Results of two-stage transverse preputial island flap urethroplasty for proximal hypospadias with chordee that mandate division of the urethral plate
| Autor: | Ahmed Zaki Mohamed Anwar, Mamdouh M. El-Hawy, Ehab M. Galal, Ehab R. Tawfiek, Mostafa Magdi Ali |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
urologic surgical procedures preputial flaps Urethroplasty medicine.medical_treatment 030232 urology & nephrology two-stage repair Urologic Surgical Procedure 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Outpatient clinic Robotic surgery Stage (cooking) proximal hypospadias Original Paper Urethral plate business.industry General surgery General Medicine medicine.disease Hypospadias medicine.symptom Chordee business |
| Zdroj: | Central European Journal of Urology |
| ISSN: | 2080-4873 |
| DOI: | 10.5173/ceju.2021.0245.r2 |
| Popis: | Introduction Reconstruction of proximal hypospadias with chordee remains a difficult task. Our work aims to evaluate the role of two-stage transverse preputial island flap urethroplasty for repair of proximal hypospadias with chordee. Material and methods This is a retrospective study including 57 children who underwent two-stage transverse preputial island flap urethroplasty. Glans meatus shaft (GMS) score was applied to 24 cases. Patient’s characteristics, operative details and complications were assessed. Hypospadias objective scoring evaluation was used for postoperative assessment. Results The mean age at the first stage operation was 23.6 months (9–84); the mean time interval between the first and second stage operations was 8.1 months (6–12) and the mean follow-up duration was 52.1 months (24–96). Urethral meatus was proximal penile in 18 patients, penoscrotal in 24 and scrotal in 15. The mean degree of ventral curvature (VC) was 51.5° (30–90). After the second stage operation, postoperative complications occurred in 16 (28.1%) patients with urethrocutaneous fistula in 6 (10.5%) cases, diverticulum in 3 (5.3%), glans dehiscence in 5 (8.8%) and meatal stenosis in 2 (3.5%). All cases of glans dehiscence occurred in severe hypospadias and small glans. Moderate GMS score was present in 10 (41.7%) cases and severe GMS in 14 (58.3%). Complications occurred in 7 (29.1%) patients with 5 (20.8%) with a severe GMS score and 2 (8.3%) with a moderate GMS score. The hypospadias objective scoring evaluation showed satisfactory results, with 39 (68.4%) patients achieving a score of 16 points. Conclusions Two-stage transverse preputial flap is a good choice for repair of proximal hypospadias with an acceptable complication rate of 28.1%. |
| Databáze: | OpenAIRE |
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