Effects of spongioplasty on neourethral function following hypospadias repair: an experimental study in rabbits

Abstract

Purpose: Spongioplasty (mobilization and midline approximation of the two branches of the bifi d dysplastic distal corpus spongiosum) can form a covering layer for the neourethra to prevent urethrocutaneous fi stula in hypospadias repair surgery. However, it remains unclear whether spongioplasty affects neourethral function. The objective of this study was to compare neourethral function after hypospadias repair with and without spongioplasty. Materials and Methods: Fourteen congenital hypospadiac New Zealand male rabbits were randomly allocated into two groups, seven animals underwent Duplay hypospadias repair and spongioplasty (experimental group), while seven underwent Duplay surgery alone (control group). Functional differences between groups were assessed by comparing neourethral compliance and fl ow rate. Two months after surgery, in vivo neourethral compliance was assessed by measuring intraluminal pressure with a digital pressure meter of an isolated neourethral segment, following progressive distension with 1, 2, and 3mL of air. Penises were harvested for urofl owmetry test using a simple device. Results: Postoperatively, fi stula developed in one and zero rabbits in the control and experimental groups, respectively. Mean pressures tended to be higher in the experimental group than in the control group (82.14 vs. 69.57, 188.43 vs. 143.26, and 244.71 vs. 186.29mmHg for 1, 2, and 3mL of air, respectively), but the difference was not statistically signifi cant. Mean fl ow rates also did not signifi cantly differ between the experimental and control groups (2.93mL/s vs. 3.31mL/s). Conclusion: In this congenital rabbit model, no obvious functional differences were found between reconstructed urethras after hypospadias repair with and without spongioplasty.

Clinical Efficacy Analysis of Biofeedback Electrical Stimulation Combined with Doxycycline in the Treatment of Type IIIA Chronic Prostatitis

“…ere are different theories on the aetiology and pathophysiology of chronic prostatitis, including occult infection, inflammation/autoimmunity, pelvic floor muscle dysfunction, voiding dysfunction, intraprostatic urinary reflux and elevated intraprostatic pressure, neuropsychological factors, adrenal axis abnormalities, genetic predisposition and oxidative stress [12][13][14][15]. Type IIIA chronic nonbacterial prostatitis, also known as chronic pelvic pain syndrome, is inflammatory prostatitis that presents with varying degrees of elevated leukocytes in both routine EPS and voided bladder three (VB3) [16].…”

Outcome Of Spongioplasty As A Standalone Covering Layer After Urethroplasty In Distal Hypospadias

“…The separation of two branches of the bifurcated urethral spongiosum, which were later reunited and utilized to cover the ventral side of the neourethra, was initially described in 2000. This technique was known as "spongioplasty" (5) . In 2009, no statistically significant change in the re-operation rate was observed after adding spongioplasty to the dartos fascia cover in a single center experience with 500 cases defining variables impacting the success of tubularized incised plate (TIP) urethroplasty (6) .…”