Introduction There are various techniques described for repair of penile hypospadias. Objective To present the anatomical repair technique and to discuss the lessons learned from this technique over 18 years. Methods All consecutive patients with penile hypospadias who underwent anatomical repair of urethra, spongiosum, bucks and dartos fascia and foreskin by the 3rd author, with a minimum of 1 year follow up from January 2003 to March 2020 at the Royal Manchester Children's Hospital, United Kingdom, were included in the study. No formal ethics approval taken as this study was done as a service evaluation. Perioperative and follow up data were recorded prospectively in the departmental database. SIPP 21 was used for statistical analysis. Fisher’s Exact Test used for sub-group analysis. Findings were considered statistically significant at p<0.05. Results 368 patients had surgery at a median age of 18 months. 94.6% had no complications, 4.1% had minor and 1.3% had significant complications. 77.5% had a distal ectopic meatus. The mean length of urethroplasty was 8mm. To widen the urethral plate, a meatoplasty (M) was performed in 34% and urethral plate incision (UPI) in 14%. Catheters were used in 71% for a median duration of 7 days, and 40% had a 6F catheter. Regards to meatal stenosis the only statistically significant causative factor was UPI with 6fr catheter. P value=0.02. Conclusions Anatomical repair provides a completely normal penis with minimal complications. Meatoplasty widens the urethral-plate and reduces the risk for meatal stenosis.
| Published in | International Journal of Clinical Urology (Volume 6, Issue 1) |
| DOI | 10.11648/j.ijcu.20220601.22 |
| Page(s) | 51-55 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Distal Hypospadias, Mid Penile Hypospadias, TIP Repair, Urethral Plate Incision, Meatoplasty
| [1] | Giannantoni A. Hypospadias classification and repair: the riddle of the sphinx. Eur Urol. 2011 Dec; 60 (6): 1190-1. |
| [2] | Springer A, Krois W, Horcher E. Trends in hypospadias surgery: results of a worldwide survey. Eur Urol. 2011 Dec; 60 (6): 1184-9. |
| [3] | Snodgrass WT. Tubularized, Incised Plate Urethroplasty for Distal Hypospadias. The Journal of Urology. 1994; 151 (2): 464-465. |
| [4] | Wilkinson DJ, Green PA, Beglinger S, et al. Hypospadias surgery in England: Higher volume centres have lower complication rates. J Pediatr Urol. 2017 Oct; 13 (5): 481. e1-481. |
| [5] | Yerkes EB, Adams MC, Miller DA, Pope JC 4th, Rink RC, Brock JW 3rd. Y-to-I wrap: use of the distal spongiosum for hypospadias repair. J Urol. 2000 May; 163 (5): 1536-8; discussion 1538-9. |
| [6] | Zhang Y, Chao M, Zhang WP, Tang YM, Chen HC, Zhang KP, Lu RG, Zhang XS, Lou DH. Using Buck's Fascia as an Integral Covering in Urethroplasty to Restore the Anatomical Structure of the Penis in One-Stage Hypospadias Repair: A Multicenter Chinese Study Comprising 1,386 Surgeries. Front Pediatr. 2021 Aug 9; 9: 695912. |
| [7] | Duckett J W. MAGPI (meatoplasty and glanuloplasty): a procedure for subcoronal hypospadias. Urol Clin North Am. 1981; 8 (3): 513–519. |
| [8] | Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: an overview of the actual techniques. Semin Plast Surg. 2011 Aug; 25 (3): 206-12. |
| [9] | Zhang B, Ruan S, Bi Y. Urethral plate in tubularized incised plate urethroplasty: how wide is enough? Transl Androl Urol. 2021 Feb; 10 (2): 703-709. |
| [10] | Snodgrass WT. Tubularized incised plate hypospadias repair: indications, technique, and complications. Urology. 1999; 54 (1): 6–11. |
| [11] | Snodgrass WT, Bush N, Cost N. Tubularized incised plate hypospadias repair for distal hypospadias. J Pediatr Urol. 2010; 6 (4): 408–13. |
| [12] | Kallampallil J, Hennayake S. Foreskin retractility following hypospadias repair with preputioplasty--medium term outcomes. J Pediatr Urol. 2013 Dec; 9 (6 Pt B): 1204-9. |
| [13] | Bhat A. General considerations in hypospadias surgery. Indian J Urol. 2008 Apr; 24 (2): 188-94. |
| [14] | Mitchell ME, Kulb TB. Hypospadias repair without a bladder drainage catheter. J Urol. 1986 Feb; 135 (2): 321-3. |
| [15] | Braungart S, Goyal A. Parental home removal of urethral catheters after urological surgery-a prospective benchmarking study. J Pediatr Urol. 2019 May; 15 (3): 252. e1-252. e4. |
APA Style
De Silva Lindamullage Amila, Cserni Tamas, Hennayake Supul. (2022). The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications. International Journal of Clinical Urology, 6(1), 51-55. https://doi.org/10.11648/j.ijcu.20220601.22
ACS Style
De Silva Lindamullage Amila; Cserni Tamas; Hennayake Supul. The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications. Int. J. Clin. Urol. 2022, 6(1), 51-55. doi: 10.11648/j.ijcu.20220601.22
AMA Style
De Silva Lindamullage Amila, Cserni Tamas, Hennayake Supul. The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications. Int J Clin Urol. 2022;6(1):51-55. doi: 10.11648/j.ijcu.20220601.22
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijcu.20220601.22,
author = {De Silva Lindamullage Amila and Cserni Tamas and Hennayake Supul},
title = {The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications},
journal = {International Journal of Clinical Urology},
volume = {6},
number = {1},
pages = {51-55},
doi = {10.11648/j.ijcu.20220601.22},
url = {https://doi.org/10.11648/j.ijcu.20220601.22},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20220601.22},
abstract = {Introduction There are various techniques described for repair of penile hypospadias. Objective To present the anatomical repair technique and to discuss the lessons learned from this technique over 18 years. Methods All consecutive patients with penile hypospadias who underwent anatomical repair of urethra, spongiosum, bucks and dartos fascia and foreskin by the 3rd author, with a minimum of 1 year follow up from January 2003 to March 2020 at the Royal Manchester Children's Hospital, United Kingdom, were included in the study. No formal ethics approval taken as this study was done as a service evaluation. Perioperative and follow up data were recorded prospectively in the departmental database. SIPP 21 was used for statistical analysis. Fisher’s Exact Test used for sub-group analysis. Findings were considered statistically significant at pResults 368 patients had surgery at a median age of 18 months. 94.6% had no complications, 4.1% had minor and 1.3% had significant complications. 77.5% had a distal ectopic meatus. The mean length of urethroplasty was 8mm. To widen the urethral plate, a meatoplasty (M) was performed in 34% and urethral plate incision (UPI) in 14%. Catheters were used in 71% for a median duration of 7 days, and 40% had a 6F catheter. Regards to meatal stenosis the only statistically significant causative factor was UPI with 6fr catheter. P value=0.02. Conclusions Anatomical repair provides a completely normal penis with minimal complications. Meatoplasty widens the urethral-plate and reduces the risk for meatal stenosis.},
year = {2022}
}
TY - JOUR T1 - The Anatomical Repair Technique to Correct Penile Hypospadias Provides Excellent Long-term Function with Low Complications AU - De Silva Lindamullage Amila AU - Cserni Tamas AU - Hennayake Supul Y1 - 2022/03/15 PY - 2022 N1 - https://doi.org/10.11648/j.ijcu.20220601.22 DO - 10.11648/j.ijcu.20220601.22 T2 - International Journal of Clinical Urology JF - International Journal of Clinical Urology JO - International Journal of Clinical Urology SP - 51 EP - 55 PB - Science Publishing Group SN - 2640-1355 UR - https://doi.org/10.11648/j.ijcu.20220601.22 AB - Introduction There are various techniques described for repair of penile hypospadias. Objective To present the anatomical repair technique and to discuss the lessons learned from this technique over 18 years. Methods All consecutive patients with penile hypospadias who underwent anatomical repair of urethra, spongiosum, bucks and dartos fascia and foreskin by the 3rd author, with a minimum of 1 year follow up from January 2003 to March 2020 at the Royal Manchester Children's Hospital, United Kingdom, were included in the study. No formal ethics approval taken as this study was done as a service evaluation. Perioperative and follow up data were recorded prospectively in the departmental database. SIPP 21 was used for statistical analysis. Fisher’s Exact Test used for sub-group analysis. Findings were considered statistically significant at pResults 368 patients had surgery at a median age of 18 months. 94.6% had no complications, 4.1% had minor and 1.3% had significant complications. 77.5% had a distal ectopic meatus. The mean length of urethroplasty was 8mm. To widen the urethral plate, a meatoplasty (M) was performed in 34% and urethral plate incision (UPI) in 14%. Catheters were used in 71% for a median duration of 7 days, and 40% had a 6F catheter. Regards to meatal stenosis the only statistically significant causative factor was UPI with 6fr catheter. P value=0.02. Conclusions Anatomical repair provides a completely normal penis with minimal complications. Meatoplasty widens the urethral-plate and reduces the risk for meatal stenosis. VL - 6 IS - 1 ER -
Information
Email: