Modified partial penile disassembly repair for improved functional and cosmetic outcome in isolated male epispadias |
| |
| Institution: | 1. Chairman Bhat''s Hypospadias and Reconstructive Urology Hospital and Research Centre, Jaipur. Former Dr. S.N. Medical College Jodhpur, Department of Urology, S.P. Medical College Bikaner, Rajasthan 334003, India;2. Department of Surgery, VIMS Bellary Karnataka, India;3. Department of Urology, VIMS Bellary Karnataka, India;4. Department of Urology, Dr. S.N. Medical College Jodhpur, Rajasthan 334003, India;1. Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children''s Hospital, Seattle, WA, USA;2. Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA, USA;3. Division of Plastic Surgery, Department of Surgery, Phoenix Children''s Hospital, Phoenix, AZ, USA;1. Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University, No.1838 North Guangzhou Rd, Guangzhou, Guangdong 510515, People''s Republic of China;2. Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Road, Shijingshan District, Beijing 100144, People''s Republic of China;1. Laboratory of Bioregenerative Medicine & Surgery, Division of Plastic Surgery, Weill Cornell Medicine, New York, NY, United States of America;2. Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States of America;1. Department of Plastic and Hand Surgery, Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany;2. Department of Neurology, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuernberg FAU, Erlangen, Germany;3. Current position: Department of Orthopaedic and Trauma Surgery, Martha-Maria Hospital, Nuernberg, Germany;4. Current position: Department of Urology, Fuerth Hospital, Fuerth, Germany;1. Department of Plastic Surgery, Sophia Children''s Hospital – Erasmus Medical Center, Rotterdam, Netherlands;2. Department of Otorhinolaryngology, Sophia Children''s Hospital – Erasmus Medical Center, Rotterdam, Netherlands;3. Department of Oral and Maxillofacial Surgery, Sophia Children''s Hospital – Erasmus Medical Center, Rotterdam, Netherlands;4. Department of Pediatric Intensive Care, Sophia Children''s Hospital – Erasmus Medical Center, Rotterdam, Netherlands |
| |
| Abstract: | Introduction and objectiveThe objective of the study was to evaluate the functional and cosmetic outcome of single-stage modified partial penile disassembly repair in isolated male epispadias.Materials and methodsA retrospective analysis of 15 cases of primary epispadias repair, from June 2015 to December 2018, was performed. Patients were classified by the type of epispadias, urinary incontinence, chordee, and rotation.Surgical techniquePenile degloving with the mobilization of the urethral plate from the ventral to the dorsal aspect with the preservation of blood supply at both ends, distally up to the level of mid-glans and proximally up to the pubic symphysis is done. Tubularization of urethral plate followed by spongioplasty, corporoplasty with medial rotation of corporeal bodies, and glanuloplasty with meatoplasty was done to bring the meatus ventrally. The skin cover is done by the rotation of the ventral flaps and the z-plasty whenever required.ResultsAge of the patients varied from 4 months to 21 years with a mean of 11 years. Thirteen patients had excellent cosmetic outcome while two patients had minimal residual chordee but did not require any surgery in a follow-up. Five patients with partial incontinence in the study group achieved continence after surgery. None of the patients developed complications such as fistula or stricture. All five male patients in the post-pubertal group reported normal erections and successful ejaculations after the surgery. Follow-up ranged from 3 months to 18 months.ConclusionsModified partial penile disassembly incorporates all the benefits of Cantwell Ransley repair and needs less extensive dissection than total penile disassembly. Both functional and cosmetic results are good with a low complication rate. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
