Evaluation of Urethral advancement and Glanuloplasty in Hypospadias repair

Abstract

Background:There has been great progress in reconstructive surgery of the male urethra in the last decades. Several complex techniques were developed to correct urethral defects with great variations in the success rate. However, there is no an ideal substitute for the male urethra as good as the urethra to our knowledge at this time .Human male urethra has a large capacity to extend under traction. This extensibility is the principle of urethral advancement technique used to correct urethral defect in hypospadias by using the urethra itself.The objective of this study was to evaluate the urethral advancement and glanuloplasty (UGPI) procedure in hypospadias repair.During a period of 1 year, 20 boys ranging between 2-16 years old underwent repair of glanular to midshaft hypospadias by UGPI procedure. At or near the tip meatus was accomplished in 75% of the patients, with 85% adequate meatal size, 85% straight penis and 70% of conical glans shape. While the complications were 15% meatal stenosis (MS), 25% meatal retraction (MR), 5% fistula , 35% bleeding and haematoma, 10% for cellulites and UTI (infection), 20% wound dehiscence, and 10% abnormal urine stream.Adequate mobilization of the urethra for advancement decreases the incidences of complications of MR and MS.The lower incidence of fistula in UGPI procedure support the sentence of "There is no an ideal substitute for the male urethra as good as the urethra".