Eur J Pediatr Surg
DOI: 10.1055/s-0039-1688479
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Recurrent Ventral Curvature with Long-Term Follow-up after Transverse Preputial Island Urethroplasty

Chaoxu Wang
1  Department of Urology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China
,
Weiping Zhang
1  Department of Urology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China
,
Hongcheng Song
1  Department of Urology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China
› Author Affiliations
Funding This study was funded by the Beijing Municipal Administration of Hospitals “Dengfeng” Talent Training Plan (DFL20151102), Beijing Municipal Administration of Hospitals “Yangfan Plan”: Pediatric Urology (ZYLX201709), and Capital Development Fund of Health (2014-2-2093).
Further Information

Publication History

06 January 2019

21 March 2019

Publication Date:
12 May 2019 (eFirst)

Abstract

Objective This study was aimed to assess the long-term outcomes of recurrent ventral curvature (VC) repaired in early childhood after transverse preputial island flap urethroplasty.

Materials and Methods A total of 378 patients underwent transverse preputial island flap urethroplasty between January 2000 and January 2005 at our hospital. Of these patients, 43 were invited for assessment of VC after puberty. The age at surgery, types of hypospadias, degrees of recurrent VC, and surgical procedures were analyzed.

Results The study included 43 patients with a mean age of 15.9 years (range, 12.3–17.9). The average age at the time of primary surgery was 1.9 years (range, 1.2–3.6). Of 43 patients, recurrent VC was identified in 14 (32.5%). In total, 8 out of 16 patients (50.0%) were successfully treated by urethral plate transection with skin release during the primary surgery, and 6 out of 27 patients (28.6%) underwent additional dorsal plication (DP; p = 0.093). Severe recurrent VC was observed in four, moderate curvature was observed in four, and mild curvature was observed in six cases. Recurrent VC was present more often in patients with complications (34.6 vs. 24.1%, p = 0.331), especially in severe urethral strictures that required open surgical reconstruction (p = 0.039).

Conclusion Although the patients in our study represent only a small portion of the overall hypospadias population, it is notable that 32.5% of these patients showed recurrent VC, including 28.6% of patients with transection plus DP. We suggest long-term follow-up of hypospadias at least during adolescence or even into adulthood.