Anatomical Studies of Hypospadias

Baskin, Laurence S.; Erol, Ali; Li, Ying Wu; Cunha, Gerald R.

doi:10.1097/00005392-199809020-00039

Cited by 50 publications

(62 citation statements)

References 17 publications

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“…In 2 (5.4%) boys, ventral penile curvature was observed by artificial erections and was corrected by dorsal plication as described by Baskin [13]. No recurrent ventral curvature developed in any of these patients during the 1.9 years of follow-up.…”

Section: Resultsmentioning

confidence: 82%

“…The mean interval between the last surgery and our operation was 14.8 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) months. Urethroplasty was performed only after confirmation of a straight penis by artificial erection.…”

Section: Methodsmentioning

confidence: 99%

“…Of the patients, 21 (56.8%) had coronal, 11 (29.7%) had subcoronal, and 5 (13.5%) had midpenile hypospadias. The mean age was 4.1 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) years. Twenty-three patients had one operation and 14 patients had two operations previously.…”

mentioning

confidence: 99%

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The midterm success rates of tubularized incised plate urethroplasty in reoperative patients with distal or midpenile hypospadias

Çakan¹,

Yalçınkaya²,

Demirel³

et al. 2005

Ped Surgery Int

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To review the midterm results of tubularized incised plate (TIP) urethroplasty (Snodgrass method) in reoperative patients with distal or midpenile hypospadias. The results of TIP urethroplasty in 37 patients who had previously failed hypospadias repair were reviewed. Of the patients, 21 (56.8%) had coronal, 11 (29.7%) had subcoronal, and 5 (13.5%) had midpenile hypospadias. The mean age was 4.1 (2-16) years. Twenty-three patients had one operation and 14 patients had two operations previously. Of all the patients, 14 did not have a foreskin because of circumcision. The urethral plate had been disturbed in 6 patients, but there was not apparent scarring of the plate. Postoperative follow-up was 2.3 years with a range of 1.1-3.9 years. Genital examination, urethral calibration, and uroflowmetry were performed in control. Satisfaction of the families about the function and appearance of penis was also evaluated. Successful functional and cosmetic results were achieved in 29 patients (78.4%). All the families were happy with penile aesthetic appearance. The urethral plate seemed healthy at the operation in nine patients who had undergone TIP urethroplasty before and the outcomes were successful in eight of them. The operation was successful in 19/23 (82.6%) patients who had undergone one operation before and in 10/14 (71.4%) patients with two operations as well (P < 0.05). In addition, sufficient outcomes were obtained in also 11 of the 14 patients with circumcision. The success rate was higher in patients <5 years (P < 0.05). The rate was also higher during the recent period (2001-2003) since the experience we had increased (P < 0.05). TIP urethroplasty was unsatisfied in four of the six patients who had had disturbed urethral plate before and in five of eight patients who did not have sufficient amount of dartos tissue for flap to cover neourethra. Complication was observed in eight patients (21.6%): four had a pinpoint fistula, two had wound dehiscence, one had meatal stenosis, and one had mild meatal regression and a short neourethral stricture. All of these complications were repaired successfully at a later date. The mean hospital stay was 4.6 days. TIP urethroplasty provides good functional and cosmetic midterm outcomes in most of the reoperative patients with distal or midpenile hypospadias unless contraindicated by previous resection or gross scarring of the urethral plate. This procedure seems not to disturb the urethral plate and, therefore, it can be applied on reoperative patients who had undergone TIP urethroplasty before. It can also be used in a circumcised patient when there is a lack of foreskin.

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Section: Resultsmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

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The midterm success rates of tubularized incised plate urethroplasty in reoperative patients with distal or midpenile hypospadias

Çakan¹,

Yalçınkaya²,

Demirel³

et al. 2005

Ped Surgery Int

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“…In this operation, the healing process of the urethral plate is crucial to the success of TIP repair [3]. The limited studies of the human fetal urethra have showed that in the hypospadiac penis, there was extensive vascularity of the abnormal distal urethra and glans compared to that of the normal penis [17] and there was no fibrous cord into the plate [18]. This increased vascularity may help to explain how well the urethral plate heals after incision [17].…”

Section: Discussionmentioning

confidence: 99%

“…The limited studies of the human fetal urethra have showed that in the hypospadiac penis, there was extensive vascularity of the abnormal distal urethra and glans compared to that of the normal penis [17] and there was no fibrous cord into the plate [18]. This increased vascularity may help to explain how well the urethral plate heals after incision [17]. In experimentally created hypospadias models, it has been shown that there was no scar tissue in the vertically incised dorsal urethral plate, whereas some inflammatory responses were seen at the ventral suture site [19,20].…”

Section: Discussionmentioning

confidence: 99%

Short-term catheterization after TIP repair in distal hypospadias: who are the best candidates?

et al. 2006

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Over the last decade, tubularized incised plate (TIP) urethroplasty has become the first choice of surgical technique in patients with distal hypospadias. Despite the excellent cosmetic and functional results, prolonged catheterization (7-14 days) remains the main disadvantage of the TIP repair. In this study, we investigated the outcomes of the short-term catheterization in children with distal hypospadias in order to elucidate any relationship between the length of catheterization and the patients' age, meatal localization and postoperative complication rates. The charts of 183 patients who underwent TIP repair for distal hypospadias in two different centers were reviewed retrospectively. Patients were grouped based on their catheter removal time (before 24 h vs. after 24 h) and the toilet status of children (toilet-trained vs. in-diaper). Children who had at least 6 months of follow-up and regular office visits were included in the study group, and the results were compared to the literature as well as the subgroups were also evaluated in terms of complications and catheterization period. A total of 128 patients with 40.4 months of the mean age (6-180 months) and 22.7 months of the follow-up (6-49 months) were included in the study. For the group 1 patients (n = 99) in whom the urethral catheter was removed before 24 h, the mean age and follow-up were 33.4 months (6-150 months) and 22.3 months (6-48 months), respectively. The catheters of group 2 patients (n = 29) were removed after 24 h, and their mean age and follow-up were 64.4 months (6-180 months) and 24.2 months (6-49 months), respectively. The group 2 patients were significantly older than those of group 1 (P < 0.05). The complications, such as fistula, meatal stenosis, tube dehiscence and buried penis, were seen in 11.1% of the group 1 and 13.8% of the group 2 (11.7% in overall), showing no statistically significant difference. On the other hand, 44% of the patients (n = 56) were toilet-trained at time of surgery. Although the mean age (79 months vs. 10.4 months) and the catheter removal time (64.3% vs. 87.5% before 24 h) of this group were significantly longer than the patients in diaper (P < 0.05), no significant difference was determined in terms of complication (14.2% vs. 9.7%). TIP repair with short-term catheterization has similar outcomes to the patients who conventionally carry their stent 7-14 days. The meatal position and the toileting status of the patients are not important in the use and length of catheterization.

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Complex and Redo Hypospadias Repairs: Management of 402 Patients

Hanna

2022

Hypospadias Surgery

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Anatomical Studies of Hypospadias

Abstract: Increased knowledge of normal and hypospadiac penile anatomy with respect to the nerves, corporeal bodies, glans and vascularity is useful for the strategic design of penile reconstructive procedures.

Cited by 50 publications

References 17 publications

The midterm success rates of tubularized incised plate urethroplasty in reoperative patients with distal or midpenile hypospadias

The midterm success rates of tubularized incised plate urethroplasty in reoperative patients with distal or midpenile hypospadias

Short-term catheterization after TIP repair in distal hypospadias: who are the best candidates?

Complex and Redo Hypospadias Repairs: Management of 402 Patients

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