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One-stage hypospadias repair
88
ABSTRACTS
MickeZson. J. gust),
Urol.
104:342-345
(Au-
1970.
A method of selection is described, based on 385 vesicoureteroplasty procedures, designed to determine which cases of minimal vesicoureteral reflux require surgical management. It is based on a scoring system in which the clinical cause of infection, degree of reflux, status of upper tract and anatomic abnormalities are evaluated. Each factor is quantitated on the basis of zero to 4 plus (zero being normal). If the sum of these variants is more than 4 plus, operative correction is indicated. The clinical cause of infection is documented by frequency, duration’and severity. Degree of reflux is based on standard cystography and the status of the upper tracts is defined by an IVP. The presence of anatomic abnormalities can be defined by the Xray findings and by endoscopy.-B. M. He&&on. NORMAL EJACULATIONAFTER Y-V URETHROPLASTY. M. Koraitum and M. Al-Ghorab. Brit. J. Urol. 42:484+465
(August),
1970.
Forty-three men who had had Y-V plasty of the bladder neck were followed up. None of them had retrograde ejaculation of semen. -I.
H. Johnston.
ONE-STAGE HYPOSPADIAS REPAIR. R. Barnes and D. Furnus. J. Urol. 104:277-280 (August),
1970.
Three methods of one-stage hypospadias repair are described. The first is a double bipedicle flap procedure applicable to cases in which the meatus is in the distal half of the phallus. It involves the use of a buried strip of skin which is attached to the flap rather
than
to the phallus
and removal
of
the ventral chordee. A urethral catheter is left in place following the operation for 3 to 4 days. The authors had performed this procedure on 4 occasions and one patient developed a small fistula. As this operation tends to pull the penis toward the scrotum a z-plasty may later be required to correct this deformity. The second operation involves an extended biiid skin strip and is used when the meatus is proximal to the mid point of the phallus. A strip of skin is obtained from the ventrum of the phallus, from the meatus proximally and extended around the corona. This is mobilized and the
chordee excised leaving a pedicle attachment on the ventral surface. The biiid distal ends are then sutured together and brought ventrally where their distal ends are sutured to the denuded ventral surface of the phallus up to the glans. The skin strip is then covered by undermining the skin at the sides. The third method used was a free tube graft from the prepuce. Perineal urethrostomy with suprapubic cystostomy was used to divert the urine in those cases in which a free graft tube or an extended b&d skin strip was used. The main factors leading to a successful procedure included complete hemostasis, obliteration of dead space, accurate approximation of skin edges and the avoiding of tension on skin flaps-B. M.
Henderson. A ONE-STAGE HYPOSPADIAS REPAIR. N. B. Hodgson. J. Urol. H&281-283 (August), 1970. This method was used in 51 patients and included correction of chordee with construction of a new urethra. It has been used in the correction of hypospadias beyond the penoscrotal junction. Four urethrocutaneous fistulas and three meatal stenoses have occurred in this group of patients requiring a second operation. The repair requires the construction of an epithelial tube from the dorsal hood which is then swung down, still attached to the prepuce to bridge the gap between the urethral opening and the glans penis. The technique is described in detail with diagrams-B. M. Henderson. DIPHALLIA. A. Savir, A. Lurie and J. Laze-
brick. Brit. J. Urol. 42:498-500
(August),
1970. The case is reported of a 3I-year-old man with double penis. One phallus was in the midline, was of normal length and shape and had a normal urethra. The other lay to the left and the urethra was epispadiac. The patient micturated through both urethrae and had full urinary control. The pubic bones were widely separated. The bladder was large but single. The patient was married with one child. He used only the midline phallus for intercourse. Ejaculation took place simultaneously in the two phalli.-I. H.
Johnston. PoLvoncmsM
Wrrrr
ANohfA~0~s
UKI~ENI-
ABSTRACTS
MickeZson. J. gust),
Urol.
104:342-345
(Au-
1970.
A method of selection is described, based on 385 vesicoureteroplasty procedures, designed to determine which cases of minimal vesicoureteral reflux require surgical management. It is based on a scoring system in which the clinical cause of infection, degree of reflux, status of upper tract and anatomic abnormalities are evaluated. Each factor is quantitated on the basis of zero to 4 plus (zero being normal). If the sum of these variants is more than 4 plus, operative correction is indicated. The clinical cause of infection is documented by frequency, duration’and severity. Degree of reflux is based on standard cystography and the status of the upper tracts is defined by an IVP. The presence of anatomic abnormalities can be defined by the Xray findings and by endoscopy.-B. M. He&&on. NORMAL EJACULATIONAFTER Y-V URETHROPLASTY. M. Koraitum and M. Al-Ghorab. Brit. J. Urol. 42:484+465
(August),
1970.
Forty-three men who had had Y-V plasty of the bladder neck were followed up. None of them had retrograde ejaculation of semen. -I.
H. Johnston.
ONE-STAGE HYPOSPADIAS REPAIR. R. Barnes and D. Furnus. J. Urol. 104:277-280 (August),
1970.
Three methods of one-stage hypospadias repair are described. The first is a double bipedicle flap procedure applicable to cases in which the meatus is in the distal half of the phallus. It involves the use of a buried strip of skin which is attached to the flap rather
than
to the phallus
and removal
of
the ventral chordee. A urethral catheter is left in place following the operation for 3 to 4 days. The authors had performed this procedure on 4 occasions and one patient developed a small fistula. As this operation tends to pull the penis toward the scrotum a z-plasty may later be required to correct this deformity. The second operation involves an extended biiid skin strip and is used when the meatus is proximal to the mid point of the phallus. A strip of skin is obtained from the ventrum of the phallus, from the meatus proximally and extended around the corona. This is mobilized and the
chordee excised leaving a pedicle attachment on the ventral surface. The biiid distal ends are then sutured together and brought ventrally where their distal ends are sutured to the denuded ventral surface of the phallus up to the glans. The skin strip is then covered by undermining the skin at the sides. The third method used was a free tube graft from the prepuce. Perineal urethrostomy with suprapubic cystostomy was used to divert the urine in those cases in which a free graft tube or an extended b&d skin strip was used. The main factors leading to a successful procedure included complete hemostasis, obliteration of dead space, accurate approximation of skin edges and the avoiding of tension on skin flaps-B. M.
Henderson. A ONE-STAGE HYPOSPADIAS REPAIR. N. B. Hodgson. J. Urol. H&281-283 (August), 1970. This method was used in 51 patients and included correction of chordee with construction of a new urethra. It has been used in the correction of hypospadias beyond the penoscrotal junction. Four urethrocutaneous fistulas and three meatal stenoses have occurred in this group of patients requiring a second operation. The repair requires the construction of an epithelial tube from the dorsal hood which is then swung down, still attached to the prepuce to bridge the gap between the urethral opening and the glans penis. The technique is described in detail with diagrams-B. M. Henderson. DIPHALLIA. A. Savir, A. Lurie and J. Laze-
brick. Brit. J. Urol. 42:498-500
(August),
1970. The case is reported of a 3I-year-old man with double penis. One phallus was in the midline, was of normal length and shape and had a normal urethra. The other lay to the left and the urethra was epispadiac. The patient micturated through both urethrae and had full urinary control. The pubic bones were widely separated. The bladder was large but single. The patient was married with one child. He used only the midline phallus for intercourse. Ejaculation took place simultaneously in the two phalli.-I. H.
Johnston. PoLvoncmsM
Wrrrr
ANohfA~0~s
UKI~ENI-