Double-face preputial island flap revisited: is it a reliable one-stage repair for severe hypospadias?
Curvature
Double face
Preputial flap
Proximal hypospadias
Single stage
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
30
03
2020
accepted:
20
06
2020
pubmed:
1
7
2020
medline:
1
10
2021
entrez:
1
7
2020
Statut:
ppublish
Résumé
We have studied outcome of double-face preputial island flap (DFPIF) technique in severe types of hypospadias: penoscrotal, scrotal and perineal. We have used DFPIF in 75 boys at a median age of 1.1 years (1.0-1.5). The meatus was penoscrotal, scrotal or perineal after de-gloving the penis. The inner face of the foreskin was used for urethroplasty and the outer face for ventral skin covering. Modifications were added: proximal anastomosis was protected by a spongioplasty; in case of urethral plate transection, we anastomosed on onlay proximal and distal segments of the flap (onlay-tube-onlay) and the tubularized part was sutured to corpus cavernosa. FU was scheduled at one month then every 3 months for a year then annually. At each consultation, the surgeon filled out a detailed cosmetic and functional sheet including flowmeter. Thirty-four patients had onlay preputial flap repair with urethral plate preservation. Forty-one had the onlay-tube-onlay technique. All children had a curvature, 19 had a significant residual curvature after dissection, corrected by dorsal plication (n = 9) and ventral lengthening (n = 10). Median FU was 4.2 years (2.7-6.5). 36 children (48%) had complications and needed redo surgery: 12 fistulas, 11 diverticula, 7 meatal stenosis, 3 strictures and 2 residual curvatures. All children but three voided within the normal limits for their age. DFPIF remains a good option for a one-stage repair of severe hypospadias. After a median of 1.8 procedures, the final success rate was 96%. The healthy well-vascularized ventral skin allows safe redo surgery when needed.
Identifiants
pubmed: 32601982
doi: 10.1007/s00345-020-03324-7
pii: 10.1007/s00345-020-03324-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1613-1624Références
Castagnetti M, El-Ghoneimi A (2010) Surgical management of primary severe hypospadias in children: systematic 20-year review. J Urol 184(4):1469–1474
doi: 10.1016/j.juro.2010.06.044
Long CJ, Canning DA (2016) Hypospadias: are we as good as we think when we correct proximal hypospadias? J Pediatr Urol 12(4):196.e1–5
doi: 10.1016/j.jpurol.2016.05.002
Elder JS, Duckett JW, Snyder HM (1987) Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol 138(2):376–379
doi: 10.1016/S0022-5347(17)43152-1
Snodgrass WT (2005) Snodgrass technique for hypospadias repair. BJU Int 95(4):683–693
doi: 10.1111/j.1464-410X.2005.05384.x
Duckett JW (1981) The island flap technique for hypospadias repair. Urol Clin North Am 8(3):503–511
pubmed: 7324317
Hayashi Y, Sasaki S, Mogami T, Yamada Y, Tsugaya M, Kohri K (1996) One-stage urethroplasty with the modified OUPF IV for proximal hypospadias. Nihon Hinyokika Gakkai Zasshi 87(1):56–60
pubmed: 8683894
Bracka A (1995) Hypospadias repair: the two-stage alternative. Br J Urol 76(Suppl 3):31–41
doi: 10.1111/j.1464-410X.1995.tb07819.x
Hinman F Jr (1991) The blood supply to preputial island flaps. J Urol 145(6):1232–1235
doi: 10.1016/S0022-5347(17)38584-1
Jordan GH (1999) Penile reconstruction, phallic construction, and urethral reconstruction. Urol Clin North Am 26(1):1–13
doi: 10.1016/S0094-0143(99)80003-2
Duckett JW Jr (1980) Transverse preputial island flap technique for repair of severe hypospadias. Urol Clin North Am 7(2):423–430
pubmed: 7404875
Hodgson NB (1970) A one-stage hypospadias repair. J Urol 104(2):281–283
doi: 10.1016/S0022-5347(17)61718-X
Asopa R, Asopa HS (1984) One stage repair of hypospadias using double island preputial skin tube. Indian J Urol 1(1):41–43
Standoli L (1982) One-stage repair of hypospadias: preputial island flap technique. Ann Plast Surg 9(1):81–88
doi: 10.1097/00000637-198207000-00013
Gonzalez R, Lingnau A, Ludwikowski BM (2018) Results of onlay preputial flap urethroplasty for the single-stage repair of mid- and proximal hypospadias. Front Pediatr 6:19
doi: 10.3389/fped.2018.00019
Lee PA, Mazur T, Danish R, Amrhein J, Blizzard RM, Money J et al (1980) Micropenis. I. criteria, etiologies and classification. Johns Hopkins Med J 146(4):156–163
pubmed: 7366061
Kiss A, Sulya B, Szasz AM, Romics I, Kelemen Z, Toth J et al (2011) Long-term psychological and sexual outcomes of severe penile hypospadias repair. J Sex Med 8(5):1529–1539
doi: 10.1111/j.1743-6109.2010.02120.x
Prasad MM, Marks A, Vasquez E, Yerkes EB, Cheng EY (2012) Published surgical success rates in pediatric urology—fact or fiction? J Urol 188(4 Suppl):1643–1647
doi: 10.1016/j.juro.2012.02.032
Patel RP, Shukla AR, Snyder HM 3rd (2004) The island tube and island onlay hypospadias repairs offer excellent long-term outcomes: a 14-year followup. J Urol 172(4 Pt 2):1717–1719 (discussion 9)
doi: 10.1097/01.ju.0000138903.20136.22
Wiener JS, Sutherland RW, Roth DR, Gonzales ET Jr (1997) Comparison of onlay and tubularized island flaps of inner preputial skin for the repair of proximal hypospadias. J Urol 158(3 Pt 2):1172–1174
doi: 10.1097/00005392-199709000-00123
Sedberry-Ross S, Stisser BC, Henderson CG, Rushton HG, Belman AB (2007) Split prepuce in situ onlay hypospadias repair: 17 years of experience. J Urol 178(4 Pt 2):1663–1667
doi: 10.1016/j.juro.2007.03.198
Baskin LS, Duckett JW, Ueoka K, Seibold J, Snyder HM 3rd (1994) Changing concepts of hypospadias curvature lead to more onlay island flap procedures. J Urol 151(1):191–196
doi: 10.1016/S0022-5347(17)34915-7
Silva e EDM, Gorduza DB, Catti M, Valmalle AF, Demede D, Hameury F et al (2009) Outcome of severe hypospadias repair using three different techniques. J Pediatr Urol 5(3):205–211 (discussion 12–4)
doi: 10.1016/j.jpurol.2008.12.010
Wallis MC, Braga L, Khoury A (2008) The role of flaps and grafts in modern hypospadiology. Indian J Urol 24(2):200–205
doi: 10.4103/0970-1591.40616
Rigamonti W, Castagnetti M (2011) Onlay on albuginea: modified onlay preputial island flap urethroplasty for single-stage repair of primary severe hypospadias requiring urethral plate division. Urology 77(6):1498–1502
doi: 10.1016/j.urology.2010.09.048
Braga LH, Lorenzo AJ, Bagli DJ, Dave S, Eeg K, Farhat WA et al (2008) Ventral penile lengthening versus dorsal plication for severe ventral curvature in children with proximal hypospadias. J Urol 180(4 Suppl):1743–1747 (discussion 7–8)
doi: 10.1016/j.juro.2008.03.087
Benson CR, Hoang L, Clavell-Hernandez J, Wang R (2018) Sexual dysfunction in urethral reconstruction: a review of the literature. Sex Med Rev 6(3):492–503
doi: 10.1016/j.sxmr.2017.09.002
Moriya K, Kakizaki H, Tanaka H, Furuno T, Higashiyama H, Sano H et al (2006) Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence. J Urol 176(4 Pt 2):1889–1892 (discussion 92-93)
doi: 10.1016/S0022-5347(06)00600-8
Blanc T, Ayedi A, El-Ghoneimi A, Abdoul H, Aigrain Y, Paris F et al (2011) Testicular function and physical outcome in young adult males diagnosed with idiopathic 46 XY disorders of sex development during childhood. Eur J Endocrinol 165(6):907–915
doi: 10.1530/EJE-11-0588
Badawy H, Orabi S, Hanno A, Abdelhamid H (2018) Posterior hypospadias: evaluation of a paradigm shift from single to staged repair. J Pediatr Urol 14(1):28.e1–28.e8
doi: 10.1016/j.jpurol.2017.07.007
Castagnetti M, El-Ghoneimi A (2011) The influence of perioperative factors on primary severe hypospadias repair. Nat Rev Urol 8(4):198–206
doi: 10.1038/nrurol.2011.24