Single-Layer Acellular Porcine Bladder Matrix as Graft in Corporoplasty for Ventral Curvature in Pediatric Proximal Hypospadias Repair: An Initial Experience.

Autor: Huen KH; Division of Pediatric Urology, UCLA Mattel Children's Hospital, Los Angeles ,CA; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA., Macaraeg A; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA., Davis-Dao CA; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA., Williamson SH; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA., Boswell TC; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA., Chuang KW; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA., Stephany HA; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA., Wehbi EJ; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA., Khoury AE; Division of Pediatric Urology, Children's Hospital of Orange County, Orange, CA; Department of Urology, University of California Irvine School of Medicine, Orange, CA. Electronic address: aekhoury@hs.uci.edu.
Jazyk: angličtina
Zdroj: Urology [Urology] 2022 Nov; Vol. 169, pp. 196-201. Date of Electronic Publication: 2022 Jul 28.
DOI: 10.1016/j.urology.2022.07.025
Abstrakt: Background: Single-layer ACell Cytal matrix (ACell Inc, Columbia, MD) is a commercially available, acellular scaffold derived from porcine bladder epithelial basement membrane and tunica propria. We describe our initial experience using Cytal as corporal graft in pediatric patients who underwent correction of ventral curvature in proximal hypospadias repair.
Methods: A retrospective review of a single-institution, 4 surgeon hypospadias database was performed between January 2020 and December 2021. Outcomes assessed were postoperative recurrent ventral curvature, corporal diverticulum, scarring on corporoplasty site on physical exam, and parental reports of atypical adverse effects.
Results: Ten males underwent correction of ventral curvature with Cytal as corporal graft for correction of ventral curvature were identified. All completed planned operations. Median age was 18.6 months (IQR 14.6-27.0). Median follow up was 14.1 months (IQR 8.9-16.5). Mean ventral curvature after degloving was 80 ± 50 degrees. All patients had straight erections. Nine of the 10 patients had straight erections verified at a subsequent artificial erection test at least 6 months from the corporoplasty (90%). The remaining patient underwent a double face onlay-tube-onlay transverse island preputial flap as a single-stage hypospadias repair and did not require any additional procedures. He had straight erections per parental history. None developed corporal diverticulum or demonstrated induration at site of corporoplasty on physical exam. There were no parental reports of atypical adverse systemic effects.
Conclusion: In the short term, single-layer Cytal is effective as corporal graft for correction of ventral curvature in proximal hypospadias repairs without incurring additional donor site morbidity.
(Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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