Circumcised hypospadias

Pieretti, Rafael V.; Pieretti, Alberto; Pieretti-Vanmarcke, Rafael

doi:10.1007/s00383-008-2254-1

Cited by 22 publications

(8 citation statements)

References 7 publications

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“…Snodgrass, in a retrospective review of 63 patients divided two groups, those with and without circumcision, reported that circumcised status did not seemed to be associated with a higher incidence of complication (12). This was confirmed by Pieretti et al (13). In those patients who have not been circumcised, the option of retaining the foreskin should be discussed but, in light of the increased potential complications such as phimosis, circumcision may be the safest approach.…”

Section: Discussionsupporting

confidence: 76%

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction

Cendron

2018

Front. Pediatr.

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IntroductionThe 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.Materials and methodsA PubMed search of all articles in the MIP variant of hypospadias was carried out followed by an exhaustive review of the literature. The charts of all patients evaluated and treated at Boston Children’s Hospital by MC between 2007 and 2017 were reviewed retrospectively. The patients were divided into two groups: those who underwent the standard procedure and those who underwent a repair using a modification of the Mathieu procedure using an inframeatal flap.ResultsThe embryologic explanation of the MIP variant is not clear but failure of the distal, glanular portion of the urethra to tubularize results in spectrum of abnormality characterized by a deep glanular groove and an abnormal opening of the urethra anywhere from the mid-glans to a subcoronal location. Surgical repair is complicated by a wide distal urethra which may be injured if not properly identified. Overall good outcomes were noted with one patient experiencing a urethra cutaneous fistula in the first group and one patient having a mild glans dehiscence in the second.ConclusionThe MIP variant of hypospadias is a rare variant of hypospadias that presents as a spectrum of urethral anomaly. Surgical repair may not always be necessary but if surgical repair is carried out, the Mathieu technique modification may offer better anatomic delineation of the urethra and will provide an extra layer of tissue to cover the reconstructed urethra. Low complication rates should be expected with adequate functional outcome such as a normal urinary stream. In addition, criteria for selecting patients for surgical repair are provided.

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Section: Discussionsupporting

confidence: 76%

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction

Cendron

2018

Front. Pediatr.

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“…As universally recommended for hypospadias, circumcision should be deferred, although evidence suggests that surgical outcomes are comparable in circumcised penises with a distal hypospadias using the tubularized incised plate (TIP) repair. 3,4 In cases of proximal hypospadias associated with unilateral or bilateral non-palpable cryptorchidism, disorders of sexual differentiation are noted in 17-29% of patients. [5][6][7] Therefore, initial evaluation should include serum electrolytes, 17-hydroxyprogesterone (17-OHP), karyotype, abdominal ultrasound to assess for Mullerian structures, and endocrine referral.…”

Section: Classificationmentioning

confidence: 99%

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Keays

Davé

2017

CUAJ

111

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“…Their findings were that prior circumcision did not negatively affect the results of their hypospadias repair. They felt that the use of a Snodgrass type of procedure has virtually eliminated the need for skin flaps for these repairs [5]. Despite the ways of performing these studies the results of both are the same.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Distal Hypospadias Repair in Circumcised Patients and Uncircumcised Patients

Rashed

Gholizade

2013

ISRN Urology

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Hypospadias is the most common anomaly in the male genital tract with an incidence of 0.8–8.2 per 1000 live male births. Routinely, hypospadias cases are repaired after one year of age, and it is recommended that a child with hypospadias not to be circumcised until hypospadias repair is completed. This study was conducted to determine whether or not circumcision prior to hypospadias repair increases the risk of complications. 30 circumcised patients and 30 persons without a history of circumcision and hypospadias were enrolled in this study and underwent surgery for hypospadias repair. The results of surgery compared between two groups. In the uncircumcised group, the mean durations of surgery and hospitalization were 55.61 ± 58.11 min and 3.17 ± 1.79 days. In circumcised group, the mean duration of surgery and hospitalization were 66.17 ± 33.65 minutes and 3.7 ± 1.62 days. There was no significant difference between these criteria and other complications of the two groups. This study shows that postoperative complications in circumcised distal hypospadias patients do not increase. Cosmetic and functional results were excellent. If there are failures in therapy and in case of postoperative complications, it is better to notice other factors such as infection.

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Circumcised hypospadias

Cited by 22 publications

References 7 publications

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Comparison of Distal Hypospadias Repair in Circumcised Patients and Uncircumcised Patients

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