Hypospadias: Surgery and Complications

Aigrain, Yves; Cheikhelard, Alaa; Lottmann, Henri; Lortat-Jacob, S.

doi:10.1159/000315495

Cited by 22 publications

(12 citation statements)

References 23 publications

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“…The rate of complications in group A with PRP coverage was less than group B with a significant difference ( P = 0.040), also it was comparable with those reported in the literature for distal hypospadias repair, indicating that this technique had no adverse effects.…”

Section: Discussionsupporting

confidence: 85%

“…21 El-Galley et al showed that the concentration of epidermal growth factor is significantly lower in the foreskins of boys with hypospadias than in boys with a normal penis. 22 The rate of complications in group A with PRP coverage was less than group B with a significant difference (P = 0.040), also it was comparable with those reported in the literature for distal hypospadias repair, [11][12][13][14][15][16][17][18][19][20][21][22][23][24] indicating that this technique had no adverse effects.…”

Section: Discussionsupporting

confidence: 84%

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Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

et al. 2019

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Objective To compare the outcome and complication rate of the platelet‐rich plasma applied as a coverage layer and dartos flap layer during primary repair of distal hypospadias. Methods A prospective randomized study was carried out comprising 180 boys (age range 12–65 months) from October 2011 to December 2016 at Al‐Azhar University Hospitals, Cairo, Egypt. A single surgeon carried out all urethroplasty. Patients were randomly divided into two groups: group A (tubularized incised plate urethroplasty with platelet‐rich plasma coverage layer) and group B (ventral dartos flap). Complication rates were compared between two groups. Results There was a significant difference in the occurrence of complications between the two groups. A total of 36 (20%) complications were recorded in 26 patients, just 12 (13.3%) reported in group A, but 24 (26.7%) complications were reported in group B. Urethrocutaneous fistula was observed in nine patients (10%) in group A, and 12 (13.3%) in group B. Partial glans dehiscence occurred in one patient in group A, and four patients in group B. No patient in group A had a superficial wound infection, compared with six patients in group B. One case of meatal stenosis and urethral stricture was recorded in each group, all of which were managed conservatively. The resultant urinary stream was single and good in 154 patients of both groups. Conclusions Platelet‐rich plasma sheet might be considered as an alternative coverage layer for distal hypospadias repair, especially in the absence of a healthy layer.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 84%

Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

et al. 2019

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“…Our model was based on primary one-stage corrections for anterior or middle hypospadias performed in a university hospital. For posterior hypospadias, multistage corrections are mostly used, which have a higher complication rate [26]. Since reoperations have different complication rates as well [27,28], this prediction model should not be used to predict complications after multistage corrections or repeat surgery.…”

Section: Discussionmentioning

confidence: 99%

Development of a prediction model for postoperative complications after primary hypospadias correction

Dokter¹,

Zanden²,

Laumer³

et al. 2020

Journal of Pediatric Surgery

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To develop a prediction model for postoperative complications after primary one-stage hypospadias correction to improve preoperative parental counseling. Materials and methods: In this retrospective cohort study, data were collected from 356 patients with anterior or middle hypospadias who had a one-stage hypospadias correction from 2003 onwards. Potential treatment-and patient-related factors were selected and used to develop a prediction model for postoperative complications within one year (wound-related complications, urinary tract infections, fistulas, stenosis, and prepuce-related complications). Multivariable logistic regression analysis with stepwise backward selection and a p-value of 0.20 was used to select the final model, which was internally validated using the bootstrap procedure. Results: Complications within one year postoperatively occurred in 66 patients (19%), of which 13% and 37% were seen in anterior and middle type of hypospadias, respectively. Hypospadias phenotype, surgical technique, chordectomy, and surgeon's experience were included in the final prediction model, whereas none of the patientrelated factors were. The final model had a good discriminative ability (bias corrected C statistic 0.70) and calibration. Conclusion: Using easily obtainable information, this model showed good accuracy in predicting complications within one year after hypospadias surgery. It is a first step towards individualized risk prediction of postoperative complications for anterior and middle hypospadias and can assist in preoperative parental counseling.

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“…Modern management concepts in hypospadias repair are based on conservation of the native urethral plate [2,3]. Tubularized incised plate (TIP) repair was first described by Snodgrass et al [4] as a means to widen and improve mobilization of the urethral plate.…”

Section: Introductionmentioning

confidence: 99%

Outcome Analysis of Tubularized Incised Plate Repair in Hypospadias: Is a Catheter Necessary?

Xue²,

Wei³

et al. 2013

Urol Int

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Objective: Tubularized incised plate (TIP) urethroplasty is performed by many pediatric urologists and has been widely accepted for repair of distal and mid-shaft hypospadias. However, the role of urethral catheter placement in TIP repair remains controversial. In this study, the surgical outcomes of indwelling urethral catheter and non-catheter TIP repairs in boys with hypospadias were compared. Methods: A total of 254 patients with primary distal and mid-shaft hypospadias underwent TIP repair and were evaluated retrospectively. A urethral catheter was placed in 103 patients (group A) and non-catheter repair was performed in 151 patients (group B). Information obtained included age, toilet training, chordee, type of hypospadias, presence or absence of a catheter, and postoperative complications. The complications recorded included wound infection, urinary tract infection, bladder spasm, urinary retention, urinary extravasation, meatal stenosis, urethral stricture, and urethrocutaneous fistula. Results: There was no statistical difference in age, toilet training, chordee, hypospadias site, or performing surgeon between the two groups. The median follow-up time was 22 and 24 months for groups A and B, respectively. The rate of bladder spasms (10.7 vs. 0%, p < 0.001) and urinary tract infection (9.7 vs. 3.3%, p = 0.034) was significantly higher for group A than group B. Although the rate of urinary retention was higher in group B than in group A (4.0 vs. 0%), there was no statistically significant difference between the two groups (p = 0.084). Likewise, the incidence of urethrocutaneous fistula and meatal stenosis was not significantly different. Conclusion: Non-catheter TIP repair is feasible and positive outcomes can be achieved with minimal complications and less patient discomfort.

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Hypospadias: Surgery and Complications

Cited by 22 publications

References 23 publications

Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

Autologous platelet‐rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair: A prospective randomized study

Development of a prediction model for postoperative complications after primary hypospadias correction

Outcome Analysis of Tubularized Incised Plate Repair in Hypospadias: Is a Catheter Necessary?

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