Plate reconstruction and tubularization urethroplasty in the repair of complicated hypospadias

Abstract

Objective To evaluate the efficacy of plate reconstruction and tubularization urethroplasty (PRTU) in the repair of complicated hypospadias. Methods From September 2010 to July 2014, 145 patients with hypospadias were repaired with PRTU technique. The average age was 52 (10-86) months. Among them, primary cases included proximal shaft (n=1), scrotal (n=76), perineal (n=56) and type IV chordee without hypospadias (n=2). And secondary cases included post-stage-I (n=9) and urethral dehiscence (n=1). PRTU was performed alone, or plus island tube or buccal mucosa, as single-stage or staged repair. Results A total of 84 patients were repaired in single-stage including PRTU alone (n=65) and plus island tube (n=19). Staged repair was performed with PRTU alone (n=56), plus island tube (n=1) and plus buccal mucosa (n=4). During a mean follow-up period of 19 (3-47) months, the complications during single-stage PRTU repair occurred at a rate of 16.9% (11/65), including fistula 4.6%(3/65), stricture 3.1%(2/65), glans dehiscence 9.2%(6/65) and urethral diverticulum 1.5%(1/65); single-stage plus flap 10.5%(2/19)[fistula 5.0%(1/19) and urethral diverticulum 5.0%(1/19)]; stage I 4.9%(3/61)(fistula 3/61) and in 6/36 patients stage II 16.7%[fistula 8.3%(3/36), stricture 2.8%(1/36), glans dehiscence 5.6%(2/36) and urehral diverticulum 2.8%(1/36)]. Conclusions PRTU may be indicated in the repair of primary or redo hypospadias with poor quality of local tissue. It can be used alone or plus island tube or free graft during single-stage or staged repairs. Key words: Hypospadias; Urologic surgical procesures, male; Comparative study