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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
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
K L M Pfistermüller, S Manoharan, D Desai, P M Cuckow
INTRODUCTION: Repair of severe primary and revision hypospadias is a demanding procedure. Debate continues as to whether a two-stage approach or single-stage technique is superior. The two-stage procedure with a free graft involves penile straightening followed by application of a graft for the neourethral plate at stage one; with tubularization at stage two after graft maturation. OBJECTIVE: To report the outcomes of a single surgeon's experience with the two-stage repair using a free graft for both severe primary and revision hypospadias with long-term follow-up...
February 2017: Journal of Pediatric Urology
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...
February 2017: Journal of Pediatric Urology
Arvind Krishnan, Sean Chagani, Austin J Rohl
Hypospadias is a congenital anomaly of the male urethra that causes significant morbidity in the pediatric male population. The mainstay of treatment is hypospadias repair surgery. However, given the common co-occurrence of microphallus in these patients, surgery remains difficult without adequate tissue for proper reconstruction of the urethra. The use of preoperative testosterone therapy, parenterally or topically, has been a topic of study for several years in urologic literature. This literature review aims to summarize the different studies that have been conducted to address whether preoperative testosterone therapy is beneficial, inconsequential, or detrimental to the surgical and cosmetic outcomes of hypospadias repair as well as to address the differences in routes of administration...
July 8, 2016: Curēus
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
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
Moisés Javier Mieles Cerchar, Rafael Gosalbez Rafel, Carlos Miguélez Lago
Hypospadias is a congenital pathology of the male genitalia that we diagnose and treat more every day. Due to an increase of case load we must have at hand a large quantity of surgical techniques for its correct treatment. Ventral corporoplasty of the corpora cavernosa is one of them that will help us to successfully treat the most severe cases within this variety which is the pathology itself. We performed a prospective study in Malaga, Spain between 2010-2015. We review the technic and its indications, and the authors personal series with 20 cases performed by 2 surgeons using the same protocol and technics...
April 2016: Archivos Españoles de Urología
Zoher M Naja, Fouad M Ziade, Raymond Kamel, Sabah El-Kayali, Nabil Daoud, Mariam A El-Rajab
BACKGROUND: Caudal block (CB) has some disadvantages, one of which is its short duration of action after a single injection. For hypospadias repair, pudendal nerve block (PNB) might be a suitable alternative since it has been successfully used for analgesia for circumcision. We evaluated PNB compared with CB as measured by total analgesic consumption 24 hours postoperatively. METHODS: In this prospective, double-blinded study, patients were randomized into 2 groups, either receiving CB or nerve stimulator-guided PNB...
December 2013: Anesthesia and Analgesia
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