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HİPOSPADİAS TÜBÜLARİZASYONUNDA KULLANILAN ÇİFT VERTİKAL İNSİZYON HANGİ DERİNLİKTE OLMALIDIR?

Year 2009, Volume: 10 Issue: 1, 23 - 27, 01.04.2009

Abstract

AMAÇ:Tübülarizasyon, özellikle hipospadias olmak üzere lümen gerektiren organların cerrahisinde kullanılantekniklerden biridir. Bu çalışmada çift vertikal insizyon ile oluşturulan tüplerde insizyon derinliğinin yaraiyileşmesi ve lümen genişliğine olan etkileri araştırılmıştır.GEREÇ veYÖNTEMLER:Yedi adet New Zealand tavşanda her bir tavşan üzerinde 3 adet derin 3 adet yüzeyelçift vertikal insizyon içeren toplam 42 adet tüp oluşturduk. Postoperatif 3., 5. ve 21. günlerde her bir tavşandan biryüzeyel, bir derin insizyonla yapılan tüp olmak üzere ikişer adet tüp çıkarıldı. Tüpler hematoxylin-eosin veMasson's trichrome ile boyandı ve inflamasyon, fibrozis ve lümen çapları açısından incelendi. Gruplar arasıparametrelerin karşılaştırılması için Mann-Whitney tek yönlü varyans analizi ve Kruskal-Wallis testi kullanıldı.İstatistiksel anlamlılık için P0.05)SONUÇ:Çalışmamızda derin insizyon ile yüzeyel insizyon arasında histopatolojik incelemede ve lümençaplarının değerlendirilmesinde anlamlı fark olmaması, aynı lümen genişliğine yüzeyel çift vertikal insizyon ileulaşılabilmesi çift vertikal yüzeyel insizyon ile tübülarizasyonun uygulanabilir bir teknik olduğunu göstermektedir

References

  • 1. BelmanAB. Hypospadias and chordee. In: BelmanAB, King LR, Kramer SA, editors. Clinical pediatric urology, 4th edition, London: Martin Dunitz, 2002: 1061-1092.
  • 2. Ehrlich RM, Alter GJ: Reconstructive and plastic surgery of the external genitalia. Philadelphia, Saunders, 1999:14-22.
  • 3. Snodgrass WT. Tubularized incised plate hypospadias repair: indications, technique, and complications. Urology. 1999;54(1):6-11.
  • 4. Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 2006;41(3):463-72.
  • 5. Borer JG, Bauer SB, Peters CA, Diamond DA, Atala A, Cilento BG Jr, Retik AB. Tubularized incised plate urethroplasty: expanded use in primary and repeat surgery for hypospadias. J Urol 2001;165(2):581-5.
  • 6. Stein R, Schröder A, Thüroff JW. Use of buccal mucosa in urethral surgery. Urologe A 2007;46(12):1657-63.
  • 7. Barbagli G, Morgia G, Lazzeri M. Retrospective outcome analysis of one-stage penile urethroplasty using a flap or graft in a homogeneous series of patients. BJU Int 2008;102(7):853-60.
  • 8. Aminsharifi A, Taddayun A, Assadolahpoor A, Khezri A. Combined use of Mathieu procedure with plate incision for hypospadias repair: a randomized clinical trial.Urology2008;72(2):305-8.
  • 9. Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994;151(2):464-5.
  • 10. Yazici M, Copcu E, Etensel B, Culhaci N, Balkaya M, Ozkisacik S, Gursoy H. Comparison of double vertical incision with various tubularization techniques and its clinical application. Urol Int 2003;71(3):299-305.
  • 11. Kolon TF, Gonzales ET Jr. The dorsal inlay graft for hypospadias repair. J Urol 2000;163(6):1941-3.
  • 12. Steckler RE, Zaontz MR. Stent-free Thiersch-Duplay hypospadias repair with the Snodgrass modification. J Urol 1997;158(3 Pt 2):1178-80.
  • 13. Rich MA, Keating MA, Snyder HM, Duckett JW. Hinging the urethral plate in hypospadias meatoplasty. J Urol 1989 Dec;142(6):1551-3.
  • 14. Retik AB, Borer JG. Primary and reoperative hypospadias repair with the Snodgrass technique. World J Urol 1998;16(3):186-91.
  • 15. Elicevik M, Tireli G, Sander S. Tubularized incised plate urethroplasty: 5 years' experience. Eur Urol 2004;46(5):655-9.
  • 16. Snodgrass W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair: results of a multicenter experience. J Urol 1996156(2 Pt 2):839-41.
  • 17. Stehr M, Lehner M, Schuster T, Heinrich M, Dietz HG. Tubularized incised plate (TIP) urethroplasty (Snodgrass) in primary hypospadias repair. Eur J Pediatr Surg 2005;15(6):420-4.
  • 18. Mustafa M. The concept of tubularized incised plate hypospadias repair for different types of hypospadias. Int Urol Nephrol 2005;37(1):89-91.
  • 19. Anwar-ul-Haq, Bader I, Akhter N, Abbasi Z. Tubularized incised plate urethroplasty of hypospadias. J Coll Physicians Surg Pak 2004;14(8):489-91.
  • 20. Snodgrass W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair for proximal hypospadias. J Urol 1998;159(6):2129-31.
  • 21. Luo CC, Lin JN. Repair of hypospadias complications using the tubularized, incised plate urethroplasty. J Pediatr Surg 1999;34(11):1665-7.
  • 22. DiSandro M, Palmer JM. Stricture incidence related to suture material in hypospadias surgery. J Pediatr Surg 1996;31(7):881-4.
  • 23. Retik AB, Keating M, Mandell J. Complications of hypospadias repair. Urol Clin North Am 1988;15(2):223-36.
  • 24. Snodgrass W. Does tubularized incised plate hypospadias repair create neourethral strictures? J Urol1999;162(3 Pt 2):1159-61.
  • 25. Bleustein CB, Esposito MP, Soslow RA, Felsen D, Poppas DP. Mechanism of healing following the Snodgrass repair. J Urol 2001;165(1):277-9.
  • 26. Lopes JF, Schned A, Ellsworth PI, Cendron M. Histological analysis of urethral healing after tubularized incised plate urethroplasty. J Urol 2001;166(3):1014-7.
  • 27. Scherz HC, Kaplan GW, Boychuk DI, Landa HM, Haghighi P. Urethral healing in rabbits. J Urol 1992;148(2 Pt 2):708-10.

How Deep Should The Double Vertical Incision Used In Tubularization For Hypospadias Be?

Year 2009, Volume: 10 Issue: 1, 23 - 27, 01.04.2009

Abstract

OBJECTIVE: Tubularization is one of the techniques used in surgery of luminal organs and especially for hypospadias. In this study, the effects of incision depth on wound healing and luminal dimensions were investigated. MATERIALand METHODS: Seven New Zealand rabbits were used. On the skin of each rabbit, 6 tubes were constructed (3 were with deep incision and 3 were superficial) with a total of 42 for the experiment. On postoperative days 3, 5 and 21, one tube with deep incision and one with superficial incision were removed from the each rabbit. The tubes were stained with hematoxylin-eosine and Masson's trichrome dyes. They were examined for inflammation, fibrosis and luminal diameters. Mann-Whitney U variance analysis and Kruskal- Wallis tests were used for statistical analysis. P0.05). CONCLUSION: Since there is no significant difference for histopathological examination and luminal diameter between groups with deep and superficial vertical incisions, and to be able to achieve similar luminal diameters with double superficial vertical incisions, tubularization with double superficial vertical incisions is suggested to be applicable to hypospadias surgery.

References

  • 1. BelmanAB. Hypospadias and chordee. In: BelmanAB, King LR, Kramer SA, editors. Clinical pediatric urology, 4th edition, London: Martin Dunitz, 2002: 1061-1092.
  • 2. Ehrlich RM, Alter GJ: Reconstructive and plastic surgery of the external genitalia. Philadelphia, Saunders, 1999:14-22.
  • 3. Snodgrass WT. Tubularized incised plate hypospadias repair: indications, technique, and complications. Urology. 1999;54(1):6-11.
  • 4. Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 2006;41(3):463-72.
  • 5. Borer JG, Bauer SB, Peters CA, Diamond DA, Atala A, Cilento BG Jr, Retik AB. Tubularized incised plate urethroplasty: expanded use in primary and repeat surgery for hypospadias. J Urol 2001;165(2):581-5.
  • 6. Stein R, Schröder A, Thüroff JW. Use of buccal mucosa in urethral surgery. Urologe A 2007;46(12):1657-63.
  • 7. Barbagli G, Morgia G, Lazzeri M. Retrospective outcome analysis of one-stage penile urethroplasty using a flap or graft in a homogeneous series of patients. BJU Int 2008;102(7):853-60.
  • 8. Aminsharifi A, Taddayun A, Assadolahpoor A, Khezri A. Combined use of Mathieu procedure with plate incision for hypospadias repair: a randomized clinical trial.Urology2008;72(2):305-8.
  • 9. Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994;151(2):464-5.
  • 10. Yazici M, Copcu E, Etensel B, Culhaci N, Balkaya M, Ozkisacik S, Gursoy H. Comparison of double vertical incision with various tubularization techniques and its clinical application. Urol Int 2003;71(3):299-305.
  • 11. Kolon TF, Gonzales ET Jr. The dorsal inlay graft for hypospadias repair. J Urol 2000;163(6):1941-3.
  • 12. Steckler RE, Zaontz MR. Stent-free Thiersch-Duplay hypospadias repair with the Snodgrass modification. J Urol 1997;158(3 Pt 2):1178-80.
  • 13. Rich MA, Keating MA, Snyder HM, Duckett JW. Hinging the urethral plate in hypospadias meatoplasty. J Urol 1989 Dec;142(6):1551-3.
  • 14. Retik AB, Borer JG. Primary and reoperative hypospadias repair with the Snodgrass technique. World J Urol 1998;16(3):186-91.
  • 15. Elicevik M, Tireli G, Sander S. Tubularized incised plate urethroplasty: 5 years' experience. Eur Urol 2004;46(5):655-9.
  • 16. Snodgrass W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair: results of a multicenter experience. J Urol 1996156(2 Pt 2):839-41.
  • 17. Stehr M, Lehner M, Schuster T, Heinrich M, Dietz HG. Tubularized incised plate (TIP) urethroplasty (Snodgrass) in primary hypospadias repair. Eur J Pediatr Surg 2005;15(6):420-4.
  • 18. Mustafa M. The concept of tubularized incised plate hypospadias repair for different types of hypospadias. Int Urol Nephrol 2005;37(1):89-91.
  • 19. Anwar-ul-Haq, Bader I, Akhter N, Abbasi Z. Tubularized incised plate urethroplasty of hypospadias. J Coll Physicians Surg Pak 2004;14(8):489-91.
  • 20. Snodgrass W, Koyle M, Manzoni G, Hurwitz R, Caldamone A, Ehrlich R. Tubularized incised plate hypospadias repair for proximal hypospadias. J Urol 1998;159(6):2129-31.
  • 21. Luo CC, Lin JN. Repair of hypospadias complications using the tubularized, incised plate urethroplasty. J Pediatr Surg 1999;34(11):1665-7.
  • 22. DiSandro M, Palmer JM. Stricture incidence related to suture material in hypospadias surgery. J Pediatr Surg 1996;31(7):881-4.
  • 23. Retik AB, Keating M, Mandell J. Complications of hypospadias repair. Urol Clin North Am 1988;15(2):223-36.
  • 24. Snodgrass W. Does tubularized incised plate hypospadias repair create neourethral strictures? J Urol1999;162(3 Pt 2):1159-61.
  • 25. Bleustein CB, Esposito MP, Soslow RA, Felsen D, Poppas DP. Mechanism of healing following the Snodgrass repair. J Urol 2001;165(1):277-9.
  • 26. Lopes JF, Schned A, Ellsworth PI, Cendron M. Histological analysis of urethral healing after tubularized incised plate urethroplasty. J Urol 2001;166(3):1014-7.
  • 27. Scherz HC, Kaplan GW, Boychuk DI, Landa HM, Haghighi P. Urethral healing in rabbits. J Urol 1992;148(2 Pt 2):708-10.
There are 27 citations in total.

Details

Other ID JA47BH84NG
Journal Section Research Article
Authors

Sezen Özkısacık This is me

Mesut Yazıcı This is me

Onur Öztan This is me

Nil Çulhacı This is me

Harun Gürsoy This is me

Publication Date April 1, 2009
Published in Issue Year 2009 Volume: 10 Issue: 1

Cite

EndNote Özkısacık S, Yazıcı M, Öztan O, Çulhacı N, Gürsoy H (April 1, 2009) How Deep Should The Double Vertical Incision Used In Tubularization For Hypospadias Be?. Meandros Medical And Dental Journal 10 1 23–27.