Surgical Treatment of Chordee without Hypospadias

Dipaola, G; Spalletta, Michele; Balducci, T.; Giacomello, Luca; Camoglio, Francesco Saverio; Bianchi, Sanzio; Ottolenghi, A.

doi:10.1159/000020375

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…A surgeon must be ready to use some different techniques to deal with proximal hypospadias. The majority of Indonesian pediatric urologists prefer TIP technique (44.3%) as a management to treat hypospadias which is comparable to another study [6], [22], [23], [24], [25], [26]. Not only for distal hypospadias, but TIP technique was also used for proximal hypospadias which had very mild chordee and only minimal dissection required for correction.…”

Section: Discussionsupporting

confidence: 60%

“…We have also noticed in this study that higher complication rate was associated with severe chordee as well as proximal hypospadias. The prevalence of proximal hypospadias (penoscrotal, scrotal, and perineal) was very high in this study (44.7%) as compared to other studies [9], [22], [23], [24]. This issue might be due to some of the distal hypospadias patients did not seek medical advice.…”

Section: Discussioncontrasting

confidence: 56%

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Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals

Duarsa

Tirtayasa

Daryanto

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Hypospadias is the second most common congenital anomalies among human congenital disabilities. There are over 300 surgery techniques being introduced to treat hypospadias. The successful of hypospadias repair is assessed by several outcomes as well as complications following surgery. AIM: This study aims to show the multicenter hypospadias data in Indonesia descriptively. METHODS: All the data were compiled based on questionnaires, which were distributed to Indonesian pediatric urologists. The questionnaire includes several questions containing demographic aspect, preferred techniques being used, and complications being found regarding hypospadias repair. RESULTS: Eighteen Indonesian pediatric urologists from 12 centres involved in this study. The data were collected from June – September 2018 based on the surgeon’s experience throughout 2017. From 591 cases based on the returned questionnaire, penile-type hypospadias was the most common type of hypospadias being treated (35.7%) followed by penoscrotal (28.9%) and scrotal-type (12.9%). Moderate severity of chordee was mostly seen among all cases (40.6%). Tubularised incised plate (TIP), + Thiersch Duplay, was the most common technique being used to treat hypospadias (44.3%), followed by onlay island preputial flap (14.9%) and two-stage technique (14%). The incidence of urethrocutaneous fistulae in this study was 13.9%. CONCLUSION: This study showed how Indonesian pediatric urologists dealt with hypospadias cases. TIP + Thiersch Duplay procedure being the preferred technique used by most participants and the rate of urethrocutaneous fistulae as one of the complications was comparable with previous studies.

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Section: Discussionsupporting

confidence: 60%

Section: Discussioncontrasting

confidence: 56%

Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals

Duarsa

Tirtayasa

Daryanto

et al. 2019

Open Access Maced J Med Sci

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“…One fourth of the hypospadias are associated with chordee [6]. Devine and Horton classified chordee into type I (skin tethering), type II (fibrotic dartos and buck's fascia), type III (corporal disproportion), and type IV (congenital short urethra) [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Hypospadias Repair: A Single Centre Experience

Khan

Majeed

Hayat

et al. 2014

Plastic Surgery International

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Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital's database and analyzed with Statistical Package for Social Sciences (SPSS). Results. A total of 428 patients with mean age of 8.12 ± 5.04 SD presented for hypospadias repair. Midpenile hypospadias were the most common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka) and TIP (tubularized incised urethral plate) repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF). The complications were significantly lower in the hands of specialists than residents (P-value = 0.0086). The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001). Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications.

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“…1 Dipaola et al reported that this disease was treated with one-stage urethroplasty (Duckett or Mathieu urethroplasty) and the incidence of complications was as high as 50%, including a recurrent chordee rate of 50% and a fistula rate of 50%, and a reoperation rate of complications of 100%. 8 Similarly, in 2013, Singh et al reported that 14 patients underwent one-stage urethroplasty (OIF or tubularized transverse inner preputial island flap or Asopa's tube urethroplasty) and the incidence of complications was as high as 64.3% (9/14), including a stricture rate of 44.4%, fistula rate of 55.6%, and reoperation rate of complications of 100%. 4 Some previous studies have shown that the treatment of chordee with a PTHU may result in significant intraoperative and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Urethroplasty for chordee with a paper‐thin hypoplastic urethra: A long‐term study

et al. 2022

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Objectives: To establish a standard surgical procedure for children with chordee with a paper-thin hypoplastic urethra, which was based on the degree of curvature and urethral plate quality. To guidelines for the management of this disorder. Methods: We reviewed 58 cases of chordee with a paper-thin hypoplastic urethra, managed between March 2006 and September 2020. The age of the patients ranged from 23 to 89 months. Operative details and postoperative complications were analyzed. Results: Mild-moderate chordee with a paper-thin hypoplastic urethra correction was performed using a tubularized incised plate (13 cases) or onlay island flap (five cases) technique after penile degloving. Severe chordee with a paper-thin hypoplastic urethra required transection of the urethra and underwent a Duckett (11 cases) or staged (29 cases) urethroplasty. Complications in the tubularized incised plate and onlay island flap groups were 7.7% and 20%, respectively. The overall complication rate was 10.3% in the staged group and 27.3% in the Duckett group. Conclusions: Reconstruction of the entire hypoplastic urethra should be recommended in the management of chordee with a paper-thin hypoplastic urethra. We propose an algorithm based on the degree of curvature and urethral plate quality. The tubularized incised plate or onlay island flap technique can be used for mild to moderate chordee with a paper-thin hypoplastic urethra, and the outcome of the tubularized incised plate technique tends to be better than that of the onlay island flap technique. Duckett or staged urethroplasty is suitable for severe chordee with a paper-thin hypoplastic urethra, and the staged technique can improve the overall success rate.

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Surgical Treatment of Chordee without Hypospadias

Cited by 13 publications

References 10 publications

Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals

Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals

Hypospadias Repair: A Single Centre Experience

Urethroplasty for chordee with a paper‐thin hypoplastic urethra: A long‐term study

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