Warren T Snodgrass1, Nicol Bush, Nicholas Cost. 1. Pediatric Urology Section, Children's Medical Center and The University of Texas Southwestern Medical Center, Dallas, Texas 75207, USA. warren.snodgrass@childrens.com
Abstract
PURPOSE: We report surgical technique and outcomes in consecutive patients with primary distal hypospadias. MATERIALS AND METHODS: A prospectively maintained database of all patients operated by WS in 2000-2008 was reviewed for pertinent data in consecutive patients. RESULTS: A total of 551 consecutive patients of mean age 17 months underwent distal tubularized incised plate hypospadias repair by urethral plate tubularization with (459) or without (92) midline incision. Follow up occurred for 426 (77%) at a mean of 8.2 months. Calibration and/or uroflowmetry were obtained in 279 (65%). Complications developed in 19 (4%), including nine fistulas, nine glans dehiscences and one delayed meatal stenosis from balanitis xerotica obliterans. These complications could not be attributed to meatal location, urethral plate configuration or incision, suture materials or methods for urethroplasty and glansplasty, or to use or not of a dartos flap barrier layer. CONCLUSIONS: No contraindication to urethral plate tubularization with or without incision was found in 551 consecutive patients operated for distal hypospadias. Reliability of the procedure was confirmed by the low complication rate and success using varied suture materials and methods. Copyright (c) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
PURPOSE: We report surgical technique and outcomes in consecutive patients with primary distal hypospadias. MATERIALS AND METHODS: A prospectively maintained database of all patients operated by WS in 2000-2008 was reviewed for pertinent data in consecutive patients. RESULTS: A total of 551 consecutive patients of mean age 17 months underwent distal tubularized incised plate hypospadias repair by urethral plate tubularization with (459) or without (92) midline incision. Follow up occurred for 426 (77%) at a mean of 8.2 months. Calibration and/or uroflowmetry were obtained in 279 (65%). Complications developed in 19 (4%), including nine fistulas, nine glans dehiscences and one delayed meatal stenosis from balanitis xerotica obliterans. These complications could not be attributed to meatal location, urethral plate configuration or incision, suture materials or methods for urethroplasty and glansplasty, or to use or not of a dartos flap barrier layer. CONCLUSIONS: No contraindication to urethral plate tubularization with or without incision was found in 551 consecutive patients operated for distal hypospadias. Reliability of the procedure was confirmed by the low complication rate and success using varied suture materials and methods. Copyright (c) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.