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416 One stage lingual augmented urethroplasty in repair of distal penile hypospadias
416
One stage lingual augmented urethroplasty in repair of distal penile hypospadias Eur Urol Suppl 2013;12;e416
Elsayed E.R., Eliwa A.M., Teelab A.A., Dawood T., Omran M., Elbendary L., Khalil S. Zagazig University, Dept. of Urology, Zagazig, Egypt INTRODUCTION & OBJECTIVES: Our aim was to evaluate the results of augmentation of shallow urethral plate by lingual graft in repair of distal penile hypospadias. MATERIAL & METHODS: Between June 2008 and May 2011, the procedure was performed by two surgeons on 23 patients with mean age 2.3 years (range 1-3). The urethral plate was shallow less than 8 mm in all patients. Of all repairs, 11 were sub coronal and 12 were coronal. Of the patients, three had history of previous hypospadias surgery. All procedures were carried out under general anesthesia using 4X magnifying loupe. After penile degloving and dorsal incision of the urethral plate, the lingual graft was harvested and sutured to the edges of the incised urethral plate from the hypospadias opening to the tip of the penis. The neourethra was closed and an intervening flap was fixed over the neourethra as a barrier against fistula formation. RESULTS: None of patients suffered meatal stenosis or required regular urethral dilatation. Of the patients, three patients developed urethrocutaneous fistula, of which two closed spontaneously and one required surgical repair 6 months later. Delayed re-intervention was performed in two patients, in one patient due to complete loss of the graft and another due to repair disruption following infection. Two patients had post-operative pain and discomfort in the graft harvesting site which disappeared within days. CONCLUSIONS: The one stage lingual augmented urethral plate urethroplasty offers promising results for repair of distal penile hypospadias with shallow urethral plate.
One stage lingual augmented urethroplasty in repair of distal penile hypospadias Eur Urol Suppl 2013;12;e416
Elsayed E.R., Eliwa A.M., Teelab A.A., Dawood T., Omran M., Elbendary L., Khalil S. Zagazig University, Dept. of Urology, Zagazig, Egypt INTRODUCTION & OBJECTIVES: Our aim was to evaluate the results of augmentation of shallow urethral plate by lingual graft in repair of distal penile hypospadias. MATERIAL & METHODS: Between June 2008 and May 2011, the procedure was performed by two surgeons on 23 patients with mean age 2.3 years (range 1-3). The urethral plate was shallow less than 8 mm in all patients. Of all repairs, 11 were sub coronal and 12 were coronal. Of the patients, three had history of previous hypospadias surgery. All procedures were carried out under general anesthesia using 4X magnifying loupe. After penile degloving and dorsal incision of the urethral plate, the lingual graft was harvested and sutured to the edges of the incised urethral plate from the hypospadias opening to the tip of the penis. The neourethra was closed and an intervening flap was fixed over the neourethra as a barrier against fistula formation. RESULTS: None of patients suffered meatal stenosis or required regular urethral dilatation. Of the patients, three patients developed urethrocutaneous fistula, of which two closed spontaneously and one required surgical repair 6 months later. Delayed re-intervention was performed in two patients, in one patient due to complete loss of the graft and another due to repair disruption following infection. Two patients had post-operative pain and discomfort in the graft harvesting site which disappeared within days. CONCLUSIONS: The one stage lingual augmented urethral plate urethroplasty offers promising results for repair of distal penile hypospadias with shallow urethral plate.