Results of two-stage transverse preputial island flap urethroplasty for proximal hypospadias with chordee that mandate division of the urethral plate

Background: Urethroplasty for hypospadias is a difficult surgery in the best of hands. One stage surgery is usually preferred for its multiple benefits. Many techniques exist each with its own merits and demerits. Aim of the study was to compare different techniques in hypospadias surgery with special emphasis on transverse prepucial onlay island flap urethroplasty.Methods: All children operated for hypospadias from the period of 2016-2019 in Department of Surgery at Geetanjali Medical College and Hospital, Udaipur were included in the group after obtained approval from institutional ethical clearance commitee. The technique to be used was decided on a case to case basis depending mainly on the position of the meatus, size of the urethral plate and chordee (ventral curvature). All patients were analyzed for various complications and overall success rate.Results: 77 patients were operated and analyzed. Overall the study could not establish the superiority of one technique above another. At the same time it establishes the versatility, satisfactory results and low complication rate of transverse prepucial onlay island flap (TPOIF) in different types of hypospadias.Conclusions: Success in urethroplasty depends on proper case selection, meticulous technique, a buttressing layer wherever possible and that TPOIF is a versatile technique for single stage hypospadias repair in distal, mid and proximal penile hypospadias.

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Hypospadias Repair: A Single Centre Experience

Plastic Surgery International ◽

10.1155/2014/453039 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 6

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.

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