Comparative study of Mirs’(Mushtaq and Shabir) technique of prepuce preserving minimally invasive urethroplasty with Snodgrass urethroplasty for repair of distal hypospadias without chordee…A prospective study (original) (raw)
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Snodgrass' urethroplasty in hypospadias surgery in Clinical Hospital Mostar--preliminary report
Collegium antropologicum, 2007
Amongst the various methods of reconstructing the hypospadic urethra such as the MAGPI, Mathieu's and Preputial island flap urethroplasty method and the Snodgrass method, the latter is being used more frequently nowadays in patients with the urethral meatus located in the proximity of the penis. In the Pediatric ward at Mostar Clinical Hospital, we have recently adopted the Snodgrass method when reconstructing the hypospadic urethra. We herewith present our research regarding the successful results in adopting the aforementioned method. Success was evaluated according to the frequency of post-operative complications, as well as the patients' satisfaction with the functional and the cosmetic result of the urethra reconstruction. The conclusions relating to our research result in an addition basis from which to evaluate whether the Snodgrass method should receive privileged preference in future operative treatment of the hypospadias over others methods, as can be seen from our...
Combined Mathieu and Snodgrass urethroplasty for hypospadias repair: A prospective randomized study
International Journal of Urology, 2010
To evaluate the outcomes of combined Mathieu and Snodgrass urethroplasty for distal hypospadias repair and to compare them with the two techniques separately. Methods: Between January 2006 and February 2009, patients with distal hypospadias were prospectively randomized to undergo one of the three following urethroplasty techniques: Mathieu urethroplasty, Snodgrass urethroplasty or a combination of the two. Operative time, intraoperative, early and late postoperative complications were reported for each procedure. Results: 101 patients were included in this study. The Mathieu technique was used for 30 patients, Snodgrass repair was carried out in 37 patients and 34 patients underwent the combined technique. Operative time ranged from 43 to 120 min. Eight patients developed urethrocutaneous fistulae. Meatal stenosis was encountered in five cases. Thirty-seven patients had rounded meatus, while a slit-like urethral opening was found in 64 cases. Conclusions: In our hands, the combined Mathieu and Snodgrass urethroplasty technique provided a better cosmetic outcome than the Mathieu technique with no incidence of meatal stenosis as seen with the Snodgrass technique.
The Journal of medical research, 2015
Background : Hypospadias is a common anomaly of male external gentalia. Most cases of hypospadias are distal type. Snodgrass procedure or tubularized incised plate urethroplasty has become the preferable and optimal treatment for primary and distal cases of hypospadias. The aim of this study was to study the effectiveness and evaluate the outcome of Snodgrass procedure presented for 44 patients with distal and mid-shaft hypospadias. Patients and method; from April 2011 to May 2014; 36 patients with distal hypospadias and 8 patients with mid-shaft hypospadias, (total 44 patients) had been submitted to corrective surgery foe their hypospdias by single stage Snodgrass TIP technique. Results: mean age of patients and mean operative time in this study were 2.8±1.8, 52.7±9.4 respectively. The functional and cosmetic results were excellent. The overall complications rate recorded was 13.6%. Urethro-cutaneous fistula developed n 3 patients (6.8%), meatal stenosis occurred in 2 patients (4.5...
Outcome of Snodgrass Repair of Distal Penile Hypospadias with Stented and Unstented Urethra
The Egyptian Journal of Hospital Medicine, 2019
Background: Hypospadias is the most common congenital malformation of penile shaft occurring in 1 per 300 male births; it is considered a common clinical problem as it causes not only functional problems but also psychological problems for parents. Objective: The objectives of this study is to review the result of TIP repair of distal penile hypospadias in terms of outcome and complications of stenting and unstenting the urethra. Patients and methods: As a prospective randomized study; this study has included patients with distal penile hypospadias operated with Snodgrass between year 2011-2018 and had divided to (group A) included 40 patients operated upon with stent preservation for a week (group B) was 20 patients with stent removed at the end of the operation. Results: Regarding group (A) the stent of 10 cases had slipped at the first 8 hour postoperative so they have been added to the count of (group B) and considered as unstented repair. It is clear here in our study that meatal stenosis rate were different from Snodgrass rate but were similar to other published studies. Other comparable items as fistula rate, urinary retention and hospital stay, were the same as published studies. Conclusion: It could tell that removing the catheter can reduce bladder spasm , urinary tract infections, and patient discomfort and improve the familiar compliance without increasing acute retention episodes and fistula rate, so that at least in some cases specially in distal types, leaving stent can be avoided.
Journal of Taibah University Medical Sciences, 2014
The mean age of the children was 1.5 years. Complications occurred in 45 patients (14.1%). A urethrocutaneous fistula occurred in 8 patients (2.5%), with 6 in group A (5.2%) and 2 in group B (0.98%). Ten patients (3.1%) developed meatal stenosis, with 7 in group A and 3 in group B. Penile torsion was recorded postoperatively in 13 patients (total rate, 4.1%), with 9 cases in group A (7.8%) and 4 in group B (2.0%). The differences between the two groups were statistically significant. Conclusion: A shorter urethral plate incision, use of a lateral dartos flap to cover the neourethra and more extensive skin degloving in Snodgrass urethroplasty reduce the rate of complications.
Journal of Paediatric Surgeons of Bangladesh, 2013
Background: Hypospadias is one of the most common congenital anomalies, occurring approximately 1in 200 to 1in 300 live birth. Urethrocutaneous fistula (U-C fistula), and meatal stenosis are the most common complication of hypospadias surgery. To reduce these complications there are different surgical procedures. Snodgrass technique is now the popular technique for its low complication rate and better cosmetic outcome. Objective: To explore the short term outcome of interrupted suture compared to continuos suture in snodgrass technique urethroplasty for distal penile hypospadias. Method: It was a randomized control trial study carried out in the department of Paediatric surgery, BSMMU during the period of June 2008 to September 2009. 32 patients with distal penile hypospadias were selected according to set inclusion and exclusion criteria. Subjects who included in the study were randomly distributed in two groups. In group A odd number of patients and in group B even number of patients were included for randomization. Group A (interrupted suture) was treated as interventional group and Group B
Journal of Pediatric Urology
Objectives: To evaluate the impact of prepuce preservation during Mathieu repair for distal hypospadias. Methods: This prospective randomized comparative study, carried out in Assiut University Hospital, between 2006 and 2009, included 200 patients with distal penile or coronal hypospadias. They underwent either Mathieu repair with prepuce preservation (group I, n Z 100) or traditional Mathieu repair with circumcision (group II, n Z 100). Follow up was at 2 weeks, and 1 and 3 months postoperatively, which only 153 patients completed (I: n Z 86 and II: n Z 67). Results: The mean operative time was 64.5 min in group I and 121.7 min in group II (p < 0.001). All patients in group I developed postoperative preputial edema. Patients from group I who had a successful operation underwent circumcision at least 3 months later. Urethrocutaneous fistulae developed in 7 and 6 patients in group I and II respectively (p Z 0.967). Fistula closure was done at least 3 months postoperatively, and there was no significant difference in success between the two groups. Two cases of glanular dehiscence were detected (one in each group); the patient from group I had a successful onlay island flap repair. Conclusions: Preputial preservation during Mathieu repair is a time-saving procedure with similar complication rate to traditional repair. Valuable local tissue is preserved to deal with complications that may occur.
Urethral advancement procedure in the treatment of primary distal hypospadias
Annals of Pediatric Surgery, 2017
Introduction Distal hypospadias is the most common genital anomaly, occurring in almost 65% of all hypospadias cases. Although there are several surgical techniques for the treatment of distal hypospadias, it is clear that none can be used to correct all forms of hypospadias. The aim of the study was to evaluate urethral advancement in the repair of primary distal penile hypospadias with regard to feasibility, complication rates and the final cosmetic outcome. Patients and methods Between October 2014 and June 2015, the urethral mobilization technique was used in 20 patients who presented at the Pediatric Surgery Unit, Tanta University Hospital, with primary distal hypospadias. A submeatal crescent-like incision was performed a few millimeters proximal to the meatus with two vertical incisions from the lateral ends of the submeatal incisions. The urethra within the corpus spongiosum was dissected from the skin of the ventral surface and from the glans and corpora cavernosa for a distance of B4 : 1. The urethra was advanced till the urethral meatus reached its normal position without any tension. Spongioplsty can be performed, and covering Buck's or Dartos' layers can be used. The follow-up was conducted on a weekly basis in the outpatient clinic in the first month, and then every month for 6 months. Results The age of the patient at the time of operation ranged from 6 to 24 months, with a mean age of 10.5 months. The operative time ranged from 60 to 90 min, with a mean time of 73.5 min. Intraoperative urethral injury occurred only in one patient. In all patients, the catheter was removed immediately postoperatively except for one patient who had operative urethral injury. Deep wound infection was noticed in only one patient, followed by partial glanular disruption. Only one patient had urethrocutaneous fistula and two patients had meatal retraction. Conclusion Urethral advancement can be used safely in the mobilization of the distal urethra with wide glanular dissection and wide lateral mobilization of glanular wings. However, it should be stressed that in the presence of hypoplastic distal urethra and/or persistent ventral curvature, another technique should be adopted. The majority of our patients had very good cosmetic results and minimal complication. However, the technique requires further studies with a larger number of patients and longer follow-up periods to draw more precise and final conclusions.
2014
Objectives: To objectively assess the functional and cosmetic outcomes of a modified tubularised incised-plate (TIP) urethroplasty (Snodgrass) technique, with particular attention to the uroflowmetry study and Hypospadias Objective Scoring Evaluation (HOSE) score. Patients and methods: In a prospective case-series study, 43 consecutive patients with primary distal hypospadias were evaluated. The modified Snodgrass technique included an extension of the midline relaxing incision of the urethral plate from within the hypospadiac meatus to the very tip of the glans. The neourethra was tubularised starting at the neomeatus and proceeding proximally. The neourethra was covered with either a single or double dartos flap. In toilet-trained boys, at least 3 months after surgery, the flow pattern, maximum (Q max ), and mean urinary flow rate (Q ave ) were recorded, and the results plotted against a recently published flow-rate nomogram from normal children. The postvoid residual urine volume was measured using ultrasonography. The cosmetic outcome was assessed using the HOSE system.
Urethroplasty for failed hypospadias repair: A matched cohort analysis
Journal of Pediatric Urology, 2011
To determine the outcome of urethroplasty for failed hypospadias repair and to compare this with a matched cohort of patients treated with urethroplasty for other reasons. Patients and methods: Between January 2000 and August 2007, 25 patients with a failed hypospadias repair were treated with urethroplasty (A). This cohort of patients was matched with a cohort of 25 patients who underwent urethroplasty for other reasons (B). The patients were matched for stricture location, stricture length, duration of follow up and type of urethroplasty. The outcomes were analysed and compared. A P-value < 0.05 was considered statistically significant. Results: There were no significant differences between the two cohorts in stricture location, stricture length, follow up and previous interventions. Patients in cohort A however were significantly younger. The surgical technique used was exactly the same in A and B. Failure was observed in 7 patients (28%) in A compared to 4 patients (16%) in B (P Z 0.45). Conclusions: Although a higher failure rate was observed after failed hypospadias repair, this is not proof of a worse outcome for urethroplasty after failed hypospadias repair due to the lack of statistical significance.