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Extended urethral mobilization in incised plate urethroplasty for severe hypospadias: a variation in technique to improve chordee correction.
J Urol 2007; 178(3 Pt 1):1031-5JU

Abstract

PURPOSE

The feasibility of tubularized incised plate urethroplasty in proximal hypospadias with severe chordee was studied after correction of chordee by extended urethral mobilization.

MATERIALS AND METHODS

Boys with severe hypospadias who underwent tubularized incised plate urethroplasty were included. A total of 34 patients (28 with proximal penile/penoscrotal hypospadias and 6 with scrotal hypospadias) 18 months to 13 years old (mean 5 years) with severe hypospadias underwent tubularized incised plate urethroplasty between January 1999 and March 2006. A Gittes test was performed to assess the chordee after penile degloving and preservation of the urethral plate. Subsequently, the urethral plate with divergent corpus spongiosum and proximal healthy urethra were mobilized up to the bulbar urethra. Glanular chordee was corrected by mobilizing the urethral plate into the glans. The urethral plate was tubularized with or without incision and spongioplasty to complete the urethroplasty.

RESULTS

Chordee correction was possible by mobilization of the urethral plate with corpus spongiosum from the meatus to the glans and the proximal urethra up to the bulbar region in 88% of the cases. Mean followup was 23 months (range 6 months to 3 years). Overall complication rate was 12% (fistula in 3 patients, meatal stenosis in 1). Two patients (6%) required dorsal plication, and in 2 (6%) the urethral plate had to be divided to correct the chordee. No patient had residual chordee during followup.

CONCLUSIONS

The technique of chordee correction by mobilization of the urethral plate and proximal urethra with preservation of the urethral plate is simple and effective, and enlarges the scope of tubularized incised plate urethroplasty in severe hypospadias.

Authors+Show Affiliations

Department of Urology, S. P. Medical College Bikaner, Rajasthan, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17632146

Citation

Bhat, Amilal. "Extended Urethral Mobilization in Incised Plate Urethroplasty for Severe Hypospadias: a Variation in Technique to Improve Chordee Correction." The Journal of Urology, vol. 178, no. 3 Pt 1, 2007, pp. 1031-5.
Bhat A. Extended urethral mobilization in incised plate urethroplasty for severe hypospadias: a variation in technique to improve chordee correction. J Urol. 2007;178(3 Pt 1):1031-5.
Bhat, A. (2007). Extended urethral mobilization in incised plate urethroplasty for severe hypospadias: a variation in technique to improve chordee correction. The Journal of Urology, 178(3 Pt 1), pp. 1031-5.
Bhat A. Extended Urethral Mobilization in Incised Plate Urethroplasty for Severe Hypospadias: a Variation in Technique to Improve Chordee Correction. J Urol. 2007;178(3 Pt 1):1031-5. PubMed PMID: 17632146.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extended urethral mobilization in incised plate urethroplasty for severe hypospadias: a variation in technique to improve chordee correction. A1 - Bhat,Amilal, Y1 - 2007/07/16/ PY - 2007/01/23/received PY - 2007/7/17/pubmed PY - 2007/10/3/medline PY - 2007/7/17/entrez SP - 1031 EP - 5 JF - The Journal of urology JO - J. Urol. VL - 178 IS - 3 Pt 1 N2 - PURPOSE: The feasibility of tubularized incised plate urethroplasty in proximal hypospadias with severe chordee was studied after correction of chordee by extended urethral mobilization. MATERIALS AND METHODS: Boys with severe hypospadias who underwent tubularized incised plate urethroplasty were included. A total of 34 patients (28 with proximal penile/penoscrotal hypospadias and 6 with scrotal hypospadias) 18 months to 13 years old (mean 5 years) with severe hypospadias underwent tubularized incised plate urethroplasty between January 1999 and March 2006. A Gittes test was performed to assess the chordee after penile degloving and preservation of the urethral plate. Subsequently, the urethral plate with divergent corpus spongiosum and proximal healthy urethra were mobilized up to the bulbar urethra. Glanular chordee was corrected by mobilizing the urethral plate into the glans. The urethral plate was tubularized with or without incision and spongioplasty to complete the urethroplasty. RESULTS: Chordee correction was possible by mobilization of the urethral plate with corpus spongiosum from the meatus to the glans and the proximal urethra up to the bulbar region in 88% of the cases. Mean followup was 23 months (range 6 months to 3 years). Overall complication rate was 12% (fistula in 3 patients, meatal stenosis in 1). Two patients (6%) required dorsal plication, and in 2 (6%) the urethral plate had to be divided to correct the chordee. No patient had residual chordee during followup. CONCLUSIONS: The technique of chordee correction by mobilization of the urethral plate and proximal urethra with preservation of the urethral plate is simple and effective, and enlarges the scope of tubularized incised plate urethroplasty in severe hypospadias. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/17632146/Extended_urethral_mobilization_in_incised_plate_urethroplasty_for_severe_hypospadias:_a_variation_in_technique_to_improve_chordee_correction_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2007.05.074?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -