Which type of urethroplasty in failed hypospadias repair? An 8-year follow up (original) (raw)
Related papers
Surgical Challenge in Patients Who Underwent Failed Hypospadias Repair: Is It Time to Change?
Urologia Internationalis, 2010
Prof. Sava Perovic was a shining example of a scientist and surgeon. He was a master of life who always urged his pupils to do better and to reach excellence, within the parameters he set as a very humane and compassionate person. As a surgeon he was innovative indeed, he was one of the pioneers of reconstructive urological surgery in both adults and children. He developed multiple surgical procedures that are used today all over the world. I had the pleasure and privilege to work with him in Perugia and Belgrade and what I remember most about him was the enormous enthusiasm and passion he put into his work every day and the great energy he emanated that involved every person that was cooperating with him. With his demise we have lost a great surgeon, an innovator, a teacher and a sincere friend.
Retrospective Descriptive Analysis of 1,176 Patients With Failed Hypospadias Repair
The Journal of Urology, 2010
Purpose: To our knowledge epidemiological data on the incidence of failed hypospadias repair and the number of patients seeking further surgical treatment remain unknown. We report an observational, descriptive survey of patients who were evaluated and treated for urethral stricture disease and/or penile defects after primary hypospadias repair.
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.
Reoperative Hypospadias Repair Based on Urethral Plate Status
UroToday International Journal, 2009
The purpose of the study was to determine the suitable procedure for redo hypospadias repair based on the status of the urethral plate. METHODS: Thirty-five patients with failed hypospadias repair were evaluated regarding the status of the urethral plate, the meatus, residual chordee, and the available surrounding tissues. The mean patient age was 5.8 years (range, 2-12 years). At presentation, 25 patients had the meatus at the distal shaft, 8 at the midshaft, and 2 had complete neourethral stricture. The urethral plate appeared healthy and wide in 30 patients and narrow in 3 patients. All patients had a straight penis with single previous repair. The initial procedure was unknown in 15 patients and was the tubularized incised plate (TIP) procedure in 20 patients. Thirty patients underwent reoperation with TIP procedure, 3 had a Mathieu technique, and 2 had onlay island flap. After repair, cosmetic and functional outcomes were evaluated. RESULTS: Mean follow-up was 23.2 months (range, 12-36 months). Complete wound dehiscence occurred in 3 (8.6%) cases that had the TIP procedure; they are awaiting further repair. No fistulae occurred. Twenty-seven patients had a vertical slit meatus at the tip of the glans and 5 had a rounded meatus. Calibration was satisfactory in all cases using 8-10 Fr plastic catheters. Uroflowmetry was done in 15 (46.9%) patients and found to be within normal limits, with a Q mean of 9.53 mL/s (range, 5-16 mL/s). CONCLUSIONS: Redo TIP urethroplasty is effective and safe when the urethral plate is healthy. When the urethral plate is narrow or the neourethra is stenosed, other alternatives should be considered for repair.
Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre
International Journal of Clinical Urology, 2021
Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including significant scarring and paucity of genital skin. We report our experience in the management of failed hypospadias repairs at our centre. Materials & Methods: We retrospectively reviewed and analysed the inpatient and outpatient records of children/adolescents undergoing redo-hypospadias repairs during the period Jan 2010 to Dec 2019. Results: A total of 37 children with a mean age of 8.62±3.76 (2 – 17) years underwent a redo repair of hypospadias. Twenty children underwent two stage buccal mucosa urethroplasty, 11 underwent tubularized incised plate (TIP) urethroplasty, 5 dorsal inlay graft urethroplasty and 1 onlay flap urethroplasty. A t...
Journal of Pediatric Urology, 2008
To determine the effect of Mathieu and tubularized incised plate (TIP) urethroplasty techniques on the outcome of repair in recurrent hypospadias. Material and methods: A total of 78 patients who had undergone surgical correction by either Mathieu or TIP urethroplasty after unsuccessful hypospadias surgery were enrolled in this study. Cases were divided into two groups according to the operation technique performed. Surgical success rate of the techniques and the prognostic significance of age, type of diversion used, caliber and length of new urethra, and the number of previous operations were analyzed statistically. Results: Mathieu and TIP urethroplasties were performed in 57 and 21 patients, respectively. No statistically significant relation was found between the groups for age, length of new urethra created, caliber of the urethra, urinary diversion used, mean operation success rates and number of previous operations. From within-group analysis, Mathieu urethroplasty was found to have a statistically significant relationship with the number of previous operations (P Z 0.025, ManneWhitney U-test). Conclusions: Age, length and caliber of new urethra, and diversion type used seem to have no effect on the success rate of Mathieu and TIP urethroplasty in recurrent hypospadias restoration. The success of the Mathieu operation diminished proportionally to the number of previous failed surgeries.
BJU international, 2017
To evaluate the outcomes of hypospadias surgery according to age and to determine if some complications are age-related. This retrospective study was based on 722 boys with hypospadias undergoing primary repair. A total of 501 boys underwent urethroplasty and were included in the study. Complications requiring an additional procedure (stenosis, fistula, dehiscence, relapse of curvature, urethrocele) were included in the analysis, as well as healing problems, infections, haematomas and detrusor-sphincter dyssynergy. Logistic regression analysis was performed. Hypospadias was anterior in 63.1%, mid-penile in 20.5%, posterior in 8.4% and scrotal in 7.9% of the boys. The median (range) age was 4 (1-16) years. The overall rates of re-intervention and complications were 22.8% and 36.2%, respectively. Age >2 years was a significant predictor of complications (P = 0.002, odds ratio 1.98 [95% confidence interval 1.26-3.13]). Some periods of time appeared to be associated with a specific c...
A prospective study of two-stage primary repair for proximal hypospadias and its short term outcomes
Aims: To study two stage repair in primary cases of proximal hypospadias using inner preputial graft and analyze short term outcomes. Methods: Single institutional prospective study of patients who underwent primary repair of proximal hypospadias between Jan 2011 to Dec 2016. Failed hypospadias repair cases or proximal hypospadias with DSD or already circumcised cases were excluded from the study. Results: 60 patients completed 2-stage repair with inner preputial graft with a mean age of 42 months(range 36m-96m)in 1 st stage and 50m (range 42m-105m). Graft uptake was 100%. On a mean follow up of 12 months(range 6m-28m), there were 10 cases of urethrocutaneous fistula-4 closed on regular dilatation and ultimately 6(10%)required closure of fistula. 2 cases of meatal stenosis required dilatation. No cases of urethral stricture were reported. Conclusions : Two stage repair for primary proximal hypospadias gave good cosmetic results overall with fewer complications. Longer follow up is required to assess quality of life in terms of sexual function.