Standard Snodgrass Technique in Conjunction With Double Layers Covering of Neourethra by Dorsal Dartos Flap Represent the First Choice of Therapy For Hypospadias
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RIWXEXODUL]HGLQFLVHGSODWH 7,3 XUHWKURSODVW\WHFKQLTXHIRUGLIIHUHQW kinds of hypospadias METHODS: From June 2002 to December 2003 and from March 2006 to January 2007 total of 36 patients aged 1-22 years (average 7.5) were operated using the concept of TIP urethrolpasty. The hypospadiac meatus were subcoronal in 28 (77.7%), midshaft in 4 (11.11%) and penoscrotal in 4 (11.11%) patients. The standard TIP urethroplasty were performed in the primary cases (26 patients) while in the secondary cases (4 patients) and in the boys who were circumcised EHIRUHDGPLVVLRQ SDWLHQWV PRGL¿HG7,3XUHWKURSODVW\ZHUHXVHG 7KHVWDQGDUGWHFKQLTXHFRQVLVWRI8VKDSHGLQFLVLRQPLGOLQHLQFLVLRQ DQG VXEFXWDQHRXV ÀDS FRYHULQJ7KH GRUVDO VXEFXWDQHRXV ÀDS ZDV harvested from preputial skin and dissected from the midline then both OD\HUV RI ÀDS ZHUH WUDQVSRVHG WR WKH YHQWUDO VLGH RI WKH SHQLVZLWK V\PPHWULFURWDWLRQ(DFKOD\HURIWKHVXEFXWDQHRXVÀDSZDVVXWXUHG to the wings of the glans and corpora cavernosa, thus the neourethra EHFDPH FRPSOHWHO\ FRYHUHG ZLWK GRXEOH OD\HUV RI ZHOOYDVFXODUL]HG tissue. In patients with chordee, hypospadias repair and chordee release ZHUHGRQHDWRQHVWDJH7KHPHDQSHULRGVRIKRVSLWDOL]DWLRQDQGIROORZ up were 0.92 days and 4.19 months respectively. 5(68/761R¿VWXODZDVREVHUYHGLQER\VZKRXQGHUZHQW primary reconstruction using standard TIP urethroplasty. Fistula ZDV REVHUYHG LQWZR SDWLHQWV  2QH SDWLHQW ZLWK SHQRVFURWDO hypospadiass who underwent 2-stage repair, and another one was circumcised before admission. One patient had meatal stenosis at the early postoperative period which was corrected by dilatation of the external meatus at intervals up to two months postoperatively. Three ER\VKDGYHU\QDUURZ¿VWXODZKLFKMXVWDOORZOHDNVRIIHZGURSVRIXULQH through urination which was closed spontaneously within two months. CONCLUSIONS: Standard TIP urethroplasty with double layers covering of neourethra by dorsal subcutaneous tissues is the procedure of choice for the treatment of primary cases of distal / midshaft hypospadias and, the concept of this technique seems to be suitable for proximal, secondary and even complicated hypospadias reconstruction

Conference
Conference Title
The American Urological Association, Annual Meeting 2008
Conference Country
United States of America
Conference Date
May 19, 2008 - May 19, 2008
Conference Sponsor
Annual Meeting