Recent Considerations for
Hypospadias Repair:
Results of 252 Operations
from 1985 to 1990

Goepel, Μ.; Otto, Thomas; Kröpfl, D.; Rübben, H.

doi:10.1159/000473720

Cited by 15 publications

(12 citation statements)

References 21 publications

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“…Although Duckett reported a complication rate varying between 7.5% and 18%, [5][6][7] subsequent studies showed higher postoperative complications of one-stage Duckett urethroplasty, the rate varying from 8.6% to 56% (Table 1). [7][8][9][10][11][12][13][14][15][16]19,20 Kass and Bolong modified the Duckett procedure by constructing the neourethra with a two-layer closure and obtained an excellent result with a complication rate of 8.6%. 19 In particular, only one fistula developed Fig.…”

Section: Discussionmentioning

confidence: 99%

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One‐stage repair of moderately severe hypospadias using a transverse preputial tubularized island flap

et al. 2001

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Background: Transverse preputial tubularized island flap (TPTIF) urethroplasty has been used for the repair of moderately severe hypospadias since Duckett described the procedure in 1980. In spite of the excellent results reported by Duckett, subsequent studies showed high complication rates. A TPTIF procedure modified to reduce the complication rate is presented. Methods: Between 1996 and 1997, 13 boys with moderately severe hypospadias were repaired with the TPTIF procedure. Patient age ranged from 10 months to 3 years with an average age of 23 months. To prevent urethrocutaneous fistula, the neourethra was constructed with a two-layer closure and the portion of anastomosis was wrapped between the native urethra and the neourethra with the tissue of the corpus spongiosum. Results:The moderately severe hypospadias was repaired without complication in 12 of 13 patients. A urethrocutaneous fistula developed at the midshaft of the penis in one patient. No meatal stenosis, urethral stricture or diverticulum developed. Conclusion: Transverse preputial tubularized island flap urethroplasty provided excellent cosmetic and functional results for moderately severe hypospadias, and postoperative complications could be decreased by the two-layer closure of the neourethra and application of the wrapping technique of the proximal anastomosed portion with corpus spongiosum tissue.

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Section: Discussionmentioning

confidence: 99%

“…However, contrary to Duckett's initial results, [5][6][7] somewhat high complication rates have been reported. [8][9][10][11][12][13][14][15][16] We modified the Duckett procedure for the repair of moderately severe hypospadias to reduce the complication rates.…”

Section: Introductionmentioning

confidence: 99%

One‐stage repair of moderately severe hypospadias using a transverse preputial tubularized island flap

et al. 2001

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“…32,33 The use of SIS as an additional layer to cover the urethra was proposed by Grossklaus 34 as an alternative to prevent fistulas. In our study, the incidence of fistula was the same in all groups, 8.3% (one animal per group), despite the fact that none of the animals remained with urinary diversion postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

Kawano

Fugita

Yamamoto

et al. 2012

Journal of Endourology

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Purpose: Several urethral conditions may require tissue substitution. One collagen-base biomaterial that recently emerged as an option is small intestinal submucosa (SIS). The aim of this study was to compare the results of SIS and buccal mucosa for urethral substitution in rabbits. Materials and Methods: Thirty-six North Folk male rabbits were randomized into three groups. In all animals, a 10 · 5 mm urethral segment was excised, and the urethral defect was repaired using a one-layer SIS patch (group I [GI]); four-layer SIS (group II [GII]); or buccal mucosa (group III [GIII]). Urethrography was performed preoperatively and after 12 weeks. After sacrifice, graft retraction was objectively measured using Scion Image Ò computer analysis and by calculation of ellipse area. The grade of fibrosis, inflammatory reaction, vascular/ epithelial regeneration, and collagen III/I ratio were analyzed by hematoxylin/eosin and Picrosirius red staining. Results: Urethrography confirmed a wide urethral caliber without any signs of strictures after surgery. Urethral fistulae was diagnosed in 8.3% of cases (1 animal each group). Average graft shrinkage was 55.2% in GI; 44.2% in GII; and 57.2% in GIII ( p < 0.05). The intensity of chronic inflammation, fibrosis, epithelium regeneration, and neovascularization was similar in all groups ( p > 0.05). Collagen III/I ratio was higher in GII (GI: 119.6; GII: 257.2 and GIII: 115.0); p < 0.01. Conclusions: The four-layer SIS is more advantageous than the one-layer SIS and buccal mucosa for urethral substitution in rabbits.

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“…Goepel et al. [8] also used a combination of Duckett's preputial tube and the Thiersch‐Duplay procedure in six patients with severe hypospadias, with success in four.…”

Section: Discussionmentioning

confidence: 99%

The modified Koyanagi repair for severe proximal hypospadias

et al. 2001

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Objective To report the method and results of a modi®ed one-stage Koyanagi repair (urethroplasty with a parameatal-based and fully extended circumferential foreskin¯ap) to preserve the vascularity to the peripheral portion of the neourethra, in the repair of severe hypospadias. Patients and methods Using a skin-incision line as in the original Koyanagi repair, a circumferential incision is made < 5 mm proximal to the corona and the urethral plate incised as for repair of chordee. A Ushaped skin incision is then made surrounding the meatus, extended to the dorsal prepuce for < 8 mm and parallel to the ®rst incision. The tissue between the prepuce and dartos is dissected on the dorsal side to ®x the prepuce as a neourethra to the dartos and to maintain blood supply. After mobilizing the loopshaped skin¯ap through the button-hole of the pedicle, the internal and external sides of the loop are sutured to construct a neourethra. Twenty patients (aged 10 months to 9 years) with severe proximal hypospadias underwent the one-stage modi®ed Koyanagi repair. Results The repair was successful after the initial procedure in 14 patients, but urethrocutaneous ®stulae developed in three and meatal stenosis in three. The overall success rate was thus 70%. Conclusions There were fewer complications than reported with the original Koyanagi repair, suggesting that the attempted vascular preservation of the neourethra was effective.

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Recent Considerations for Hypospadias Repair: Results of 252 Operations from 1985 to 1990

Cited by 15 publications

References 21 publications

One‐stage repair of moderately severe hypospadias using a transverse preputial tubularized island flap

One‐stage repair of moderately severe hypospadias using a transverse preputial tubularized island flap

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

The modified Koyanagi repair for severe proximal hypospadias

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