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TÜRKÇE
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Our experience with Proximal Hypospadia „ONE STAGE OPERATION“
X Ademaj
Universitätsklinikum Gießen und Marburg Klinik für Kinderchirurgie
OBJECTIVE: To report current results of preputial flap urethroplasty using the principle of the dorsal preputial flap for the one-stage repair of mid+ and proximal hypospadias.
METHODS: Our study was a retrospective chart review of patients in a prospectively kept database of all hypospadias operations performed at two institutions from Januar 2011 to December 2016. All patients who underwent proximal hypospadias repair using a preputial flap urethroplasty. A successful result was considered to be a straight penis, absence of voiding symptoms, and no stenosis formation. As follow -up procedure we used uroflow.
RESULTS: We retrospcetively analyzed our medical records of total 85 boys including distal and proximal form of Hypospadie.The boys with proximal Hypospadie were 16 (20%). The postoperative results and the treatment of complication were noted. We never administered any testosterone or dehydrotestosterone preoperatively.The penile curvature was corrected with chordectomy alone in 13 patients, 3 required a dorsal plication of the tunica albuginea. In 69 patients (80 %) with distal Hypospadie , the initial operation about 90% was successfully.
CONCLUSION: Complications due to the proximal Hypospadie in the remaining patients were easily managed. Compared to a planned two-stage approach, the technique described in this report resulted in significantly fewer procedures till complete resolution of the problem. The most common complication is fistulae , stenosis and urethral stricture. The reported rate of fistula formation varies between 15-20% (4-5 patients).
Our experience with one stage repair Urethroplasty provide aditional evidence that postoperative complications can be easly managed by fistula closure or Urethra dilatation. Hypospadias repair has become on of the most common procedure during the 1990s. With greater surgical experience and the advances that new approaches have brought, the complication rate has dropped dramatically and cosmetic has improved.
Our experience with Proximal Hypospadia „ONE STAGE OPERATION“
X Ademaj
Universitätsklinikum Gießen und Marburg Klinik für Kinderchirurgie
OBJECTIVE: To report current results of preputial flap urethroplasty using the principle of the dorsal preputial flap for the one-stage repair of mid+ and proximal hypospadias.
METHODS: Our study was a retrospective chart review of patients in a prospectively kept database of all hypospadias operations performed at two institutions from Januar 2011 to December 2016. All patients who underwent proximal hypospadias repair using a preputial flap urethroplasty. A successful result was considered to be a straight penis, absence of voiding symptoms, and no stenosis formation. As follow -up procedure we used uroflow.
RESULTS: We retrospcetively analyzed our medical records of total 85 boys including distal and proximal form of Hypospadie.The boys with proximal Hypospadie were 16 (20%). The postoperative results and the treatment of complication were noted. We never administered any testosterone or dehydrotestosterone preoperatively.The penile curvature was corrected with chordectomy alone in 13 patients, 3 required a dorsal plication of the tunica albuginea. In 69 patients (80 %) with distal Hypospadie , the initial operation about 90% was successfully.
CONCLUSION: Complications due to the proximal Hypospadie in the remaining patients were easily managed. Compared to a planned two-stage approach, the technique described in this report resulted in significantly fewer procedures till complete resolution of the problem. The most common complication is fistulae , stenosis and urethral stricture. The reported rate of fistula formation varies between 15-20% (4-5 patients).
Our experience with one stage repair Urethroplasty provide aditional evidence that postoperative complications can be easly managed by fistula closure or Urethra dilatation. Hypospadias repair has become on of the most common procedure during the 1990s. With greater surgical experience and the advances that new approaches have brought, the complication rate has dropped dramatically and cosmetic has improved.