Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias
AimsTo report current results of preputial flap onlay urethroplasty using the principle of the total preputial flap (TPF) for the one-stage repair of mid- and proximal hypospadias.MethodsThis study was a retrospective chart review of patients in a prospectively kept database of all hypospadias opera...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fped.2018.00019/full |
| _version_ | 1811222432211533824 |
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| author | Ricardo González Anja Lingnau Barbara Magda Ludwikowski |
| author_facet | Ricardo González Anja Lingnau Barbara Magda Ludwikowski |
| author_sort | Ricardo González |
| collection | DOAJ |
| description | AimsTo report current results of preputial flap onlay urethroplasty using the principle of the total preputial flap (TPF) for the one-stage repair of mid- and proximal hypospadias.MethodsThis study was a retrospective chart review of patients in a prospectively kept database of all hypospadias operations performed at two institutions from January 1 2011 to August 2017. Inclusion criteria: all patients who underwent hypospadias repair using a preputial only flap urethroplasty based on the principle of the TPF. Demographic data, duration of follow-up, complications, and reoperations were recorded. A successful result was considered to be a straight penis, a glanular meatus, and absence of voiding symptoms. Whenever possible an uroflow was obtained during the follow-up visits.ResultsForty-nine children met the inclusion criteria. All patients had marked penile curvature. Three patients had chromosomal abnormalities. The mean age at the time of surgery was 22 months (11–110) and the mean duration of follow-up 23.4 months (1–79). In 48 cases, the urethral plate could be preserved without dividing it. The penile curvature was corrected with chordectomy alone in 10 patients, 38 required a dorsal plication of the tunica albuginea, and 1 required an additional ventral dermal graft. In 38 patients (77.5%), the initial operation was successful, and no further operations were needed. There were eight urethrocutaneous fistulas, three dehiscences of the glans approximation. One patient suffered a wound infection and partial loss of the flap.ConclusionOne-stage repair of mid- and proximal hypospadias preserving the urethral plate and using a TPF for the urethroplasty and coverage of the ventral penis is successful in 77.5% of cases. Complications in the remaining patients were easily managed or did not require treatment. Compared to a planned two-stage approach, the technique described in this report resulted in significantly fewer procedures till complete resolution of the problem. |
| first_indexed | 2024-04-12T08:16:46Z |
| format | Article |
| id | doaj.art-8050dc8e2c2d4b249f8c83b54d9e8dda |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-12T08:16:46Z |
| publishDate | 2018-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-8050dc8e2c2d4b249f8c83b54d9e8dda2022-12-22T03:40:47ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602018-02-01610.3389/fped.2018.00019330133Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal HypospadiasRicardo González0Anja Lingnau1Barbara Magda Ludwikowski2Pediatric Surgery and Urology, Kinder- und Jugendkrankenhaus AUF DER BULT, Hanover, GermanyDepartment of Urology, Charité Universitätsmedizin Berlin, Berlin, GermanyPediatric Surgery and Urology, Kinder- und Jugendkrankenhaus AUF DER BULT, Hanover, GermanyAimsTo report current results of preputial flap onlay urethroplasty using the principle of the total preputial flap (TPF) for the one-stage repair of mid- and proximal hypospadias.MethodsThis study was a retrospective chart review of patients in a prospectively kept database of all hypospadias operations performed at two institutions from January 1 2011 to August 2017. Inclusion criteria: all patients who underwent hypospadias repair using a preputial only flap urethroplasty based on the principle of the TPF. Demographic data, duration of follow-up, complications, and reoperations were recorded. A successful result was considered to be a straight penis, a glanular meatus, and absence of voiding symptoms. Whenever possible an uroflow was obtained during the follow-up visits.ResultsForty-nine children met the inclusion criteria. All patients had marked penile curvature. Three patients had chromosomal abnormalities. The mean age at the time of surgery was 22 months (11–110) and the mean duration of follow-up 23.4 months (1–79). In 48 cases, the urethral plate could be preserved without dividing it. The penile curvature was corrected with chordectomy alone in 10 patients, 38 required a dorsal plication of the tunica albuginea, and 1 required an additional ventral dermal graft. In 38 patients (77.5%), the initial operation was successful, and no further operations were needed. There were eight urethrocutaneous fistulas, three dehiscences of the glans approximation. One patient suffered a wound infection and partial loss of the flap.ConclusionOne-stage repair of mid- and proximal hypospadias preserving the urethral plate and using a TPF for the urethroplasty and coverage of the ventral penis is successful in 77.5% of cases. Complications in the remaining patients were easily managed or did not require treatment. Compared to a planned two-stage approach, the technique described in this report resulted in significantly fewer procedures till complete resolution of the problem.http://journal.frontiersin.org/article/10.3389/fped.2018.00019/fullhypospadiaspreputial flapone-stage repairuroflowonlay urethroplastydouble face flap |
| spellingShingle | Ricardo González Anja Lingnau Barbara Magda Ludwikowski Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias Frontiers in Pediatrics hypospadias preputial flap one-stage repair uroflow onlay urethroplasty double face flap |
| title | Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias |
| title_full | Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias |
| title_fullStr | Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias |
| title_full_unstemmed | Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias |
| title_short | Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias |
| title_sort | results of onlay preputial flap urethroplasty for the single stage repair of mid and proximal hypospadias |
| topic | hypospadias preputial flap one-stage repair uroflow onlay urethroplasty double face flap |
| url | http://journal.frontiersin.org/article/10.3389/fped.2018.00019/full |
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