Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce

Purpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact prepuce (MIP).Materials and Methods: A retrospective analysis was performed in 27 MIP children, 13 of whom underwent tubularized incised plate urethroplasty (TIP procedure), 7 underwent the Duplay procedur...

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Main Authors: Shou Xing Duan, Jianhong Li, Xuewu Jiang, Xuan Zhang, Wenhui Ou, Maxian Fu, Kaihong Chen, Lian Zheng, Shu Hua Ma
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-03-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fped.2020.00128/full
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author Shou Xing Duan
Shou Xing Duan
Jianhong Li
Xuewu Jiang
Xuan Zhang
Wenhui Ou
Maxian Fu
Kaihong Chen
Lian Zheng
Shu Hua Ma
author_facet Shou Xing Duan
Shou Xing Duan
Jianhong Li
Xuewu Jiang
Xuan Zhang
Wenhui Ou
Maxian Fu
Kaihong Chen
Lian Zheng
Shu Hua Ma
author_sort Shou Xing Duan
collection DOAJ
description Purpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact prepuce (MIP).Materials and Methods: A retrospective analysis was performed in 27 MIP children, 13 of whom underwent tubularized incised plate urethroplasty (TIP procedure), 7 underwent the Duplay procedure, 5 underwent the Mathieu procedure, 1 underwent meatal advancement and glanuloplasty (MAGPI procedure), and 1 underwent the glans approximation procedure (GAP). The patients were followed for 6–36 months to evaluate the surgical outcomes by the Pediatric Penile Perception Score (PPPS).Results: A total of 27 patients with a mean age of 8.12 ± 3.0 years were enrolled in this study, and 25 cases (25/27, 92.6%) were accidentally discovered during the first visit for phimosis. The patients had a formed urethra of 0.5 to 1.5 cm. Complications occurred in 4 of the 27 patients (14.81%): 2 patients with urethral fistula and 2 patients with meatal stenosis. One patient had a case of self-healed urethral fistula, and the remaining 3 patients underwent reoperation. The post-operative effect was satisfactory in all patients, and the urinary flow and stream during urination were normal. The overall average PPPS score of non-operative surgeons and parents was satisfactory. There were no significant differences in meatus appearance, glans appearance, skin appearance, and general appearance PPPS score among the Mathieu, TIP, and Duplay surgical procedures.Conclusions: MIP clinical manifestations are concealed and usually noted when circumcision is attempted. The suitable procedure for each patient should be tailored according to the anatomic features, and several techniques can be used with good functional and cosmetic results.
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spelling doaj.art-1270005c8aba4b278043651a207c6da02022-12-21T20:30:46ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-03-01810.3389/fped.2020.00128510251Diagnosis and Treatment of Hypospadias With Megameatus Intact PrepuceShou Xing Duan0Shou Xing Duan1Jianhong Li2Xuewu Jiang3Xuan Zhang4Wenhui Ou5Maxian Fu6Kaihong Chen7Lian Zheng8Shu Hua Ma9Department of Pediatric Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Pediatric Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Pediatric Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Pediatric Surgery, Shenzhen Pingshan District Woman's and Children's Hospital, Southern Medical University, Shenzhen, ChinaDepartment of Pediatric Surgery, Shenzhen Pingshan District Woman's and Children's Hospital, Southern Medical University, Shenzhen, ChinaDepartment of Pediatric Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Pediatric Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Pediatric Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, ChinaPurpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact prepuce (MIP).Materials and Methods: A retrospective analysis was performed in 27 MIP children, 13 of whom underwent tubularized incised plate urethroplasty (TIP procedure), 7 underwent the Duplay procedure, 5 underwent the Mathieu procedure, 1 underwent meatal advancement and glanuloplasty (MAGPI procedure), and 1 underwent the glans approximation procedure (GAP). The patients were followed for 6–36 months to evaluate the surgical outcomes by the Pediatric Penile Perception Score (PPPS).Results: A total of 27 patients with a mean age of 8.12 ± 3.0 years were enrolled in this study, and 25 cases (25/27, 92.6%) were accidentally discovered during the first visit for phimosis. The patients had a formed urethra of 0.5 to 1.5 cm. Complications occurred in 4 of the 27 patients (14.81%): 2 patients with urethral fistula and 2 patients with meatal stenosis. One patient had a case of self-healed urethral fistula, and the remaining 3 patients underwent reoperation. The post-operative effect was satisfactory in all patients, and the urinary flow and stream during urination were normal. The overall average PPPS score of non-operative surgeons and parents was satisfactory. There were no significant differences in meatus appearance, glans appearance, skin appearance, and general appearance PPPS score among the Mathieu, TIP, and Duplay surgical procedures.Conclusions: MIP clinical manifestations are concealed and usually noted when circumcision is attempted. The suitable procedure for each patient should be tailored according to the anatomic features, and several techniques can be used with good functional and cosmetic results.https://www.frontiersin.org/article/10.3389/fped.2020.00128/fullhypospadiasmegameatusintact prepuceurethral platePPPS
spellingShingle Shou Xing Duan
Shou Xing Duan
Jianhong Li
Xuewu Jiang
Xuan Zhang
Wenhui Ou
Maxian Fu
Kaihong Chen
Lian Zheng
Shu Hua Ma
Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce
Frontiers in Pediatrics
hypospadias
megameatus
intact prepuce
urethral plate
PPPS
title Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce
title_full Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce
title_fullStr Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce
title_full_unstemmed Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce
title_short Diagnosis and Treatment of Hypospadias With Megameatus Intact Prepuce
title_sort diagnosis and treatment of hypospadias with megameatus intact prepuce
topic hypospadias
megameatus
intact prepuce
urethral plate
PPPS
url https://www.frontiersin.org/article/10.3389/fped.2020.00128/full
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