Research Article
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Year 2019, Volume: 9 Issue: 4, 373 - 377, 31.12.2019
https://doi.org/10.16899/jcm.561241

Abstract

References

  • 1. Pohl HG, Atala A, Retik AB. 2-stage hypospadias repair: Histrocial perspectives and current practice. AUA update series. 2004; 23: 34-39.,Moursy EE. Outcome of proximal hypospadias repair using three different techniques. J Pediatr Urol. 2010; 6: 45-53.3. Saafan HA. Two stages repair of proximal hypospadias: review of 33 cases. Ann of pediatr surg. 2010; 6(2): 89-92.4. Ghali AMA. Hypospadias repair by skin flaps: a comparison of onlay preputial island flaps with either Mathieu’s meatal-based or Duccet’s tubularized flaps. BJU Int. 1999; 83: 1032-1038.5. Braga LHP, Salle JLP, Lorenzo AJ, Skeldon S, Dave S, Farhat WA, Khoury AE. Comparative analysis of tubularized incised plate versus onlay ısland flap urethroplasty for penoscrotal hypospadias. J Urol. 2007; 178: 1451-1457.6. Dahshoury el ZM, Gamal W, Hammady A, Hussein M, Salem E. Modified double face onlay island preputial skin flap with augmented glanuloplasty for hypospadias repair. J Pediatr urol. 2013; 9: 745-749.7. Yang T, Zou Y, Zhang L, Su C, Li Z, Wen Y. Byars two stage procedure for hypospadias after urethral plate transection. J Pediatr Urol. 2014; 10: 1133-1138.8. Van der Torn F, De Jong PVM, De Gier RPE, Callewaert PRH, Van der Horst HJR, Steffens MG, Hoebeke P, Nijman RJM. Introducing the HOPE (hypospadias objective penile evaluation)-score: A validation study of an objective scoring system for evaluation cosmetic appearance in hypospadias patients. J Pediatr Urol. 2013; 9: 1006-1017.9. AbouZeid AA. Modified Byars’ flaps for securing skin closure in proximal and mid-penile hypospadias. Ther Ad Urol. 2011; 3(6): 251-256.10. Asanuma H, Satoh H, Shishido S. Dorsal inlay graft urethroplasty for primary hypospadiac repair. Int J Urol 2007: 14; 43-47.11. Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology and technique. J Pediatr Surg. 2006. 41: 463-472.12. Samuel M, Capps S. Staged proximal hypospadias repair: Modified thiersch duplay with midline incision in urethral plate followed by Mathieu urethroplasty. J Pediatr Surg. 2002; 37(1): 104-107.13. Gozar H, Ardelean M, Gurzu S. One-stage proximal hypospadias using lateral penile flap-preliminary results in a single-center experience. Indian J Surg. 2014; 76(2): 171-173.14. Jayanthy VR. The modified Koyanagi hypospadias repair fort he one-stage repair of proximal hypospadias. Indian J Urol. 2008; 24: 206-209.15. Nerli RB, Guntaka AK, Patil RA, Patne PB. Dorsal inlay inner preputial graft primary hypospadias repair. Afr J Pediatr Surg. 2014; 11(2): 105-108.16. Ghanem MA, Nijman RJM. Outcome analysis of tubularized incised urethral plate using dorsal dartos flap for proximal penile hypospadias repair. 2010; J Pediatr Urol. 6: 477-480.17. Hadidi AT. Proximal hypospadias with small flat glans: the lateral-based onlay flap technique. J Pediatr Surg. 2010; 47: 2151-2157.18. Zheng DC, Yao HJ, Cai ZK, Da J, Chen Q, Chen YB, Zhang K, Xu MX. Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single- center experince. Asian J Androl. 2015; 17: 94-97.19. McNamara ER, Schaeffer AJ, Logvinenko T, Seager C, Rosoklija I, Nelson CP, Retik AB, Diamond DA. Management of proximal hypospadias with 2-stage repair: 20-year experience. J Urol. 2015; 194(4): 1080-1085.20. Ozcan R, Emre S, Kendigelen P, Eliçevik M, H Emir, Soylet Y, Buyukunal SN. Results of two-stage technique for treatment of proximal hypospadias with severe curvature: Creation of a urethral plate using a vascularized preputial ısland flap. J Urol. 2016; 13(2): 2629-2634.21. Johal NS, Nitkunan T, O’Malley K, Cuckow PM. The two-stage repair for severe primary hypospadias. Eur Urol. 2006; 50: 366-371.

PROKSİMAL HİPOSPADİASLI VE CİDDİ KORDİLİ ÇOCUKLARIN İKİ AŞAMALI AMELİYAT SONUÇLARININ HİPOSPADİAS OBJEKTİVE PENİL SKORLAMA (HOPS) İLE DEĞERLENDİRİLMESİ

Year 2019, Volume: 9 Issue: 4, 373 - 377, 31.12.2019
https://doi.org/10.16899/jcm.561241

Abstract

Abstract

Purpose

Surgical
management for the severe proximal hypospadias remains controversial and it
might be challenging. In this study,we evaluated the surgical outcome of
patients with proximal hypospadias managed by two staged repair with dorsal
prepucial flaps.

Patients and Methods

Forty
one boys with proximal hypospadias are enrolled
between
January 2006 and September 2016
. The location of the urethral meatus was at the penoscrotal junction
(PSH), at the scrotum (SH) or at the perineum (PRH). First stage; chordee was
released and the prepucial flaps were constructed. Second stage; urethroplasty
was performed according to Thiersch-Duplay principle.

We
assessed postoperative complication rates and utilized Hypospadias Objective
Penile Evaluation (HOPE) scoring to evaluate the cosmetic outcome.

Results

There
are a total of 41 boys (31 PSH(%76), 3 SH(%7) 
and 7 PRH(%17).
The mean age at first operation
was 15±5,3 months.
The
mean interval between the stages of the surgical procedures was
10.1±4.,9months.

Sixteen patients had various enzyme deficiency or
dysgenesis. In two patients, diverticulum is developed after the repair.
stenosis has encountered  in 10 patients
and fistula in 5. Two patients had dehiscence at glanular level. R
elation did not demonstrated 
between the severity of hypospadias and development of fistula,
stricture and diverticulum (p>0,05)
. HOPE scores; 9,4 for the position of the meatus, 5,8
for shape of the meatus, 7,2 for shape of the glans penis, 9,3 for penile
torsion and 9,8 penile curvature.

 Conclusion





















Incorporating
the  dorsal prepucial skin flaps in
staged procedures has both satisfactory cosmetic and functional success
rates. 





References

  • 1. Pohl HG, Atala A, Retik AB. 2-stage hypospadias repair: Histrocial perspectives and current practice. AUA update series. 2004; 23: 34-39.,Moursy EE. Outcome of proximal hypospadias repair using three different techniques. J Pediatr Urol. 2010; 6: 45-53.3. Saafan HA. Two stages repair of proximal hypospadias: review of 33 cases. Ann of pediatr surg. 2010; 6(2): 89-92.4. Ghali AMA. Hypospadias repair by skin flaps: a comparison of onlay preputial island flaps with either Mathieu’s meatal-based or Duccet’s tubularized flaps. BJU Int. 1999; 83: 1032-1038.5. Braga LHP, Salle JLP, Lorenzo AJ, Skeldon S, Dave S, Farhat WA, Khoury AE. Comparative analysis of tubularized incised plate versus onlay ısland flap urethroplasty for penoscrotal hypospadias. J Urol. 2007; 178: 1451-1457.6. Dahshoury el ZM, Gamal W, Hammady A, Hussein M, Salem E. Modified double face onlay island preputial skin flap with augmented glanuloplasty for hypospadias repair. J Pediatr urol. 2013; 9: 745-749.7. Yang T, Zou Y, Zhang L, Su C, Li Z, Wen Y. Byars two stage procedure for hypospadias after urethral plate transection. J Pediatr Urol. 2014; 10: 1133-1138.8. Van der Torn F, De Jong PVM, De Gier RPE, Callewaert PRH, Van der Horst HJR, Steffens MG, Hoebeke P, Nijman RJM. Introducing the HOPE (hypospadias objective penile evaluation)-score: A validation study of an objective scoring system for evaluation cosmetic appearance in hypospadias patients. J Pediatr Urol. 2013; 9: 1006-1017.9. AbouZeid AA. Modified Byars’ flaps for securing skin closure in proximal and mid-penile hypospadias. Ther Ad Urol. 2011; 3(6): 251-256.10. Asanuma H, Satoh H, Shishido S. Dorsal inlay graft urethroplasty for primary hypospadiac repair. Int J Urol 2007: 14; 43-47.11. Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology and technique. J Pediatr Surg. 2006. 41: 463-472.12. Samuel M, Capps S. Staged proximal hypospadias repair: Modified thiersch duplay with midline incision in urethral plate followed by Mathieu urethroplasty. J Pediatr Surg. 2002; 37(1): 104-107.13. Gozar H, Ardelean M, Gurzu S. One-stage proximal hypospadias using lateral penile flap-preliminary results in a single-center experience. Indian J Surg. 2014; 76(2): 171-173.14. Jayanthy VR. The modified Koyanagi hypospadias repair fort he one-stage repair of proximal hypospadias. Indian J Urol. 2008; 24: 206-209.15. Nerli RB, Guntaka AK, Patil RA, Patne PB. Dorsal inlay inner preputial graft primary hypospadias repair. Afr J Pediatr Surg. 2014; 11(2): 105-108.16. Ghanem MA, Nijman RJM. Outcome analysis of tubularized incised urethral plate using dorsal dartos flap for proximal penile hypospadias repair. 2010; J Pediatr Urol. 6: 477-480.17. Hadidi AT. Proximal hypospadias with small flat glans: the lateral-based onlay flap technique. J Pediatr Surg. 2010; 47: 2151-2157.18. Zheng DC, Yao HJ, Cai ZK, Da J, Chen Q, Chen YB, Zhang K, Xu MX. Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single- center experince. Asian J Androl. 2015; 17: 94-97.19. McNamara ER, Schaeffer AJ, Logvinenko T, Seager C, Rosoklija I, Nelson CP, Retik AB, Diamond DA. Management of proximal hypospadias with 2-stage repair: 20-year experience. J Urol. 2015; 194(4): 1080-1085.20. Ozcan R, Emre S, Kendigelen P, Eliçevik M, H Emir, Soylet Y, Buyukunal SN. Results of two-stage technique for treatment of proximal hypospadias with severe curvature: Creation of a urethral plate using a vascularized preputial ısland flap. J Urol. 2016; 13(2): 2629-2634.21. Johal NS, Nitkunan T, O’Malley K, Cuckow PM. The two-stage repair for severe primary hypospadias. Eur Urol. 2006; 50: 366-371.
There are 1 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Unal Bıcakcı 0000-0002-9604-4184

Yaşar Issı 0000-0002-2515-8483

Beytullah Yağız This is me 0000-0003-0882-1789

Berat Dilek Demirel 0000-0002-9358-0045

Publication Date December 31, 2019
Acceptance Date November 26, 2019
Published in Issue Year 2019 Volume: 9 Issue: 4

Cite

AMA Bıcakcı U, Issı Y, Yağız B, Demirel BD. PROKSİMAL HİPOSPADİASLI VE CİDDİ KORDİLİ ÇOCUKLARIN İKİ AŞAMALI AMELİYAT SONUÇLARININ HİPOSPADİAS OBJEKTİVE PENİL SKORLAMA (HOPS) İLE DEĞERLENDİRİLMESİ. J Contemp Med. December 2019;9(4):373-377. doi:10.16899/jcm.561241