Introduction of a modified single stage reconstruction technique of male penopubic epispadias
Abstract Objective To represent the long-term outcomes of our modified single-stage technique for the reconstruction of isolated penopubic epispadias in male patients. Patients and methods Data from 113 patients were obtained from bladder-exstrophy-epispadias database of our tertiary center. A total...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-022-01089-2 |
| _version_ | 1817987128381931520 |
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| author | Masoud Bitaraf Pouya Mahdavi Sharif Parham Torabinavid Abdol-Mohammad Kajbafzadeh |
| author_facet | Masoud Bitaraf Pouya Mahdavi Sharif Parham Torabinavid Abdol-Mohammad Kajbafzadeh |
| author_sort | Masoud Bitaraf |
| collection | DOAJ |
| description | Abstract Objective To represent the long-term outcomes of our modified single-stage technique for the reconstruction of isolated penopubic epispadias in male patients. Patients and methods Data from 113 patients were obtained from bladder-exstrophy-epispadias database of our tertiary center. A total of seven boys with isolated penopubic epispadias with no prior history of surgery and any other anomaly underwent our modified surgical approach from February 1997 to September 2019. The mean ± SD age at surgery was 6.5 ± 2.4 years. Volitional voiding status and cosmetic appearance were evaluated at each follow-up interval. Postoperative follow-up was performed at quarterly intervals in the first year and once a year in subsequent years. Results The mean ± SD of follow-up was 8.5 ± 6 years. All boys who were incontinent achieved urinary control and the ability of normal transurethral micturition following the surgery. Four boys became completely dry, and the other three attained social dryness. Postoperative mean (SD) bladder capacity was significantly increased from 54.5 (11) to 124 (40.0) within 6 months, and to 194 (47.5) at 18 months after surgery. Dorsal curvature has been resolved in all cases, and no postoperative complications were noted except for surgical site infection in one patient treated with antibiotics and bilateral vesicourethral reflux resolved after injection of bulking agents. Four patients had normal erectile function and ejaculation, while the others have not reached puberty yet. Moreover, none of the patients developed urethrocutaneous fistula, stricture, or penile ischemia. Conclusion The present findings suggest the safety and effectiveness of the combination of single-stage urethro-genitoplasty, bladder neck plication, and fat pad pedicled flap in management of boys with isolated penopubic epispadias that can lead to the achievement of urinary control, acceptable sexual function, and cosmetically satisfactory genitalia. Minimal morbidity, low complication rate, and promising outcomes are essential factors, supporting the notion of introducing this technique as a valid option for management of this entity. |
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| format | Article |
| id | doaj.art-4a1cf811464542a9ac3a9c3942e945dc |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-14T00:17:55Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-4a1cf811464542a9ac3a9c3942e945dc2022-12-22T02:23:04ZengBMCBMC Urology1471-24902022-08-012211810.1186/s12894-022-01089-2Introduction of a modified single stage reconstruction technique of male penopubic epispadiasMasoud Bitaraf0Pouya Mahdavi Sharif1Parham Torabinavid2Abdol-Mohammad Kajbafzadeh3Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children’s Medical Center, Tehran University of Medical SciencePediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children’s Medical Center, Tehran University of Medical SciencePediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children’s Medical Center, Tehran University of Medical SciencePediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Children’s Medical Center, Tehran University of Medical ScienceAbstract Objective To represent the long-term outcomes of our modified single-stage technique for the reconstruction of isolated penopubic epispadias in male patients. Patients and methods Data from 113 patients were obtained from bladder-exstrophy-epispadias database of our tertiary center. A total of seven boys with isolated penopubic epispadias with no prior history of surgery and any other anomaly underwent our modified surgical approach from February 1997 to September 2019. The mean ± SD age at surgery was 6.5 ± 2.4 years. Volitional voiding status and cosmetic appearance were evaluated at each follow-up interval. Postoperative follow-up was performed at quarterly intervals in the first year and once a year in subsequent years. Results The mean ± SD of follow-up was 8.5 ± 6 years. All boys who were incontinent achieved urinary control and the ability of normal transurethral micturition following the surgery. Four boys became completely dry, and the other three attained social dryness. Postoperative mean (SD) bladder capacity was significantly increased from 54.5 (11) to 124 (40.0) within 6 months, and to 194 (47.5) at 18 months after surgery. Dorsal curvature has been resolved in all cases, and no postoperative complications were noted except for surgical site infection in one patient treated with antibiotics and bilateral vesicourethral reflux resolved after injection of bulking agents. Four patients had normal erectile function and ejaculation, while the others have not reached puberty yet. Moreover, none of the patients developed urethrocutaneous fistula, stricture, or penile ischemia. Conclusion The present findings suggest the safety and effectiveness of the combination of single-stage urethro-genitoplasty, bladder neck plication, and fat pad pedicled flap in management of boys with isolated penopubic epispadias that can lead to the achievement of urinary control, acceptable sexual function, and cosmetically satisfactory genitalia. Minimal morbidity, low complication rate, and promising outcomes are essential factors, supporting the notion of introducing this technique as a valid option for management of this entity.https://doi.org/10.1186/s12894-022-01089-2EpispadiasUrinary incontinenceUrogenital abnormalitiesBladder exstrophy and epispadias complexReconstructive surgical proceduresMale urogenital diseases |
| spellingShingle | Masoud Bitaraf Pouya Mahdavi Sharif Parham Torabinavid Abdol-Mohammad Kajbafzadeh Introduction of a modified single stage reconstruction technique of male penopubic epispadias BMC Urology Epispadias Urinary incontinence Urogenital abnormalities Bladder exstrophy and epispadias complex Reconstructive surgical procedures Male urogenital diseases |
| title | Introduction of a modified single stage reconstruction technique of male penopubic epispadias |
| title_full | Introduction of a modified single stage reconstruction technique of male penopubic epispadias |
| title_fullStr | Introduction of a modified single stage reconstruction technique of male penopubic epispadias |
| title_full_unstemmed | Introduction of a modified single stage reconstruction technique of male penopubic epispadias |
| title_short | Introduction of a modified single stage reconstruction technique of male penopubic epispadias |
| title_sort | introduction of a modified single stage reconstruction technique of male penopubic epispadias |
| topic | Epispadias Urinary incontinence Urogenital abnormalities Bladder exstrophy and epispadias complex Reconstructive surgical procedures Male urogenital diseases |
| url | https://doi.org/10.1186/s12894-022-01089-2 |
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