PROKSİMAL HİPOSPADİASLI VE CİDDİ KORDİLİ ÇOCUKLARIN İKİ AŞAMALI AMELİYAT SONUÇLARININ HİPOSPADİAS OBJEKTİVE PENİL SKORLAMA (HOPS) İLE DEĞERLENDİRİLMESİ

Year 2019, Volume: 9 Issue: 4, 373 - 377, 31.12.2019

Unal Bıcakcı , Yaşar Issı , Beytullah Yağız Berat Dilek Demirel

https://doi.org/10.16899/jcm.561241

Cited By: 1

Abstract

Abstract

Purpose

Surgical
management for the severe proximal hypospadias remains controversial and it
might be challenging. In this study,we evaluated the surgical outcome of
patients with proximal hypospadias managed by two staged repair with dorsal
prepucial flaps.

Patients and Methods

Forty
one boys with proximal hypospadias are enrolled between
January 2006 and September 2016. The location of the urethral meatus was at the penoscrotal junction
(PSH), at the scrotum (SH) or at the perineum (PRH). First stage; chordee was
released and the prepucial flaps were constructed. Second stage; urethroplasty
was performed according to Thiersch-Duplay principle.

We
assessed postoperative complication rates and utilized Hypospadias Objective
Penile Evaluation (HOPE) scoring to evaluate the cosmetic outcome.

Results

There
are a total of 41 boys (31 PSH(%76), 3 SH(%7) 
and 7 PRH(%17). The mean age at first operation
was 15±5,3 months. The
mean interval between the stages of the surgical procedures was
10.1±4.,9months.

Sixteen patients had various enzyme deficiency or
dysgenesis. In two patients, diverticulum is developed after the repair.
stenosis has encountered  in 10 patients
and fistula in 5. Two patients had dehiscence at glanular level. Relation did not demonstrated 
between the severity of hypospadias and development of fistula,
stricture and diverticulum (p>0,05). HOPE scores; 9,4 for the position of the meatus, 5,8
for shape of the meatus, 7,2 for shape of the glans penis, 9,3 for penile
torsion and 9,8 penile curvature.

 Conclusion

Incorporating
the  dorsal prepucial skin flaps in
staged procedures has both satisfactory cosmetic and functional success
rates. 

Keywords

Proksimal Hipospadias, Prepusyal Flepler

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