Tubularized incised plate urethroplasty for hypospadias reoperations in 100 patients |
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Authors: | Mehmet Eliçevik Gülay Tireli Oyhan Demirali Murat Ünal Serdar Sander |
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Institution: | 1.Department of Pediatric Surgery and Pediatric Urology,Bak?rk?y Maternal and Childrens’ Hospital,Istanbul,Turkey |
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Abstract: | Objectives To determine the key points for a successful redo hypospadias procedure using tubularized incised plate urethroplasty operation.
Methods A retrospective chart review of a cohort of 100 patients (Mean age: 4.5 years, range: 2–12) who had undergone a redo tubularized
incised plate urethroplasty operation was performed. Fischer exact and Chi square tests were used for statistical analysis.
Results The incidence of complications of tubularized incised plate urethroplasty reoperation after failed repairs of meatal advancement
and glanuloplasty procedure (n: 14), meatal based flap (n: 36), and tubularized incised plate urethroplasty (n: 50) were 29% (n: 4), 22% (n: 8) and, 28% (n: 14) respectively (P > 0.05). The overall complication rate was 26% (n: 26). Eighteen patients (18%) had fistula, five had meatal stenosis (5%), two had dehiscence (2%) and one had neourethral
stenosis (1%). Postoperatively, fistula was closed in 18 patients and 5 underwent meatoplasty. Two patients with dehiscence
and one with neourethral stenosis underwent an unsuccessful third redo tubularized incised plate urethroplasty reoperation
and they were candidates for a complex hypospadias repair (3%). The ultimate success rate of tubularized incised plate urethroplasty
reoperation after treatment of complications was 97%.
Conclusion Tubularized incised plate urethroplasty is a safe and efficacious alternative procedure for hypospadias reoperations if the
urethral plate has no scars and outcome is favourable if the first failed hypospadias repair is a meatal based flap procedure.
The complication rate increases if the urethral plate has been previously incised in the midline and a redo third redo must
be avoided. |
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Keywords: | Tubularized incised plate urethroplasty Reoperations Hypospadias |
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