The hypospadias classification affected the surgical outcomes of staged oral mucosa graft urethroplasty in hypospadias reoperation

Abstract

The staged graft urethroplasty is a recommended technique for repairing complex hypospadias. This retrospective study aimed to investigate the outcomes of this technique in hypospadias patients undergoing reoperation and to analyze the underlying contributing factors including age, meatus location, and graft and suture type.We retrospectively analyzed 40 hypospadias patients undergoing reoperation who received a staged oral graft urethroplasty, including 15 buccal mucosal grafts and 25 lingual mucosal grafts. Median age at presentation was 18.5 years, and median follow-up was 17.5 months (range 8–30 months). The patients were classified according to their original meatus location.Twenty-five complications developed in 12 of 40 (30%) cases, including 6 fistulas (15%), 7 infections (17.5%), 9 cases of glans dehiscence (22.5%), and 3 cases of stenosis (7.5%). There was no significant difference in the overall complication rates between prepuberty and postpuberty groups. In addition, no significant difference in complications was found between the 2 graft techniques. The complications were significantly higher in the original perineal type compared with the original penoscrotal type (7/10 vs 5/30, P = .0031). Seven patients who originally had perineal hypospadias developed multiple complications.Based on this study, the staged graft urethroplasty is an effective technique in reoperative hypospadias repairs with reasonable complication risk. The hypospadias classification affects the surgical outcomes.

Evaluation of Preputial and Buccal Mucosal Grafts in Two-Stage Repair of Severe Proximal Hypospadias

“…Our outcomes are similar to those in the existing literature with Snodgrass et al Faure et al [14] and Badawy H et al [10] by 38%,38.4% and 43.2% respectively, which was considerably higher than that reported by Bracka [7], Manasherova d et al [8] and Zheng D et al [20] by 23.5%,28% and 33% respectively.…”

“…In our study, urethra-cutaneous fistula was seen in 18.2% with preputial graft group and 23.8% in buccal graft group, which was comparable to the reported rate of fistula in grafted two stage technique. Zheng et al [20], Manasherova D et al [8] and Badawy H et al [10] have reported 20.5%, 20% and 21.6% fistula rate in their respective studies with Bracka-staged repair using preputial graft.…”

“…Manasherova D et al [8], Faure A et al [14], and Zheng D et al [20] have reported 14%, 18%, 9% and 13% fistula rate in their respective studies with two-stage repair of proximal hypospadias using buccal mucosal graft.…”

Role of tunica vaginalis flap and dartos flap in tubularized incisional plate for primary hypospadias repair: A retrospective monocentric study

“…Dhua and the association reported that TVF had an optimal tissue coverage of the neourethra than the DF (3 fistulae in the DF group) (3). In contrast, Zheng et al reported similar fistula rates of DF and TVF (27). A systematic review recommended a double DF for distal hypospadias and TVF for proximal hypospadias during TIP surgery (28).…”

MMP-2 and TIMP-2 expression, quantitative analysis and biomechanical changes in scar hypertrophy after autologous free transplantation of rabbit oral mucosa and scrotal skin

“…Hypospadias is a common congenital malformation of male reproductive system. The incidence rate of hypospadias is about 0.3% ( Barbagli et al, 2017 , Zheng et al, 2017 , Horiguchi, 2017 , Nelson et al, 2005 , Li et al, 2003 , Baskin, 2008 , Sugarman et al, 2015 ). The main clinical manifestations are chordee, dorsal prepuce covering the glans penis and abnormal urethral external orifice located at any position of the ventral side of the penis.…”