Ingrafts in hypospadias surgery: Longer-term outcomes

Loloi, Justin; Harrington, Stephen; Boltz, Suzanne; Decter, Ross M.

doi:10.1016/j.jpurol.2020.04.030

Cited by 5 publications

(3 citation statements)

References 14 publications

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“…Various grafts such as buccal mucosa, bladder mucosa and genital skin are used for urethral defect repair in cases of cripple hypospadias whose penile skin and urethral plate are not suitable for use due to previous unsuccessful operations. Skin grafts are not preferred as the first choice due to complications such as infection, hair growth, fistula and stone formation, development of diverticula and stenosis (10). The most important problem encountered when the bladder mucosa is used as a replacement material in urethral defect repair is the hypertrophy and stickiness of the mucosa in the part of the newly formed urethra exposed to air at the tip of the penis as seen in bladder exstrophy (11).…”

Section: Discussionmentioning

confidence: 99%

Autologous Free Reverse Inlay Vein Graft in the Treatment of Cripple Hypospadias; an experimental rabbit model

Çalışkan¹,

SÜRER

GÜNHAN>

2023

Türkiye Çocuk Hast Derg

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Objective: The aim of this study is using the autologous reverse inlay jugular vein graft as a substitute for defective urethral plate and the incorporation of the graft to the urethral plate. Cripple hypospadias are the patients who have a history of previous multiple unsuccessful hypospadias surgery and still having anatomical and functional complications. Insufficient local or support tissue for the repair of defective urethral plate is always a problem. Material and Methods: In the study fourteen male 8-10 months old which is weighting four kg, New Zealand type rabbit are divided into two equal groups. Juguler vein graft (1st group) and buccal mucosal graft (2nd group) harvested and transferred to defective area in the urethral plate as a free flap. Results: In the histopatologic examination, epithelization, fibrosis and inflammation degrees were evaluated between the groups and in-groups. In the histopatological examination of the 1st group, uroepithelization is complete or nearly complete, fibrotic activity is (+) and the inflammation was found minimal. In the second group after 21st day, the uroepithelization on the graft is nearly thirty percent, fibrotic activity is (++) and the inflammation is also found minimal. Conclusion: From the results of the study, in the treatment of defective urethra in cripple hypospadias cases, reverse free juguler vein graft can be used as an alternative for buccal mucosa graft as a substitution material which has been used for a long time.

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Section: Discussionmentioning

confidence: 99%

Autologous Free Reverse Inlay Vein Graft in the Treatment of Cripple Hypospadias; an experimental rabbit model

Çalışkan¹,

SÜRER

GÜNHAN>

2023

Türkiye Çocuk Hast Derg

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“…Effective anti-inflammatory and prepuce skin or other grafts around the new urethral canal for repair may reduce the occurrence of urinary leakage. 16 In most clinical studies, priority is given to how to increase the success rate of surgery. However, few studies have been carried out on how to reduce the corresponding risk after surgery, and how to early identify and timely manage urethral stricture.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical effects between microscopic surgery and conventional surgery in children with penile hypospadias and difference analysis of postoperative urodynamics

Guo

Zheng²,

Shi³

et al. 2023

Pak J Med Sci

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Objective: To compare and analyze the clinical effects of microscopic surgery and conventional surgery in children with penile hypospadias and the differences in postoperative urodynamic indexes. Methods: It was a clinical comparative study. A total of 80 children with penile hypospadias admitted to Beijing Children’s Hospital Affiliated to Capital Medical University Baoding Hospital from July 2018 to September 2022 were selected and randomly divided into two group. The experimental group were treated with microscopic urethroplasty, while the control group were treated with traditional urethroplasty. The operative effect, operation time, total intraoperative blood loss, postoperative hospital stay and incidence of surgical complications were compared and analyzed between the two groups. All the children were followed up for two years, and the changes in urodynamic parameters including maximum urine flow rate (Qmax), average urine flow rate (Qavc), urine flow time (FT), peak time (TQmax) and residual urine (PVR) were compared before, two weeks after, six months after and two years after surgery. Results: The efficacy of the experimental group was significantly higher than that of the control group (p=0.013). The intraoperative blood loss and postoperative hospital stay in the experimental group were significantly better than those in the control group (p=0.000). The incidences of urinary leakage and urethral stricture in the experimental group were lower than those in the control group (p<0.05). The Qmax level in the experimental group was higher than that in the control group at six months and two years after surgery, while the FT level was lower than that of the control group (p<0.05). Conclusion: Microscopic surgery is a method with significant clinical value in the treatment of penile hypospadias. doi: https://doi.org/10.12669/pjms.39.5.6986 How to cite this: Guo S, Zheng W, Shi X, Zhang B, Wang J. Comparison of clinical effects between microscopic surgery and conventional surgery in children with penile hypospadias and difference analysis of postoperative urodynamics. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.6986 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…To reduce the incidence of fistula, covering the neourethra with adjacent tissues such as fascia, dartos, and penile flap is most reliable. Recently, medics have tried to repair hypospadias with buccal mucosa ( 2 , 3 ). Springer et al ( 4 ) shared their experience of repairing urethrocutaneous fistula with an acellular collagen matrix graft and considered it a safe and effective adjunct to prevent further recurrence of fistula.…”

Section: Introductionmentioning

confidence: 99%

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

Yang

et al. 2022

Front. Pediatr.

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BackgroundUrethrocutaneous fistula is one of the most common complications arising from hypospadias surgery. The purpose of our study was to investigate the effectiveness and safety of allogeneic human acellular dermal matrix (HADM) application as a means of preventing the occurrence of urethrocutaneous fistula following hypospadias surgery.MethodsThis is a non-randomized study of 219 cases (out of 270 patients with hypospadias) which satisfied inclusion and exclusion criteria. These patients were divided into two groups: 101 HADM patients, and 118 control patients (who did not receive HADM). In the control group, 77 boys were treated by single-stage urethroplasty (TIP) and 41 underwent staged urethroplasty (Thiersch-Duplay). In the HADM group, 59 boys underwent the TIP and 42 underwent the Thiersch-Duplay. In the postoperative period, we recorded the incidence of infection, urethrocutaneous fistula, and urethral stricture complications in these two groups of patients. The effectiveness and safety of HADM in preventing urethrocutaneous fistula following hypospadias surgery were evaluated according to these indicators.ResultsIn the control group, following the operation there were 16 cases of infection, 38 cases of urethrocutaneous fistula after extubating, and 5 cases of urethral stricture. In the HADM group, there were 19 cases of postoperative infection, 12 cases of urethrocutaneous fistula after extubating, and 5 children with urethral stricture. In comparing the two groups, it was found that the postoperative infection rate (13.6 vs. 18.8%) and the incidence of urethral stricture (4.2 vs. 5.0%) were not statistically significant (P > 0.05), while the postoperative urethrocutaneous fistula rate (32.2 vs. 11.9%) was statistically significant (P < 0.001).ConclusionIt is found that HADM application can significantly reduce the incidence of urethrocutaneous fistula complications, without increasing the risk of infection and urethral stricture.

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Ingrafts in hypospadias surgery: Longer-term outcomes

Cited by 5 publications

References 14 publications

Autologous Free Reverse Inlay Vein Graft in the Treatment of Cripple Hypospadias; an experimental rabbit model

Autologous Free Reverse Inlay Vein Graft in the Treatment of Cripple Hypospadias; an experimental rabbit model

Comparison of clinical effects between microscopic surgery and conventional surgery in children with penile hypospadias and difference analysis of postoperative urodynamics

Application of Allogeneic Human Acellular Dermal Matrix Reduces the Incidence of Fistula in Hypospadias Repair

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