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Technique for repair of minimal distal balanitic hypospadias
1Department of Urology, University of Arkansas College of Medicine and Arkansas Children's Hospital, Little Rock, Arkansas 72205-7199, USA. redmanjohnf@uams.edu
Insights
This study presents a simple surgical technique for repairing minimal distal hypospadias, achieving excellent cosmetic results with an elliptical meatus. The method involves excising the distal urethral plate and advancing the meatus.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Congenital Anomalies
Background:
- Minimal distal hypospadias, while not medically serious, is often a cosmetic concern for parents seeking normal appearance for their child.
- Parental concern drives the demand for surgical correction of even minor hypospadias.
- A straightforward surgical approach is needed for this common condition.
Purpose of the Study:
- To present a simple surgical technique for the repair of minimal distal hypospadias.
- To evaluate the efficacy and cosmetic outcome of the described surgical method.
- To achieve a natural-appearing elliptical meatus post-repair.
Main Methods:
- A cohort of 28 boys aged 3 to 100 months underwent the described surgical repair.
- The technique involved excision of the distal urethral plate and advancement of the meatus.
- Many patients (82.2%) had concomitant repairs for other penile or inguinal anomalies.
Main Results:
- All 28 patients demonstrated successful healing within 3 to 4 months post-surgery.
- Uniformly excellent cosmetic outcomes were observed.
- The resulting meatus was consistently elliptical in all cases.
Conclusions:
- The described technique of excising the distal urethral plate and advancing the meatus is recommended for minimal distal hypospadias.
- This method offers simplicity in execution.
- It reliably produces a desirable elliptical meatus, addressing cosmetic concerns.
Objectives:
Although not pernicious, minimal distal hypospadias is frequently obvious to parents, whose concern that their child be completely normal prompts their request for repair. A simple technique for the repair of this anomaly that results in an elliptical meatus is presented.
Methods:
A total of 28 boys ranging in age from 3 to 100 months (mean 21.8) underwent a surgical technique in which the distal urethral plate was excised, followed by advancement of the meatus into the defect thus created. Only 5 boys (17.8%) underwent hypospadias repair as an isolated procedure. Other concomitantly repaired anomalies included hooded prepuce, phimosis, redundant prepuce after neonatal circumcision, ventral penile curvature, inguinal hernia, undescended testis, penile torsion, and meatal stenosis.
Results:
All patients had healed well at a follow-up of 3 to 4 months (mean 3.2) and uniformly had an excellent cosmetic appearance with an elliptical meatus.
Conclusions:
We recommend a technique for the repair of minimal distal hypospadias, consisting of excision of the distal urethral plate with advancement of the dorsal lip of the meatus into the created defect, for its simplicity and resultant elliptical meatus.
