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

Akan, Mab; Amin, Ali; Sibli, Mmr; Shahinoor, AM; Anisuzzaman, M; Islam, Md. Reazul; Zaman, MN

doi:10.3329/jpsb.v2i1.15158

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…In the hypospadias penis, the important local healing factors, i.e., vascular-collagenous tissues, are insufficient on the ventral skin as compared with the dorsal skin. This may be responsible for the higher incidence of complications like frustrating UCF after operation 6 .…”

Section: Introductionmentioning

confidence: 99%

Result of simple versus layered repair of urethro-cutaneous fistula developing after hypospadias surgery

Biswas,

Islam,

Amin

et al. 2024

J. paediatr. surg. Bangladesh

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Background: Urethro-cutaneous fistula (UCF) after hypospadias surgery occurs regardless of the location of the meatus, procedure performed or experience of the surgeon. Hypospadias repair continues to be a singularly demanding form of surgical expression with considerable artistic latitude. The commonest complication of hypospadias surgery is fistula formation, which almost always requires repeat and similarly demanding surgery. Aims and Objectives: The aim of our study was to compare the result between simple and layered repair of UCF developing after hypospadias surgery. Materials and Methods: This comparative type of study was carried out in the Department of Paediatric Surgery, BSMMU, Dhaka from June 2015 to August 2016 for a period of 15 (fifteen) months. Forty (40) diagnosed cases of UCF were included in the study. All the participants were randomized into two groups named Group A & Group B. Group A was assigned to the simple repair technique & Group B was assigned to the layered repair technique. Relevant data were collected in a predesigned questionnaire. Results: The recurrent fistula formation rate was much higher in Group A (30%) than in Group B (05%), which was statistically significant in between the two groups. The majority of the fistulae recurred within a few days of the removal of the stent (from 7th to 10th POD). 6, out of 7 recurrent UCF were observed in this period. No recurrent fistula was observed beyond 4 weeks after operation. Conclusions: This study revealed that, the layered repair technique, with the addition of vascularized dorsal dartos fascia reduces the recurrent fistula formation rate in a significant number. Though more time consuming and technically difficult, we recommend wide application of layered repair technique in the management of post hypospadias UCF. Journal of Paediatric Surgeons of Bangladesh (2019) Vol. 10 (1 & 2): 37-42

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Section: Introductionmentioning

confidence: 99%

Result of simple versus layered repair of urethro-cutaneous fistula developing after hypospadias surgery

Biswas,

Islam,

Amin

et al. 2024

J. paediatr. surg. Bangladesh

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“…Histological analysis of the ventral skin of the hypospadiac penis, distal to the meatal opening shows that collagen and vascular tissues are insufficient here significantly. 8 Those locally deficient healing factors may be responsible for the causation of frustrating urethrocutaneous fistula after hypospadias surgery as both the factors are essential for wound healing. 9 To augment ventrally in terms of collagen and vascular tissues, a local vascular flap termed the dorsal vascular preputial flap is created and transferred ventrally to fix it over the neourethra created by the Snodgrass technique.…”

Section: Introductionmentioning

confidence: 99%

Comparative study between snodgrass urethroplasty and modified snodgrass urethroplasty for distal penile hypospadias in terms of post-operative urethrocutaneous fistula formation

Akan

Mondal²,

Mojmdar³

et al. 2022

Int J Contemp Pediatr

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Background: Hypospadias is a congenital defect involving the male urethra characterized by the absence of urethral meatus at its normal position. This anomaly is usually associated with the ventrally deficient but dorsally hooded skin. In some cases, the penis is ventrally curved. Surgery is the option for this defect. So many procedures have been developed but none is free from the development of urethrocutaneous fistula. Now-a-days, the popular Snodgrass procedure is widely practiced but still fistula occurs. Many factors are thought to be responsible for it. The most important one is defective ventral penile skin which is deficient of vascular and collagen tissues. To minimize these deficient factors, a dorsal vascular preputial flap is transferred ventrally (modified) to reduce fistula formation further. A comparative study was disigned to determine the role of dorsal vascular flap.Methods: The prospective observational study was conducted in the department of pediatric surgery, Bangabandhu Sheikh Mujib medical university, Dhaka, Bangladesh since February 2017 to May 2021.Results: A total of 40 patients with distal penile hypospadias were included in this study. They were divided into Group A and group B, 20 for each. Snodgrass procedure was for Group A and the modified Snodgrass procedure was done for group B. The outcome of both the groups was determined in terms of fistula formation. Seven patients in group-A and one patient in group B developed fistula. The results were analyzed and were found statistically significant.Conclusions: Modified Snodgrass urethroplasty has a better outcome.

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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

Cited by 2 publications

References 13 publications

Result of simple versus layered repair of urethro-cutaneous fistula developing after hypospadias surgery

Result of simple versus layered repair of urethro-cutaneous fistula developing after hypospadias surgery

Comparative study between snodgrass urethroplasty and modified snodgrass urethroplasty for distal penile hypospadias in terms of post-operative urethrocutaneous fistula formation

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