A modified onlay island flap vs. Mathieu urethroplasty for distal hypospadias repair: A prospective randomised study (original) (raw)
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JPMA. The Journal of the Pakistan Medical Association, 2014
To evaluate the surgical outcome of tubularised incised plate urethroplasty and onlay island flap repair for mid and proximal penile hypospadias. The prospective study was conducted at the Bahawal Victoria Hospital, Bahawalpur from June 2011 to May 2013. A total of 60 patients with mid and proximal penile hypospadias in the age range of 02 to 06 years were included. Patients with hypospadias other than mid and proximal penile, with chordee and history of previous hypospadias repair were excluded. Patients were divided into two equal groups. Urethroplasty was done for group I and flap repair for group II. The follow-up period was 12-24 months. SPSS 16 was used for statistical analysis. The mean duration of surgery was 62 +/- 8.72 minutes for group I and 90 +/- 11.25 minutes for group II (p < 0.0001). In group I, only 03 (10.0%) patients had complications, while in group II, 09 (30.0%) patients developed complications (p = 0.02). Cosmetic results were also excellent in group I comp...
Evaluation of distally folded onlay flap in repair of distal penile hypospadias
Journal of Pediatric Urology
Abstract Objective: To evaluate the results of using a distally folded onlay flap in the repair of distal penile hypospadias, with regard to meatal stenosis, urethrocutaneous fistula and esthetic outcome. Patients and methods: This prospective study involved 36 patients with mean age 3.2 years (range 1e4); 18 had a shallow urethral plate, 10 a small glans, and 8 had undergone a previous operation but still had available preputial skin. All underwent the elective technique of distally folded onlay flap, which was carried out under general anesthesia using a 4Â magnifying loupe. Starting with penile degloving and then harvesting the transverse island preputial flap provides a flap about 1 cm longer than the urethral plate. Two lateral incisions are made along the urethral plate with no need for dissection deep into the glanular wings. The flap is sutured to the urethral plate, leaving 1 cm distal to the tip of the glans, which is folded back to be sutured to the edges of the glanular wings. Results: There were no cases of meatal stenosis or requirement for urethral dilatation. Two patients had a urethrocutaneous fistula; one closed spontaneously while the other needed surgical repair 6 months later. Regarding esthetic appearance, 32 were scored good and 4 satisfactory.
Background/Purpose: The tubularized incised plate (TIP) and the single faced Onlay preputial island flap procedures are two popular procedures used for the repair of mid-penile hypospadias deformity. This study was designed to compare these two techniques objectively. Materials and Methods: Forty five boys with similar mid-penile hypospadias deformities were selected for this study at Cairo University Children Hospital. All were 2 years or more at the time of operation. They were assigned randomly to either a TIP (n=24) or an Onlay procedure (n=21). Operative details for each patient were recorded and the patients were followed up for a minimum of one year post operatively. Results were compared for three groups of variables: cosmetic outcome, occurrence of complications and function results which was assessed by uroflowmetry studies. Results were compiled and compared statistically. Results: There were no differences between the two techniques as regard incidence of complications a...
World Journal of Urology
Purpose We conducted this study, comparing the outcomes among Transverse Onlay Island Flap, inlay grafted incised plate and our previous records of tubularized incised plate urethroplasty (TIPU) in patients with narrow urethral plates, aiming to determine which method of repair provides a good outcome. Methods This hybrid study included two datasets. The first from a prospective randomized study evaluating outcomes of two treatment modalities; Inlay graft and only flap for distal hypospadias with shallow urethral plate with 80 patients (40 patients in each group) included, the second based on our previous records of TIPU in 40 patients with distal primary hypospadias with narrow urethral plate. Results The success rate in inlay graft urethroplasty group (n = 40) was 87.5%; glandular dehiscence occurred in one case (2.5%), fistulas occurred in 2 cases (5%), and narrow meatus occurred in two cases (5%). Success rate in onlay flap urethroplasty group (n = 40) was 82.5%; glandular dehis...
Urologia Internationalis, 2010
Introduction: To determine whether the Mathieu technique with a single de-epithelized dartos flap, tabularized incised plate urethroplasty (TIPU) with a single de-epithelized dartos flap, or TIPU with double de-epithelized dartos flaps is the more appropriate treatment for distal hypospadias in terms of fistula rates. Methods: We present 2 surgeons’ experiences with 95 cases of hypospadias repair using dartos flap neourethra covering. The study includes patients who underwent Mathieu and TIPU repair of hypospadias. They were divided into 3 groups: group 1 was treated with Mathieu urethroplasty with a single de-epithelized dartos flap; groups 2 and 3 were treated with a modified Snodgrass technique (group 2 with a single flap and group 3 with double flaps). Results: The results were quite successful, and indicated the superiority of the double de-epithelized dartos flaps (with no fistulas). Conclusion: Double dartos flaps that are rotated around the penis are more effective than a si...
International urology and nephrology, 2016
Several techniques have been used to repair mid-penile hypospadias; however, high failure rates and major complications have been reported. In this study, we describe a novel technique using a well-vascularized flap of the inner and outer preputial skin. A total of 110 male children with hypospadias underwent repair by our technique between 2008 and 2015. The inclusion criteria were children with mid-penile or slightly more proximal hypospadias, with or without ventral chordae, and an intact prepuce of the cobra eyes variety. Recurrent cases, patients with other preputial types, and circumcised children were excluded from this study. The prepared flap was sutured in its natural longitudinal orientation to the created urethral plate strip to form a neo-urethra over a urethral catheter. Outcome measures included surgical success without the formation of a urethra-cutaneous fistula, no ischaemia of the flaps, glans dehiscence or infection and functional outcome and cosmetic appearance....
Bangladesh Journal of Urology
Introduction: The optimal treatment of hypospadias remains controversial. Severaltechniques have been described, but the best approach remains unsettled. Objective:To compare the outcomes of two popular methods, Tubularized incised plateurethroplasty (TIPU) and Transverse preputialonlay island flap (TPOIF) for the correctionof distal penile hypospadias. Materials and method: This prospective interventional study was conducted in theDepartment of Urology, Dhaka Medical College Hospital, during the period of September2015 to March 2017. 40 patients with distal hypospadias with minimum or no chordeeand no previous history of circumcision or hypospadias surgery were allocated into twogroups by simple random sampling with equal number of distribution. In Group-A, patientswere subjected to correct the defect by TIPU procedure while in Group-B, they wereoperated by TPOIF urethroplasty technique. In this study, the outcomes of theaforementioned procedures were compared in terms of operative...
https://www.ijrrjournal.com/IJRR\_Vol.5\_Issue.9\_Sep2018/Abstract\_IJRR0018.html, 2018
Introduction-Hypospadias is a common congenital anomaly of the male gender. It is classified into distal or anterior, middle and proximal or posterior hypospadias which are further subdivided into different types on the basis of the location of the meatus. Aims-To compare between tubularised incised plate and preputial flap onlayurethroplasty for single stage urethroplasty for anterior and mid penile hypospadias without or minimal chordee. Materials And Methods-75 boys were selected from patients presenting to the LLR Hospital, having hypospadias anomaly. All had comparable anterior and mid-penile deformities with no apparent or minimal chordee. Result-Both technique result in acceptable anterior position of neomeatus and had comparable complication rates. Onlay flap repair have more fistula rate and dehiscence rate. TIP repair has more meatal stenosis rate Conclusion-We prefer TIP repair as being technically easier with simple complications, superior cosmetic outcome and satisfying vertical slit like meatus.