Hypospadias repair with the art of anatomy

Abstract

Objective To improve the success of the hypospadias repair. Methods Four hundred and two patients with congenital hypospadias at surgery. The numbers of subcoronal meatus,shaft of penis,penoscrotum,perineal hypospadias were 28,183,154 and 37 cases respectively,383 patients had curvature of penis. Three hundred patients in group A (28 of subcoronal meatus,183 of shaft of penis and 89 of penoscrotum),hypospadias were treated with tubularized incised plate urethroplasty. Soluted the fibric trabs of ventrial urethra and surrounding,skin degloving,mobilization of divergent corpus spongiosum,mobilization of hypoplastic urethra and if necessary,dorsal plication to corrected the curvature. Duckett +Duplay technique urethroplasty was applied to another 102 patients (group B:65 of penoscrotum,37 of perineal hypospadias). All the patients were dissected at the natural layer with the art of anatomy. Results All repairs were completed in one stage. Follow-up was from 6 to 24 months. 289 (96.3% ) in group A and 94 (92.2%) in group B operation were success once only,there were 14 of fistula,5 of urethral stenosis and 3 of urethral diverticulum,and all of them cured by the second surgery. Conclusion To keep the art of anatomy in the management of the congenital hypospadias,dissected and sutured the natural layer,will have a good visual fields in surgery and good outcome with few complication. Key words: Anatomy; Hypospadias; Art; Urethroplasty