Single-Layer Acellular Porcine Bladder Matrix as Graft in Corporoplasty for Ventral Curvature in Pediatric Proximal Hypospadias Repair: An Initial Experience

Huen, Kathy H.; Macaraeg, Amanda; Davis-Dao, Carol A.; Holzman, Sarah A.; Boswell, Timothy C.; Chuang, Kai-wen; Stephany, Heidi A.; Wehbi, Elias J.; Khoury, Antoine E.

doi:10.1016/j.urology.2022.07.025

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Moreover, a study mentioned fistula formation of around 8% with spongioplasty technique and the results are much superior to ours as sample size in the study mentioned was also large like 113 patients. [10][11][12] In our study no patient from URAGPI group developed fistula. Many studies on distal and anterior hypospadias have also witnessed fistula free successful repair with URAGPI.…”

Section: Discussionsupporting

confidence: 39%

Comparison of urethrocutaneous fistula after tubularized incised plate urethroplasty and urethral advancement and glanuloplasty incorporated in coronal hypospadias.

Dar

Ahmed

Afzal

et al. 2023

TPMJ

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Objective: To find the incidence of urethrocutaneous fistula after Tubularized Incised Plate Urethroplasty (TIPU) and Urethral Advancement and Glanuloplasty Incorporated (URAGPI) repairs in children presenting with coronal hypospadias. Study Design: Randomized Prospective Study. Setting: Department of Paediatric Surgery, Pak Emirates Military Hospital, Rawalpindi. Period: 10th March 2022 to 10th November 2022. Material & Methods: A total of 40 children were enrolled in the study. Patients were randomly allocated to receive either TIPU (n=20) or URAGPI (n=20) technique after approval of hospital ethical review committee. Data was collected on a specifically designed proforma. Outcome was measured in terms of incidence of urethrocutaneous fistula in the two study groups. Results: Average age of patients was 28.2 ± 9.7 (months) in TIPU and 29.6 ± 9.9 months in URAGPI group. Frequency of fistula was 4 (20.0%) in TIPU repair compared to none 0 (0.0%) in the URAGPI repair. Difference in proportions of urethrocutaneous fistula was found statistically significant between the two groups (p-value = 0.03). Conclusion: Incidence of urethrocutaneous fistula was found greater in TIPU technique when compared with URAGPI technique.

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Section: Discussionsupporting

confidence: 39%

Comparison of urethrocutaneous fistula after tubularized incised plate urethroplasty and urethral advancement and glanuloplasty incorporated in coronal hypospadias.

Dar

Ahmed

Afzal

et al. 2023

TPMJ

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“…Choosing the appropriate surgical approach, cutting the appropriate flap depending on the degree of development of the penis, urethral plate, and foreskin are crucial considerations during the procedure, in addition to the surgeon’s skills and experience. Postoperative complications may be reduced by introducing newer surgical materials; however, for the foreseeable future, PH will remain challenging for pediatric urologists [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative complications following one-stage proximal hypospadias repair involving the disconnection of the urethral plate: a retrospective study

Hu,

Zhao,

et al. 2023

BMC Pediatr

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Background Children with hypospadias are at risk of serious physical and mental health problems, including abnormal urination, sexual dysfunction, and infertility. The sole available treatment is the surgical restoration of genital appearance and function. Proximal hypospadias (PH) correction is more challenging and carries a higher risk of complications than does distal hypospadias correction, with a higher likelihood of postoperative complications requiring additional surgery, resulting in considerable economic and psychological strain for families. Herein, we aimed to identify factors associated with complications following one-stage PH repair with urethral plate disconnection. Methods We retrospectively analyzed data from 236 children who underwent PH repair at our center between December 2020 and December 2022. We collected information on age, surgical procedure, length of the reconstructed urethra (LRU), glans width (GW), ventral curvature, surgical approach, preoperative androgen use, suture type, presence of prostatic utricle, body mass index, season of surgery, anesthesia type, low birth weight, preterm birth, follow-up period, and complications. Surgical complications included urethral fistulas, urethral diverticula, anastomotic strictures, urethral strictures, glans dehiscence, and penile curvature recurrences. The study population was divided into complication and no-complication groups, and univariate and multivariate analyses were conducted. Results Of the 236 patients with PH who had a median follow-up of 10.0 (8.0, 14.0) months, 79 were included (33.5%) in the complication group and 157 were included (66.5%) in the no-complication group. In the univariate analysis, age (P < 0.001), LRU (P < 0.001), degree of penile curvature (P = 0.049), and PH with prostatic utricle (P = 0.014) were significantly associated with complications after PH repair. In the multivariate logistic regression analysis, LRU (P<0.001, odds ratio [OR] = 3.396, 95% confidence interval [CI]: 2.229–5.174) and GW (P = 0.004, OR = 0.755, 95%CI: 0.625–0.912) were independent factors influencing postoperative complications. The optimal LRU threshold was 4.45 cm (area under the curve, 0.833; sensitivity, 0.873; specificity, 0.873; P<0.001, OR = 3.396, 95% CI: 2.229–5.174). Conclusions LRU and GW are independent factors affecting PH complications. An LRU of < 4.45 cm and an increased GW can reduce the risk of complications.

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“…Initially, Cytal was designed to treat wounds of partial thickness and full thickness, such as surgical and traumatic wounds, pressure ulcers, and diabetic ulcers ( Valerio et al, 2015 ). To understand its application in urethral tissue reconstruction, Huen et al (2022) summarized their preliminary experience in implanting Cytal in children who underwent ventral curvature correction during the repair of proximal hypospadias. They reviewed surgeries during 2020 and 2021 within 4 surgeon hypospadias databases in a single institution.…”

Section: Biomaterialsmentioning

confidence: 99%

Research progress of biomaterials and innovative technologies in urinary tissue engineering

Duan

Wang

Fan

et al. 2023

Front. Bioeng. Biotechnol.

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Substantial interests have been attracted to multiple bioactive and biomimetic biomaterials in recent decades because of their ability in presenting a structural and functional reconstruction of urinary tissues. Some innovative technologies have also been surging in urinary tissue engineering and urological regeneration by providing insights into the physiological behavior of the urinary system. As such, the hierarchical structure and tissue function of the bladder, urethra, and ureter can be reproduced similarly to the native urinary tissues. This review aims to summarize recent advances in functional biomaterials and biomimetic technologies toward urological reconstruction. Various nanofirous biomaterials derived from decellularized natural tissues, synthetic biopolymers, and hybrid scaffolds were developed with desired microstructure, surface chemistry, and mechanical properties. Some growth factors, drugs, as well as inorganic nanomaterials were also utilized to enhance the biological activity and functionality of scaffolds. Notably, it is emphasized that advanced approaches, such as 3D (bio) printing and organoids, have also been developed to facilitate structural and functional regeneration of the urological system. So in this review, we discussed the fabrication strategies, physiochemical properties, and biofunctional modification of regenerative biomaterials and their potential clinical application of fast-evolving technologies. In addition, future prospective and commercial products are further proposed and discussed.

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Single-Layer Acellular Porcine Bladder Matrix as Graft in Corporoplasty for Ventral Curvature in Pediatric Proximal Hypospadias Repair: An Initial Experience

Cited by 4 publications

References 18 publications

Comparison of urethrocutaneous fistula after tubularized incised plate urethroplasty and urethral advancement and glanuloplasty incorporated in coronal hypospadias.

Comparison of urethrocutaneous fistula after tubularized incised plate urethroplasty and urethral advancement and glanuloplasty incorporated in coronal hypospadias.

Risk factors for postoperative complications following one-stage proximal hypospadias repair involving the disconnection of the urethral plate: a retrospective study

Research progress of biomaterials and innovative technologies in urinary tissue engineering

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