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 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 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 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 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.

Midshaft Hypospadias: Review of Surgical Technique

2019 ◽  
Author(s):  
Erin R. McNamara ◽  
Bryan Sack ◽  
Alan B. Retik
Keyword(s):  
Surgical Technique ◽  
Key Words ◽  
Common Type ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Tubularized Incised Plate Urethroplasty ◽  
Skin Coverage

Surgical technique for midshaft hypospadias has evolved since the time of Horton and Devine. The most common type of repair that is currently used is the tubularized incised plate urethroplasty, which is a modification of the Thiersch-Duplay hypospadias repair. The authors review the steps of this procedure in detail and discuss troubleshooting for issues that may arise during the repair. Alternatives for chordee correction and skin coverage are reviewed. The authors briefly discuss outcomes and possible complications. In addition, there is a step-by-step video of a midshaft hypospadias repair that highlights the surgical technique. This review contains 9 figures, and 23 references. Key Words: chordee, dartos flap, hypospadias, midshaft hypospadias, surgical technique, tubularized incised plate (TIP), urethrocutaneous fistula, ventral curvature

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