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Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection： a single-center experience

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Asian Journal of Andrology 2015年第1期17卷 94-97,I0009页

作者： Da-Chao Zheng Hai-Jun Yao Zhi-Kang Cai Jun Da Qi Chen Yan-Bo Chen Ke Zhang Ming-Xi Xu Mu-Jun Lu Zhong Wang Department of Urology Shanghai 9th People's Hospital Shanghai Jiaotong University School of Medicine Shanghai 200011 China.

It is still debatable whether single- or two-stage urethroplasty is a more suitable technique for treating hypospadias with severe chordee after urethral plate transection. This retrospective study evaluated these two techniques. A total of 66 patients of proximal hypospadias with severe chordee were divided into two groups according to the techniques they underwent： 32 and 34 patients underwent single-stage （Duckett） or two-stage urethroplasty, respectively. Median ages at presentation were 7.5 years and 11.0 years in single-stage and two-stage repair groups, respectively. Median follow-ups were 28.5 months （20-60 months） and 35 months （18-60 months） in the single-stage and two-stage groups, respectively. The meatus of the neourethra was located at the top of the glans in all patients. No recurrence of chordee was found during follow-up, and all patients or parents were satisfied with the penile length and appearance. Complications were encountered in eight patients in both groups, with no statistically significant differences between the two techniques. The late complication rate of stricture was higher after the single-stage procedure （18.75% vs 0%）. The complication rate after single-stage repairs was significantly lower in the prepubescent subgroup （10.52%） than in the postpubescent cohort （46.15%）. These results indicate that the urethral plate transection effectively corrects severe chordee associated with proximal hypospadias during the intermediate follow-up period. Considering the higher rate of stricture after single-stage urethroplasty, two-stage urethroplasty is recommended for proximal hypospadias with severe chordee after urethral plate transection.

关键词： chordee proximal hypospadias single-stage urethroplasty two-stage urethroplasty

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Comparison of outcomes in three surgical techniques for proximal hypospadias:staged transverse preputial island flap urethroplasty versus single-stage repairs

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Asian Journal of Andrology 2023年第5期25卷 616-620页

作者： Yu-Si Wang Hong-Chengg Song Pei Liu Yi-Wei Fang Wei-Ping Zhang Department of Urology Beijing Children's Hospital Affiliated to Capital Medical UniversityNational Center for Children's HealthBeijing 100045China

To evaluate and compare the outcomes and complications of three different surgical techniques for treating primary proximal hypospadias with ventral curvature(VC)≥30°,we retrospectively reviewed the medical records of patients who underwent primary repair of proximal hypospadias with vC≥30°after degloving at Beijing Children's Hospital Affiliated to Capital Medical University(Beijing,China)from January 2019 to January 2021.A total of 152 patients were divided into three groups:transverse preputial island flap(TPIF)combined with Duplay,modified Koyanagi,and staged TPIF,which were performed on 55,16,and 81 patients,respectively.A total of 39(25.7%)patients had *** rates were similar for the TPIF combined with the Duplay group(40.0%)and modified Koyanagi group(50.0%)but lower for the staged TPIF group(11.1%;P<0.01).The incidence of urethrocutaneous fistulas was significantly higher in TPIF combined with Duplay group(21.8%)compared to staged TPIF group(4.9%;P=0.01).In univariate analysis,the length of the urethral defect was the single factor that could predict complications;the cutoff was 4.55 *** patients in the long urethral defect group than in the short one had complications(34.1%vs 15.7%,P=O.O1).These results indicate that staged TPIF produced a better outcome,whereas more patients in the TPIF combined with Duplay group presented with two or more complications.

关键词： complications proximal hypospadias ventral curvature

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