Long-term Results of Distal Urethral Advancement Glanuloplasty for Distal Hypospadias

Caione, Paolo; Capozza, Nicola; Lais, Alberto; Ferro, Fabio; Matarazzo, Ennio; Nappo, Simona Gerocarni

doi:10.1097/00005392-199709000-00120

Cited by 6 publications

(14 citation statements)

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“…Therefore, the fear of late chordee, ischemia of the anastomosis site or even necrosis is not justified. 5,15,16 If the limits proposed in the current study are followed, no mobilization related complications would be expected, such as meatal retraction or dehiscence.…”

Section: Resultsmentioning

confidence: 84%

“…14 Also, surgical techniques of hypospadias repair that use the original urethral tissue rather than flap or graft techniques result in fewer complications. [15][16][17] Penile extensibility is limited by the tunica albuginea of the corpora cavernosa. 18,19 The tunica albuginea of the corpus spongiosum has a thin adventitia and its collagen fibers do not form a complex structure, as do those of the tunica albuginea of the corpora cavernosa.…”

Section: Resultsmentioning

confidence: 99%

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Urethral Extensibility Applied to Reconstructive Surgery

Silva

Sampaio

2002

Journal of Urology

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Purpose: The human male urethra has great capacity to extend under traction. This extensibility is the principle of some surgical techniques used to overcome urethral defects and for penile lengthening. However, to our knowledge safe limits of urethral extensibility in reconstructive surgery have not been yet established by a morphological study. To this end we measured fresh human cadaveric urethras with and without traction.Materials and Methods: We analyzed the macroscopically normal, fresh cadaveric urethra from 25 men 6 months to 73 years old at death (mean age 30.6). Penile length and length of the total, penile, bulbar and membranous urethra were measured. Length under maximal constant traction and the maximal stretched length without penile curvature at artificial erection were determined. Extensibility is expressed as the percent of the variation in initial length at rest and maximal constant traction length. Maximal stretched length without penile curvature at artificial erection is expressed as a percent of maximal constant traction length.Results: Total urethral extensibility was higher than penile extensibility (p Ͻ0.001). Urethral extensibility decreased with aging (r ϭ Ϫ0.806, p Ͻ0.001). Mean extensibility of the whole male urethra was 66.2% Ϯ 7.2% and differences among urethral segments were not significant (p ϭ 0.283). Mean maximal stretched length without penile curvature at artificial erection was 75.2% Ϯ 3.8% and it did not change with age.Conclusions: Knowledge of the safe anatomical limit of urethral extensibility applied to reconstructive surgery may avoid complications and the necessity for more complex techniques. This limit should be approximately 75% of the maximal constant traction length or a gap-tonormal urethra ratio of 1:4. However, age related variations should be considered.KEY WORDS: urethra, penis, reconstructive surgical procedures, elasticityThe human male urethra can be divided into the prostatic, membranous and spongy urethral segments, which have structural differences. The spongy urethra, also called the anterior urethra due to its location, consists of an almost central tunnel of urothelial mucosa supported by a network of interconnected spaces lined with endothelium surrounded by a thin fibrous envelope. The lamina propria of the mucosa is loose connective tissue with abundant elastic networks. No independent submucosa layer is distinguishable. The anterior urethra is composed of a large portion of extracellular matrix distributed in a unique structure. Smooth muscle cells and elastic fibers are major components of the extracellular matrix and, in addition to the spongy feature, they provide the human male urethra with a large capacity to extend under traction. 1 This extensibility is the principle of several surgical techniques used to correct urethral defects and more recently provide a real increase in penile length. 2-10 While excessive mobilization of the spongy urethra is not desirable, the success rate of these surgical techniques depends on the possibil...

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Section: Resultsmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Urethral Extensibility Applied to Reconstructive Surgery

Silva

Sampaio

2002

Journal of Urology

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“…(15) ilk kez MAGPI tekniğini tanımlamışlar ve 207 vakalık serilerinde sadece bir olguda fistül, dört olguda ise meatal geri çekilme saptamışlardır. Caione MAGPI uygulanan 118 distal hipospadiaslı olguyu ortalama 6,3 yıl takip etmiş ve hastaların sadece %5'inde cerrahi gerektiren komplikasyonların geliştiğini bildirmiştir (16). Ülkemizde 2007 yılında yayınlanan bir çalışmada ise MAGPI sonrası fistül oranı %2,7 olarak bildirilmiştir (17).…”

Section: Discussionunclassified

Distal Hipospadias Cerrahisinin Devlet Hastanesinde Uygulanabilirliği: 48 Vakanın Geriye Dönük Analizi

Özgör¹,

Sarılar²,

Berberoğlu³

et al. 2014

Haseki

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“…Patients with a reduced maximum ow as a result of stenosis were treated by urethral sounds. Urethral strictures were dilated during multiple (2)(3)(4)(5) sessions, by weekly introduction of catheters of progressively increasing calibre. Sounds were inserted under intravenous sedation to reduce distress to the patient.…”

Section: Methodsmentioning

confidence: 99%

Correction of hypospadias with a vertical preputial island flap: the Göteborg experience of 47 patients

Santanelli

2001

Scandinavian Journal of Plastic and Reconstructive Surgery and

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We report the follow-up of 47 patients with penile hypospadias who were treated by the Scuderi procedure between 1988 and 1998 at Sahlgrenska University Hospital, Göteborg, Sweden. Forty of the patients (85%) had had no previous operations, while the remaining seven had had meatotomy with chordectomy only, or an unsuccessful Dennis-Browne procedure. Hypospadias was distal in 35 (74%), mediopenile in 8 (17%), and proximal in 4 (9%); 21 (45%) showed signs of curvature. After a Scuderi urethroplasty one patient developed a fistula (2%) and 4 developed mild stenosis. The early success rate was therefore 42/47 (89%) and this later increased to 46/47 (98%) after non-surgical treatment of the stenoses. The results support the use of the Scuderi procedure for correction of primary and secondary penile hypospadias with a low complication rate.

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Long-term Results of Distal Urethral Advancement Glanuloplasty for Distal Hypospadias

Abstract: Long-term followup confirms the validity of distal urethral advancement and glanuloplasty for correcting a large number of coronal and subcoronal hypospadias cases.

Cited by 6 publications

References 10 publications

Urethral Extensibility Applied to Reconstructive Surgery

Urethral Extensibility Applied to Reconstructive Surgery

Distal Hipospadias Cerrahisinin Devlet Hastanesinde Uygulanabilirliği: 48 Vakanın Geriye Dönük Analizi

Correction of hypospadias with a vertical preputial island flap: the Göteborg experience of 47 patients

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