Surgical Treatment Of Hypospadias Research Articles

Preoperative psychological status of children with hypospadias and their families

Objective To explore the preoperative psychological status of children with hypospadias and their families, and to provide theoretical guidance for clinical nursing during the treatment of hypospadias. Methods A questionnaire survey was conducted on children with hypospadias and their family members 1 day before surgery to understand the psychological behaviors of the children and their family members' attitudes and attitude towards the disease. Results Parents with different educational levels, occupations, whether children were only children, ranking at home, and whether they follow their parents for a long time will make their families have different attitudes toward the disease.Family members of children with hypospadias have prominent problems in somatization, interpersonal sensitivity, anxiety, depression and terror (P<0.001). Compared with the Chinese norm, children with hypospadias showed statistically significant differences in activity level, attention to time limit and persistence, rhythm, attention to dispersion, response threshold, response intensity and avoidance(P<0.05). Children with hypospadias had prominent problems in depression factors, hyperkinetic factors, aggressive factors, social withdrawal factors, and poor communication factors, and the differences were statistically significant(P<0.05). Conclusions Hypospadias can have a significant negative impact on the psychology and behavior of children and their families.In the surgical treatment of hypospadias, medical staff should pay attention to the psychological and behavioral effects of hypospadias on children and their families.Psychological intervention can improve the treatment satisfaction of children and their families. Key words: Child; Hypospadias; Psychology

Correcting Glanular Dislocation in Hypospadias With Up-to-Tip Technique and Double Wing Flaps

The surgical treatment of hypospadias contains urethral reconstruction and correction of penile curvature. In some severe type of hypospadias, it also needs correction of penoscrotal transposition and cleft of scrotum. However, there are few literatures that refer to the correcting of deformity of glanular dislocation. This study aimed to correct the deformity of glanular dislocation in patients with hypospadias with up-to-tip technique and double wing flaps. From May of 2011 to September of 2012, 49 patients who underwent hypospadias with glanular dislocation repairing received up-to-tip technique to correct the deformity of glanular dislocation in our department by a single surgeon (J.Z.). An X-shaped incision was made in the ventral median of glans, and the glans was dissected from the penis cavernosus, then 2 wing-shaped flaps appeared. The 2 sides of flaps were rotated and lifted with new urethra inside. The divergent glans flaps were closed with vertical mattress suture. Follow-up was from 12 to 30 months. All patients had excellent cosmetic results immediately after the operation. The glans was straight and was upturned obviously. The wing flaps of glans were partially dehisced in 2 (4.08%) cases after the operation. The other patients had good wound healing. No urethral stricture in distal urethra was observed. Up-to-tip technique and double wing flap can effectively correct the deformity of glanular dislocation in the patients with hypospadias. After the operation, the glans configuration was improved.

Surgical Treatment of Hypospadias: Technical Procedures and Results

Surgical Treatment of Hypospadias: Technical Procedures and Results

In Vivo Biomechanical Assessment of Anterior Rabbit Urethra After Repair of Surgically Created Hypospadias

We studied the in vivo biomechanical properties of the anterior urethra in a rabbit hypospadias simulation model at long-term followup after urethroplasty. A total of 38, 9-week-old white New Zealand male rabbits were randomized into active treatment and control groups. The active treatment group included hypospadias-like simulation and acute repair (sham, mobilization and advancement, tubularized incised posterior urethral plate). After 23 weeks all groups underwent biomechanical investigation using impedance planimetry. Cross-sectional area pressure measurements during bag distention were conducted at 3 different positions along the urethra, and biomechanical (tension-strain) relations were computed. The biomechanical parameters studied were urethral luminal dimension (cross-sectional area pressure relation) and its deformability to luminal pressure (tension-strain relation). The urethral cross-sectional area was significantly larger in the mobilization and advancement group compared to the tubularized incised plate group (p <0.001), shams and controls at the distal distention site (p <0.05), and other groups at the intermediate distention site (p <0.05). The strain-tension curves were not significantly different between the groups. All groups showed a nonlinear cross-sectional area pressure and circumferential wall tension-strain relationships in the 3 distention sites. The urethras exhibited a decreasing ability to be distended with increasing pressures, indicating self-protection against damage. At long-term followup no differences in tension-strain relations were found between groups, despite the fact that the mobilization and advancement group had enlarged urethras. Our hypospadias simulation animal model could be useful to test commonly used or new urethroplasty techniques and their functional (biomechanical) long-term results before clinical use.

Robotic hypospadias surgery: a new evolution.

The dictum that "there is nothing new in surgery not previously described," is quoted regularly and is particularly true of hypospadias. There is an ongoing search for solutions to many troublesome issues concerning surgical treatment of hypospadias, such as what age is the most appropriate to apply surgery, or in how many stages surgery should be performed. We present a case report of the first robotic hypospadias surgery to propose a departure from the standard practice, in the hope of expanding medical expertise and teaching globally. The use of a robot for reconstructive surgery is not novel; its use for extracorporeal surgery is, but we contend that there is no difference in the surgical steps to carry out a hypospadias repair. In addition, we envision that the benefits of applying robotic surgery for extracorporeal reconstructive procedures will greatly impact the current paradigm of surgery and surgical education. For those surgeons who already possess comfort with robotic skills, reconstructive procedures outside of a major cavity are feasible, and time will provide safety and efficacy data. Our hope is that others will join in the advancement of telesurgery and its applications and appreciate the potential expansion of surgical knowledge that will be afforded by this change in how we teach and operate.

Urethral Mobilization and Advancement For Midshaft to Distal Hypospadias

No AccessJournal of UrologyHypospadias1 Oct 2002Urethral Mobilization and Advancement For Midshaft to Distal Hypospadias Anthony Atala Anthony AtalaAnthony Atala More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64402-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A urethral mobilization and advancement technique for repairing glanular, subglanular and midshaft hypospadias with or without chordee was developed, and has been used for more than 6 years. A brief description of the procedure and the results are presented. Materials and Methods: From 1995 to 2001, 73 boys 4 months to 12 years old underwent repair of glanular (14), subglanular (38) and midshaft (20) hypospadias. Chordee was present in 37 boys. Upon initiating the surgery, a circumcising incision was made proximal to the urethral orifice. The ventral glanular mucosa was preserved. The penile skin was degloved and any chordee was corrected. The meatus was circumscribed and the urethra was mobilized proximally until a 4 to 5:1 ratio was achieved between the length of the mobilized urethra and the initial distance measured from the meatus to the distal margin of the glanular groove. The ventral glans was incised deeply to the corpora cavernosa and the glans wings were mobilized laterally. The urethral meatus was advanced and sutured to the distal glans. The glans wings were approximated over the urethra. The glanular mucosal wings were approximated ventrally, and the skin was resected and closed in the usual fashion. A urethral catheter was left overnight. Results: Followup ranged from 6 months to more than 6 years. None of the patients had a urethrocutaneous fistula or meatal stenosis. There were no episodes of new, persistent or recurrent chordee. Two patients had meatal retraction wherein the urethra migrated proximally but still within the glans. Only 1 of these patients required a second procedure. One patient had a hematoma that resolved spontaneously. Conclusions: The hypospadias technique described, which uses wide urethral and glanular mobilization and advancement, can be useful for repair of midshaft to distal hypospadias with or without chordee with minimal complications and excellent cosmetic results. References 1 : A new operation for balanic hypospadias. NY Med J1898; 67: 147. Google Scholar 2 Belman A.B. Urethroplasty. Society for Pediatric Urology Newsletter, December 28, 1977 Google Scholar 3 : Urethral advancement for distal hypospadias repair in circumcised patients. Plast Reconstr Surg1982; 70: 496. Google Scholar 4 : Distal hypospadias repair. J Urol1984; 131: 928. Link, Google Scholar 5 : Sleeve advancement distal hypospadias repair. J Urol1990; 144: 523. Link, Google Scholar 6 : Distal hypospadias repair by urethral sliding advancement and Y-V glanuloplasty. J Urol1991; 146: 644. Link, Google Scholar 7 : Mobilization of the urethra in the surgical treatment of hypospadias. J Urol1981; 125: 394. Link, Google Scholar 8 : Urethral advancement technique for repair of distal hypospadias. Eur Urol1990; 17: 40. Google Scholar 9 : Hypospadias repair using a modification of Beck’s operation: followup. J Urol1997; 157: 2308. Link, Google Scholar 10 : Anterior urethral advancement: a one-stage technique for hypospadias repair. Br J Plast Surg1984; 37: 530. Google Scholar 11 : Urethral advancement for distal hypospadias: 14 years’ experience. Eur Urol1994; 26: 90. Google Scholar 12 : Bulbar elongation anastomotic meatoplasty (beam) for subterminal and hypospadiac urethroplasty. J Urol1997; 158: 1160. Link, Google Scholar 13 : Mobilization of the anterior urethra as an aid in the one-stage repair of hypospadias. Urol Clin North Am1981; 8: 521. Google Scholar 14 : The adaptability of the glans flap in hypospadias repair. Plast Reconstr Surg1977; 60: 416. Google Scholar 15 : Transverse corporeal plication for persistent chordee. Urology1989; 34: 360. Google Scholar From the Department of Urology, Children’s Hospital, Harvard Medical School, Boston, Massachusetts© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKoenig J, Kottwitz M and McKenna P (2013) Urethral Mobilization for Distal and Mid Shaft Hypospadias with ChordeeJournal of Urology, VOL. 190, NO. 4S, (1545-1549), Online publication date: 1-Oct-2013.Lalla M, Gregersen H, Olsen L and Jørgensen T (2010) In Vivo Biomechanical Assessment of Anterior Rabbit Urethra After Repair of Surgically Created HypospadiasJournal of Urology, VOL. 184, NO. 2, (675-682), Online publication date: 1-Aug-2010.Mollaeian M, Sheikh M, Tarlan S and Shojaei H (2008) Urethral Mobilization and Advancement With Distal Triangular Urethral Plate Flap for Distal and Select Cases of Mid Shaft Hypospadias: Experience With 251 CasesJournal of Urology, VOL. 180, NO. 1, (290-294), Online publication date: 1-Jul-2008.Lalla M, Danielsen C, Austevoll H, Olsen L and Jørgensen T (2018) Biomechanical and Biochemical Assessment of Properties of the Anterior Urethra After Hypospadias Repair in a Rabbit ModelJournal of Urology, VOL. 177, NO. 6, (2375-2380), Online publication date: 1-Jun-2007. Volume 168Issue 4 Part 2October 2002Page: 1738-1741 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsreconstructive surgical procedureshypospadiasurethra, penisMetricsAuthor Information Anthony Atala More articles by this author Expand All Advertisement PDF downloadLoading ...

RADICAL BULBAR DISSECTION TO CORRECT SEVERE CHORDEE AND PROXIMAL HYPOSPADIAS

We describe a technique of proximal hypospadias correction that involves freeing the proximal normal bulbar urethra from perineal attachments to lengthen the ventral penis and decrease chordee. Correction was performed in 9 patients with a mean age of 11.5 months who had proximal hypospadias and severe chordee that was perineal in 2, mid scrotal in 6 and penoscrotal in 1. After the penis was degloved the bulbar urethra was detethered to or beyond the perineal body without lifting the urethra from the corpora cavernosa. Any remaining penile chordee was corrected and the urethral plate was transected only when chordee persisted. When the urethral plate was intact and the penis straight, tubularized incised plate urethroplasty was done to correct hypospadias in 1 stage. Otherwise 2-stage repair was performed. Using this maneuver penile straightening was achieved in 2 of the 9 patients, resulting in a glanular urethral or penoscrotal meatus. Dorsal plication sutures required in 4 cases resulted in a mid shaft and penoscrotal meatus in 1 and 3, respectively. Residual chordee in the remaining 3 patients necessitated division of the urethral plate and 2-stage repair despite aggressive mobilization of the proximal urethra. Simultaneous tubularized incised plate urethroplasty was then performed in the 4 penoscrotal and 1 mid shaft meatus. All 6 patients who underwent a successful 1-stage procedure have excellent cosmetic results, while 1 required meatotomy. No fistula or chordee was present at a mean of 13.8 months of followup (range 3.9 to 27.1). This safe, rapid technique may compensate for significant penile tethering and chordee in a subpopulation of patients with proximal hypospadias, such as 6 of the 9 in our study. It also allows successful tubularized incised plate urethroplasty to be done simultaneously.

Surgical treatment of hypospadias at different ages. Part 2: Adolescents and adults

— The Authors describe their diagnostic and therapeutic protocol for hypospadic patients in adolescent and adult age. Patients can be divided into: those who have received unsatisfactory treatment, those who have not yet been treated and patients with Penile curvature without hypospadia.

Beidseitige konnatale Resthörigkeit und Hypospadie -Ein neues Syndrom?

Five children with hypospadia and profound hearing loss were presented to the Clinic for Speech and Communication Disorders of the University of Mainz. Anamnestic and laboratory investigations strongly suggest, that the malformations are interrelated and may represent a new syndrome. Therefore it appears to be helpful to carry out a routine hearing check in children, who are hospitalized for the first surgical treatment of hypospadias.

Mobilization of the urethra in the surgical treatment of hypospadias: S. A. Koff. J Urol 125:394–397, (March), 1981

Mobilization of the urethra in the surgical treatment of hypospadias: S. A. Koff. J Urol 125:394–397, (March), 1981

Mobilization of the Urethra in the Surgical Treatment of Hypospadias

Urethral mobilization is an adjunctive surgical technique for improving the position of the urethral meatus in a hypospadias operation. In patients with mild degrees of hypospadias and chordee the mobilized urethral meatus can be placed out onto the glans without constructing a neourethra. In more severe cases of hypospadias urethral advancement distally will reduce the length requirement for the neourethra. Mobilization of the urethra has been done in 21 children in conjunction with standard hypospadias repair techniques and the outcome has been highly successful for the majority.

Surgical treatment of hypospadias: Experience in the treatment of 400 consecutive cases using Leveuf's technique

Summary Experience over 11 years in treating 398 cases of hypospadias has shown that a three-stage technique based on the methods described by Blair and Byars for the correction of the chordee and by Leveuf for the reconstruction of a new urethra give consistently satisfactory results. The post-operative complications of each stage are discussed in detail.

Our experience in the surgical treatment of hypospadias

Our experience in the surgical treatment of hypospadias

What can be expected from surgical treatment of hypospadias? : L. G. Farkaš. Čs. Pediat. 23:38–43 (January) 1968

What can be expected from surgical treatment of hypospadias? : L. G. Farkaš. Čs. Pediat. 23:38–43 (January) 1968

Surgical Treatment of Hypospadias

Surgical Treatment of Hypospadias

Surgical Treatment of Hypospadias, Especially Scrotal and Perineal

Surgical Treatment of Hypospadias, Especially Scrotal and Perineal

The surgical treatment of hypospadias, especially scrotal and perineal.

The surgical treatment of hypospadias, especially scrotal and perineal.