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Penis

Penis

The penis serves a dual role in sexual reproduction and urination. It consists of three main regions: the glans penis, the body, and the root, each with distinct functions and unique anatomical features.
Anatomy of the Penis
The glans penis, or the head, is the terminal part of the penis and houses the external urethral orifice, the exit point for urine and semen. Covered by the prepuce, or foreskin, the glans is noted for its sensitivity and plays a key role in sexual pleasure. The body of the...

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Urethroplasty with Pedicled Tunica Vaginalis for the Treatment of Long-segment Anterior Urethral Stricture Caused by Lichen Sclerosus of Glans Penis

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Salvaging the dehisced glans penis.

C M White¹, M K Hanna²

¹New Jersey Medical School, Newark, NJ, USA.

Journal of Pediatric Urology

|June 17, 2018

Summary

This summary is machine-generated.

This study presents a successful two-stage salvage repair for glans dehiscence after hypospadias surgery. The method reconstructs the urethral plate and optimizes healing for favorable outcomes.

Keywords:

Buccal graft Glans dehiscence Hypospadias

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Area of Science:

Urology
Pediatric Surgery

Background:

Glans dehiscence after hypospadias repair often results in a scarred or absent urethral plate, presenting a surgical challenge.
A flat, grooveless glans penis is considered unfavorable for reconstruction.

Purpose of the Study:

To evaluate the outcome of a two-stage salvage repair for glans dehiscence in patients with prior hypospadias surgery.
To assess the safety and efficacy of reconstructing the urethral plate and glans anatomy.

Main Methods:

Retrospective review of 49 patients undergoing a two-stage repair for glans dehiscence.
Stage 1 involved deep glans incision, grafting (oral mucosa or preputial skin), and repair of fistulas/chordee.
Stage 2 involved neo-plate tubularization 6-12 months later, with adjunctive treatments like nitroglycerine ointment and hyperbaric oxygen therapy in select cases.

Main Results:

The two-stage approach successfully repaired glans dehiscence in 49 patients.
Complications included graft hypertrophy, skin graft contraction, and one recurrent fistula, all managed with revisions.
No patients developed meatal stenosis or recurrent glans dehiscence post-repair.

Conclusions:

A two-stage salvage repair effectively addresses glans dehiscence following hypospadias repair.
This technique allows for the safe and successful creation of a new urethral plate and glans groove.
While graft take can be unpredictable, the staged approach optimizes healing and functional outcomes.