Repair of hypospadias complications using the previously utilized urethral plate

Garrick R. Simmons, Mark P. Cain, Anthony J. Casale, Michael A. Keating, Mark C. Adams, Richard C. Rink

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objectives. To review our results of patients who underwent repeat hypospadias surgery using local skin flaps with preservation of the urethral plate. Methods. We retrospectively reviewed the medical records of all patients who underwent a reoperative hypospadias repair using the urethral plate between 1988 and 1996. A total of 53 patients were identified who developed either a large fistula (47 patients) or severe stricture (6 patients) after the initial repair. Seventeen patients underwent a repeat Mathieu flip-flap and 36 an onlay flap. The mean age at the time of surgery was 5.2 years (range 1 to 27). The mean duration of follow-up was 17 months (range 6 to 108). Results. The initial failed hypospadias repair was corrected with a single procedure in 44 (83%) of the 53 patients. The 9 patients who had further complications required 17 additional procedures. A meatal-based flap had been used in 4 of these patients and an onlay flap in 5. Three of the 9 patients who had further complications presented with urethral strictures after the previous repair. Conclusions. Fistula and stricture are common complications of hypospadias surgery. The use of the urethral plate in primary repairs has helped decrease the complication rate. We report the effectiveness of using local skin flaps and preserving the urethral plate in complex reoperative hypospadias surgery. These techniques were successful in 83% of these challenging patients. Patients with stricture after hypospadias surgery are at increased risk of further complications.

Original languageEnglish (US)
Pages (from-to)724-726
Number of pages3
JournalUrology
Volume54
Issue number4
DOIs
StatePublished - Oct 1999
Externally publishedYes

Fingerprint

Hypospadias
Inlays
Pathologic Constriction
Fistula
Urethral Stricture
Skin
Reoperation
Medical Records

ASJC Scopus subject areas

  • Urology

Cite this

Simmons, G. R., Cain, M. P., Casale, A. J., Keating, M. A., Adams, M. C., & Rink, R. C. (1999). Repair of hypospadias complications using the previously utilized urethral plate. Urology, 54(4), 724-726. https://doi.org/10.1016/S0090-4295(99)00322-2

Repair of hypospadias complications using the previously utilized urethral plate. / Simmons, Garrick R.; Cain, Mark P.; Casale, Anthony J.; Keating, Michael A.; Adams, Mark C.; Rink, Richard C.

In: Urology, Vol. 54, No. 4, 10.1999, p. 724-726.

Research output: Contribution to journalArticle

Simmons, GR, Cain, MP, Casale, AJ, Keating, MA, Adams, MC & Rink, RC 1999, 'Repair of hypospadias complications using the previously utilized urethral plate', Urology, vol. 54, no. 4, pp. 724-726. https://doi.org/10.1016/S0090-4295(99)00322-2
Simmons, Garrick R. ; Cain, Mark P. ; Casale, Anthony J. ; Keating, Michael A. ; Adams, Mark C. ; Rink, Richard C. / Repair of hypospadias complications using the previously utilized urethral plate. In: Urology. 1999 ; Vol. 54, No. 4. pp. 724-726.
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abstract = "Objectives. To review our results of patients who underwent repeat hypospadias surgery using local skin flaps with preservation of the urethral plate. Methods. We retrospectively reviewed the medical records of all patients who underwent a reoperative hypospadias repair using the urethral plate between 1988 and 1996. A total of 53 patients were identified who developed either a large fistula (47 patients) or severe stricture (6 patients) after the initial repair. Seventeen patients underwent a repeat Mathieu flip-flap and 36 an onlay flap. The mean age at the time of surgery was 5.2 years (range 1 to 27). The mean duration of follow-up was 17 months (range 6 to 108). Results. The initial failed hypospadias repair was corrected with a single procedure in 44 (83{\%}) of the 53 patients. The 9 patients who had further complications required 17 additional procedures. A meatal-based flap had been used in 4 of these patients and an onlay flap in 5. Three of the 9 patients who had further complications presented with urethral strictures after the previous repair. Conclusions. Fistula and stricture are common complications of hypospadias surgery. The use of the urethral plate in primary repairs has helped decrease the complication rate. We report the effectiveness of using local skin flaps and preserving the urethral plate in complex reoperative hypospadias surgery. These techniques were successful in 83{\%} of these challenging patients. Patients with stricture after hypospadias surgery are at increased risk of further complications.",
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