CC BY-NC 4.0 · Arch Plast Surg 2013; 40(06): 766-772
DOI: 10.5999/aps.2013.40.6.766
Original Article

Correction of Problematic Hypospadias with Dartos Fascia-Reinforced Flap and Slanted Incision of Fistula

Dong Sik Choi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Korea
,
Jeong Woo Lee
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Korea
,
Jung Dug Yang
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Korea
,
Ho Yun Chung
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Korea
,
Byung Chae Cho
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Korea
,
Jin Suk Byun
BS Aesthetic Clinic, Daegu, Korea
,
Kang Young Choi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyungpook National University, Daegu, Korea
› Institutsangaben

Background Hypospadias is the most common congenital malformation of the male urinary tract, wherein the urethral opening is located proximal to the normal site. Tubularized incised-plate urethroplasty reconstruction, and its efficacy, remains controversial due to the high recurrence rate. This study aimed to evaluate the results of dartos fascia-reinforced flap surgery in hypospadias patients with previous operative complications.

Methods Nine patients (mean age, 12 years) who had previous one- or two-stage repair with TIP urethroplasty and suffered from urethrocutaneous fistulas or fissures as complications, underwent dartos fascia-reinforced flap surgery in our clinic between January 2010 and December 2012. The mean postoperative follow-up period was 6 months.

Results Among the 9 patients, 7 had complete correction. In all the patients, the maximum uroflow angle was >45°. No patient complained of an unnatural urinating position. The patients and parents gave very high satisfaction scores (4.7 points) with regard to the appearance of the outer genitalia.

Conclusion The dartos fascia-reinforced flap could be a useful and reliable option for complications of hypospadias repair or fissure with the prepuce preserved, given that histological aspects vary and that the possibility of recurrence in the glanular region is high.



Publikationsverlauf

Eingereicht: 18. Juni 2013

Angenommen: 02. September 2013

Artikel online veröffentlicht:
01. Mai 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 2006; 41: 463-472
  • 2 Paulozzi LJ, Erickson JD, Jackson RJ. Hypospadias trends in two US surveillance systems. Pediatrics 1997; 100: 831-834
  • 3 Gallentine ML, Morey AF, Thompson Jr IM. Hypospadias: a contemporary epidemiologic assessment. Urology 2001; 57: 788-790
  • 4 Baran CN, Tiftikcioglu YO, Ozdemir R. et al. What is new in the treatment of hypospadias?. Plast Reconstr Surg 2004; 114: 743-752
  • 5 Barbagli G, De Angelis M, Palminteri E. et al. Failed hypospadias repair presenting in adults. Eur Urol 2006; 49: 887-894
  • 6 Ha HK, Lee SD. Outcome and risk factors of tubularized incised plate urethroplasty in patients with reoperative hypospadias repairs. Korean J Urol 2009; 50: 67-71
  • 7 Abdel-Hamid Mohamid El-Hawy M. Minimal modifications could decrease fistula rate during tubularized incised plate procedure in distal hypospadias repair. J Pediatr Urol. 01.11.2012. [Epub]. https://dx.doi.org/10.1016/j.jpurol.2012.10.008
  • 8 Korean Urological Association. Urology. 3rd ed. Seoul: Korea Publisher; 2001
  • 9 Yoo C, Moon K, Kim KS. The individualized surgical approach of penoscrotal transposition according to the anatomical position of the penis. Korean J Urol 2006; 47: 287-292
  • 10 Kim MK, Kim YG. Hypospadias repair: recent concept and development in surgical techniques. Korean J Urol 2008; 49: 1059-1066
  • 11 Snodgrass WT, Bush N, Cost N. Tubularized incised plate hypospadias repair for distal hypospadias. J Pediatr Urol 2010; 6: 408-413
  • 12 Borer JG, Bauer SB, Peters CA. et al. Tubularized incised plate urethroplasty: expanded use in primary and repeat surgery for hypospadias. J Urol 2001; 165: 581-585
  • 13 Chon WH, Bang SI, Lee SD. Ten-year experience of adult hypospadias repairs at a single center. Korean J Urol 2008; 49: 1144-1148
  • 14 Manzoni G, Bracka A, Palminteri E. et al. Hypospadias surgery: when, what and by whom?. BJU Int 2004; 94: 1188-1195