 2003 to March 2020 at the Royal Manchester Children's Hospital, United Kingdom, were included in the study. No formal ethics approval taken as this study was done as a service evaluation. Perioperative and follow up data were recorded prospectively in the departmental database. SIPP 21 was used for statistical analysis. Fisher's Exact Test used for sub-group analysis. Findings were considered statistically significant at p<0.05. Results 368 patients had surgery at a median age of 18 months. 94.6% had no complications, 4.1% had minor and 1.3% had significant complications. 77.5% had a distal ectopic meatus. The mean length of urethroplasty was 8mm. To widen the urethral plate, a meatoplasty (M) was performed in 34% and urethral plate incision (UPI) in 14%. Catheters were used in 71% for a median duration of 7 days, and 40% had a 6F catheter. Regards to meatal stenosis the only statistically significant causative factor was UPI with 6fr catheter. P value=0.02. Conclusions Anatomical repair provides a completely normal penis with minimal complications. Meatoplasty widens the urethral-plate and reduces the risk for meatal stenosis.

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Foreskin retractility following hypospadias repair with preputioplasty – Medium term outcomes

Cited by 14 publications

References 15 publications

Preputial reconstruction in hypospadias repair

Preputial reconstruction in hypospadias repair

Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications

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