Snodgrass Hypospadias Repair with Vascularized Dartos Flap: The Perfect Repair for Virgin Cases of Hypospadias?

Cheng, Earl Y.; Vemulapalli, Sreenivas N.; Kropp, Bradley P.; Pope, John C.; Furness, Peter D.; Kaplan, William E.; Smith, Dean

doi:10.1016/s0022-5347(05)64398-4

Cited by 84 publications

(32 citation statements)

References 16 publications

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“…The TIP method has been favored in hypospadias cases by a gradually increasing number of supporters in recent years. [19][20][21][22] The fistula rate in large hypospadias studies seems to vary from 0 to 33%. 23 Failure, fistula, and meatal stenosis are the most common complications encountered and they most likely to develop within 6 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017

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Background: Hypospadias is a relatively common congenital defect of the male external genitalia. The objective of this study was to evaluate whether the early removal of urethral stent following TIP Snodgrass repair of hypospadias can reduces postoperative complications of this procedure.Methods: In Al-Yarmouk teaching hospital, the surgical procedure included 61 tabularized incised plate (TIP) repairs for penile hypospadias. The patients were prospectively observed over 36 months and randomized into 2 groups, group (A) was 30 patients where the urethral stent was removed after 24 hours of operation, and group (B) was 31 cases where the stent removed in the 6th postoperative day. Suprapubic urinary diversion was done for all patients. All of the operations were performed by the same surgeon. Complications and cosmetic appearance were documented at last follow-up.Results: The average age of the patients was 3.9 years, urethrocutaneous fistula was observed in 2 cases in group A (6.6 %), while 11 patients had fistula in group B (35.4 %) with a statistically significant difference (p < 0.05). meatal stenosis was reported in 4 patients in (group A) (13.3%), while 12 patients had such complication in group B (38.7%) with a statistically Significant difference as (P< 0.05). 6.6 % of group A developed wound infection, while 32.2 % had wound infection postoperatively in group B with a statistically significant difference (P< 0.05). Complete surgical failure when wound dehiscence occurs, it was found that no significant difference between the 2 groups (P value=0.1).Conclusions: TIP repair is a versatile operation that can be performed in almost all cases of penile hypospadias. We believe that early stent removal after 1 day of surgery for hypospadias repair simplifies postoperative care, highly reduces risk of development of urethrocutaneous fistula, meatal stenosis and wound infection, so obviates the need for antibiotics.

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Section: Discussionmentioning

confidence: 99%

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017

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“…Although the initial description did not highlight the importance of interposing dartos tissue between the neourethral suture line and the ventral skin closure, several subsequent descriptions of the procedure by Snodgrass and others do stress the importance of providing a barrier layer to decrease fistula rates 9,10 .…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair

Chakraborty

Majumdar

Zahid

et al. 2015

J. paediatr. surg. Bangladesh

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Abstract:Background/purpose: The tubularized incised plate urethroplasty (Snodgrass technique) presents the procedure of choice for distal hypospadias repair. Fistula formation is the most common complication with various rates. Avoiding overlap of suture lines in the Snodgrass repair is critical to minimize fistula formation through second-layer coverage of the neourethra. We compared the outcome of double-layer dartos flaps to flapless procedure in the tubularized incised plate urethroplasty for distal hypospadias repair to assess the effectiveness of dartos flap in this method.

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“…In our cases we also had used single or double layer in between neourethra and skin coverage. Cheng et al have also suggested a two layer closure of the neourethra to minimize the fi stula rate 21,22 . Some western study shows fi stula forma on rate less than 2%.…”

Section: Discussionmentioning

confidence: 99%

Snodgrass Tubularized Incised Plate Urethroplasty for Distal and Midpenile Hypospadias

Thapa

Pun

2014

J. Nepal Paedtr. Soc.

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Introduction: Despite hundreds of repair techniques for hypospadias, the introduction of tubularized incised plate urethroplasty (TIP) by Warren T. Snodgrass has become popular because of good functional and cosmetic outcome. The objective of this study was to share our experience of Snodgrass tubularized incised plate (TIP) urethroplasty for the repair of distal and mid-penile hypospadias. Materials and Methods: This prospective study was carried out for a period of 24 months. It included 46 male patients with the mean age of 4.1 years (18 months to 10 years). Proximal hypospadias and those distal with moderate to severe chordee were excluded. All cases underwent TIP urethroplasty as described by Snodgrass and the neourethra was covered by single or double layer of dorsal prepucial layer. The results were analyzed on the basis of duration of surgery, types of postoperative complications like urethrocutaneous fistula, meatal stenosis and wound dehiscence. Functional results assessed with ease of voiding, force and direction of urinary stream and cosmetic with external look of penis. Results: The overall complication rate requiring surgical intervention was 8 (17.3%). Mean duration of surgery was 66 minutes (60-80 minutes). Urethrocutaneous fistula occurred in 5 (10.8%), meatal stenosis in 1 (2.1%) and wound dehiscence in 2 (4.3%) patient. The cosmetic appearance was excellent in all patients involved in this study except 2 cases of wound dehiscence. All of them had vertically oriented slit like meatus with straight urinary stream. Conclusion: Tubularized incised plate urethroplasty gives good functional and excellent cosmetic results with low rate of complications in distal and mid-penile hypospadias.

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Snodgrass Hypospadias Repair with Vascularized Dartos Flap: The Perfect Repair for Virgin Cases of Hypospadias?

Cited by 84 publications

References 16 publications

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair

Snodgrass Tubularized Incised Plate Urethroplasty for Distal and Midpenile Hypospadias

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