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Repair of megameatus: a modified approach.
J Pediatr Urol 2015; 11(2):100-1JP

Abstract

OBJECTIVE

To demonstrate surgical reconstruction of a megameatus variant of hypospadias by using a modified, patient-specific approach.

METHODS

An 8-month-old male had a megameatus, which was discovered after newborn circumcision. In repair of megameatus, it is important to recognize the full extent to which the distal urethra is widened, in order to avoid inadvertent urethrotomy during mobilization of the glans wings and skin immediately proximal to the glans. In this case, a small wedge of tissue was excised from the ventral aspect of the urethra, and a midline relaxing incision of the urethral plate was made. Standard principles of hypospadias repair should be followed, with tension-free urethral tubularization, coverage of the neourethra with well-vascularized tissue, and adequate mobilization of the glans wings to allow midline reconstruction without compression of the underlying neourethra.

RESULTS

There were no perioperative or postoperative complications in this case. The urethral meatus was positioned near the tip of the glans penis, and there was no evidence of meatal stenosis or urethrocutaneous fistula at 5-months follow-up.

CONCLUSION

Each case of megameatus is unique, and a variety of surgical techniques can be used in formulating an approach that achieves optimal cosmetic and functional outcomes.

Authors+Show Affiliations

Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 24, Chicago, IL 60611, USA. Electronic address: mfaasse@sbcglobal.net.Department of Urology, Loyola University Stritch School of Medicine, 2160 South 1st Ave., Maywood, IL 60153, USA. Electronic address: elizdray@gmail.com.Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Box 24, Chicago, IL 60611, USA. Electronic address: echeng@luriechildrens.org.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

25791426

Citation

Faasse, M A., et al. "Repair of Megameatus: a Modified Approach." Journal of Pediatric Urology, vol. 11, no. 2, 2015, pp. 100-1.
Faasse MA, Dray EV, Cheng EY. Repair of megameatus: a modified approach. J Pediatr Urol. 2015;11(2):100-1.
Faasse, M. A., Dray, E. V., & Cheng, E. Y. (2015). Repair of megameatus: a modified approach. Journal of Pediatric Urology, 11(2), pp. 100-1. doi:10.1016/j.jpurol.2015.01.003.
Faasse MA, Dray EV, Cheng EY. Repair of Megameatus: a Modified Approach. J Pediatr Urol. 2015;11(2):100-1. PubMed PMID: 25791426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repair of megameatus: a modified approach. AU - Faasse,M A, AU - Dray,E V, AU - Cheng,E Y, Y1 - 2015/03/04/ PY - 2015/01/19/received PY - 2015/01/21/accepted PY - 2015/3/21/entrez PY - 2015/3/21/pubmed PY - 2016/4/9/medline KW - Hypospadias KW - Megameatus with intact prepuce KW - Pediatric KW - Pyramid procedure KW - Surgical technique KW - Tubularized incised plate SP - 100 EP - 1 JF - Journal of pediatric urology JO - J Pediatr Urol VL - 11 IS - 2 N2 - OBJECTIVE: To demonstrate surgical reconstruction of a megameatus variant of hypospadias by using a modified, patient-specific approach. METHODS: An 8-month-old male had a megameatus, which was discovered after newborn circumcision. In repair of megameatus, it is important to recognize the full extent to which the distal urethra is widened, in order to avoid inadvertent urethrotomy during mobilization of the glans wings and skin immediately proximal to the glans. In this case, a small wedge of tissue was excised from the ventral aspect of the urethra, and a midline relaxing incision of the urethral plate was made. Standard principles of hypospadias repair should be followed, with tension-free urethral tubularization, coverage of the neourethra with well-vascularized tissue, and adequate mobilization of the glans wings to allow midline reconstruction without compression of the underlying neourethra. RESULTS: There were no perioperative or postoperative complications in this case. The urethral meatus was positioned near the tip of the glans penis, and there was no evidence of meatal stenosis or urethrocutaneous fistula at 5-months follow-up. CONCLUSION: Each case of megameatus is unique, and a variety of surgical techniques can be used in formulating an approach that achieves optimal cosmetic and functional outcomes. SN - 1873-4898 UR - https://www.unboundmedicine.com/medline/citation/25791426/Repair_of_megameatus:_a_modified_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-5131(15)00034-0 DB - PRIME DP - Unbound Medicine ER -