Urethral fistulae following surgery for scrotal or perineal hypospadias: A 20-year review

Misra, Devesh; Amin, Amir Mohd; Vareli, Anastasia; Lee, Leonie; McIntosh, Mikhailia; Friedmacher, Florian

doi:10.1016/j.jpurol.2020.06.018

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…The size of the UCF has been an important consideration for most of the studies included in this series. Jamal et al and Karakus et al [ 20 21 ] have included UCF <2 mm only in their series while Xu et al , Yang et al , and Misra et al [ 14 15 16 ] have explored the utility of PATIO up to 5 mm. Bayesian method-derived estimates have depicted that the proposed surgical procedure is most effective for UCF <4 mm, with the best results reported for UCF <2 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Eighteen studies have been short listed for evidence synthesis of which inversion of the UCF tract has been described in 13 only. [ 4 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 ] The other five studies have described single ( n = 3) and double ligation of the UCF tract ( n = 2). Two entries each were identified for Kranz et al and Singh et al ; chronologically, the first one (Kranz et al , 2015, and Singh et al , 2018) was abstracts only while the later one[ 10 24 ] was complete studies, respectively.…”

Section: R Esultsmentioning

confidence: 99%

“…Within the pooled cohort, data pertaining to the size of UCF are not available for 5 studies. [ 4 7 8 10 13 ] UCF <5 mm has been included in three studies[ 14 15 16 ] with 84.4% success (26/167 failures). In Yang et al , there was only 1 patient with a UCF size >4 mm; the UCF was coronal in location and was managed successfully with double ligation.…”

Section: R Esultsmentioning

confidence: 99%

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Defining the indications of PATIO technique for urethrocutaneous fistula repair

Goel,

Choudhury,

Phugat

et al. 2023

J Indian Assoc Pediatr Surg

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A BSTRACT Introduction: Despite the advancements in technique and technology, urethrocutaneous fistula (UCF) formation continues to be the most common complication after hypospadias repair. Objective: The objective of the current synthesis is to define the indications of PATIO technique for UCF repair. Materials and Methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Ovid, Embase, Web of Science, and Google Scholar were interrogated for studies presenting primary data upon UCF repair by the PATIO technique. Data analysis was performed on MedCalc and R software. Results: Eighteen studies were identified relevant to the current context: inversion of UCF tract has been described in 13 and ligation in 5. There were 2 duplications (abstract and manuscript). The overall success for PATIO is 88.2% (314/356). The success rate was variable between classic PATIO (inversion at 87.2%), ligation-inversion at 86.9%, and ligation alone at 88.9%. The success rate was not improvised upon by supplementing inversion of UCF tract with ligation ( p = 0.957) or addition of a waterproofing layer ( p = 0.622). PATIO has been used for single or multiple UCFs post hypospadias repair, genital piercing, and genitoplasty in cis- or transgender population for UCF up to 5 mm in size. The success rates were best for UCF <2 mm and worst for those approaching 5 mm. The results were, however, unaffected by the location of UCF along the penile shaft. Besides, the use of urethral catheter is optional and may be eliminated with shorter hospitalization. Conclusions: PATIO repair may be considered for repair of UCFs (a) with diverse etiologies, (b) located anywhere along the penile shaft included coronal UCF, (c) preferably <4 mm in size, (d) single or multiple in number; multiple PATIOs may be done in the same setting, (e) in patients unwilling for prolonged hospitalization, (f) in patients unwilling for a urethral catheter, and (g) in hypospadias cripples wherein mobilization of distant tissues such as tunica vaginalis flap or a buccal mucosal graft may be required for supplementing the UCF repair.

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Section: Discussionmentioning

confidence: 99%

Section: R Esultsmentioning

confidence: 99%

Section: R Esultsmentioning

confidence: 99%

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Defining the indications of PATIO technique for urethrocutaneous fistula repair

Goel,

Choudhury,

Phugat

et al. 2023

J Indian Assoc Pediatr Surg

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“…The construction of abundant tissue barriers between the newly established urethra and the skin is the key to the surgery for hypospadias, which can reduce the occurrence of postoperative urinary stula and promote the healthy formation of the newly formed urethra [5].…”

Section: Introductionmentioning

confidence: 99%

Clinical Value of Microsurgery Combined with Covering New Urethra by Multilayer Sarcolemma Tissues in the Treatment of Hypospadias in Male Children and Analysis of Urodynamic Parameters

Zheng,

Guo,

Shi

et al. 2024

Preprint

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Objective To compare and analyze differences in the clinical effect and postoperative urodynamic indexes of microsurgery combined with covering new urethra by multilayer sarcolemma tissues and conventional surgery alone in the treatment of male children with hypospadias. Methods A total of 80 male children with penile hypospadias who were hospitalized in Beijing Children's Hospital Affiliated to Capital Medical University Baoding Hospital were randomly divided into two groups, with 40 in each group. Children in the study group underwent microsurgery combined with covering new urethra by multilayer sarcolemma tissues, while those in the control group were provided with traditional tubularized incised plate (TIP) urethroplasty alone. Further comparative analysis was performed on the operation effect, operation time, total intraoperative bleeding, postoperative length of stay in the hospital and the incidence of surgical complications between the two groups. All male children were followed up for 6 months to compare and analyze the changes of urodynamic parameters such as maximum urinary flow rate (Qmax), mean urinary flow rate (Qavc), post-void residual urine (PVR) before and after surgery. Results There were statistically significant differences that the operation time(p = 0.03) was longer while the postoperative length of stay in the hospital (p = 0.000) was shorter in the study group than those in the control group. The effective rate of the study group was 97.50%, while that of the control group was 82.50%, with statistically significant difference (p = 0.025). The incidence of surgical complications was 7.50% in the study group and 25.00% in the control group 3 months after operation (p = 0.034). There was statistically significant difference that the Hose score of the study group was significantly higher than that of the control group (p = 0.000). Meanwhile, there was no significant difference in indicators such as Qmax, Qavc and PVR between the two groups before surgery; while the levels of Qmax and Qavc in the study group were higher than those in the control group 6 months after surgery, with statistically significant difference (p = 0.000). Conclusion Microsurgery combined with covering new urethra by multilayer sarcolemma tissues has certain clinical value in the treatment of male children with hypospadias, which shows good therapeutic effect, shorter length of stay in the hospital, lower incidence of postoperative complications, and significantly improved urodynamic indicators, despite slightly complicated operation and relatively longer duration of operation.

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“…Hypospadias, one of the common diverse urologic anomalies among children, is characterized by a failure of urethral groove closure leading to an opening on the ventral aspect of the penis ( 1 , 2 ). The severity of hypospadias depends on the failure timing of the incomplete fusion of the urethral folds.…”

Section: Introductionmentioning

confidence: 99%

Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review

Jin

Wu²,

Shen

et al. 2022

Front. Psychiatry

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Hypospadias is one of the most common congenital malformations in boys. Due to abnormal appearance in the penis with abnormal urination and erection, patients with hypospadias were vulnerable to suffering from stress and psychiatric difficulties. The present study aims to summarize all the current evidence of the association between hypospadias and the risk of psychiatric disorders by a comprehensive review. Seventeen clinical studies were identified in the four electronic databases. A total of 953,872 participants were involved, while 15,729 of them were hypospadiac patients and the remaining 938,143 were normal controls. The standard age for surgery for hypospadias ranged from 20.4 months to 21.5 years. Eight out of seventeen (8/17, 47%) included studies explicitly showed that patients with hypospadias had a significantly higher risk of psychosocial disorders (all P < 0.05). Specific types of psychiatric disorders included depression, anxiety, shyness, timidness, isolation, fear of ridicule, attention-deficit hyperactivity, autism spectrum, behavioral/emotional disorders, temper tantrums, emotionality, affective, psychosexual problems, and suicidal tendencies. Based on this review, psychiatric illnesses are frequently detected in hypospadiac patients' childhood, thus proper psychiatric guidance and early interventions from physicians, nurses, and parents may help these children to grow into less affected men.

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Urethral fistulae following surgery for scrotal or perineal hypospadias: A 20-year review

Cited by 6 publications

References 23 publications

Defining the indications of PATIO technique for urethrocutaneous fistula repair

Defining the indications of PATIO technique for urethrocutaneous fistula repair

Clinical Value of Microsurgery Combined with Covering New Urethra by Multilayer Sarcolemma Tissues in the Treatment of Hypospadias in Male Children and Analysis of Urodynamic Parameters

Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review

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