The Effect of the Duckett procedure on the Outcome and Prognosis of Children with Suburethral Cleft

Geng, Huihui; Cheng, Siwei; Yang, Xinghai; Huang, Yanhui

doi:10.1155/2022/7444104

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…The surgical plan for proximal hypospadias can be divided into single and staged operations. Duckett repair is a classic single-stage procedure (2). Single-stage procedures are often associated with high rates of complications and reoperations, which defeats the initial purpose of a single-stage procedure.…”

Section: Introductionmentioning

confidence: 99%

Repair of proximal hypospadias with single-stage (Duckett’s method) or Bracka two-stage: a retrospective comparative cohort study

Wu¹,

Guan²,

Wang³

et al. 2023

Transl Pediatr

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Background: Surgical correction of proximal hypospadias is challenging. The complication rate of proximal hypospadias is still high, and the debate over its optimal treatment is ongoing. Duckett's method is a classic non-staging operation, and two-stage Bracka repair is an attractive alternative procedure. Herein, we retrospectively analyzed the effects of two surgical techniques on proximal hypospadias in order to reduce the complication rates of proximal hypospadias, and analyzed the various risk factors that cause complications.Methods: This study retrospectively evaluated 94 consecutive patients who underwent repair of penoscrotal or proximal defects between 2015 and 2019. Patients were assigned to two groups: 46 patients were treated with Bracka and 48 with Duckett. Patient age at surgery, urethral meatus location, and postoperative complications were recorded. One-way analysis of variance (ANOVA) was used to analyze the length and curvature of the penis and the length of the urethral defect.Results: There was no significant difference between the two groups in terms of age and type of hypospadias. In the Bracka group, there was 1 case (2.2%) of meatal stenosis after the first stage, which was restored with ureteral dilatation. After second-stage repair, a urethral fistula was noted in 4 cases (8.7%) and strictures in 2 cases (4.3%). In the Duckett group, urethral fistulas were noted in 8 cases (16.7%), strictures in 4 cases (8.3%), partial glans dehiscence in 4 cases (8.3%), and diverticulum in 1 case (2.1%) postoperatively.Compared with the Duckett group, the overall complication rate for Bracka repair was lower (35.4% vs. 13%, P=0.016). In addition, compared with the Duckett group, children with perineal hypospadias who were treated with the Bracka operation had fewer postoperative complications (100% vs. 13%, P=0.015).Risk factor analysis showed that the initial curvature of the penis, initial urethral defect, and degree of penile curvature after skin degloving were not correlated with complications. There was a significant correlation between urethral defects after correction of the chordee and urethral fistulas (P=0.019).Conclusions: Compared with the Duckett procedure, the Bracka two-stage repair may be a safer and more reliable approach for proximal hypospadias in children. The Bracka two-stage repair should be used for perineal hypospadias. The larger the urethral defect after chordee correction, the greater the possibility of a postoperative urethral fistula.

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Section: Introductionmentioning

confidence: 99%

Repair of proximal hypospadias with single-stage (Duckett’s method) or Bracka two-stage: a retrospective comparative cohort study

Wu¹,

Guan²,

Wang³

et al. 2023

Transl Pediatr

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“…2 Hypospadias has a complex etiology and depends on the underlying biological mechanisms [2]. This mechanism can be associated with many other malformations, especially cryptorchidism [3]. Because testosterone and dihydrotestosterone (DHT) affect the development of male external genitalia, the etiology of hypospadias is thought to often be caused by disturbances in fetal androgens due to genetic mutations.…”

Section: Introductionmentioning

confidence: 99%

Enhancement Risk Disease Cardiovascular in Children with Hypospadias

Putra,

Prayuda,

Suherman

et al. 2023

Int Jou of PHE

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Hypospadias is a congenital disorder in boys due to low fetal androgen hormones. Hypospadias is one of the congenital disorders with the highest prevalence. Several studies have revealed the association of hypospadias with cardiovascular disease. There are still very few studies that summarize cardiovascular manifestations in pediatric hypospadias. Therefore, this study was designed to describe the cardiovascular risk in pediatric patients with hypospadias. Method : Journal searches were carried out through several research databases including Google Scholar, PubMed, and Sciencedirect . The keywords used were "hypospadias", "cardiovascular", and "pediatric". The results of the literature search were 1,543 journals with 20 journals meeting the criteria. Results and Discussion : Hypospadias is one of the second most common congenital abnormalities in men after testicular undescensus . Children born with hypospadias are proven to experience changes in vascular structure, namely increased carotid intima media thickness (CMIT) and are associated with hypertension. Hypospadias patients have impaired endothelial function, decreased vasorelaxation, and increased vasoreactivity. The underlying mechanism is a Rho kinase and ROS dependent process. Conclusion: Children with hypospadias have a higher risk of cardiovascular disease.

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Systematic review of the comparison between simultaneous and staged surgical interventions for proximal hypospadias in children: Duckett’s procedure versus Bracka’s procedure

Pepelyaeva,

Kovarskiy

2024

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Selecting a treatment method for proximal hypospadias in children remains challenging. This systematic review compares the outcomes of treating proximal hypospadias with the Duckett and Bracka techniques. Literature sources published between 2008 and 2023 were searched through PubMed, Google Scholar, and eLibrary using the following keywords in English: “proximal hypospadias,” “repair OR urethroplasty,” and “outcomes OR complications.” For Russian-language sources, the keywords were “proximal hypospadias,” “urethroplasty,” “complications,” “Duckett operation,” and “Bracka operation,” After screening, four full-text articles met the inclusion criteria and were included in this review. Data from 385 patients was analyzed: 218 underwent Duckett repair and 167 underwent Bracka repair. The overall complication rate in the postoperative period was 31.11% and 10.18% for Duckett and Bracka operation, respectively. No study has been performed at a high methodological level. Currently, studies comparing single-stage and staged surgeries for proximal hypospadias are lacking. It is crucial to conduct multicenter or comparative studies that involve closer collaboration between clinics, include a larger number of patients, and have a longer followup period.

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The Effect of the Duckett procedure on the Outcome and Prognosis of Children with Suburethral Cleft

Cited by 3 publications

References 26 publications

Repair of proximal hypospadias with single-stage (Duckett’s method) or Bracka two-stage: a retrospective comparative cohort study

Repair of proximal hypospadias with single-stage (Duckett’s method) or Bracka two-stage: a retrospective comparative cohort study

Enhancement Risk Disease Cardiovascular in Children with Hypospadias

Systematic review of the comparison between simultaneous and staged surgical interventions for proximal hypospadias in children: Duckett’s procedure versus Bracka’s procedure

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