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Proximal hypospadias

Christopher J Long, Douglas A Canning
Hypospadias surgery is a humbling art form. The evolution of surgical techniques has made distal hypospadias outcomes favorable, but recent publications suggest that our complication rates for proximal hypospadias are much higher than previously reported. To explain these shortcomings, we examine the literature and focus on the lack of standardized documentation, the subsequent inability to objectify the severity of the phenotype, and the underestimation of complications due to lack of long-term follow up. The variability in surgical technique and the fact that the literature abounds with small case series from single institutions also limits our ability to compare outcomes...
2016: F1000Research
Hazem Elmoghazy, Mohamed M Hussein, Elnisr Mohamed, Abdelbasset Badawy, Gamal Alsagheer, Ahmed Mamdouh Abd Elhamed
BACKGROUND: Several techniques have been used to repair mid-penile hypospadias; however, high failure rates and major complications have been reported. In this study, we describe a novel technique using a well-vascularized flap of the inner and outer preputial skin. METHODS: A total of 110 male children with hypospadias underwent repair by our technique between 2008 and 2015. The inclusion criteria were children with mid-penile or slightly more proximal hypospadias, with or without ventral chordae, and an intact prepuce of the cobra eyes variety...
September 13, 2016: International Urology and Nephrology
Douglas A Canning
No abstract text is available yet for this article.
September 2016: Journal of Urology
Nicolas Fernandez, Rebeca Escobar, Ignacio Zarante
INTRODUCTION: Hypospadias is a congenital abnormality of the penis, in which there is incomplete development of the distal urethra. There are numerous reports showing na increase of prevalence of hypospadias. Association of craniofacial malformations in patients diagnosed with hypospadias is rare. The aim of this study is to describe the association between hypospadias and craniofacial congenital anomalies. MATERIALS AND METHODS: A retrospective review of the Latin-American collaborative study of congenital malformations (ECLAMC) data was performed between January 1982 and December 2011...
July 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
M S Ansari, Shikhar Agarwal, Sanjoy Kumar Sureka, Anil Mandhani, Rakesh Kapoor, Aneesh Srivastava
INTRODUCTION: Apart from numerous clinical factors, surgical experience and technique are important determinants of hypospadias repair outcome. This study was aimed to evaluate the learning curve of hypospadias repair and the impact of changing trends in surgical techniques on the success of primary hypospadias repair. MATERIALS AND METHODS: We retrospectively analyzed of data of 324 patients who underwent primary repair of hypospadias between January 1997 and December 2013 at our center...
July 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Akihiro Kanematsu, Yoshihide Higuchi, Shiro Tanaka, Takahiko Hashimoto, Michio Nojima, Shingo Yamamoto
INTRODUCTION: Patients with hypospadias are treated surgically during childhood, which has the intention of enabling a satisfactory sexual life in adulthood. However, it is unclear whether patients with corrected hypospadias can lead a satisfactory sexual life and sustain a marital relationship and produce offspring. AIM: To evaluate factors associated with achievement of sexual intercourse, marriage, and paternity in patients with hypospadias who have reached adulthood...
October 2016: Journal of Sexual Medicine
F J Schneuer, C Bower, A J A Holland, V Tasevski, S E Jamieson, A Barker, L Lee, J A Majzoub, N Nassar
STUDY QUESTION: Are maternal first trimester levels of serum free-beta hCG associated with the development of hypospadias or undescended testis (UDT) in boys? SUMMARY ANSWER: Overall, first trimester maternal levels of serum free-beta hCG are not associated with hypospadias or UDT. However, elevated levels were found in severe phenotypes (proximal hypospadias and bilateral UDT) suggesting an altered pathway of hormonal release in early pregnancy. WHAT IS KNOWN ALREADY: Human chorionic gonadotrophin peaks in first trimester of pregnancy stimulating fetal testosterone production, which is key to normal male genital development...
August 2016: Human Reproduction
Yuk Him Tam, Kristine Kit Yi Pang, Yuen Shan Wong, Siu Yan Tsui, Hei Yi Wong, Jennifer Wai Cheung Mou, Kin Wai Chan, Kim Hung Lee
PURPOSE: To investigate and compare the outcomes after tubularized incised plate (TIP) urethroplasty in mid-shaft and proximal hypospadias using a standard and a modified technique. METHODS: We conducted a retrospective study in 104 consecutive children who underwent mid-shaft or proximal TIP repairs from Jan 2007 to Sept 2015. Patients in Cohort One had dorsal dartos (DD) neourethral coverage while patients in Cohort Two had either de-epithelialized split preputial (DESP) or tunica vaginalis (TV) flap coverage...
November 2016: Pediatric Surgery International
Alaa El-Ghoneimi
No abstract text is available yet for this article.
August 2016: Journal of Pediatric Urology
Alireza Mirshemirani, Alireza Mahdavi, Mehdi Sarafi
Complications in hypospadias surgery are not uncommon however penile skin or flap necrosis is rarely reported. Ischemia of the flap or graft is a major complication in two stage repair of hypospadias. A 2-year old boy with proximal penile hypospadias, operated earlier for chordee correction and urethral plate formation with a preputial flap, presented for stage 2 repair. Ten days after surgery patient developed skin and neourethral necrosis. Early debridement was done followed by coverage with scrotal flaps...
July 2016: APSP Journal of Case Reports
Joel Shen, Maya Overland, Adriane Sinclair, Mei Cao, Xuan Yue, Gerald Cunha, Laurence Baskin
We recently described a two-step process of urethral plate canalization and urethral fold fusion to form the human penile urethra. Canalization ("opening zipper") opens the solid urethral plate into a groove, and fusion ("closing zipper") closes the urethral groove to form the penile urethra. We hypothesize that failure of canalization and/or fusion during human urethral formation can lead to hypospadias. Herein, we use scanning electron microscopy (SEM) and analysis of transverse serial sections to better characterize development of the human fetal penile urethra as contrasted to the development of the human fetal clitoris...
July 5, 2016: Differentiation; Research in Biological Diversity
Kelly Christina de Castro Paiva, André Netto Bastos, Laura Pimenta Miana, Eveline de Souza Barros, Plínio Santos Ramos, Lara Meneguelli Miranda, Natália Maia Faria, André Avarese de Figueiredo, José de Bessa, José Murillo B Netto
INTRODUCTION: The use of preoperative hormonal stimulation before hypospadias surgery aims to increase penile size and achieve better surgical results; however, the rules are not clear in the literature. We evaluated the effects of topical testosterone and estrogen in the hypospadic penis regarding biometric measures, side effects, and serum hormonal levels. To our knowledge, this is the first study using estradiol prior to hypospadias surgery. PATIENTS AND METHODS: Sixty-nine children with hypospadias were randomly divided into three study groups: a control group (CG) of 17 children given placebo cream; a testosterone group (TG) of 28 children who used 1% testosterone propionate; and an estradiol group (EG) of 24 children using 0...
August 2016: Journal of Pediatric Urology
Pierre-Alain Hueber, Monica Salgado Diaz, Yann Chaussy, Julie Franc-Guimond, Diego Barrieras, Anne-Marie Houle
INTRODUCTION: A variety of techniques are available for proximal hypospadias repair. Onlay, proximal tubularized incised plate (TIP), and Duckett are among the popular choices because they can be performed as a one-step procedure. However, the decision to select a procedure often comes down to the surgeon's preference rather than that supported by evidence-based data. In particular, there is a paucity of literature on the long-term urinary outcomes after proximal hypospadias repair. OBJECTIVE: The aim of this study was to evaluate the evolution of long-term uroflowmetry parameters after proximal hypospadias surgery over a long-term follow-up including the adolescent period...
August 2016: Journal of Pediatric Urology
N C Bush, T D Barber, D Dajusta, J C Prieto, A Ziada, W Snodgrass
BACKGROUND: Teaching and learning hypospadias repair is a major component of pediatric urology fellowship training. Educators must transfer skills to fellows, without increasing patient complications. Nevertheless, few studies report results of surgeons during their first years of independent practice. PURPOSE: To review outcomes of distal hypospadias repairs performed during the same 2-year period by consecutive, recently matriculated, surgeons in independent practice, and to compare them to results by their mentor (with >20 years of experience)...
June 2016: Journal of Pediatric Urology
Douglas A Canning
No abstract text is available yet for this article.
April 2016: Journal of Urology
C J Long, D A Canning
OBJECTIVE: Hypospadias surgery is a humbling art form. Although outcomes with distal hypospadias are favorable, recent publications have suggested that the complication rates are much higher than previously anticipated for proximal hypospadias. The present review examined the literature concerning proximal hypospadias, to explore some of the inadequacies and identify some of the reasons behind these shortfalls in the reported data. METHODS: A systematic review of the published literature was conducted using keywords relevant to proximal hypospadias and long-term outcomes...
August 2016: Journal of Pediatric Urology
Junshan Lin, Cheng Xie, Ruiqing Chen, Dumiao Li
OBJECTIVE: To investigate androgen receptor (AR) expression and the effect of epidermal growth factor (EGF) and testosterone on AR expression level.
 METHODS: EGF or different concentrations of testosterone were incubated with the primary urethral plate fibroblasts from patients with hypospadias. The levels of AR expression in the fibroblasts were detected by immunocytochemical assays and graphical analysis.
 RESULTS: There was no significant difference in AR activation under physiological concentrations (3×10(-8) mol/L) of testosterone between the control and the distal hypospadias group (P>0...
May 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
M Peycelon, G Rossignol, C O Muller, E Carricaburu, P Philippe-Chomette, A Paye-Jaouen, A El Ghoneimi
INTRODUCTION: The absence of a testis occurs for various reasons in children, but testicular prosthesis implantation in children is uncommon. The optimal time for prosthesis placement is still unclear, and its complication rate has been poorly studied in children. OBJECTIVE: The aim of this study was to determine the risk factors of complications in cases of testicular prosthesis implantation in children. STUDY DESIGN: A monocentric, retrospective review was performed of children implanted with a testicular prosthesis between 2008 and 2014...
August 2016: Journal of Pediatric Urology
Chao Chen, Ti-Quan Yang, Jia-Bo Chen, Ning Sun, Wei-Ping Zhang
PURPOSE: To compare the effects of staged tranverse preputial island flap(TPIF) urethroplasty and Byars two-stage procedure for proximal hypospadias with severe chordee. MATERIALS AND METHODS: A total of 87 consecutive children of proximal hypospadias with severe chordee were included in the study from March 2011 to March 2014. While 42 children were repaired with stged TPIF (group 1), 45 children were treated with two-stage Byars urethroplasty (group 2). Mean age at first stage surgery were 26...
May 31, 2016: Journal of Urology
Congxing Lin, Ralf Werner, Liang Ma, Jeffrey H Miner
Hypospadias, a congenital malformation of the penis characteristic of an abnormal urethral orifice, affects 1 in every 125 boys, and its incidence is rising. Herein we test the hypothesis that the basement membrane protein laminin α5 (LAMA5) plays a key role in the development of the mouse genital tubercle, the embryonic anlage of the external genitalia. Using standard histological analyses and electron microscopy, we characterized the morphology of the external genitalia in Lama5 knockout (LAMA5-KO) mouse embryos during both androgen-independent genital tubercle development and androgen-mediated sexual differentiation...
August 2016: Mechanisms of Development
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