Morphology and urodynamics after longitudinal urethral plate incision in proximal hypospadias repairs: long-term
1University of Medical Sciences, Bydgoszcz, Department of Paediatric Surgery, Children's Hospital, Torun, Poland.
Aim:
To determine whether longitudinal neourethra incision disturbs the healing and growth of the neourethra, and to see how it affects the urine flow after proximal hypospadias repairs.
Subjects And Methods:
Nine patients were examined, in whom longitudinal incision had been performed 9 - 15 years earlier, after previous penis lengthening operations. Calibration, urethrography, endoscopy, and urodynamics were carried out in all patients.
Results:
In all but 1 patient the external meatus had steadily been growing in width, and in 8 out of 9 it was within the normal size range. Urethroscopy showed single hairs growing into the lumen in 3 patients. No scarring was demonstrated in any patient. Saccular dilatation of the neourethra was found in 6 out of 9, urethral stricture was shown in only 1 patient. Peak flow rate was within 2 SD in 5 patients, and below 2 SD in 3. Average flow rate was below 2 SD in 6 patients and in all patients it was markedly low. In the patient with urethral stricture both peak flow rate and average flow rate were well below normal.
Conclusions:
Although longitudinal neourethra incision allows for easy and safe closure, longitudinal incision may result in functional meatal stenosis with formation of a wide neourethra. This may be due to disproportional low resistance of the urethral wall, compared with external meatus, to urine flow.
