Correction of Residual Ventral Penile Curvature After Division of the Urethral Plate in the First Stage of a 2-Stage Proximal Hypospadias Repair

Introduction. Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. Many various tissues are used (local skin flaps, bladder mucosa grafts, buccal mucosa grafts etc.) for the reconstruction of the neourethra. Objective. Our aim was to evaluate advantages and disadvantages of combined buccal mucosa graft and penile skin flap in urethral reconstruction in severe hypospadias repair. Methods. Between December 2005 and August 2009, 48 patients with severe hypospadias, aged from nine months to 12 years (mean age 23 months) underwent surgery. Thirty-four (71%) had penoscrotal and 14 (29%) scrotal hypospadias. Ventral penile curvature was present in all cases, and was corrected by incision of the short urethral plate. Urethroplasty was performed using a buccal mucosa graft combined with dorsal penile skin flap. Results. Mean follow-up was 22 months (range from 9 months to 3 years). Satisfactory functional and aesthetic results were achieved in 40 (83%) patients. Fistula was noted in six cases and was solved by minor revision. Urethral stenosis in two cases was resolved by simple dilatation. Conclusion. Urethral reconstruction using the buccal mucosa graft and dorsal penile skin flap in severe hypospadias repair could be the method of choice. Using this technique, single stage urethral reconstruction is possible with satisfactory esthetical and functional results.

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Our expirience in distal hipospadias and tip urethroplasty

Trakia Journal of Sciences ◽

10.15547/tjs.2020.04.010 ◽

2020 ◽

Vol 18 (4) ◽

pp. 350-354

Author(s):

Kr. Kalinova ◽

K. Georgiev

Keyword(s):

Surgical Outcome ◽

Pediatric Surgery ◽

University Hospital ◽

Hypospadias Repair ◽

Urethral Plate ◽

Proximal Hypospadias ◽

Distal Hypospadias ◽

Surgery Department ◽

Snodgrass Procedure

PURPOSE: We began performing the Snodgrass procedure in 2012 /tabularized incised plate urethroplasty, described by Orkiszewski in 1987/ and improved and popularized by Warren Snodgrass in 1994 (1). METHODS: Snodgrass TIP urethroplasty was performed between January 2013- January 2020 for distal hypospadias in 12 boys aged 8 months to 12 years were included, with data on the demography of the patients, type of hypospadias, extent of urethral plate incision, type of flap, used to cover the urethroplasty, the surgical outcome and follow-up for meatal stenosis. RESULTS: We reviewed the boys with hypospadias repair of Snodgrass TIP urethroplasty, who is performed between January 2013-January 2020 in the Pediatric Surgery Department of University hospital–Stara Zagora. Cases of proximal hypospadias with severe chordae and those who had undergone previous urethroplasty were excluded. CONCLUSION: On the basis of our experience we feel that the Snodgrass considered not only for primary but also for reoperative repair of distal hypospadias.

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