Hypospadias | An-Najah Staff

Multicentric Experience on Double Dartos Flap Protection In Tubularized Incised Plate Urethroplasty For Distal And Midpenile Hypospadias

Thu, 2011-10-20 14:31 — Mahmoud Mustafa

Journal Title, Volume, Page:

Pediatric Surgery International December 2011, Volume 27, Issue 12, pp 1331-1336

Year of Publication:

2011

Link:

http://link.springer.com/article/10.1007%2Fs00383-011-2978-1

Authors:

Bertozzi M

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Yıldız A

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Kamal B

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Mustafa M

Urology Department, Rafidia Teaching Hospital, An-najah University School of Medicine, Nablus, West-Bank, Palestine

Current Affiliation:

Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine

[email protected]

Prestipino M

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Yiğiter M

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Al-Darawany H

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Oral A

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Nardi N

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Appignani A

S. C. di Clinica Chirurgica Pediatrica, Ospedale S. Maria della Misericordia, Università degli Studi di Perugia, 06100 S. Andrea delle Fratte, Perugia, Italy

Preferred Abstract (Original):

Purpose We report a multicenter experience using double dartos flap to protect the neourethra in TIP urethroplasty for distal and midpenile hypospadias.
Methods A total of 394 patients underwent tubularized incised plate urethroplasty for primary distal and midpenile hypospadias using double dartos flap protection by ten pediatric surgeons and urologists at five different institutions.
Results Tubularized incised plate urethroplasty protected by a double dartos flap was simple to perform and flaps were easy to obtain. Complications occurred in 23 patients (5.83%): fistulas 1.01% (4 cases), stenosis 0.25% (1 case), mild stenosis 2.53% (10 cases), dehiscence of ventral cutis 0.50% (2 cases) and penile torsion 1.26% (5 cases). All fistulae had a spontaneous resolution.
Conclusion Double dartos flap to protect tubularized incised plate urethroplasty is safe with a low complication rate. The neourethra is covered entirely with a double layer of vascularized tissue and the double coverage appears a good choice for preventing urethrocutaneous fistula formation.

Standard Snodgrass Technique In Conjunction With Double-Layer Covering of The Neourethra With Dorsal Dartos Flap Is The Therapy of First Choice For Hypospadias

Thu, 2011-05-12 13:01 — Mahmoud Mustafa

Journal Title, Volume, Page:

International Urology and Nephrology (2008), Volume: 40, Issue: 3, Pages: 573-576

Year of Publication:

2008

Link:

http://link.springer.com/article/10.1007%2Fs11255-008-9363-6

Authors:

Mahmoud Mustafa

Urology Department, Medicana Hospital, Istanbul, Turkey

Current Affiliation:

Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine

[email protected]

Bassem S. Wadie

Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

Hassan Abol-Enein

Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

Preferred Abstract (Original):

Purpose: To evaluate the validity of the standard tubularized incised plate (TIP) urethroplasty technique for different kinds of hypospadia.
Materials and methods: From June 2002 to December 2003 and from March 2006 to October 2007 38 patients aged 1–22 years (average 7.34) were operated using the concept of TIP urethroplasty. The hypospadiac meatus were subcoronal in 28 patients (73.68%), midshaft in six (15.78%), and penoscrotal in four (10.52%). Standard TIP urethroplasty in conjunction with double-layer covering of the neourethra with dorsal dartos flap were used in the primary cases (28 patients). In the secondary cases (four patients) and in boys who were circumcised before admission (six patients), modified TIP urethroplasty was used. The mean periods of hospitalization and follow-up were 0.92 days and 4.19 months, respectively.
Results: No fistulas were observed in boys who underwent primary reconstruction using standard TIP urethroplasty. Fistulas were observed in two patients (5.26%)—one patient with penoscrotal hypospadias who underwent two-stage repair and another who was circumcised before admission. One patient had meatal stenosis at the early postoperative period which was corrected by dilatation of the external meatus at intervals up to 2 months postoperatively.
Conclusion Standard TIP urethroplasty with double-layer covering of the neourethra with dorsal subcutaneous tissue is the procedure of choice for treatment of primary cases of distal/midshaft hypospadias. This technique seems suitable for reconstruction of proximal, secondary, and even complicated hypospadias.