DISTAL HYPOSPADIAS REPAIR BY THE MODIFIED THIERSCH-DUPLAY TECHNIQUE WITH OR WITHOUT HINGING THE URETHRAL PLATE

1999 ◽  
pp. 1156-1158 ◽  
Author(s):  
ROSS M. DECTER ◽  
DAVID F. FRANZONI
Keyword(s):  
Hypospadias Repair ◽  
Urethral Plate ◽  
Distal Hypospadias

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 Comparison of Modified Mathieu versus Standard Tubularised Incised-Plate Urethroplasty for Distal Hypospadias Repair

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naeem M ◽  
◽  
Khan MK ◽  
Shah G ◽  
Izhar M ◽  
...  
Keyword(s):  
Categorical Variables ◽  
Fisher Exact Test ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Meatal Stenosis ◽  
Group I ◽  
Tubularized Incised Plate ◽  
Distal Hypospadias ◽  
The Difference ◽  
Mathieu Procedure

Objective: To compare the outcomes of modified Mathieu versus standard tubularised incised-plate urethroplasty for distal hypospadias repair. Materials and Methods: This prospective comparative study was conducted on 54 cases affected by distal hypospadias presenting to Institute of Kidney Disease, Hayatabad, Peshawar form February 2015 to June 2020. The inclusion criteria was patients with distal hypospadias (coronal, sub-coronal, or distal penile), age range of 15 to 60 months. Cases with severe chordee/ventral curvature, history of previous hypospadias repair, and poorly developed urethral plate were excluded. The patients with distal hypospadias were divided into two equal groups: in-group I repair done with Mathieu procedure plus incision of the urethral plate (modified Mathieu) and in-group II repair was performed with Tubularized Incised Plate (TIP). The principal author performed functional and cosmetic assessment at follow up visits which includes; denvo meatus; size and pressure of the stream; and complications like meatal stenosis, urethral cutaneous fistula. Fisher Exact test was used to compare categorical variables between the two groups and student t test for continuous variables. Results: The mean age of the study was 38.13±12.55 months. The operating time was less in TIP than modified Mathieu procedure statistically (P=0.036, 95% CI=0.315, 9.02). In modified Mathieu procedure the sprayed stream of micturition was higher (n=4, 14.8%) while in TIP procedure the frequency of narrow stream was higher (n=4, 14.8%). The difference was statistically significant (P=0.054). Only in modified Mathieu procedure the meatus shape was round in 4 (14.8%) cases and the results were statistically different (P=0.038). Post-operative fistula was higher TIP (n=6, 22.2%) than modified Mathieu (n=1, 3.7%) statistically (P=0.043). Only in TIP procedure postoperative meatal stenosis was found in 5 (18.5%) and the difference was statistically significant (P=0.019). Conclusion: The modified Mathieu technique can improve the cosmetic outcome through creation of slit-like meatus, low incidence of fistula and meatal stenosis than tubularized incised plate urethroplasty in the repair of distal hypospadias.

scholarly journals Our expirience in distal hipospadias and tip urethroplasty

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.

scholarly journals A modification of the TIP procedure for distal hypospadias: The burrowing technique

2014 ◽  
Vol 8 (5-6) ◽  
pp. 425 ◽  
Author(s):  
Erin D. Wishart ◽  
Peter D. Metcalfe
Keyword(s):  
Odds Ratio ◽  
Complication Rates ◽  
Hypospadias Repair ◽  
Multiple Series ◽  
Urethral Plate ◽  
Tubularized Incised Plate ◽  
Tubularized Incised Plate Urethroplasty ◽  
Distal Hypospadias ◽  
Hypospadias Surgery ◽  
Reoperation Rates

Introduction: The tubularized incised plate urethroplasty (TIP) hypospadias repair is a commonly performed procedure for hypospadias. Multiple series document excellent cosmetic outcome in conjunction with low complication rates. We describe a modification that we have named the “burrowing technique.” We believe that this technique facilitates dissection of the glans, which improves mobility, decreases tension with closure, and potentially improves outcomes.Methods: A retrospective review was performed of 193 coronalor mid-shaft hypospadias repairs by a single surgeon. The first 98 were performed using the TIP procedure, then the burrowing technique was developed and a subsequent 95 were analyzed for outcomes using this modification. Urethral plate characteristics and glandular size did not influence the choice of surgical technique. Cases were selected to allow for a “learning curve,” and were consecutively accrued. None of the boys had undergone prior hypospadias surgery. Proximal 2 stage repairs and distal (glanular) repairs were excluded.Results: A total of 193 boys underwent repair, 98 with the traditional TIP procedure and 95 using the burrowing modification. In total, 37 (19.2%) patients required re-operation for either fistulas or dehiscence; 23 (23.5%) in the non-burrowing group and 14 (14.7%) in the burrowing group, odds ratio 0.54 (p = 0.10).Conclusions: The TIP procedure has revolutionized the management of distal hypospadias. The burrowing modification increases glandular mobility simplifying the procedure and demonstrates a non-statistically significant trend in reducing reoperation rates.

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