Pediatric UrologyCan Spongioplasty Prevent Fistula Formation and Correct Penile Curvature in TIP Urethroplasty for Hypospadias?
Section snippets
Material and Methods
From June 2007 to December 2011, we treated 74 patients with hypospadias according to a surgical strategy based on the position of the meatus and the degree of penile curvature (Fig. 1).
Meatoplasty was performed in 9 patients with glanular hypospadias. Of 13 patients with scrotal hypospadias, 10 underwent a modified Koyanagi repair8 and 3 underwent 2-stage repair.
In the remaining 52 patients whose hypospadiac meatuses were located from the penoscrotal junction to the corona, the foreskin was
Results
Complications occurred in 4 of 47 patients (8.5%) who underwent TIP repair during postoperative follow-up periods ranging from 7 months to 5 years (mean 2 years and 7 months). Urethrocutaneous fistulae occurred in 3 cases, and glans dehiscence occurred in 1 case. When we analyzed the effect of spongioplasty on the complication rate, we found that postoperative complications occurred in 3 of the 37 patients (8%) that underwent spongioplasty and 1 of the 10 patients (10%) who did not. Thus, there
Discussion
Hypospadias surgery represents one of the most challenging problems in the field of pediatric urology because various complications can occur, such as urethrocutaneous fistula, neourethral stricture, neomeatal stenosis, neourethral diverticulum, and neourethral dehiscence. Urethrocutaneous fistula is the most common complication and displays an incidence of 5%-44%.10, 11 Since Retik et al4 developed the dartos flap as an intermediate layer between the neourethra and penile skin, it has become
Conclusions
Spongioplasty does not seem to obviate the need for the dartos flap to improve postoperative outcomes, although the rate of complications such as urethrocutaneous fistula might decrease by adding spongioplasty to the dartos flap procedure.
However, when spongioplasty was performed, dorsal tunica albuginea plication was not necessary in more than half of the patients with hypospadia with moderately severe curvature. Even when dorsal plication was required after spongioplasty, the length of the
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Spongioplasty with Buck's fascia covering dorsal inlay graft urethroplasty for primary hypospadias repair
2023, Journal of Pediatric UrologyComparison of interrupted- and continuous-suture urethroplasty in tubularised incised-plate hypospadias repair: A prospective study
2017, Arab Journal of UrologyCitation Excerpt :Therefore, besides the surgical technique used for hypospadias repair, other factors affecting the outcome of hypospadias repair may exist. Some of these factors including patient age, type of hypospadias, presence and degree of chordee, quality and width of urethral plate, type of suture, type of suturing technique, use of magnification during repair, type of dressing used after repair, use of catheter during repair, provision of soft tissue coverage over urethra, and use of antibiotics after repair have been reported in literature [1–19]. However, the exact roles of these factors in the successful outcome of hypospadias repair are yet to be determined.
A scoping review on chordee correction in boys with ventral congenital penile curvature and hypospadias
2024, Indian Journal of Urology
Financial Disclosure: The authors declare that they have no relevant financial interests.