Effect of Suturing Technique and Urethral Plate Characteristics on Complication Rate Following Hypospadias Repair: A Prospective Randomized Study

Sarhan, Osama; Saad, Mohd Sazli; Helmy, Tamer E.; Hafez, Ashraf T.

doi:10.1016/j.juro.2009.04.034

Cited by 94 publications

(75 citation statements)

References 16 publications

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“…17 The presence of a narrow and shallow urethral plate has also been associated with an increased risk of complications, 18 although this finding has not been confirmed in sub sequent studies. 19,20 Moreover, the assessment of urethral plate characteristics seems to be somewhat subjective, with wide interobserver variability. 21 It is worth noting that some anatomical characteristics-such as the presence of a short penis, which is relatively common in patients with proximal hypospadias-can cause dissatisfaction in the absence of complications.…”

Section: Risk Factors For Failed Hypospadiasmentioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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| Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs ranges from 5-70%, but the actual incidence of failed hypospadias is unknown as complications can become apparent many years after surgery and series with lifelong follow-up data do not exist. Moreover, little is known about uncomplicated repairs that fail in terms of patient satisfaction. Risk factors for complications include factors related to the hypospadias (severity of the condition and characteristics of the urethral plate), the patient (age at surgery, endocrine environment, and wound healing impairment), the surgeon (technique selection and surgeon expertise), and the procedure (technical details and postoperative management). The most important factors for preventing complications are surgeon expertise (number of cases treated per year), interposition of a barrier layer between the urethroplasty and the skin, and postoperative urinary drainage. Major complications associated with failed hypospadias include residual curvature, healing complications (preputial dehiscence, glans dehiscence, fistula formation, and urethral breakdown), urethral obstruction (meatal stenosis, urethral stricture, and functional obstruction), urethral diverticula, hairy urethra, and penile skin deficiency.

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Section: Risk Factors For Failed Hypospadiasmentioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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“…Literatürde sınırlı sayıda tek tek, devamlı, subkutiküler, tam kat sütürasyon teknikleri anlatılmaktadır (10). Bununla beraber, neoüretra aşamasında kullanılan sütür tekniğinin sonucu etkilemediğini bildiren araştırmalarda bulunmaktadır (9). Diğer yandan, subkütiküler ve tam kat sütür atılmasının cerrahi sonuçlarını değiştirmediğini bildiren çalışmalarda vardır (8).…”

Section: Discussionunclassified

Long-Term Results of Modified Connell Suture Technique in Repair of Distal and Mid Penile Hypospadias

Yuvanç

2018

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Hipospadias eksternal üretral meanın penisin ventral yüzünde proksimale açılması ile karakterize konjenital bir anomalidir. Hipospadias onarımında temel hedef üretranın glansın distaline taşınması ve penisin normal görünümünün tekrar sağlanmasıdır. Birçok onarım tekniği sonuçları paylaşılmış olmasına karşın, pek azında cerrahi esnasında kullanılan sütürün uygulanma tekniği tartışılmıştır.Çalışmanın amacı hipospadias onarımında ilk kez tarif edilen Modifiye Connell sütür tekniğinin (MCST) perioperatif ve postoperatif sonuçlarını değerlendirmektir. Bulgular: Ortalama yaş 5.6 ± 1.2 yıl, ortalama takip süresi 4.05 yıldır. 13 subkoronal, 3 koronal ve 9 midpenil hipospadias vakası vardı. Operasyon esnasında Modifiye Connell sütürasyonu için harcanan ortalama süre 8.3 ± 2.1 dakika olarak belirlendi. Ortalama turnike süresi ise 12.3 ± 3.4 dakika olarak saptandı. 25 olgunun 24'ünde (%96) cerrahi başarılı sonuç alınmıştır. Sadece 1 olguda dilatasyona yanıt veren meatal stenoz izlenmiştir. Hiçbir olguda üretro-kutanöz fistül izlenmemiştir. Uzun dönem takip sonuçları uygun kalibreli ve kozmetik olarak kabul edilebilir ileri doğru, tazyikli, tek, kompakt bir idrar akımı ile düzgün işleyen bir üretra sağlandığını ortaya koydu. Sonuç:Hipospadias onarımında MCST uygulama esnasında güvenilir, hızlı, yara dudaklarının uc-uca getirilmesinde ve epitelyum hattının inverte edilmesinde avantajlı, watertight, doku kanlanmasını bozmayan ve dolayısıyla yara iyileşmesini kolaylaştırıp postoperatif fistül gelişimi riskini azaltan ve fibrotik bir iyileşme hattı yerine vasküler bir hat oluşturarak üretral stenoz ve penil kurvatur riskini azaltan bir yöntemdir.Objective: Hypospadias is a congenital anomaly characterized by opening of the urethra to the ventral surface of the proximal penis. The main goal of hypospadias repair is to restore the normal appearance of the penis and distal transport of the urethra to the glans. Although the results of many repair techniques have been shared, few have discussed the technique of applying the suture used during surgery.To evaluate the perioperative and postoperative results of Modified Connell suture technique (MCST), which was described for the first time in hypospadias repair. Material and Methods:Results of 25 patients who repaired for distal and midpenile hypospadias with Tubularized Incised Plate Urethroplasty (TIPU) and underwent MCST at urethroplasty and glanduloplasty stages between January 2011 and February 2015 were retrospectively screened. Recurrences and circumcised cases were removed. The results of perioperative suturing time, penile tourniquet time and postoperative complications and postoperative 1st week, 1st month, 3rd month and annual followup were recorded.

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“…A prospective randomized study showed no influence of suture technique on outcomes of tabularized incised plate urethroplasty [5]. Another Prospective study showed increased likelihood of post-operative complications with increase in GMS scoring [6].…”

Section: Discussionmentioning

confidence: 99%

Hypospadias Repair and Its Complications at the Plastic Surgery Department, Khoula Hospital

Hashish¹,

Balushi²,

Haridi³

et al. 2017

MPS

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This study reviewed the complications associated with hypospadias repair surgery done at Khoula hospital, Oman during the period of January, 2010 to October, 2015. During this period, 178 cases were operated. Snodgrass and Bracka's techniques were the most used techniques. Complications were noted in 16 out of 82 patients operated using Snodgrass technique and 2 out 10 patients operated via Bracka's technique. This study helped in shifting the practice towards the technique associated with the lowest complications. As a result we adopted for our practice MAGPI for glandular hypospadias, Snodgrass for any type of hypospadias without chordee and Bracka's two stages repair for hypospadias with chordee.

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Effect of Suturing Technique and Urethral Plate Characteristics on Complication Rate Following Hypospadias Repair: A Prospective Randomized Study

Cited by 94 publications

References 16 publications

Failed hypospadias in paediatric patients

Failed hypospadias in paediatric patients

Long-Term Results of Modified Connell Suture Technique in Repair of Distal and Mid Penile Hypospadias

Hypospadias Repair and Its Complications at the Plastic Surgery Department, Khoula Hospital

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