ABSTRACT
We reviewed our experience in reconstructing forked corpus spongiosum (FCS) in distal/midshaft hypospadias repair and analyzed the efficacy of this surgical technique. From August 2013 to December 2018, 137 consecutive cases of distal/midshaft hypospadias operated by the same surgeon in Urology Department, Children's Hospital of Fudan University (Shanghai, China), were retrospectively analyzed. Sixty-four patients who underwent routine tubularized incised plate (TIP) or onlay island flap (ONLAY) surgery were included in the nonreconstructing group, and 73 patients who underwent reconstructing FCS during TIP or ONLAY surgery were included as the reconstructing group. Thirty-eight cases underwent TIP, and 26 underwent ONLAY in the nonreconstructing group, with a median follow-up of 44 (range: 30-70) months. Twenty-seven cases underwent TIP, and 46 underwent ONLAY in the reconstructing group, with a median follow-up of 15 (range: 6-27) months. In the nonreconstructing/reconstructing groups, the mean age at the time of surgery was 37.55 (standard deviation [s.d.]: 29.65)/35.23 (s.d.: 31.27) months, the mean operation duration was 91.95 (s.d.: 12.17)/93.84 (s.d.: 14.91) min, the mean neourethral length was 1.88 (s.d.: 0.53)/1.94 (s.d.: 0.53) cm, and the mean glans width was 11.83 (s.d.: 1.32)/11.56 (s.d.: 1.83) mm. Twelve (18.8%)/5 (6.8%) postoperative complications occurred in the nonreconstructing/reconstructing groups. These included fistula (5/2), glans dehiscence (3/0), diverticulum (1/2), residual chordee (3/0), and meatus stenosis (0/1) in each group. There was a significant difference in the overall rate of complications (P= 0.035). These results indicate that the technique of reconstructing FCS provides excellent outcomes with fewer complications in distal/midshaft hypospadias repair.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the techniques of surgical correction of penoscrotal transposition with hypospadias.</p><p><b>METHODS</b>We retrospectively studied 83 cases of penoscrotal transposition with hypospadias treated by surgery from January 2003 to June 2009, and analyzed the surgical techniques and follow-up results.</p><p><b>RESULTS</b>The patients underwent urethroplasty with simultaneous or staged surgical correction of penoscrotal transposition. Postoperative follow-up was conducted for 0.5-5 years. Eighty-one of the patients were satisfied with the appearance of the reconstructed penis and scrotum, and satisfactory outcomes were achieved in the other 2 with severe hypospadias after a second surgical correction of penoscrotal transposition.</p><p><b>CONCLUSION</b>Urethroplasty with simultaneous or staged surgical correction of penoscrotal transposition is recommendable for its resultant penile straightness, desirable penoscrotal appearance, good surgical prognosis and few postoperative complications.</p>
Subject(s)
Child , Child, Preschool , Humans , Infant , Male , Abnormalities, Multiple , Diagnosis , General Surgery , Hypospadias , Diagnosis , General Surgery , Penis , Congenital Abnormalities , General Surgery , Retrospective Studies , Scrotum , Congenital Abnormalities , General Surgery , Treatment Outcome , Urethral Diseases , Diagnosis , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of ovotesticular disorders of sex development (DSD) in children.</p><p><b>METHODS</b>We reviewed the clinical data of 9 cases of ovotesticular DSD admitted in our department from 1988 to 2007.</p><p><b>RESULTS</b>The patients ranged in age from 9 months to 9 years, 7 raised as males and 2 as females. As for the karyotype, 4 cases were 46,XX, 2 were 46,XX/46,XY, 1 was 46,XY, and the other 2 had no karyotype data. All of them presented with obscure external genitalia: perineal or penoscrotal hypospadias with or without cryptorchidism in males and hypertrophy of the clitoris in females. They were diagnosed with ovotesticular DSD by gonad biopsy and underwent genitoplasty.</p><p><b>CONCLUSION</b>The gender assignment of the ovotesticular DSD patient was chiefly based on the development of external genitalia, dominant gonad, karyotype and the parent's will. Laparoscopic technology is recommended in gonad biopsy and orchiopexy during the treatment of ovotesticular DSD.</p>