Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including significant scarring and paucity of genital skin. We report our experience in the management of failed hypospadias repairs at our centre. Materials & Methods: We retrospectively reviewed and analysed the inpatient and outpatient records of children/adolescents undergoing redo-hypospadias repairs during the period Jan 2010 to Dec 2019. Results: A total of 37 children with a mean age of 8.62±3.76 (2 – 17) years underwent a redo repair of hypospadias. Twenty children underwent two stage buccal mucosa urethroplasty, 11 underwent tubularized incised plate (TIP) urethroplasty, 5 dorsal inlay graft urethroplasty and 1 onlay flap urethroplasty. A total of three (8.10%) children developed an urethrocutaneous fistula needing an additional stage for repair. Uroflowmetry done in all children showed adequate maximum flow rates, with minimal to nil residuals. Conclusions: The majority of hypospadias failures can be salvaged with one stage surgery including Mathieu flip flap Urethroplasty, Tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty. A two stage buccal mucosa urethroplasty may be necessary in cases wherein the urethral plate or skin substitute is grossly scarred, or the ventral curvature greater than 30 degrees. Complications do occur following redo procedures but eventually excellent functional and cosmetic results can be achieved.
| Published in | International Journal of Clinical Urology (Volume 5, Issue 1) |
| DOI | 10.11648/j.ijcu.20210501.19 |
| Page(s) | 43-46 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Failed Hypospadias, Penile Stricture, Glans Dehiscence, Urethrocutaneous Fistula, Chordee
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APA Style
Shoubhik Chandra, Priyeshkumar Patel, Rajendra Nerli, Shridhar Ghagane, Neeraj Dixit. (2021). Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre. International Journal of Clinical Urology, 5(1), 43-46. https://doi.org/10.11648/j.ijcu.20210501.19
ACS Style
Shoubhik Chandra; Priyeshkumar Patel; Rajendra Nerli; Shridhar Ghagane; Neeraj Dixit. Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre. Int. J. Clin. Urol. 2021, 5(1), 43-46. doi: 10.11648/j.ijcu.20210501.19
AMA Style
Shoubhik Chandra, Priyeshkumar Patel, Rajendra Nerli, Shridhar Ghagane, Neeraj Dixit. Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre. Int J Clin Urol. 2021;5(1):43-46. doi: 10.11648/j.ijcu.20210501.19
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Download@article{10.11648/j.ijcu.20210501.19,
author = {Shoubhik Chandra and Priyeshkumar Patel and Rajendra Nerli and Shridhar Ghagane and Neeraj Dixit},
title = {Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre},
journal = {International Journal of Clinical Urology},
volume = {5},
number = {1},
pages = {43-46},
doi = {10.11648/j.ijcu.20210501.19},
url = {https://doi.org/10.11648/j.ijcu.20210501.19},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20210501.19},
abstract = {Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including significant scarring and paucity of genital skin. We report our experience in the management of failed hypospadias repairs at our centre. Materials & Methods: We retrospectively reviewed and analysed the inpatient and outpatient records of children/adolescents undergoing redo-hypospadias repairs during the period Jan 2010 to Dec 2019. Results: A total of 37 children with a mean age of 8.62±3.76 (2 – 17) years underwent a redo repair of hypospadias. Twenty children underwent two stage buccal mucosa urethroplasty, 11 underwent tubularized incised plate (TIP) urethroplasty, 5 dorsal inlay graft urethroplasty and 1 onlay flap urethroplasty. A total of three (8.10%) children developed an urethrocutaneous fistula needing an additional stage for repair. Uroflowmetry done in all children showed adequate maximum flow rates, with minimal to nil residuals. Conclusions: The majority of hypospadias failures can be salvaged with one stage surgery including Mathieu flip flap Urethroplasty, Tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty. A two stage buccal mucosa urethroplasty may be necessary in cases wherein the urethral plate or skin substitute is grossly scarred, or the ventral curvature greater than 30 degrees. Complications do occur following redo procedures but eventually excellent functional and cosmetic results can be achieved.},
year = {2021}
}
TY - JOUR T1 - Redo Hypospadias Repair: Our Experience in a Tertiary Care Centre AU - Shoubhik Chandra AU - Priyeshkumar Patel AU - Rajendra Nerli AU - Shridhar Ghagane AU - Neeraj Dixit Y1 - 2021/05/31 PY - 2021 N1 - https://doi.org/10.11648/j.ijcu.20210501.19 DO - 10.11648/j.ijcu.20210501.19 T2 - International Journal of Clinical Urology JF - International Journal of Clinical Urology JO - International Journal of Clinical Urology SP - 43 EP - 46 PB - Science Publishing Group SN - 2640-1355 UR - https://doi.org/10.11648/j.ijcu.20210501.19 AB - Introduction: Treating children following a failed hypospadias repair can be challenging. Complications include urethrocutaneous fistulas, glans dehiscence, meatal stenosis and urethral strictures. Glans dehiscence remains the most common indication for re-operative urethroplasty. The repair can be challenging because of several factors including significant scarring and paucity of genital skin. We report our experience in the management of failed hypospadias repairs at our centre. Materials & Methods: We retrospectively reviewed and analysed the inpatient and outpatient records of children/adolescents undergoing redo-hypospadias repairs during the period Jan 2010 to Dec 2019. Results: A total of 37 children with a mean age of 8.62±3.76 (2 – 17) years underwent a redo repair of hypospadias. Twenty children underwent two stage buccal mucosa urethroplasty, 11 underwent tubularized incised plate (TIP) urethroplasty, 5 dorsal inlay graft urethroplasty and 1 onlay flap urethroplasty. A total of three (8.10%) children developed an urethrocutaneous fistula needing an additional stage for repair. Uroflowmetry done in all children showed adequate maximum flow rates, with minimal to nil residuals. Conclusions: The majority of hypospadias failures can be salvaged with one stage surgery including Mathieu flip flap Urethroplasty, Tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty. A two stage buccal mucosa urethroplasty may be necessary in cases wherein the urethral plate or skin substitute is grossly scarred, or the ventral curvature greater than 30 degrees. Complications do occur following redo procedures but eventually excellent functional and cosmetic results can be achieved. VL - 5 IS - 1 ER -
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