scholarly journals Hypospadias Repair: A Single Centre Experience

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mansoor Khan ◽  
Abdul Majeed ◽  
Waqas Hayat ◽  
Hidayat Ullah ◽  
Shazia Naz ◽  
...  
Keyword(s):  
Social Sciences ◽  
Postoperative Complications ◽  
Single Stage ◽  
Hypospadias Repair ◽  
Surgical Skill ◽  
Two Stage ◽  
Urethral Plate ◽  
Single Centre Experience ◽  
Male Patients ◽  
Hypospadias Surgery

Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital’s database and analyzed with Statistical Package for Social Sciences (SPSS). Results. A total of 428 patients with mean age of 8.12 ± 5.04 SD presented for hypospadias repair. Midpenile hypospadias were the most common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka) and TIP (tubularized incised urethral plate) repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF). The complications were significantly lower in the hands of specialists than residents (P-value = 0.0086). The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001). Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications.

A comparative study of two-stage versus single-stage repair of severe Hypospadias

2020 ◽  
Vol 8 (2) ◽  
pp. 24-28
Author(s):  
sabbani krishna murthy
Keyword(s):  
Cross Section ◽  
Single Stage ◽  
Moderate Degree ◽  
Hypospadias Repair ◽  
Medical Sciences ◽  
Two Stage ◽  
Urethral Plate ◽  
P Values ◽  
Type Of Surgery ◽  
Selection Of

Background: The main aim of hypospadias repair is to preserve the urethral plate whenever possible. This study was undertaken to compare the outcome of repair of severe hypospadias with moderate chordee by single-stage Snodgrass with two-stage repair with dermal graft corporoplasty. Methods: This prospective cross-section study was done in the Department of Urology, Chalmida Anand Rao Institute of Medical Sciences, Bommakal, Karimnagar. The selection of the patients the type of surgery was based on the type of case. A total of n=31 patients were operated for severe hypospadias out of which n=14 single surgeries and n=17 two-staged surgeries were performed. Results: N=25 patients were found with a moderate degree of chordee. No complications were found in n=11(78.57%) in single-stage repairs and two-stage repairs n=15(88.23%) were without complications the p values were found to be 0.012 which is significant. HOSE scores Erection correction was better in two staged surgeries as compared to single-stage repairs with p values <0.001 which is considered significant. Conclusion: We can conclude that the repair of severe hypospadias with moderate chordee by two-staged repair showed better outcomes as compared to single-stage repair. The incidence of postoperative complications is also lesser with two-staged repairs. However, the choice of the procedure must be based on the type of hypospadias, choice of patients and economical constraints.

scholarly journals Hypospadias in toddlers: a multivariable study of prognostic factors in distal to mid-shaft hypospadias and review of literature

2022 ◽  
Vol 5 (1) ◽  
pp. e000225
Author(s):  
M Reza Roshandel ◽  
Tannaz Aghaei Badr ◽  
Fahimeh Kazemi Rashed ◽  
Samantha Salomon ◽  
Seyyed Mohammad Ghahestani ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Fistula Formation ◽  
Hypospadias Repair ◽  
Urethral Plate ◽  
Factors Affecting ◽  
Tubularized Incised Plate ◽  
Multivariable Regression ◽  
Tubularized Incised Plate Urethroplasty ◽  
Predicting Factor ◽  
Hypospadias Surgery

BackgroundTubularized incised plate urethroplasty is the most common hypospadias repair technique. However, there are unanswered questions and debates about the anatomical prognostic factors affecting the repair outcomes. This study tried to address some of the problems in the studies compromising the results of the current body of literature.MethodsA prospective cohort of 101 males aged 1–3 years undergoing primary distal to mid-shaft hypospadias repair were enrolled in the study. Complications including edema, erection, inadvertent removal of the urethral stent, surgical wound infection, bladder spasm, hematoma, and hemorrhage were evaluated. Studies in the current literature were reviewed to achieve a better perspective for future investigations.ResultsPersistent complications were found in 16 cases (15.8%) including fistula formation, the persistence of chordee, meatal stenosis, glans, and urethral dehiscence. The mean follow-up time was 6.6±3.4 months. In the single-variable analysis, the meatal location, the length and width of the urethral plate, and the reversible acute postoperative events were significantly associated with the complications. Furthermore, fistula formation was associated with acute surgical site infection (p<0.001). However, the multivariable regression study revealed the presurgical meatal location to be the only statistically significant factor (p=0.03). Notably, the glans diameter or glanular groove shape, urethral plate dimensions, or presence of mild chordee were not independently associated with the outcomes (p>0.05).ConclusionsOur study on the toddlers with hypospadias surgery revealed that the location of urethral meatal was the main predicting factor in the development of major complications. Furthermore, the fistula formation at the infected surgical site emphasizes the importance of postsurgical care.

Two-stage complex hypospadias repair when urethral plate has to be divided: Ventral corporoplasty using a tunica vaginalis flap

2013 ◽  
Vol 9 (5) ◽  
pp. 693.e1-693.e2 ◽  
Author(s):  
Antonio Macedo ◽  
Herick Bacelar ◽  
Atila Rondon ◽  
Sergio Ottoni ◽  
Riberto Liguori ◽  
...  
Keyword(s):  
Hypospadias Repair ◽  
Tunica Vaginalis ◽  
Two Stage ◽  
Urethral Plate

scholarly journals Objective Scoring Evaluation and Uroflowmetry Assessment of Two-Stage Hypospadias Repair: Single Center Experience

2013 ◽  
Vol 12 (2) ◽  
pp. 133-139
Author(s):  
Naser S Hussein ◽  
Shapiee B Samat ◽  
Mohd Abdullah ◽  
Mohd N Gohar
Keyword(s):  
Medical Science ◽  
Scoring Systems ◽  
Hypospadias Repair ◽  
Two Stage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Urethral Plate ◽  
Non Invasive ◽  
Single Center Experience

Background: Hypospadias is a common congenital anomaly affecting the penis, two-stage repair becoming more interesting in era of tubularized –incised urethral plate (TIP). Functional outcome of hypospadias repair either single or two stage is as important as cosmetic outcome. In contemporary series , structured scoring systems (Hypospadias Objective Scoring Evaluation-HOSE and Pediatric Penile Perception Scoring -PPPS), evaluation of photographs and uroflowmetry, were used to assess results of hypospadias repair. Objectives: We have assessed outcomes of two-stage hypospadias repair using Hypospadias Objective Scoring Evaluation(HOSE) and uroflowmetry. Material and Methods: Over a period of eight years, from January 1997 to December 2004, One hundred and twenty six hypospadias patients were treated, ninety of them had two-stage repair and36 single-stage repairs. The HOSE questionnaire and uroflowmetry were obtained to evaluate the long term outcome of two –stage hypospadias repair. Results: The age at time of assessment ranged from 8 to 23 year-old, with mean follow up of 39.78months. Thrifty five patients had proximal hypospadias and 20 had distal varieties of hypospadias. Operations performed were 37 Bracka?s and 18 Byar?s procedures. Of the 55 patients had complete two stage hypospadias repair and agree to participate in the study , Nineteen patients had acceptable HOSE and 36 had non-acceptable score. Uroflow rates of 43 subjects were below the fifth centile in three patients ,equivocal (between 5th and 25th centile ) in four patients and above 25th centile in 36 subjects. Conclusion: Two –stage repair is a suitable technique for all types of hypospadias with versatile outcomes. HOSE and uroflowmetry are simple, easy, non invasive and non expensive tools to assess long term outcomes objectively. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 133-139 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14940

Reoperation and Postoperative Outcomes for Single-Stage versus Two-Stage Breast Reconstruction Following Mastectomy: A Meta-Analysis

2018 ◽  
Vol 1 (1) ◽  
pp. 6-17
Author(s):  
Renee Aboushi ◽  
◽  
W. Kurtis Childe ◽  
Christopher S Hollenbeak ◽  
Harold Yang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Primary Endpoint ◽  
Meta Analysis ◽  
Tissue Expander ◽  
Single Stage ◽  
Reconstruction Method ◽  
Two Stage ◽  
Secondary Endpoints ◽  
Reoperation Rates

Introduction Implant based breast reconstructions has become widely accepted as an appropriate reconstruction method following mastectomy for breast cancer. The two most common techniques include immediate reconstruction and implantation (single-stage procedure) or the use of a tissue expander with delayed insertion of implant and reconstruction (two-stage procedure). Using existing studies and available data, a meta-analysis was performed analyzing reoperation rates and postoperative complications between these two methods based upon available literature. Methods A literature search was performed by two individual investigators using the databases PubMed, Cochrane, and Medline. All articles comparing implant based single and two stage breast reconstructions outcomes between 2006 and 2016 were utilized. The primary endpoint of interest was reoperation rates. Secondary endpoints included postoperative complications such as infection, seroma, hematoma, and necrosis. Results A total of five studies met the inclusion criteria, for a total of 12,357 breast reconstructions. 2,281 breast reconstructions were singlestage and 10,076 were two-staged. The primary endpoint of reoperation was increased reoperation rate in the single-stage breast reconstruction (OR=0.78, CI 0.67-0.91; p<0.05). Secondary endpoints demonstrated no statistical significance in infections (OR 1.06, CI 0.84-1.34; p=0.40), hematoma (OR=1.66, CI 0.91-3.05; p=0.09) and necrosis (OR=1.13, CI 0.76-1.68; p=0.29). However, there was an increased incidence of seroma formation in two-stage reconstruction (OR=1.86, CI 1.05-3.28; p<0.005). Conclusions Single and two-staged implant breast reconstructions had similar infection, hematoma, and necrosis rates. Single-stage reconstructions resulted in a significant increase in reoperation/revision rates.

scholarly journals Sidik-Chaula Urethroplasty and the Manset Flap for Non-Glanular Hypospadias Repair

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Chaula L Sukasah ◽  
Laureen Supit
Keyword(s):  
Postoperative Complications ◽  
Primary Repair ◽  
Hypospadias Repair ◽  
Operative Techniques ◽  
Two Stage ◽  
Simple Modification ◽  
Second Stage ◽  
Different Types ◽  
The One ◽  
Rate Of Success

Hypospadias present with a wide array of meatal position and curvature. Choosing an operative technique for the different types of hypospadias has been challenging and controversial among the plastic, urologic, and pediatric surgeons. Regardless of the selected techniques, primary hypospadias repair still frequently results in complications requiring further surgery, such as fistula, residual chordee, and stricture. Owing to its practicality, the single stage urethroplasties are more-popular and widely used at present. However, our experience found higher rates of postoperative complications with the one-stage procedure compared to the two-stage for repair of non-glanular hypospadia. This article details the operative techniques of the two-stage Sidik-Chaula urethroplasty, a technique that we have implemented in our institution over two decades. It is applicable for the primary repair of any distal, middle, and proximal hypospadias. We also introduce the Manset Flap, a simple modification to the first stage of urethroplasty, which ease neourethra creation in the second stage. However, due to prior insufficient medical recordkeeping, we are yet unable to produce a quantified rate of success and complications by utilizing this technique. A study is currently being done to produce the numbers.

scholarly journals Grafted tubularised incised plate urethroplasty: an excellent option in primary hypospadias with poor urethral plate

2017 ◽  
Vol 4 (7) ◽  
pp. 2270 ◽  
Author(s):  
Pradyumna Pan
Keyword(s):  
Standard Technique ◽  
Urethral Reconstruction ◽  
Hypospadias Repair ◽  
Urethral Meatus ◽  
Surgical Experience ◽  
Urethrocutaneous Fistula ◽  
Viable Option ◽  
Urethral Plate ◽  
Urinary Stream ◽  
Hypospadias Surgery

Background: Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. We here-in assess the cosmetic and functional outcome with primary single stage dorsal inlay urethroplasty using preputial skin grafts in tubularised incised-plate. We extended this indication to be the standard technique for primary hypospadias repair with poor urethral plate, flat glans and minimal ventral curvature.Methods: Children with a narrow urethral plate, shallow glans and minimal ventral curvature formed the study group. Children having severe chordee needing transection of the urethral plate,having undergone circumcision and failed hypospadias repair was excluded. This prospective study included the surgical experience of 87 cases of primary hypospadias operated upon between 2010 and 2016.Results: A straight penis was achieved in 97.7% of the patients with a 3.4% incidence of urethrocutaneous fistula. Acceptable cosmetic results were achieved in 96.5% of cases. Slit like appearance of neo urethral meatus was achieved in 96.5%, position was on the tip in 81 patients and in 6 it was mid glans. Glans dehiscence was seen in 3 patients. Meatal stenosis in 1, stricture, diverticulum and penile torsion was not seen in this series. Single and straight urinary stream was seen in 91.95%, splaying of urine in 3 patients and a thin stream in 4 patients.Conclusions: Primary dorsal inlay inner preputial graft urethroplasty successfully fulfils all traditional hypospadias repair criteria. It offers a viable option in the management of primary hypospadias with a narrow urethral plate.

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.

360: A Contemporary Analysis of Two-Stage Hypospadias Repair

2007 ◽  
Vol 177 (4S) ◽  
pp. 120-120
Author(s):  
Pamela I. Ellsworth ◽  
Anthony Caldamone
Keyword(s):  
Hypospadias Repair ◽  
Two Stage
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