Urethroplasty Using Diverticular Tissue for Hypospadias.
Nobuyuki Mitsukawa1, Yoshitaka Kubota2, Shinsuke Akita2
1Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Chiba University, Chiba, Japan. nmitsu@air.linkclub.or.jp.
Lower Urinary Tract Symptoms
|September 14, 2016
Summary
This case study details a novel approach to treating severe urethral stricture following hypospadias surgery. A urethral diverticulum was successfully reconstructed into a neourethra, offering a new treatment option.
Area of Science:
- Urology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Hypospadias surgery can lead to complications like urethral strictures.
- Severe urethral stricture can cause urinary retention, necessitating emergency intervention.
- Urethral diverticula are a known, though infrequently reported, complication of hypospadias repair.
Observation:
- A 3-year-old patient developed a severe urethral stricture and urinary retention post-hypospadias urethroplasty.
- An emergency cystostomy was performed, followed by an attempt at urethral reconstruction.
- A large, well-vascularized, and epithelialized urethral diverticulum was identified in the scrotum.
Findings:
- The urethral diverticulum was successfully utilized as a skin flap for neourethra reconstruction.
- The neourethra was reconstructed up to the glans region using the diverticular tissue.
- No postoperative complications were observed, and satisfactory micturition was achieved.
Implications:
- This technique demonstrates a viable method for reconstructing urethral defects using native diverticular tissue.
- It offers a potential solution for complex cases of urethral stricture after hypospadias repair.
- Further research into this reconstructive approach may expand treatment options for similar urological conditions.
