Surgical Repair of Anterior Hypospadias with Fish-Mouth Meatus and Intact Prepuce Based on Anatomical Characteristics
| Autor: | Toshiki Koyama, Tomohiko Koyanagi, Naohiko Shimoda, M Murakumo, Katsuya Nonomura, Hidehiro Kakizaki |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Surgical repair Hypospadias medicine.medical_specialty Urologic Surgical Procedures Male Meatus business.industry Fish mouth Urology Anatomy medicine.disease Urologic Surgical Procedure Surgical Flaps Surgery Treatment Outcome Urethra Child Preschool medicine Hypospadias repair Variant form Humans business |
| Zdroj: | European Urology. 34:368-371 |
| ISSN: | 1421-993X 0302-2838 |
| Popis: | A variant form of anterior hypospadias, called a megameatus and intact prepuce (MIP), is thought to be less amenable to conventional distal hypospadias repair. The feasibility of using the standard technique with a parameatal-based foreskin flap is described herein.Nine children with the MIP variant underwent repair. A foreskin flap for urethroplasty was harvested from either the ventral (Mathiew) or unilateral site. The glans was split along with the cleft glanular groove to create the glans wings. The flap was laid on the urethral plate to form a neourethra, and glanulomeatoplasty was completed by approximation of the glans wings. Sleeve reapproximation of the penile foreskin was performed for uncircumcised skin closure.The functional and cosmetic results of the procedure were excellent in 8 cases including 1 with temporary postoperative edema of redundant foreskin. The last case underwent excision of the ventral excess foreskin for cosmetic reasons.Although the etiology of the MIP variant remains obscure, the urethral plate distal to the meatus is uniformly pliable and healthy in this variant. Furthermore, the ventral portion just proximal to the meatus is well developed and not atretic so that the parameatal ventral foreskin is safely harvested for onlay urethroplasty. |
| Databáze: | OpenAIRE |
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