Reoperative Urethroplasty after Failed Hypospadias Repair | ||||
| The Medical Journal of Cairo University | ||||
| Article 73, Volume 87, September, September 2019, Page 3325-3332 PDF (621.59 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2019.65627 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| MOHAMMED A. ZEDAN, M.Sc.; TAREK A. GAMEEL, M.D.; MOHAMMED A. GHALWASH, M.D.; OSAMA M. EL-GAMAL, M.D. | ||||
| The Department of Urology, Faculty of Medicine, Tanta University, Egypt | ||||
| Abstract | ||||
| Abstract Background: Reported reoperation rates after primary hypospadias repair can exceed 50%. Failed hypospadias occurs when the primary surgery does not achieve the cosmetic and functional goals of a straight penis with glanular meatus that enables normal urinary and sexual function. Treatment of patients with failed hypospadias repair can be a challenging task in the majority of cases and the selection of the most appropriate technique for this repair is the corner stone for success in these cases. Aim of Study: Is to evaluate the results and success rate of some common techniques for redo urethroplasty in cases with failed hypospadias repair. Patients and Methods: The study included forty two patients with recurrent hypospadias and their ages ranged from 2-15 years. The final position of the external urethral meatus after release of chordee, was subcoronal (13 cases), distal penile (13 cases), mid-penile (13 cases) and penoscrotal (3 cases). TIP technique was applied in 12 cases, Mathieu technique in 10 cases, transverse dorsal preputial onlay flap in 10 cases and two-stage repair with buccal mucosa graft in 10 cases. The operative technique was selected according to the status of the urethral plate and the nearby penile skin. Results: Our overall results showed that 24 patients (57.14%) had successful repair while failed repair was reported in 8 patients (19.04%). Minor complications were also reported in 10 cases (23.80%) which included urethrocutaneous fistula, meatal stenosis and urethral diverticulum. The success rates of TIP, Mathieu, transverse dorsal preputial onlay flap and the two-stage repair were 58.33%, 50%, 50% and 70% respec-tively. Conclusion: TIP urethroplasty is an effective technique for redo hypospadias repair if the patient has a non-scarred and wide urethral plate. Similar results can also be achieved by Mathieu's repair or transverse onlay flap in patients with narrow and non-scarred urethral plate. However, patient with scarred unhealthy urethral plate should have a two stage repair with buccal mucosa graft. | ||||
| Keywords | ||||
| Hypospadias-reoperation; Hypospadias compli-cations; Risks for hypospadias; Complications | ||||
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