Repair of megameatus: A modified approach

Faasse, Mark A.; Dray, Elizabeth; Cheng, Earl Y.

doi:10.1016/j.jpurol.2015.01.003

Cited by 16 publications

(10 citation statements)

References 4 publications

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“…The first is characterized by a ventral curvature of the penis and a normal position of the meatus with a distorted foreskin. The latter is characterized by a coronal lying meatus adjacent to a non-closed glans with a very wide open navicular fossa and a normal developed circular prepuce [21, 32]. …”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Hypospadias, all there is to know

2017

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Hypospadias is one of the most common congenital anomalies in men. The condition is typically characterized by proximal displacement of the urethral opening, penile curvature, and a ventrally deficient hooded foreskin. In about 70%, the urethral meatus is located distally on the penile shaft; this is considered a mild form that is not associated with other urogenital deformities. The remaining 30% are proximal and often more complex. In these cases, endocrinological evaluation is advised to exclude disorders of sexual differentiation, especially in case of concomitant unilateral or bilateral undescended testis. Although the etiology of hypospadias is largely unknown, many hypotheses exist about genetic predisposition and hormonal influences. The goal of hypospadias repair is to achieve cosmetic and functional normality, and currently, surgery is recommended between 6 and 18 months of age. Hypospadias can be corrected at any age with comparable complication risk, functional, and cosmetic outcome; however, the optimal age of repair remains conclusive. Although long-term overall outcome concerning cosmetic appearance and sexual function is fairly good, after correction, men may more often be inhibited in seeking sexual contact. Moreover, lower urinary tract symptoms occur twice as often in patients undergoing hypospadias repair and can still occur many years after the initial repair. Conclusion: This study explores the most recent insights into the management of hypospadias. What is Known: • Guidelines advise referral for treatment between 6 and 18 months of age.• Cosmetic outcome is considered satisfactory in over 70% of all patients. What is New: • Long-term complications include urinary tract symptoms and sexual and cosmetic issues.• New developments allow a more individualized approach, hopefully leading to less complications and more patient satisfaction.

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Section: Diagnostic Evaluationmentioning

confidence: 99%

Hypospadias, all there is to know

2017

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“…In recent years, an increasing number of articles have focused on this rare hypospadias variant, and the awareness of and surgical procedures for MIP continue to evolve (4,5). Due to the anatomical particularity of MIP, it is necessary for clinicians to design a suitable surgical method taking into account the development of the glans, the width of the urethral plate, the depth of the urethral groove, and the shape and position of the urethral opening, to achieve good therapeutic effects (3,6,7).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce

Duan

Jiang

et al. 2020

Front. Pediatr.

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“…Because the anatomical characteristics of the MIP hypospadias variant present a unique challenge to surgeons for correction (6), increasingly more articles have been focusing on this rare condition in recent years, and awareness and surgical management of MIP continue to evolve (7,8). Although various techniques have been proposed as the "ideal repair" of the MIP hypospadias variant, none has proven superior, and no study has specifically compared the common techniques for treating MIP until now.…”

Section: Introductionmentioning

confidence: 99%

Megameatus intact prepuce treated with urethral plate-preserving surgery: a retrospective study of an unusual hypospadias variant

et al. 2019

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Background: Megameatus intact prepuce (MIP) is a unique variant of hypospadias and is a clinically rare condition. Due to the anatomical characteristics of the MIP hypospadias variant presenting a unique challenge to surgeons, no single urethroplasty method provides a universal solution for all patients. The purpose of this study was to evaluate the outcomes of hypospadias after MIP repair by urethral platepreserving urethroplasty.Methods: A retrospective study was performed on 25 coronal or distal MIP patients, with a median age of 8, with most deficiencies being discovered during their first hospital visit for phimosis. Correction with urethroplasty was performed for all patients; 5 underwent the Mathieu procedure, 13 underwent the tubularized incised plate (TIP) procedure, and 7 underwent the Duplay procedure. The 25 patients were followed up for 6 to 36 months to evaluate the surgical outcomes.Results: There were no significant differences in intraoperative bleeding, hospital stays, postoperative analgesia rate, and cure rate among the three surgical procedures. The operative time for the Mathieu procedure was longer than that for the TIP and Duplay procedures, which did not differ. Complications occurred in 4 of the 25 patients (16.0%), and the overall complication-free survival rate at 1 year after surgery was 80.5%. The age at the time of surgery, urethral plate width, urethroplasty length, surgical procedures, or meatal location (coronal or distal penis) were not independently predictive of complications. Conclusions:The clinical manifestations of MIP are often concealed and then accidentally discovered during hospital visits for phimosis; thus, the actual incidence of MIP might be higher. The urethral plate should be preserved during MIP-correcting treatment, especially for coronal or distal MIP. The same satisfactory outcomes can be obtained with Mathieu, TIP, or Duplay urethroplasty.

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Repair of megameatus: A modified approach

Cited by 16 publications

References 4 publications

Hypospadias, all there is to know

Hypospadias, all there is to know

Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce

Megameatus intact prepuce treated with urethral plate-preserving surgery: a retrospective study of an unusual hypospadias variant

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