Nonstented Tubularized Incised Plate Distal Hypospadias Repair: A Single Center 5 Years’ Experience

Assadi, Akram; Alzubaidi, Ahmad; Cline, Joseph K.; Sharadin, Cynthia; Travis, A. Jill; Marley, Kristen; Dewan, Christian; Gleason, Joseph M.

doi:10.1016/j.urology.2020.08.014

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Though hypospadias is one of the most common malformations, few studies focusing on its psychiatric comorbidity and the correlated data have been conflicting ( 31 ). Due to abnormal appearance in the penis with abnormal urination and erection ( 32 ), patients with hypospadias were vulnerable to suffering from stress and psychiatric difficulties on account of the negative effects on their social behaviors, school success, gender roles, and self-confidence ( 14 ). As illustrated in Table 1 , nearly half of the included studies (6/14, 47%) suggested that patients with hypospadias were clearly more liable to suffer from psychosocial disorders than the controls.…”

Section: Discussionmentioning

confidence: 99%

Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review

Jin

Wu²,

Shen

et al. 2022

Front. Psychiatry

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Hypospadias is one of the most common congenital malformations in boys. Due to abnormal appearance in the penis with abnormal urination and erection, patients with hypospadias were vulnerable to suffering from stress and psychiatric difficulties. The present study aims to summarize all the current evidence of the association between hypospadias and the risk of psychiatric disorders by a comprehensive review. Seventeen clinical studies were identified in the four electronic databases. A total of 953,872 participants were involved, while 15,729 of them were hypospadiac patients and the remaining 938,143 were normal controls. The standard age for surgery for hypospadias ranged from 20.4 months to 21.5 years. Eight out of seventeen (8/17, 47%) included studies explicitly showed that patients with hypospadias had a significantly higher risk of psychosocial disorders (all P < 0.05). Specific types of psychiatric disorders included depression, anxiety, shyness, timidness, isolation, fear of ridicule, attention-deficit hyperactivity, autism spectrum, behavioral/emotional disorders, temper tantrums, emotionality, affective, psychosexual problems, and suicidal tendencies. Based on this review, psychiatric illnesses are frequently detected in hypospadiac patients' childhood, thus proper psychiatric guidance and early interventions from physicians, nurses, and parents may help these children to grow into less affected men.

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Section: Discussionmentioning

confidence: 99%

Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review

Jin

Wu²,

Shen

et al. 2022

Front. Psychiatry

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“…3-5 Despite this, the majority of surgeons continue to use urethral stents, 2 perhaps because of their benefit in preventing the estimated 1-12% rate of urinary retention after surgery. 6,7 To date, there is no high quality evidence associating type of urethral with any significant difference in long term hypospadias surgery outcomes.…”

Section: Discussionmentioning

confidence: 99%

Material properties of urethral stents for hypospadias repair

Jamdee

Foster

et al. 2021

Preprint

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Introduction: Despite the prevalence of hypospadias surgery and the near ubiquitous use of postoperative urethral stents, there has been no evaluation of the material properties of commonly used choices. Our study sets out to close this gap with an evaluation and comparison of the material properties of four urethral stents commonly used after hypospadias surgery. Study Design: Thermal analysis and mechanical analysis of the Zaontz Urethral Stent, the Firlit-Kluge Urethral Stent, the Koyle Diaper Stent, and the Bard Premature Infant Feeding Tube were performed. Results: Thermal analysis shows that all four compositions tested are rubbery polymers at body temperature, with glass transition temperatures far below human body temperatures. The Zaontz and Koyle stents are thermoplastic elastomers with strong melting transitions above body temperature, but the Firlit-Kluge stent is completely amorphous at body temperature and is likely chemically cross-linked to generate the polymer network. The Bard feeding tube was by far the stiffest, with a Young's Modulus of 14.0±0.78 (compared to the Zaontz stent at 4.12±0.56, the Firlit-Kluge stent at 4.92±0.63, and the Koyle stent at 4.09±0.49.) The Firlit-Kluge stent was the strongest, with 84.3±2.83 MPa required to fracture it compared to the Zaontz stent at 65.5±2.57, the Koyle stent at 66.8±3.16, and then Bard feeding tube at 34.6±1.89. Discussion: While there is little information associating urethral stent type with outcomes after hypospadias surgery, material properties may account for findings of prior studies. Stiffer stents may contribute to decreased postoperative comfort, while a stent that is too soft and extensible may have issues with dislodgement, kinking and breaking. Conclusion: This study provides a foundation for future work optimizing urethral stents, designing support for regenerative medicine applications, and improving hypospadias outcomes.

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“…All patients were applied the Thiersch–Duplay procedure to repair the residual urethral defect during the second-stage operation. The overall success rate was 91.5%–96.6% in the tubularized incised plate urethroplasty ( 9 , 10 ), while it was 53%–88.2% in Byars’ two-stage repair ( 2 , 11 – 13 ). In our research, the overall success rate of staged TIP urethroplasty (90%) is higher than that of Byars’ two-stage repair (60.6%).…”

Section: Introductionmentioning

confidence: 96%

The effect of staged TIP urethroplasty on proximal hypospadias with severe chordee

et al. 2022

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BackgroundProximal hypospadias with severe chordee is still a formidable challenge for most pediatric urologists, and the treatment approach remains controversial. Here, we describe a modified two-stage technique to repair proximal hypospadias with severe chordee.MethodsWe retrospectively identified 53 children referred for proximal hypospadias with severe chordee from July 2016 to July 2019, who underwent a two-stage urethroplasty. In group 1, the children were repaired with staged tubularized incised plate (TIP) urethroplasty, while Byars’ two-stage urethroplasty was attempted in group 2. We corrected chordee by releasing all remaining attachments to the corpora after degloving the penis, transceting the urethral plate, and dorsal plication. The mean age of patients in the first stage of surgery was 26.6 months in group 1 and 24.8 months in group 2. Postoperative complications in the two groups included: fistula, urethral stricture, urethral diverticulum, and glanular dehiscence.ResultsA total of 20 cases were repaired with staged TIP urethroplasty (group 1), and 33 cases were repaired with Byars’ two-stage urethroplasty (group 2). The length of follow-up in group 1 was 39.8 ± 10.1 months, and in group 2, it was 38.1 ± 8.7 months (P > 0.05). After the second stage of surgery, 1 case (5%) in group 1 and 11 cases (33.3%) in group 2 developed a urinary fistula (P < 0.05). One case (5%) in group 1 and three cases (9.1%) in group 2 had urethral stricture (P > 0.05). All strictures were cured by repeated dilation, and no patient required reoperation. No cases in group 1 and one case (3%) in group 2 had urethral diverticulum (P > 0.05). There was no residual chordee in both groups. Two cases (10%) in group 1 and 13 cases (39.3%) in group 2 required reoperation (P < 0.05).ConclusionsStaged urethroplasty is appropriate to repair proximal hypospadias with severe chordee. Particularly, staged TIP urethroplasty is a good choice for patients with proximal hypospadias and severe chordee, especially those with better penile development, wider urethral plate, larger glans, and deeper navicular fossa of the urethra.

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Nonstented Tubularized Incised Plate Distal Hypospadias Repair: A Single Center 5 Years’ Experience

Cited by 3 publications

References 13 publications

Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review

Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review

Material properties of urethral stents for hypospadias repair

The effect of staged TIP urethroplasty on proximal hypospadias with severe chordee

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