Management of severe hypospadias

Catti, Massimo; Demède, Delphine; Valmalle, A.F.; Mure, Pierre-Yves; Hameury, F.; Mouriquand, Pierre

doi:10.4103/0970-1591.40621

Cited by 30 publications

(7 citation statements)

References 35 publications

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“…Various methods are available, including resection of ventral fibrous tissue or dorsal plication. 10 In cases of severe chordee, grafts such as a corporeal tunica vaginalis free graft, buccal mucosa graft, one created from small intestinal submucosa, and flaps have been used to achieve full correction of the penile curvature. 11 12 13 14 15 …”

Section: Discussionmentioning

confidence: 99%

Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience

et al. 2015

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It is still debatable whether single- or two-stage urethroplasty is a more suitable technique for treating hypospadias with severe chordee after urethral plate transection. This retrospective study evaluated these two techniques. A total of 66 patients of proximal hypospadias with severe chordee were divided into two groups according to the techniques they underwent: 32 and 34 patients underwent single-stage (Duckett) or two-stage urethroplasty, respectively. Median ages at presentation were 7.5 years and 11.0 years in single-stage and two-stage repair groups, respectively. Median follow-ups were 28.5 months (20−60 months) and 35 months (18−60 months) in the single-stage and two-stage groups, respectively. The meatus of the neourethra was located at the top of the glans in all patients. No recurrence of chordee was found during follow-up, and all patients or parents were satisfied with the penile length and appearance. Complications were encountered in eight patients in both groups, with no statistically significant differences between the two techniques. The late complication rate of stricture was higher after the single-stage procedure (18.75% vs 0%). The complication rate after single-stage repairs was significantly lower in the prepubescent subgroup (10.52%) than in the postpubescent cohort (46.15%). These results indicate that the urethral plate transection effectively corrects severe chordee associated with proximal hypospadias during the intermediate follow-up period. Considering the higher rate of stricture after single-stage urethroplasty, two-stage urethroplasty is recommended for proximal hypospadias with severe chordee after urethral plate transection.

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Section: Discussionmentioning

confidence: 99%

Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience

et al. 2015

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“…The Snodgrass tubularized incised plate (TIP) urethroplasty has become a primary technique for repair of distal and middle hypospadias. 2 Although many techniques have been introduced for the treatment of hypospadias, urethrocutaneous fistula (UCF) and meatal stenosis, which are the most frequent complications requiring…”

Section: Introductionmentioning

confidence: 99%

Comparison of Dartos flap and spongioplasty in Snodgrass urethroplasty in distal penile hypospadias

Verma

Murtaza

Kundal

et al. 2021

World Jnl Ped Surgery

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BackgroundHypospadias surgery has been continuously evolving, although there is no single technique which can be said to be perfect and suitable for all types of hypospadias. Tubularized incised plate (TIP) urethroplasty (Snodgrass procedure) is presently the most common surgical procedure performed for distal penile hypospadias (DPH). The aim of this study was to compare the outcome of TIP urethroplasty using Dartos flap (DF) and spongioplasty as second layer in DPH.MethodsA total of 30 patients of DPH were repaired using TIP urethroplasty with DF or spongioplasty as second layer from January 2017 to June 2018. Out of 30 patients, TIP with DF was done in 15 patients (group A) and TIP with spongioplasty was done in the remaining 15 patients (group B). Preoperative mean age and weight were comparable in both groups. Postoperative complications, namely, postoperative edema, residual chordee, urethrocutaneous fistula (UCF), meatal stenosis and final cosmesis, were recorded.ResultsIn both groups, complications included postoperative edema (Gp A-1Gp B-1), residual chordee (Gp A-1, Gp B-1), UCF (Gp A-3, Gp B-4), meatal stenosis (Gp A-1, Gp B-5) and poor cosmesis (Gp A-3, Gp B-4). Wound infection was managed with appropriate antibiotics, and meatal stenosis responded to calibration in five patients.Although it seems that DF has a better outcome clinically, the difference between the two techniques was statistically not significant.ConclusionDF as an additional cover to TIP is associated with an acceptable complication and has good cosmesis compared with spongioplasty; however, the difference is not statistically significant.

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“…Research by Karabulut et al stated that glans dehiscence was significantly higher in proximal than distal hypospadias (5%). A different perspective in other studies suggests that increased glans dehiscence is more likely due to small glans size and testosterone use rather than the type of hypospadias ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 71%

A Thorough Analysis of The Effects and Complications of Two Different Suturing Techniques in Hypospadias Repair Using Tubularized-Incised Plate Urethroplasty: a Meta-Analysis

Subihardi,

Yatindra,

Rahman

et al. 2023

Med Arch

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Background: Hypospadias is a male congenital anomaly that requires urethroplasty via the tubularized-incised plate (TIP) technique. This technique is simple, and the results are promising, although it has few postoperative complications, including the associated suture technique. Objective: Comparing the continuous and interrupted suturing techniques on the TIP procedure for hypospadias repair. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors thoroughly searched electronic databases of PubMed, Scopus, ScienceDirect, and Web of Science. The compared endpoints were the total complication, wound infection, meatal stenosis, glans dehiscence, and urethral stricture presented as risk ratio (RR), with average operating time as mean difference (MD), in 95% confidence intervals (CIs). All statistical analyses were performed using Revman 5.4. Results: Ten eligible studies were included, totalling 1,894 patients. Pooled RR showed no significant difference in overall complication, surgical site infection, meatal stenosis, glans dehiscence, and urethral stricture between continuous and interrupted sutures. In subgroup analysis, the interrupted suture had fewer complications when using polyglactin material (RR: 1.51, 95% CI 1.07 to 2.14; p = 0.02). The continuous suture showed lesser operative time than the interrupted suture (MD: -6 .67, 95% CI -12.52 to -0.82; p = 0.03). Discussion and Conclusion: No significant complication difference existed between continuous and interrupted suturing techniques. Fewer complications were obtained when using interrupted sutures with polyglactin material. However, continuous suture required less operative time.

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Management of severe hypospadias

Cited by 30 publications

References 35 publications

Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience

Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience

Comparison of Dartos flap and spongioplasty in Snodgrass urethroplasty in distal penile hypospadias

A Thorough Analysis of The Effects and Complications of Two Different Suturing Techniques in Hypospadias Repair Using Tubularized-Incised Plate Urethroplasty: a Meta-Analysis

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