Proximal Hypospadias With Severe Chordee: Single Stage Repair Using Corporeal Tunica Vaginalis Free Graft

Kajbafzadeh, Abdol‐Mohammad; Arshadi, Hamid; Payabvash, Seyedmehdi; Salmasi, Amirali; Najjaran-Tousi, Vahid; Alam, Alireza

doi:10.1016/j.juro.2007.05.062

Cited by 48 publications

(27 citation statements)

References 19 publications

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“…Recently, Kajbafzadeh et al [8] reported UP elevation, ventral corporotomy with tunica vaginalis grafting, and TIP urethroplasty as a single-stage operation for 13 proximal hypospadias cases. With mean follow up of 27 months there was one case of residual VC < 20 and one fistula.…”

Section: Discussionmentioning

confidence: 99%

Tubularized incised plate proximal hypospadias repair: Continued evolution and extended applications

Snodgrass

Bush

2011

Journal of Pediatric Urology

116

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Section: Discussionmentioning

confidence: 99%

Tubularized incised plate proximal hypospadias repair: Continued evolution and extended applications

Snodgrass

Bush

2011

Journal of Pediatric Urology

116

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“…13 Severity of ventral penile curvature is also associated with an increased complication rate. 15 In our study we found a total of 55 cases with varying degree of chordee, of which 3.6% of mild, 38.8% of moderate and 35.7% of severe cases had complications (p = 0.0001). The degree of curvature was directly proportional to severity of (Table 2).…”

Section: Discussionmentioning

confidence: 52%

“…We did only spongioplasty as water proofing, but others have used tunica vaginalis to reduce the complication in proximal hypospadias. 15 We recommend using additional dartos or tunica vaginalis to prevent complications in poorly developed spongiosum patients.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study to Evaluate the Role of Different Variables in Results of TIPU for Hypospadias

Bhat¹,

Bhat²,

Sabharwal³

et al. 2014

UROL

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The objective of this article is to evaluate the role of different variables affecting the results of tubularised incised plate repair for hypospadias.We prospectively evaluated 125 patients of TIPU repair from April 2009 to October 2011. Study parameters were age, severity of hypospadias, degree of curvature and torsion, size of penis and glans, width of urethral plate, development of spongiosum and complication rate. Patients were classified into five groups by age; Group I-6 months to 2 years, Group II-2 to5 years, Group III-5 to10 years, Group IV-10 to 15 years and Group V-older than 15 years. Results were analyzed with reference to different variables.Age ranged from 6 months to 26 years (mean 8.8 years). Complication rate when comparing group V and youngest patients (groups I & II) was 20% Vs 3.6% (p=0.08), and when comparing older children (G-III and IV) with youngest patients (group I & II) was 15% Vs 3.6% (p=0.135). More severe hypospadias had higher complications (30% in proximal, 5.7% in distal (p = 0.001). The complication rate was 3.6%, 38.8% and 35.7% respectively in cases with mild, moderate and severe curvature (p = 0.001). Complications were higher in patients with poor spongiosum and higher age (p = 0.001) and in patients with narrow urethral plate (p = 0.0001). Follow up period was from about 10 months to 2 years (mean = 20 months).Urethral fistula and stricture were the most commonly reported complications. Important factors in outcome of TIPU repair were the degree of curvature, width of urethral plate development of spongiosum, age of child and severity of hypospadias. The development of urethral plate and spongiosum is directly proportional to the complication rate. Complications increase significantly with the increasing age of the patient.

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“…They are also easy to be cultured in vitro and the commonly used DMEM medium could satisfy their nutritional requirement [10,11]. Mesothelium-lined grafts including peritoneum [12,13] and tunica vaginalis [14,15] have already been attempted in urethral reconstruction with good results. In our previous study, we successfully used a kind of mesothelium-lined autologous tubular tissue as urethral graft [16].…”

Section: Discussionmentioning

confidence: 99%

Tubularized Urethral Replacement Using Tissue-Engineered Peritoneum-Like Tissue in a Rabbit Model

Xia²,

Zhang³

et al. 2012

Urol Int

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Introduction: This study aims to investigate whether mesothelial cells could function as seed cells to construct tissue-engineered peritoneum-like tissue for urethral reconstruction in a rabbit model. Materials and Methods: Bladder acellular matrices were prepared and trimmed to 1.5 × 1 cm. Nine male rabbits underwent omentum biopsy and autologous mesothelial cells were isolated. After in vitro expansion, the cells were seeded onto the matrices and incubated for 7 days. In 18 rabbits, a pendulous urethral segment 1.5 cm long was totally excised and urethroplasty was performed with tubularized matrices seeded with cells in 9 animals and without cells in 9 as controls. Urethrography was performed at 1, 2 and 6 months postoperatively. Meanwhile, the neourethras were harvested and analyzed grossly and histologically. Results: Histological analysis of the cell-seeded grafts revealed a loose collagen matrix covered with a single layer of mesothelim. Serial urethrography indicated a wide urethral caliber without stricture formation in animals implanted with cell-seeded matrices, while all animals of the control group developed stricture. Histological analysis of the implanted cell-seeded matrices demonstrated a normal urethral architecture by 1 month, composed of multilayers of urothelium surrounded by smooth muscle bundles, which became increasingly organized with time. By 6 months, the neourethra could be hardly distinguished from native urethra both grossly and histologically. Conclusions: Autologous mesothelial cells could be successfully used as seed cells for tubularized urethral reconstruction in male rabbits.

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Proximal Hypospadias With Severe Chordee: Single Stage Repair Using Corporeal Tunica Vaginalis Free Graft

Abstract: In this preliminary report the majority of patients with proximal hypospadias and severe chordee were successfully treated with single stage repair using tunica vaginalis free graft for correction of severe chordee.

Cited by 48 publications

References 19 publications

Tubularized incised plate proximal hypospadias repair: Continued evolution and extended applications

Tubularized incised plate proximal hypospadias repair: Continued evolution and extended applications

A Prospective Study to Evaluate the Role of Different Variables in Results of TIPU for Hypospadias

Tubularized Urethral Replacement Using Tissue-Engineered Peritoneum-Like Tissue in a Rabbit Model

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