Late chordee correction after tubularized incised plate repair for proximal hypospadias:An underreported problem

作     者：Amr Abdelhamid Abouzeid Mohammad Seada Mohamed Waly Amr Abdelhamid Abouzeid;Mohammad Seada;Mohamed Waly

作者机构：Department of Pediatric SurgeryAin Shams University Faculty of MedicineCairoEgypt Department of Pediatric SurgeryBenha Specialized Children HospitalBenhaEgypt 

出 版 物：《UroPrecision》 (精准泌尿学（英文）)

年 卷 期：2024年第2卷第2期

页      面：51-57页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：complications hypospadias proximal severe ventral curvature 

摘      要：Background:Repair of proximal hypospadias remains a challenge with no consensus on the best surgical *** reports have shown recurrence of chordee after plate-preserving *** this report,we present our experience in managing cases who presented with persistent/recurrence of chordee after tubularized incised plate(TIP)repair for proximal ***:Between 2015 and 2023,the study included eight patients who presented with ventral penile curvature after previous hypospadias repair in infancy(TIP urethroplasty).Reoperation to correct persistent ventral curvature was performed several years after the primary TIP repair(3-15 years;mean 7.9 years;median 7.5 years).The reoperation was a two-stage procedure:the first stage comprised transection of the urethra and grafting(lower lip mucosal graft);the second stage(6 months later)was a Thiersch-Duplay ***:Complications included poor taking of the graft after the first stage in one case(12.5%),which was regrafted using buccal(cheek)*** after second stage included urethro-cutaneous fistulae in five(62.5%)that were successfully surgically treated at a later ***-up after second stage ranged between 6 months and 7 years(mean 2.4 years;median 1 year).Satisfaction with reoperation to correct penile curvature was noted by parents as well as older children(adolescents)who appreciated better cosmesis by increasing ventral penile length and improved ***:Preservation of the urethral plate in proximal hypospadias may result in shortened penile length,mostly on the ventral aspect.A two-stage reoperation to increase the length of the penile urethra can successfully reverse this complication.