SURGICAL MANAGEMENT OF HYPOSPADIAS IN CHILDREN AN UPDATE FOCUSING ON CHORDEE PENILE CURVATURE

Main Article Content

Syed Ghafar Shah
Hamza Khan Shahbazi
Ekramuddin
Younis Khan
Hamza Fayyaz

Keywords

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Abstract

Introduction: Hypospadias, a condition where the urethra opens on the underside of the penis with related ventral penile ebb and flow, is the second most normal genital birth deformity in boys, following cryptorchidism.


Objectives: The main objective of the study is to find the surgical management of hypospadias in children an update focusing on chordee penile curvature.


Material and methods: The study was conducted at the Institute of Kidney Diseases, Hayatabad Peshawar, a tertiary care center known for its expertise in urological conditions and surgical interventions from June 2022 to June 2023. A retrospective observational study design was employed to assess the surgical management of hypospadias with a specific focus on chordee or penile curvature correction.


Results: A total of 134 patients diagnosed with hypospadias and undergoing surgical intervention for chordee correction were included in the study. The age distribution of the patients ranged from 1 to 18 years, with a mean age of 8.5 ± 2.3 years. The surgical procedures utilized for chordee correction included the Tubularized Incised Plate (TIP) technique (n = 65), the Mathieu procedure (n = 45), and the Onlay Island Flap Urethroplasty (n = 24), among others.


Conclusion: It is concluded that this study provides valuable insights into the surgical management of hypospadias with a particular emphasis on chordee correction. The findings underscore the significance of tailored surgical approaches that address both functional and cosmetic aspects of the condition.

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References

1. Castagnetti, Marco. "Surgical Management of Primary Severe Hypospadias in Children: An Update Focusing on Penile Curvature." Nature Reviews Urology, vol. 19, no. 3, 2022, pp. 147-160, https://doi.org/10.1038/s41585-021-00555-0.
2. Andersson, M. et al. Urological results and patient satisfaction in adolescents after surgery for proximal hypospadias in childhood. J. Pediatr. Urol. 16, 660.e1–660.e8 (2020).
3. Pasterski, V., Prentice, P. & Hughes, I. A. Consequences of the Chicago consensus on disorders of sex development (DSD): current practices in Europe. Arch. Dis. Child. 95, 618–623 (2010).
4. Castagnetti, Marco, and Alaa El-Ghoneimi. "Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review." The Journal of Urology, vol. 184, no. 4, 2010, pp. 1469-1475, https://doi.org/10.1016/j.juro.2010.06.044.
5. Keays, Melise A., and Sumit Dave. "Current Hypospadias Management: Diagnosis, Surgical Management, and Long-term Patient-centred Outcomes." Canadian Urological Association Journal, vol. 11, no. 1-2Suppl1, 2017, p. S48, https://doi.org/10.5489/cuaj.4386.
6. Braga LH, Lorenzo AJ, Bagli DJ. Ventral penile lengthening versus dorsal plication for severe ventral curvature in children with proximal hypospadias. J Urol. 2008;180:1743–7.
7. Belman BA. Re: outcome analysis of severe chordee correction using tunica vaginalis as a flap in boys with proximal hypospadias. J Urol. 2007;178:1697. https://doi.org/10. 1016/j.juro.2007.03.399.
8. Hassan HS, Almetaher HA, Negm M, et al. Urethral mobilization and advancement for distal hypospadias. Ann Pediatr Surg. 2015;11:239–43.
https://doi.org/10.1097/01.XPS.0000472853.75905.28.
9. Asopa HS, Elhence IP, Atri SP, et al. One-stage correction of penile hypospadias using a foreskin tube: A preliminary report. Int Surg. 1971;55:435–40.
10. Decter RM, Franzoni DF. Distal hypospadias repair by the modified Thiersh-Duplay technique with or without hinging the urethral plate: a near ideal way to correct distal hypospadias. J Urol. 1999;162:1156–8. https://doi.org/10.1016/S0022-5347(01)68109-6.
11. Castagnetti M, El-Ghoneimi A. Surgical management of primary severe hypospadias in children: an update focusing on penile curvature. Nat Rev Urol. 2022 Mar;19(3):147-160. doi: 10.1038/s41585-021-00555-0. Epub 2022 Jan 17. PMID: 35039660.
12. Yang Z, Li J, Liu P, Fang Y, Wang X, Fan S, Li Z, Shao Z, Xia Y, Wang Z, Liu H, Sun N, Song H, Zhang W. Effectiveness of penile ventral curvature correction and the trend of hypospadias repair: a prospective study of the national center in China. BMJ Paediatr Open. 2023 Jul;7(1):e001984. doi: 10.1136/bmjpo-2023-001984. PMID: 37463825; PMCID: PMC10357771.
13. Castagnetti M, El-Ghoneimi A. Surgical management of primary severe hypospadias in children: an update focusing on penile curvature. Nat Rev Urol2022;19:147–60. 10.1038/s41585-021-00555-0