Managing a complex case of hypospadias cripple and chordee
Objectives. Hypospadias is a congenital affliction in which the urethral meatus is located on the underside of the penis. These cases are usually treated during childhood by pediatric surgeons, but more complex forms tend to reoccur, and after several failed attempts end up as hypospadias cripple in...
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| Format: | Article |
| Language: | English |
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Digital ProScholar Media
2017-11-01
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| Series: | Journal of Clinical and Investigative Surgery |
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| Online Access: | https://www.proscholar.org/jcis/archive/2017/22/99104.pdf |
| _version_ | 1817995827685097472 |
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| author | Costin Gingu Alexandru V. Dick Mugurel Crasneanu Stelian I. Ianiotescu Andrei Andresanu Osama Abbas Himedan Mihai Dumitrache Ioanel Sinescu |
| author_facet | Costin Gingu Alexandru V. Dick Mugurel Crasneanu Stelian I. Ianiotescu Andrei Andresanu Osama Abbas Himedan Mihai Dumitrache Ioanel Sinescu |
| author_sort | Costin Gingu |
| collection | DOAJ |
| description | Objectives. Hypospadias is a congenital affliction in which the urethral meatus is located on the underside of the penis. These cases are usually treated during childhood by pediatric surgeons, but more complex forms tend to reoccur, and after several failed attempts end up as hypospadias cripple in the care of urologists at an adult age. The aim of this paper is to present the management of a complex case of hypospadias cripple associated with penile curvature (chordee). Materials and Methods. A 24 year old patient presented in our clinic with hypospadias cripple and ventral penile curvature. At the physical examination we found a penoscrotal urethral meatus, heavy scaring of the distal ventral penis and a ventral chordee of approximately 90 degrees in erect state. A two stage “Bracka” repair technique with buccal mucosa graft was chosen. The first stage of the surgery consisted of removing the scarred and defective distal urethral plate and the fibrotic tissue responsible for the penile curvature, preparing the corpora cavernosa for the graft, clefting the glans, harvesting two buccal mucosa grafts from both inner cheeks, and finally quilting the grafts on the defect. The second stage of the repair was performed after a period of about six months, and consisted in the tubularization of the matured graft and glans plasty. Results and Conclusions. No immediate or late complications occurred after any of the two stages of the surgery; no significant ventral chordee was observed and no urethral fistula occurred till the one year follow-up. A two stage “Bracka” repair technique is best suited for treating these patients, correcting ventral chordee in the first session. |
| first_indexed | 2024-04-14T02:13:44Z |
| format | Article |
| id | doaj.art-e22a12cf89554802b7023bfce70d6327 |
| institution | Directory Open Access Journal |
| issn | 2559-5555 |
| language | English |
| last_indexed | 2024-04-14T02:13:44Z |
| publishDate | 2017-11-01 |
| publisher | Digital ProScholar Media |
| record_format | Article |
| series | Journal of Clinical and Investigative Surgery |
| spelling | doaj.art-e22a12cf89554802b7023bfce70d63272022-12-22T02:18:22ZengDigital ProScholar MediaJournal of Clinical and Investigative Surgery2559-55552017-11-01229910410.25083/2559.5555.22.99104Managing a complex case of hypospadias cripple and chordeeCostin Gingu0Alexandru V. Dick1Mugurel Crasneanu2Stelian I. Ianiotescu3Andrei Andresanu4Osama Abbas Himedan5Mihai Dumitrache6Ioanel Sinescu7Carol Davila University, Department of Urology, Bucharest, RomaniaFundeni Clinical Institute, Department of Uronephrology and Renal Transplantation, Bucharest, RomaniaFundeni Clinical Institute, Department of Uronephrology and Renal Transplantation, Bucharest, RomaniaFundeni Clinical Institute, Department of Uronephrology and Renal Transplantation, Bucharest, RomaniaFundeni Clinical Institute, Department of Uronephrology and Renal Transplantation, Bucharest, RomaniaFundeni Clinical Institute, Department of Uronephrology and Renal Transplantation, Bucharest, RomaniaProf. Dr. Theodor Burghele Clinical Urology Hospital, Department of Urology, Bucharest, RomaniaCarol Davila University, Department of Urology, Bucharest, RomaniaObjectives. Hypospadias is a congenital affliction in which the urethral meatus is located on the underside of the penis. These cases are usually treated during childhood by pediatric surgeons, but more complex forms tend to reoccur, and after several failed attempts end up as hypospadias cripple in the care of urologists at an adult age. The aim of this paper is to present the management of a complex case of hypospadias cripple associated with penile curvature (chordee). Materials and Methods. A 24 year old patient presented in our clinic with hypospadias cripple and ventral penile curvature. At the physical examination we found a penoscrotal urethral meatus, heavy scaring of the distal ventral penis and a ventral chordee of approximately 90 degrees in erect state. A two stage “Bracka” repair technique with buccal mucosa graft was chosen. The first stage of the surgery consisted of removing the scarred and defective distal urethral plate and the fibrotic tissue responsible for the penile curvature, preparing the corpora cavernosa for the graft, clefting the glans, harvesting two buccal mucosa grafts from both inner cheeks, and finally quilting the grafts on the defect. The second stage of the repair was performed after a period of about six months, and consisted in the tubularization of the matured graft and glans plasty. Results and Conclusions. No immediate or late complications occurred after any of the two stages of the surgery; no significant ventral chordee was observed and no urethral fistula occurred till the one year follow-up. A two stage “Bracka” repair technique is best suited for treating these patients, correcting ventral chordee in the first session.https://www.proscholar.org/jcis/archive/2017/22/99104.pdfhypospadiascripplechordeepenile curvature |
| spellingShingle | Costin Gingu Alexandru V. Dick Mugurel Crasneanu Stelian I. Ianiotescu Andrei Andresanu Osama Abbas Himedan Mihai Dumitrache Ioanel Sinescu Managing a complex case of hypospadias cripple and chordee Journal of Clinical and Investigative Surgery hypospadias cripple chordee penile curvature |
| title | Managing a complex case of hypospadias cripple and chordee |
| title_full | Managing a complex case of hypospadias cripple and chordee |
| title_fullStr | Managing a complex case of hypospadias cripple and chordee |
| title_full_unstemmed | Managing a complex case of hypospadias cripple and chordee |
| title_short | Managing a complex case of hypospadias cripple and chordee |
| title_sort | managing a complex case of hypospadias cripple and chordee |
| topic | hypospadias cripple chordee penile curvature |
| url | https://www.proscholar.org/jcis/archive/2017/22/99104.pdf |
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