scholarly journals Role of urethral plate and fossa navicularis biopsies in the detection of balanitis xerotica obliterans in boys undergoing redo hypospadias repair

2017 ◽  
Vol 15 (4) ◽  
pp. 326-330
Author(s):  
Mohamed Sultan ◽  
Mohamed El-Shazly ◽  
Eid Elsherif ◽  
Sheren Younes ◽  
Mohamed Selim
Keyword(s):  
Hypospadias Repair ◽  
Urethral Plate ◽  
Balanitis Xerotica Obliterans ◽  
Fossa Navicularis

scholarly journals Spongioplasty with Dartos Flap Coverage in the Snodgrass Technique of Hypospadias Repair

2020 ◽  
Vol 38 (2) ◽  
pp. 64-67
Author(s):  
Sahadeb Kumar Das ◽  
Kaniz Hasina ◽  
Md Ashraf Ul Huq ◽  
Syed Abdul Adil ◽  
Md Mahbubul Alam ◽  
...  
Keyword(s):  
Prospective Study ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Flap Coverage ◽  
Dartos Flap ◽  
Distal Hypospadias ◽  
A Prospective Study

Objective: The aim of the study is to evaluate the role of spongiosal tissue with dartos flap coverage for preventing Urethrocutaneous Fistula (UCF) formation in the Snodgrass technique. Materials and Methods: It is a prospective study, performed on 35 patients of mid penile and distal hypospadias aged 15 months to 144 months who underwent urethroplasty in the Snodgrass technique using spongiosal tissue and dartos flap for neourethral coverage. Results: Among 35 patients, Age ranged from 15 months to 144 months (mean 85.94 months). Chordee was corrected by penile degloving alone in 11 patients, partial mobilization of urethral plate with spongiosum in 20 patients and 4 patients required dorsal plication. Glans groove was deep in 19 patients, shallow in 13 patients and no groove noticed in 3 patients. Sixteen patients had narrow urethral plate (<8mm) and 19 patients had adequate urethral plate (>8mm). Urethrocutaneous Fistula (UCF) was encountered in five patients (14.28%), meatal stenosis in two patients (5.71%), and partial glanular dehiscence in one patient. Conclusions: Approximation of spongiosal tissue along with dartos flap as the intermediate layer for neourethral coverage reduces fistula formation. J Bangladesh Coll Phys Surg 2020; 38(2): 64-67

scholarly journals Role of tubularization of urethral plate in development of urethrocutaneous fistula post hypospadias repair

2017 ◽  
Vol 9 (2) ◽  
pp. 141
Author(s):  
AbdullahK Mohammedkhalil ◽  
BasimS Alsaywid ◽  
AbdullahA Mesawa ◽  
SaifY Alzahrani ◽  
AseelH Askar ◽  
...  
Keyword(s):  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate

scholarly journals The Role of Sonic Hedgehog-Gli2 Pathway in the Masculinization of External Genitalia

Endocrinology ◽  
2011 ◽  
Vol 152 (7) ◽  
pp. 2894-2903 ◽  
Author(s):  
Shinichi Miyagawa ◽  
Daisuke Matsumaru ◽  
Aki Murashima ◽  
Akiko Omori ◽  
Yoshihiko Satoh ◽  
...  
Keyword(s):  
Signaling Pathway ◽  
Sonic Hedgehog ◽  
Hedgehog Signaling ◽  
External Genitalia ◽  
Sexually Dimorphic ◽  
Hedgehog Signaling Pathway ◽  
Initial Development ◽  
Urethral Plate ◽  
Male External Genitalia

During embryogenesis, sexually dimorphic organogenesis is achieved by hormones produced in the gonad. The external genitalia develop from a single primordium, the genital tubercle, and their masculinization processes depend on the androgen signaling. In addition to such hormonal signaling, the involvement of nongonadal and locally produced masculinization factors has been unclear. To elucidate the mechanisms of the sexually dimorphic development of the external genitalia, series of conditional mutant mouse analyses were performed using several mutant alleles, particularly focusing on the role of hedgehog signaling pathway in this manuscript. We demonstrate that hedgehog pathway is indispensable for the establishment of male external genitalia characteristics. Sonic hedgehog is expressed in the urethral plate epithelium, and its signal is mediated through glioblastoma 2 (Gli2) in the mesenchyme. The expression level of the sexually dimorphic genes is decreased in the glioblastoma 2 mutant embryos, suggesting that hedgehog signal is likely to facilitate the masculinization processes by affecting the androgen responsiveness. In addition, a conditional mutation of Sonic hedgehog at the sexual differentiation stage leads to abnormal male external genitalia development. The current study identified hedgehog signaling pathway as a key factor not only for initial development but also for sexually dimorphic development of the external genitalia in coordination with androgen signaling.

scholarly journals Redo hypospadias repair: experience at a tertiary care children’s hospital

2012 ◽  
Vol 1 (1) ◽  
Author(s):  
Ahmed Al-Sayyad ◽  
John G. Pike ◽  
Michael P. Leonard
Keyword(s):  
Tertiary Care ◽  
Institutional Review Board ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Institutional Review ◽  
Tubularized Incised Plate ◽  
Distal Shaft ◽  
The Status ◽  
Initial Severity

Objective: Treatment of patients with failed hypospadias repairs can be challenging.Our study aimed to determine the best type of redo repair dependingon the location and size of the urethral meatus, the status of the urethralplate and genital skin, the severity of residual chordee and the amount ofscar tissue.Methods: The Institutional Review Board approved our retrospective chart reviewof patients who had a redo hypospadias repair at our institution over the past6 years. We recorded the type and number of previous repair(s), the type andnumber of redo procedure(s),as well as the complications and functional outcomes.Results: There were 28 patients, aged 1–12 (mean 3.8) years, with failed hypospadiasrepairs. The initial severity of the hypospadias were as follows: perineal(1), penoscrotal (9), proximal shaft (1), mid-shaft (9), distal shaft (4), coronal(3) and mega-meatus (1). Of all the patients, 24 had 1 repair, 3 had 2 repairsand 1 had 3 repairs. The initial repairs comprised 11 tubularized island flaps(TIFs), 8 Snodgrass tubularized incised plate (TIP) techniques, 5 Mathieu repairs,1 Meatal Advancement and GlanuloPlasty Incorporated (MAGPI) technique,1 Pyramid, 1 Arap technique and 1 Thiersch-Duplay repair. Twenty-one of 28 patients had 1 redo operation, 5 had 2 redo operations, 1 had 3 redo operationsand 1 had 4 redo operations, for a total of 38 redo operations. Of these,26 were TIP techniques (68.4%), 3 were Mathieu (7.9%), 3 were TIF repairs(7.9%), 2 were onlay island flaps (5.3%) and 4 were buccal mucosal grafts(10.5%). Follow-up was 1–5 years (mean 3.5 yr). The final locations of urethralmeatus included glans (18), corona (6), mid-shaft (3) and penoscrotal (1).Complications after redo surgery comprised 4 urethrocutaneous fistulae, 2 meatalstenoses, 1 urethral stricture and 3 dehiscences. Sixteen patients were followedwith yearly uroflow with a Q-mean (mean uroflow) range of 3–14 mL/s (mean8.1 mL/s).Conclusion: The majority of hypospadias failures can be salvaged with one operation.The TIP repair is our procedure of choice in most cases. In the settingof a poor urethral plate, TIF or buccal mucosa may be necessary. Complicationsare not infrequent in redo procedures.

scholarly journals Redo hypospadias repair by a single surgeon after failed hypospadias surgeries: Experience from a developing country

2020 ◽  
pp. 17-23
Author(s):  
Md. Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tanvir Kabir Chowdhury
Keyword(s):  
Developing Country ◽  
Complication Rate ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Meatal Stenosis ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty ◽  
Principal Author

Background: Hypospadias surgeries are often complicated with fistulas, meatal stenosis and disruptions. We report our series of redo surgeries for failed primary repairs. Methods: We prospectively observed all the redo hypospadias repairs done by the principal author between 2013 and 2017. Thiersch-Duplayurethroplasty was done if the urethral plate was adequately wide and intact; tubularized incised plate (TIP) urethroplasty was performed if the urethral plate was intact but, narrower than 8 mm; 2 stage procedures were done with oral mucosal graft (OMG) if the urethral plate was deficient or scarred with significant chordee. Result: There was a total of 31 patients. Age ranged from 18 months to 15 years (mean 8.05 ±4.27 years). Sixteen (51.61%) patients underwent only one surgery, 10 (32.26%) patients underwent 2 surgeries, 2 patients (6.45%) underwent 3 surgeries, and 3 patients (9.68%) underwent 4 surgeries prior to presenting to us before our redo surgeries.We had performed TIP urethroplasty in 16 (51.61%) patients, meatal based flap urethroplasty in 12 (38.71%), OMG followed by urethroplasty in 2 (6.45%), and repair of urethra-cutaneous (UC) fistula in 1 (3.23%) patient. Ten (32.26%) Complications occurred in 8 (25.80%) patients. Unsuccessful repair was noted in 03 (9.67%) patients (UC fistula 1, glans dehiscence with UC fistula 1, and glans dehiscence 1). Conclusion: Thiersch-Duplay and TIP repair can be successfully performed in redo hypospadiassurgeries with acceptable complication rate. OMG graft can be reserved for cases with gross scarring of the urethral plate. Keywords: Failed hypospadias repair; Tubularized incised plate urethroplasty; Thiersch-Duplay; Outcome

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