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Distal 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
Chen Shuzhu, Wu Min, Liu Yidong, Ye Weijing
BACKGROUND: Over the past two decades, Snodgrass tubularized incised plate (TIP) urethroplasty has become one of the dominant surgical techniques with wide applications and excellent cosmetic results. However, TIP has many limitations. We performed a retrospective study at our department and assessed the outcome of the inlay internal preputial graft for extending the applications of TIP. METHODS: Between January 2009 and December 2013, we performed a retrospective study consisting of approximately 508 primary distal and moderate cases...
2016: SpringerPlus
K Cox, A Kyriakou, B Amjad, S O'Toole, M E Flett, M Welsh, S F Ahmed, S Cascio
INTRODUCTION: Anogenital distance (AGD) is a recognised marker of in utero androgen action. OBJECTIVE: This study aimed to evaluate the relationship between severity of hypospadias and AGD. STUDY DESIGN: Boys undergoing hypospadias repair in a single tertiary centre between May 2012 and February 16 were included in the study. Anogenital distance was measured from the centre of the anus to the base of the penis, and anoscrotal distance (ASD) from the centre of the anus to the junction between the smooth perineal skin and scrotal skin...
September 9, 2016: Journal of Pediatric Urology
Emir Tas, Jessica Sebastian, Suneeta Madan-Khetarpal, Philip Sweet, Alexander N Yatsenko, Nijole Pollock, Aleksandar Rajkovic, Francis X Schneck, Svetlana A Yatsenko, Selma Feldman Witchel
Hand-Foot-Genital syndrome is a rare autosomal dominant condition characterized by distal limb anomalies and urogenital malformations. This disorder is associated with loss-of-function mutations in the HOXA13 gene. HOXA13 plays an important role in the development of distal limbs and lower genitourinary tract of the fetus. We report a novel familial 589 kb deletion in the 7p15.2 region identified in a male toddler and his mother. The proband had severe penoscrotal hypospadias, mild skeletal anomalies of the hands and feet, cardiac, renal, and gastrointestinal anomalies...
September 20, 2016: American Journal of Medical Genetics. Part A
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
Adel Elbakry, Mahmoud Hegazy, Adel Matar, Ahmed Zakaria
OBJECTIVES: To compare the outcome of hypospadias repair using tubularised incised-plate (TIP) urethroplasty and tubularisation of an intact and laterally augmented urethral plate. PATIENTS AND METHODS: This prospective randomised study included 370 patients with primary distal hypospadias. All had urethral plate widths of 8-10 mm and a glans of ⩾15 mm. Exclusion criteria were previous repair, circumcision, a wide urethral plate of >10 mm or a narrow plate of <8 mm in diameter, a small glans of <15 mm in diameter, chordee of >30°, and hormonal stimulation...
June 2016: Arab Journal of Urology
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
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
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
Idil Rana User, Süleyman Cüneyt Karakus, Vedat Akçaer, Bülent Hayri Özokutan, Haluk Ceylan
OBJECTIVE: Congenital anterior urethrocutaneous fistula, is a rare anomaly characterised by fistulisation of penile urethra to skin and presence of a concomitant normal or hypospadiac external urethral meatus. It may be seen as an isolated anomaly or may accompany genitourinary or anorectal malformations. We aim to present 3 new cases and define the common properties of patients stated in literature. METHOD: Information of 3 patients aged 2, 3 and 6 with this diagnosis were reviewed retrospectively and features of 51 patients in 25 articles with literature search...
June 2016: Archivos Españoles de Urología
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
Veronica Alonso, Sonia Perez, Rafael Barrero, Francisco Garcia-Merino
Vas deferens ectopia is a rare congenital anomaly frequently associated with anorectal abnormalities and hypospadias. We present a Currarino syndrome case with an ectopic vas deferens terminating in a distal retroiliac ureter. A left vasectomy, ureteral decussation over the iliac vessels and a Cohen's type ureteral reimplantation were performed. The objectives are to preserve renal function, prevent epididymitis and preserve fertility. There is no evidence in the literature that recommends surgical correction of the vas deferens...
May 24, 2016: Urology
Marco Castagnetti, Michele Gnech, Lorenzo Angelini, Waifro Rigamonti, Vincenzo Bagnara, Ciro Esposito
INTRODUCTION: We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair. MATERIALS AND METHODS: A systematic search of the literature published after 06/1995 was performed in 06/2015 using the keyword "hypospadias." Only studies on the outcome of PR in children, defined as dehiscence of the reconstructed prepuce or secondary phimosis needing circumcision, were selected...
2016: Frontiers in Pediatrics
Bioku Muftau Jimoh, Ikuerowo Stephen Odunayo, Igwilo Chinwe, Omisanjo Olufunmilade Akinfolarin, Adewumi Oluwafemi, Esho Julius Olusanmi
INTRODUCTION: The World Health Organization's manual on male circumcision listed Plastibell technique as a well-proven paediatric method with respect to the results and complications. Although, literatures abound on its wide acceptability, there are few multi-centered reports from this environment. The objective was to evaluate the cases of infant circumcision by Plastibell device from two medical institutions. METHODS: All consecutive infants who had Classical Plastibell Circumcision (PC) at the Federal Staff Medical Centre, Abuja and the Lagos State University Teaching Hospital, Ikeja between February 2011 and June 2015 were included in this cross-sectional study...
2016: Pan African Medical Journal
Mahmoudreza Moradi, Babak Kazemzadeh, Brandy Hood, Haress Rezaee, Kaveh Kaseb
OBJECTIVE: To present the meatal mobilization with glanuloplasty inclusive (MMGPI) modification of meatal advancement and glanuloplasty inclusive. MATERIALS AND METHODS: A total of 120 patients with anterior hypospadias underwent MMGPI between September 2008 and October 2014 at Kermanshah University of Medical Sciences. Satisfactory outcomes were defined as continuous straight urinary flow and catheterization of new meatus without difficulty. Cosmetic outcomes were considered acceptable if patients maintained a slit-like meatus at the glanular tip...
August 2016: Urology
N Boudaoud, M Pons, M-A Bouche Pillon Persyn, F Lefebvre, M-L Poli Merol, C Francois
Hypospadias is a hypoplasia of the tissues forming the ventral side of the penis responsible of an ectopic meatus of the urethra. This congenital anomaly results in a fusion defect of the two epithelial surfaces of the urethral groove between the 11th and the 18th weeks of development. The earlier this process arrests, the more the form is proximal and severe. This is the second genital malformation in boys with 1 case per 250 male births. Its origin is often multifactorial (genetic, endocrine, placental and environmental)...
May 10, 2016: Annales de Chirurgie Plastique et Esthétique
Gino J Vricella, Douglas E Coplen
PURPOSE OF REVIEW: This article provides a subjective, concise review of contemporary advances in reconstructive urology as it pertains to adult hypospadias repair. Herein, we highlight the most important and interesting articles among the many published within the past 12 months. RECENT FINDINGS: The main themes in the recent literature covered herein, include management of postoperative complications, long-term follow-up, and penile cosmesis. SUMMARY: Recent literature would suggest beauty is in the eye of the beholder when it comes to cosmesis after hypospadias repair...
July 2016: Current Opinion in Urology
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