Abstract
ABSTRACTPurpose:Spongioplasty (mobilization and midline approximation of the two branches of the bifid dysplastic distal corpus spongiosum) can form a covering layer for the neourethra to prevent urethrocutaneous fistula in hypospadias repair surgery. However, it remains unclear whether spongioplasty affects neourethral function. The objective of this study was to compare neourethral function after hypospadias repair with and without spongioplasty.Materials and Methods:Fourteen congenital hypospadiac New Zealand male rabbits were randomly allocated into two groups, seven animals underwent Duplay hypospadias repair and spongioplasty (experimental group), while seven underwent Duplay surgery alone (control group). Functional differences between groups were assessed by comparing neourethral compliance and flow rate. Two months after surgery, in vivo neourethral compliance was assessed by measuring intraluminal pressure with a digital pressure meter of an isolated neourethral segment, following progressive distension with 1, 2, and 3mL of air. Penises were harvested for uroflowmetry test using a simple device.Results:Postoperatively, fistula developed in one and zero rabbits in the control and experimental groups, respectively. Mean pressures tended to be higher in the experimental group than in the control group (82.14 vs. 69.57, 188.43 vs. 143.26, and 244.71 vs. 186.29mmHg for 1, 2, and 3mL of air, respectively), but the difference was not statistically significant. Mean flow rates also did not significantly differ between the experimental and control groups (2.93mL/s vs. 3.31mL/s).Conclusion:In this congenital rabbit model, no obvious functional differences were found between reconstructed urethras after hypospadias repair with and without spongioplasty.
Highlights
Urethrocutaneous fistula is one of the most common complications following hypospadias repair
A simple and effective method has been reported in a rabbit model by Jesus et al, this method measures neourethral compliance based on the intraluminal pressure of an isolated neourethral segment following progressive distension with air using a tensiometer [6]
The development of the rabbit penis and urethra are homologous to those processes in humans, and rabbit hypospadias can be induced by 5ɑ-reductase inhibitors [7], in the present study, we evaluated neourethral function following hypospadias repair with and without spongioplasty in a rabbit model of congenital hypospadias
Summary
Urethrocutaneous fistula is one of the most common complications following hypospadias repair. Fibrous tissues located on both sides of the urethral plate are known as two branches of the bifid dysplastic corpus spongiosum (in some patients they may persist as healthy, well formed pillars of erectile tissues), in recent years, the use of these tissues in spongioplasty, covering the neourethra alone or with the aid of other tissue layers, has been shown to satisfactorily reduce the fistula rate [1,2,3,4,5]. The development of the rabbit penis and urethra are homologous to those processes in humans, and rabbit hypospadias can be induced by 5ɑ-reductase inhibitors [7], in the present study, we evaluated neourethral function following hypospadias repair with and without spongioplasty in a rabbit model of congenital hypospadias
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
