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Distal hypospadias

C M White, M K Hanna
OBJECTIVE: The glans penis may show a deep groove (surgically favorable), or may appear flat with an absent sulcus (unfavorable). Glans dehiscence following hypospadias repair, especially after multiple surgeries, frequently results in a scarred, obliterated, or absent urethral plate. The glans penis appears to be flat and grooveless. This study reported on the outcome of a two-stage salvage repair for glans dehiscence in 49 consecutive patients. MATERIALS AND METHODS: Retrospective chart review was performed for all patients who underwent repair for glans dehiscence following hypospadias repair...
May 30, 2018: Journal of Pediatric Urology
Pierre Pescheloche, Benoit Parmentier, Thevy Hor, Olivier Chamond, Maud Chabaud, Sabine Irtan, Georges Audry
INTRODUCTION: Fistulas are a common complication of hypospadias surgery; they are more frequent after mid-shaft and posterior hypospadias repair. Surgical treatment of fistula still remains challenging with a significant failure rate. The basic principle is to add layers between skin and neourethra in order to decrease the incidence of recurrent urethrocutaneous fistula (UCF). We report our experience of UCF repair using a vascularized tunica vaginalis flap (TVF) after posterior and mid-shaft hypospadias surgery...
May 21, 2018: Journal of Pediatric Urology
Ge Liu, Xin Liu, Joel Shen, Adriane Sinclair, Laurence Baskin, Gerald R Cunha
This paper addresses the developmental mechanisms of formation of the mouse and human penile urethra and the possibility that two disparate mechanisms are at play. It has been suggested that the entire penile urethra of the mouse forms via direct canalization of the endodermal urethral plate. While this mechanism surely accounts for development of the proximal portion of the mouse penile urethra, we suggest that the distal portion of the mouse penile urethra forms via a series of epithelial fusion events. Through review of the recent literature in combination with new data, it is unlikely that the entire mouse urethra is formed from the endodermal urethral plate due in part to the fact that from E14 onward the urethral plate is not present in the distal aspect of the genital tubercle...
May 2018: Differentiation; Research in Biological Diversity
Bing Liu, Di Wang, Zhe Yang, Yong Tang, Yangqun Li, Wen Chen
Objective: To present method and experiences in using the buccal mucosa with the Snodgrass procedure for repair of hypospadias. Methods: Between August 2012 and April 2015, 55 boys with hypospadias were treated with Snodgrass procedure combined with buccal mucosa. The age ranged from 1 to 7 years (mean, 4 years). There were 32 cases of distal penile type, 14 cases of proximal penile type, and 9 cases of coronal sulcus type. The buccal mucosa taking from inner cheek was fixed into the incised urethral plate...
January 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Rabea G Omar, Mostafa M Khalil, Hammouda Sherif, Hesham Elezaby
OBJECTIVE: To use the prepuce for double functions one as a second layer for the neourethra to decrease the incidence of urethrocutaneous fistula and the second as a skin covering for the ventral aspect of the penis. MATERIAL AND METHODS: From January 2013 to December 2016, 37 cases of hypospadias with mild to moderate chordee were included in this study. The cases with ventral penile skin defect were managed by tubularized incised plate urethroplasty (TIPU) using pedicled preputial flap...
March 16, 2018: Turkish Journal of Urology
Smail Acimi
OBJECTIVE: To report the information concerning the pathogenesis of proximal hypospadias and causes of curvature associated with it. MATERIAL AND METHODS: From January 2009 to December 2015, 74 patients underwent repair of proximal hypospadias. In 70 patients we performed a systematic biopsies in the lateral areas of the urethral plate, as well as under this plate. The study of the histological structure of these areas was performed using routine staining with hematoxylin and eosin (H&E), and the Masson's trichrome which color the collagen fibers in blue and monoclonal antibody against alpha-smooth muscle actin...
March 6, 2018: Turkish Journal of Urology
Elizabeth B Roth, John V Kryger, Charles T Durkee, Melissa A Lingongo, Ruth M Swedler, Travis W Groth
Purpose: To evaluate the impact of prophylactic antibiotics after distal hypospadias repair on postoperative bacteriuria, symptomatic urinary tract infection, and postoperative complications in a prospective, randomized trial. Materials and Methods: Consecutive patients aged 6 months to 2 years were enrolled at our institution between June 2013 and May 2017. Consenting patients were randomized to antibiotic prophylaxis with trimethoprim-sulfamethoxazole versus no antibiotic...
2018: Advances in Urology
Stephen Canon, Mary K Marquette, Adam Crane, Ashay Patel, Ismael Zamilpa, Shasha Bai
The usage of prophylactic oral antibiotics following distal hypospadias repair with stenting has been recently challenged. This study evaluated the incidence of symptomatic urinary tract infections (UTIs) following stented, distal hypospadias repair and the impact of prophylactic antibiotic therapy. Subjects 0 to 5 years of age with distal hypospadias were randomized to either Group 1 (antibiotics) or Group 2 (no prophylactic therapy). Urinalysis/urine culture was obtained intraoperatively with no preoperative antibiotics given...
2018: Global Pediatric Health
Tamer E Helmy, Wael Ghanem, Hesham Orban, Helmy Omar, Mahmoud El-Kenawy, Ashraf T Hafez, Mohammed Dawaba
OBJECTIVE: To detect whether grafting the incised plate during Snodgrass repair would improve outcome. MATERIALS AND METHODS: Sixty patients with primary distal hypospadias were included. Patients were equally randomized using closed envelop method to either Snodgrass or grafted tubularized incised plate repair (GTIP). All operations were performed by a single surgeon. All intaroperative data were recorded. All patients were followed up for 1 year. Success was defined as slit shaped meatus at the tip of the glans with no stenosis, fistula or diverticulum...
March 21, 2018: Journal of Pediatric Surgery
Reem B Aldamanhori, Nadir I Osman, Richard D Inman, Christopher R Chapple
OBJECTIVE: To describe the surgical approach and outcomes in the treatment of adult patients with complications of childhood hypospadias surgery, as such patients present a significant reconstructive challenge due to the combination of anatomical and cosmetic deformity, which often results in major functional and psychosexual sequelae. PATIENTS AND METHODS: We analysed prospectively collected data on 79 adults with complications of childhood hypospadias surgery, who were operated on between 2004 and 2016...
April 19, 2018: BJU International
Sybren P Rynja, Tom P V M de Jong, J L H Ruud Bosch, Laetitia M O de Kort
OBJECTIVE: To study long-term urinary and sexual function, and cosmetic outcomes in adult patients who underwent single-stage transverse preputial island tube (TPIT) for proximal hypospadias repair in childhood. Long-term data on outcomes of patients with proximal hypospadias with severe coexisting curvature and insufficient urethral plate are scarce, but are necessary to decide which repair technique is most beneficial. PATIENTS, SUBJECTS AND METHODS: Patients with proximal hypospadias operated with TPIT (TPIT Group) were compared to patients with distal hypospadias repair (Distal Group) and to a control group of male medical students (Control Group)...
April 6, 2018: BJU International
Marc Cendron
Introduction: The megameatus intact prepuce (MIP) variant of hypospadias is a rare variant of hypospadias that is diagnosed either early at the time of circumcision or later as the foreskin is retracted. The true incidence of the anomaly is difficult to determine precisely as some patient never come to medical attention but is felt to under 5% of all cases of hypospadias. The purposes of this study are to review the embryology and clinical findings of MIP and then, in light of a personal experience, present a series of patients evaluated for MIP who were treated with a modification of the Mathieu technique...
2018: Frontiers in Pediatrics
Michael Chua, Christopher Welsh, Bisma Amir, Jan Michael Silangcruz, Jessica Ming, Michele Gnech, Stephanie Sanger, Armando Lorenzo, Luis H Braga, Darius Bägli
INTRODUCTION: Studies have shown that non-stented distal hypospadias repair eliminates stent-related bladder spasm and stent removal discomfort without increasing complications; however, results are inconsistent. We performed a systematic review to assess the complication rates of non-stented compared to the stented distal hypospadias repair. METHODS: The literature search included randomized control trials (RCTs) and cohort studies published prior to October 2016 in all languages (PROSPERO CRD42016047563)...
February 9, 2018: Journal of Pediatric Urology
Mohamed Sultan, Mohamed El-Shazly, Eid Elsherif, Sheren Younes, Mohamed Selim
Objectives: To evaluate the presence of balanitis xerotica obliterans (BXO), clinically and pathologically, in the urethra of boys with failed previous hypospadias repair and where surgical management was planned. Patients and methods: Between February 2010 and March 2015, boys with failed distal penile hypospadias repair who were planned for surgical management were evaluated for the presence of clinical and pathological evidence of BXO. Samples were obtained from the urethral plate and fossa navicularis, after obtaining informed consent and ethical approval...
December 2017: Arab Journal of Urology
Archika Gupta, Rajesh Gupta, Punit Srivastav, Ankush Gupta
Objective: To compare the effect of interrupted- and continuous-suture urethroplasty on complication rates in Snodgrass tubularised incised-plate (TIP) hypospadias repair. Patients and methods: This was a prospective randomised study comprising 100 boys (age range 1-5 years) with primary subcoronal, distal- and mid-penile hypospadias who underwent repair from October 2010 to March 2015 in a tertiary care hospital. Boys with glanular, recurrent, and proximal hypospadias were excluded from the study...
December 2017: Arab Journal of Urology
Marcel Drlík, Radim Kočvara, Josef Sedláček, Zdeněk Dítě, Ivana Vítková, Martin Komarc
INTRODUCTION: We found midline epithelial adhesions in the glandar urethral plate in patients with hypospadias. After dissolution, a blind epithelized channel becomes visualized inside of the plate pointing to immature embryonic luminization. In addition it reveals that the epithelized surface of the distal urethral plate is larger than previously considered. OBJECTIVE: To determine the incidence and extent of these new anatomical details of urethral plate in hypospadias patients...
November 17, 2017: Journal of Pediatric Urology
S P Rynja, T P V M de Jong, J L H R Bosch, L M O de Kort
INTRODUCTION: The use of hormonal therapy was first described in 1971 before hypospadias surgery, and it has been debated ever since. The long-term outcomes after puberty of patients treated with pre-operative testosterone in childhood are lacking. OBJECTIVES: Possible long-term effects of testosterone are often asked about in daily practice. The current study investigated the long-term outcomes regarding height, penile length and penile cosmesis in adult men after hypospadias surgery in childhood with and without pre-operative testosterone...
February 2018: Journal of Pediatric Urology
Shanshan Wang, Mingxin Shi, Dongqing Zhu, Ranjiv Mathews, Zhengui Zheng
OBJECTIVE: To determine whether the guinea pig phallus would be an appropriate model of human penile development, we characterized the embryology and sexual differentiation of guinea pig external genitalia and attended to induce hypospadias in males and tubular urethra formation in females pharmacologically. MATERIALS AND METHODS: The external genitalia of guinea pig were collected from genital swelling initiation to newborn stages, and scanning electronic microscopy and histology were performed to visualize the morphology and structure...
March 2018: Urology
G V Kozyrev, A A Protasov, V V Nikolaev, F K Abdullaev, G A Abdulkarimov, M E Karmanov
Aesthetically acceptable cosmetic results of surgical correction of external genital organ defects are important for treatment evaluation along with well-known criteria of good functional outcomes.The purpose of this study was to improve the results of treating children with hypospadias by improving the assessment of results and introducing multi-step correction modalities. MATERIALS AND METHODS: From 2013 to 2015, 476 patients with various forms of hypospadias were treated at the Department of Uroandrology of RCCH...
October 2017: Urologii︠a︡
N C Bush, W Snodgrass
INTRODUCTION: Two reports have found that urethral plate (UP) widths <8 mm before tubularized incised plate (TIP) incision increased urethroplasty complications. The present study measured pre-incision UP width in consecutive boys undergoing TIP to determine if it affected outcomes. METHODS: The present study followed the method previously used by Holland and Smith, and Sarhan et al. to measure UP width before creating glans wings or performing midline plate incision in consecutive patients with primary hypospadias and ventral curvature <30°, who all underwent TIP repair (Summary Fig...
December 2017: Journal of Pediatric Urology
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