Displaying all 14 publications

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  1. Arshad AR
    Br J Plast Surg, 2005 Jun;58(4):481-6.
    PMID: 15897031
    Hypospadias is a congenital deformity characterised by an abnormally located urethral opening, that could occur anywhere proximal to its normal location on the ventral surface of glans penis to the perineum. Many operations had been described for the management of this deformity.
    Matched MeSH terms: Hypospadias/pathology; Hypospadias/surgery*
  2. Fahmy O, Khairul-Asri MG, Schwentner C, Schubert T, Stenzl A, Zahran MH, et al.
    Eur Urol, 2016 08;70(2):293-8.
    PMID: 26776935 DOI: 10.1016/j.eururo.2015.12.047
    CONTEXT: Although urethral covering during hypospadias repair minimizes the incidence of fistula, wide variation in results among surgeons has been reported.

    OBJECTIVE: To investigate what type of flap used during Snodgrass or fistula repair reduces the incidence of fistula occurrence.

    EVIDENCE ACQUISITION: We systematically reviewed published results for urethral covering during Snodgrass and fistula repair procedures. An initial online search detected 1740 reports. After exclusion of ineligible studies at two stages, we included all patients with clear data on the covering technique used (dartos fascia [DF] vs tunica vaginalis flap [TVF]) and the incidence of postoperative fistula.

    EVIDENCE SYNTHESIS: A total of 51 reports were identified involving 4550 patients, including 33 series on DF use, 11 series on TVF use, and seven retrospective comparative studies. For distal hypospadias, double-layer DF had the lowest rate of fistula incidence when compared to single-layer DF (5/855 [0.6%] vs 156/3077 [5.1%]; p=0.004) and TVF (5/244, 2.0%), while the incidence was highest for single-layer DF among proximal hypospadias cases (9/102, 8.8%). Among repeat cases, fistula incidence was significantly lower for TVF (3/47, 6.4%) than for DF (26/140, 18.6%; p=0.020). Among patients with fistula after primary repair, the incidence of recurrence was 12.2% (11/90) after DF and 5.1% (5/97) after TVF (p=0.39). The absence of a minimum follow-up time and the lack of information regarding skin complications and rates of urethral stricture are limitations of this study.

    CONCLUSION: A double DF during tubularized incised plate urethroplasty should be considered for all patients with distal hypospadias. In proximal, repeat, and fistula repair cases, TVF should be the first choice. On the basis of these findings, we propose an evidence-based algorithm for surgeons who are still in their learning phase or want to improve their results.

    PATIENT SUMMARY: We systematically reviewed the impact of urethral covering in reducing fistula formation after hypospadias repair. We propose an algorithm that might help to maximize success rates for tubularized incised plate urethroplasty.

    Matched MeSH terms: Hypospadias/surgery*
  3. Roger, A.I., Rachel, Anne J.
    MyJurnal
    A congenital urethrocutaneous fistula is a rare anomaly which was first described in 1962 by Gupta. Clinically, children present when their guardian is alarmed by either frequent urinary dribbling or unusual stream when they pass urine. This congenital anomaly can present in isolation or be accompanied by a chordee, hypospadia and anorectal malformations in a newborn. The surgical management will either be a primary repair of the fistula or converting it to a hypospadia before proceeding with a single or staged hypospadia repair. Surgical technique will depend on the local tissue factors and associated anomalies.
    Matched MeSH terms: Hypospadias
  4. Tan HL, Nah SA, Budianto II, Sehat S, Tamba R
    J Pediatr Surg, 2012 Dec;47(12):2294-7.
    PMID: 23217892 DOI: 10.1016/j.jpedsurg.2012.09.022
    Octyl cyanoacrylate has been used for many years for simple skin closure, but its use in hypospadias repair and as a urethral stent fixator has not been previously reported. We report our experience.
    Matched MeSH terms: Hypospadias/diagnosis; Hypospadias/surgery*
  5. Rynja SP, Bosch JLHR, de Jong TPVM, van der Werf-Kok ET, de Kort LMO
    J Pediatr Urol, 2019 Dec;15(6):625.e1-625.e8.
    PMID: 31521557 DOI: 10.1016/j.jpurol.2019.08.007
    OBJECTIVE: The objective of this study is to investigate the coping styles used by patients with hypospadias. Long-term hypospadias studies generally show satisfying outcomes, but some report a lower quality of life (QoL) or poorer psychosocial adjustment, particularly in patients with proximal hypospadias. A lower QoL or psychosocial adjustment was found to be associated with passive coping styles in other pediatric patient populations. Hypothetically, patients with hypospadias also develop different coping styles due to medical experiences in childhood, leading to the lower QoL outcomes on the long term. However, coping styles of patients with hypospadias have never been analyzed.

    PATIENTS AND METHODS: Adult men with hypospadias repair in childhood were recruited (n = 55; aged 19.9 [IQR 19.2-22.1]). Coping styles were determined with the Utrecht Coping List (UCL) and results compared with a reference group of male students (n = 55, age 20-30 years, no medical history). Sub analysis of coping styles of the hypospadias groups was done based on three items: severity of hypospadias, time of last hypospadias surgery and occurrence of postoperative complications.

    RESULTS: Compared to the reference groups, patients with hypospadias had higher scores on Avoidance (P 

    Matched MeSH terms: Hypospadias/psychology*
  6. McClosky AJ
    Matched MeSH terms: Hypospadias
  7. Ramzisham AR, Thambidorai CR
    Pediatr Surg Int, 2005 Jun;21(6):478-81.
    PMID: 15902476
    A rare case of a newborn male with a perineal hamartoma, accessory scrotum, anorectal anomaly, hypospadias, and bifid scrotum is reported, with discussion of its embryological significance. Only three other cases with such a combination of anomalies have been reported in the English literature.
    Matched MeSH terms: Hypospadias/complications*
  8. Ramanujam TM, Sergius A, Usha V, Ramanathan S
    Pediatr Surg Int, 1998 Nov;14(1-2):134-7.
    PMID: 9880724
    Urethral duplication (UD) is an uncommon malformation. Obstruction rarely occurs in hypospadiac UD. We describe two children with incomplete hypospadiac UD in association with posterior urethral valves, a combination not previously recognised. The embryonic significance of this anomaly is discussed. Keywords Urethral duplication. Hypospadias. Posterior urethral valve. Megalourethra
    Matched MeSH terms: Hypospadias/complications*; Hypospadias/pathology; Hypospadias/surgery
  9. Tan TT, Khalid BA
    Postgrad Med J, 1993 Apr;69(810):315-7.
    PMID: 8321801
    The case of a 32 year old male with normal male adrenarchal hair pattern, bilateral gynaecomastia, a small phallus, hypospadias and bilateral poorly developed testes presenting with primary infertility secondary to azoospermia and a pelvic cyst is described. Repeated chromosomal analysis showed 46XX chromosomal constitution. Laparotomy revealed a simple cyst between the urinary bladder and the rectum. XX male syndrome is a rare cause of male infertility. The majority of cases is due to interchange of a fragment of the short arm of the Y chromosome containing the region that encodes the testes determining factor with the X chromosome. The presence of a simple cyst in the anatomical location of the uterus to our knowledge has not been reported in the literature.
    Matched MeSH terms: Hypospadias/etiology
  10. Patankar JZ, Fazal S, Ubaidullah S, Mukesh S
    Med J Malaysia, 2013 Aug;68(4):305-8.
    PMID: 24145257
    The importance of an adequate caliber neo-meatus for success of any hypospadias repair cannot be overstated. TIP repair incorporates a midline relaxing incision thus enabling tubularization but ultimately may not result in adequate neourethral caliber to avoid fistulas or meatal stenosis when the plate was narrow or flat, respectively. Objectives of this study is to evaluate results of a modification of TIP - "wide skeletonization" tubularized incised plate (TIP) - for repair of distal penile hypospadias with narrow urethral plate (UP), with regard to meatal stenosis and urethrocutaneous fistula.
    Matched MeSH terms: Hypospadias*
  11. Yeap BH, Mohan N
    Med J Malaysia, 2008 Dec;63(5):388-90.
    PMID: 19803297 MyJurnal
    The last decade has witnessed an alarming increase in the worldwide incidence of hypospadias. For non-hypospadiologists, the surgical correction of hypospadias will be increasingly demanding. This paper aims to evaluate the effectiveness of a treatment strategy devised by a single-surgeon practice in Malaysia to tackle this anticipated surge of caseload. Over a period exceeding eight years, 254 boys underwent corrective hypospadias surgery by a single paediatric surgeon at Alor Star Hospital, Malaysia. Patient demographics, racial distribution and meatal location were among the data collected retrospectively. The various types of corrective procedure employed, their outcome as well as complications were evaluated. Distal type of hypospadias dominated this series. There was an explainable peculiarity in the age distribution of hypospadias. For all types of repair, the complication rate was 33% consisting mainly of urethrocutaneous fistula (18%) and meatal stenosis (9%). Complication rate for tubularised incised plate (TIP) urethroplasty, the commonest technique of repair, was 30%, mainly from meatal stenosis (15%) and urethrocutaneous fistula (13%). Univariate analysis revealed that proximal hypospadias, repairs done during the initial four years of study and utilisation of repair other than TIP to be adverse risk factors. Tubularised incised plate urethroplasty was appropriate for almost all types of hypospadias. For the remainder, the two stage repair is satisfactorily employed. This study from a primary referral centre also dispelled the notion that proximal hypospadias predominate in this region. The versatility and reliability of TIP urethroplasty lends itself readily in tackling primary and repeat hypospadias surgery within a single-surgeon practice.
    Matched MeSH terms: Hypospadias/surgery*
  12. Carran M, Shaw IC
    N Z Med J, 2012;125(1358):52-63.
    PMID: 22864157
    It is well known that the endocrine-disrupting chemical (EDC) dibutylphthalate (DBP) inhibits testosterone synthesis and can lead to feminisation in male laboratory animals. Moreover, it has long been speculated that human exposure would result in the similar effects, but this is difficult to study because specific human exposure cohorts are rare. We report increases in the incidences of hypospadias (p<0.05), cryptorchidism (p<0.05) and breast cancer (p<0.05) in the children of New Zealand soldiers who served in Malaya (1948-1960) and were exposed to DBP applied daily to their clothing as an acaricide to prevent tick-transmitted bush typhus. In addition, we modelled absorption of DBP from the soldiers' clothing and using published data for skin absorption, and calculated a large theoretical absorbed dose of 64 mg/kg body weight/day which is similar to DBP's lowest observed adverse effect level (LOAEL) of 50 mg/kg body weight/day and thus indicates a biological effect is possible. This is the first report of a multigenerational developmental effect following DBP exposure in human males.
    Matched MeSH terms: Hypospadias/etiology*; Hypospadias/epidemiology
  13. Hussein NS, Samat SB, Abdullah MA, Gohar MN
    Turk J Urol, 2013 Jun;39(2):90-5.
    PMID: 26328087 DOI: 10.5152/tud.2013.015
    OBJECTIVE: The functional outcome following hypospadias repair is as important as the cosmetic outcome. Currently, structured scoring systems, patient questionnaires and evaluations of photographs and uroflowmetry are used to assess the results of hypospadias repair. In the present study, we assessed the outcomes of two-stage hypospadias repair using Hypospadias Objective Scoring Evaluation-HOSE and measures of uroflowmetry.

    MATERIAL AND METHODS: Over a period of eight years, from January 1997 to December 2004, 126 hypospadias patients were treated, 90 of these patients received two-stage repairs and 36 patients received single-stage repairs. HOSE questionnaire and uroflowmetry data were obtained to evaluate the long-term outcome of the two-stage hypospadias repairs.

    RESULTS: The age at the time of assessment ranged from 8 to 23 years-old, with a mean follow-up time of 39.78 months. Thirty-five patients had proximal hypospadias, and 20 had distal hypospadias. Of the 55 patients who received complete two-stage hypospadias repair and agreed to participate in the study, nineteen patients had acceptable HOSE scores and 36 patients had non-acceptable scores. The uroflow rates of 43 of the subjects were below the fifth percentile in three patients, equivocal (between the 5(th) and 25(th) percentile) in four patients and above the 25(th) percentile in 36 patients.

    CONCLUSION: Two-stage repair is a suitable technique for all types of hypospadias with varying outcomes. HOSE and uroflowmetry are simple, easy, non-invasive and non-expensive tools for objectively assessing the long-term outcomes of hypospadias repair.

    Matched MeSH terms: Hypospadias
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