Abstract
ABSTRACTFailed hypospadiass cases may result in hypovascular, scarred penis with residual penile chordee and leave the patient with minimal residual skin for penile resurfacing and urethroplasty. Local tissue expansion has become a good alternative to provide skin for penis by using expanders however they require long periods of time for expansion. Besides, rapid tissue expansion was also described in different tissues. We used rapid intraoperative expansion technique by using a Foley catheter in a failed hypospadias case who had minimal residual skin secondary to infection and we concluded that rapid intraoperative tissue expansion with Foley catheter is an effective, feasible reconstructive method for easy dissection and penile resurfacing in failed hypospadiass cases.
Highlights
The risk of complications such as fistula, infection, residual penile curvature in hypospadiass surgery is relatively high even though perfect surgeries are performed; correction of the complications with secondary surgeries are still challenging especially in patients with scarred, inadequate penile tissue [1]
A four-year old boy who was treated primarily a year ago in another center for penoscrotal hypospadias encountered infection following the first surgery which resulted in scarred, inadequate penile skin for reconstruction
Foley catheter has been described as atool for rapid expansion in cleft palate repair, alopecia repair, tissue defect repair following mass excision such as basal cell carcinoma, melanocytic nevus from forehead, temple, eyelid, periorbital region and extremities [4, 6,7,8,9,10]
Summary
The risk of complications such as fistula, infection, residual penile curvature in hypospadiass surgery is relatively high even though perfect surgeries are performed; correction of the complications with secondary surgeries are still challenging especially in patients with scarred, inadequate penile tissue [1]. Several failed hypospadiass surgeries may result in hypovascular, shortened, scarred penis with penile chordee and leave the patient with minimal residual local skin for penile coverage and urethral reconstruction [2]. In case of complicated hypospadias repairs, tissue for resurfacement of penis can be acquired from local tissue or from extragenital areas. Vordermark described tissue expansion for penile reconstruction [5] By combining these methods, we used rapid intraoperative expansion technique by using a Foley catheter in a failed hypospadias case who had minimal residual skin secondary to infection
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