Preoperative glans &amp; penile dimensions in different hypospadias grades

Sennert, Michael; Wirmer, Johannes; Hadidi, Ahmed T.

doi:10.1016/j.jpurol.2021.09.020

Cited by 14 publications

(9 citation statements)

References 22 publications

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“…In terms of risk factors for GD, previous studies have found this complication to be more common in severe vs. distal repairs [ 2 ], and this is a major reason why we included only severe cases in this study. The small glans size observed in in two thirds of patients with severe hypospadias has been suggested to account for the higher GD rate in severe hypospadias [ 12 , 13 ]. Consistently, recent studies have investigated the role of preoperative hormonal stimulation with testosterone to promote glans growth and prevent GD [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Glans dehiscence after severe hypospadias repair. Is it a real complication? Clues from a study in post-pubertal patients

et al. 2023

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Introduction Glans dehiscence (GD) is reportedly a common complication after proximal hypospadias repairs. However, the need for surgical correction is controversial. The aim of this study was to assess awareness, risk factors, and outcome of GD in post-pubertal patients. The agreement with surgeon assessment was also evaluated. Methods The design was retrospective. All consecutive patients treated for proximal hypospadias between 2000 and 2011 were included. The presence of GD was self-reported, and the participants could optionally upload a photograph for surgeon assessment. Cosmetic and functional outcomes were assessed by validated questionnaires (HOSE, PPPS, KINDL®, IIEF-5). Results were compared between patients with and without GD. Results Of 219 patients, 34 (16%) participated. Fourteen of them (41%) self-reported GD. Eighteen patients (8%) also uploaded a photograph and, in ten of them (56%), the surgeon noted the presence of GD with poor agreement [k = − 0.444 (95 CI − 0.856 to − 0.033)] with patient report. Patients self-reporting GD had had more frequently a penile curvature at diagnosis (12/14 = 86%, p = 0.01), and had undergone a single-staged repair (100% vs. 65%, p = 0.03). No difference was found in cosmetic and functional outcomes. Results were similar also comparing groups with and without GD as assessed by the surgeon. Conclusion GD was a common finding after severe hypospadias repair. It was more common in case of surgeon assessment with poor agreement between patients and surgeons. GD did not prove to have clear clinical implications. Therefore, in our opinion, surgical repair of GD should be recommended only on patients request.

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Section: Discussionmentioning

confidence: 99%

Glans dehiscence after severe hypospadias repair. Is it a real complication? Clues from a study in post-pubertal patients

et al. 2023

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“…The existence of ventral curvature is an important feature of PH, 8 the preoperative initial meatal location and existence of a severe chordee are important variables that influence not only the presence technique but also postoperative outcomes 9 . Recurrent ventral curvature can occur after proximal TIP repair because of preservation of the urethral plate, and it is a devastating postoperative complication 3 .…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

et al. 2022

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Objectives To identify the risk factors associated with developing complications after transection of the urethral plate for proximal hypospadias with severe chordee. Methods We used a prospective database to identify patients with proximal hypospadias and severe chordee who underwent transection of the urethral plate and primary hypospadias repair in 2011 and 2021. All patients underwent urethroplasty with a follow‐up period of >12 months. The association between variables (age, surgical technique, length of urethral defect, and surgeon volume) and postoperative complications (fistulas, urethral strictures, diverticula and glans dehiscence) was analyzed. Results Altogether, 493 patients were included, of whom 133 (26.9%) had postoperative complications. Univariate and multivariate analyses revealed that the preoperative proximal meatal position, one‐stage repair, longer urethral defect length, and low surgeon volume were significant risk factors for postoperative complications with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was considered the best cutoff value for predicting postoperative complications. Conclusions Preoperative proximal meatal location, one‐stage repair, longer urethral defect length, and low surgeon volume were associated with postoperative complications in patients with proximal hypospadias with severe chordee who underwent transection of the urethral plate. A urethral defect length of ≥4.55 cm was significantly associated with the development of complications.

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“…The presence of ventral curvature is an important feature of hypospadias, and a correlation has been revealed between the grade of curvature and the severity of hypospadias. 10 Our data showed that proximal hypospadias is significantly more common than distal hypospadias in patients with SC, and the degree of curvature in the proximal hypospadias group was more severe than that in the distal hypospadias group. Acimi et al considered that the essential factor responsible for the formation of the curvature associated with hypospadias is hypoplasia of the tissues in the ventral aspect of the penis.…”

Section: Discussionmentioning

confidence: 43%

“…11 Sennert et al reported that proximal hypospadias was usually accompanied by more severe ventral hypoplasia causing SC compared to distal hypospadias. 10 All patients with SC required treatment. The main methods to correct chordee include lengthening the ventral aspect of the penis or shortening the dorsal penis.…”

Section: Discussionmentioning

confidence: 99%

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Hypospadias With Severe Chordee: Effect of Urethral Plate Transection on Penile Length

Zhou

Yin

et al. 2022

Urology

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Preoperative glans & penile dimensions in different hypospadias grades

Cited by 14 publications

References 22 publications

Glans dehiscence after severe hypospadias repair. Is it a real complication? Clues from a study in post-pubertal patients

Glans dehiscence after severe hypospadias repair. Is it a real complication? Clues from a study in post-pubertal patients

Risk factors for postoperative complications in children with proximal hypospadias with severe chordee who underwent urethral plate transection

Hypospadias With Severe Chordee: Effect of Urethral Plate Transection on Penile Length

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