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Published on: January 7, 2019
Two-stage repair with long channel technique for primary severe hypospadias
Tianyou Yang1, Qigen Xie2, Qifeng Liang1
1Department of Pediatric Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Affiliated Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Insights
This study introduces a two-stage repair with a long channel technique for severe hypospadias in children. The technique showed excellent short-term results, offering a promising option for complex hypospadias cases.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Genitourinary Reconstructive Surgery
Background:
- Hypospadias is a congenital condition requiring surgical correction.
- Severe hypospadias presents unique reconstructive challenges.
- Existing surgical methods may have limitations in complex cases.
Purpose of the Study:
- To present a novel two-stage surgical repair for primary severe hypospadias.
- To describe the "long channel technique" for hypospadias reconstruction.
- To evaluate the initial outcomes of this technique.
Main Methods:
- Sixteen children with primary severe hypospadias underwent a two-stage repair.
- The first stage involved a technique similar to Bracka's two-stage repair.
- The second stage created a long subcutaneous channel for a tubularized scrotal flap neourethra.
Main Results:
- Mean follow-up was 10 months with no fistula, dehiscence, stricture, or stenosis.
- One scrotal wound infection resolved with antibiotics.
- Excellent cosmetic and functional outcomes were observed post-second stage.
Conclusions:
- The two-stage repair with long channel technique is a viable option for primary severe hypospadias.
- This method demonstrates excellent short-term efficacy.
- Further studies may explore long-term outcomes and broader applicability.
Objective:
To introduce a 2-stage repair with long channel technique for primary severe hypospadias.
Patients And Methods:
Between March 2010 and November 2013, 16 children with primary severe hypospadias underwent 2-stage repair with long channel technique. The technique applied in the first stage was almost the same as Bracka 2-stage repair. The second stage was usually performed 6 months later. A small transverse skin incision, distal to the meatal opening and about 1 cm in length, was made. Dissection was carried out deep into the surface of corpora cavernosa and a plane between the subcutaneous tissue and corpora cavernosa was reached. A long channel between the subcutaneous tissue and corpora cavernosa was created from the para-meatus incision to the apex of glans. A rectangle, pedicle scrotal septal skin flap was elevated and tubularized into neourethra around a stenting tube. The neourethra was delivered through the subcutaneous channel and fixed at the apex of glans.
Results:
The mean operation time of the first and second stages was 65 and 55 minutes, respectively. The mean age at the first and second operation was 28 and 36 months, respectively. The mean follow-up was 10 months. No fistula, glans dehiscence, urethral stricture, and meatal stenosis were recorded. One scrotal surgical wound infection occurred after second stage and healed successfully with antibiotics treatment. The overall cosmetic and functional outcomes after second stage were excellent.
Conclusion:
Two-stage repair with long channel technique was applicable for primary severe hypospadias, with excellent short-term outcomes.
