Hypospadias. Laurence S. Baskin, M.D. Chief, Pediatric Urology University of California, San Francisco
|
|
- Sharon Harrington
- 6 years ago
- Views:
Transcription
1 UCSF Pediatric Urology Center for the Study and Treatment of Hypospadias Written for Pediatricians, Family Practitioners, Nurse Practitioners, Health Care Workers and Families of Patients with Hypospadias Hypospadias Laurence S. Baskin, M.D. Chief, Pediatric Urology University of California, San Francisco Adapted from the Handbook of Pediatric Urology Lipponcott-Raven, 1997, Baskin, Kogan and Duckett I. Introduction A. Hypospadias is a congenital defect of the penis, resulting in incomplete development of the anterior urethra, corpora cavernosa and prepuce (foreskin). B. Clinically, the hypospadiac urethral meatus does not cause significant urinary symptoms other than a urinary stream which may be deflected in a downward fashion. C. Hypospadias is also associated with penile curvature and may result in infertility secondary to difficulty in semen delivery. II. Embryology A. At one month gestation the male and female genitalia are essentially indistinguishable. B. Under the influence of testosterone the male external genitalia become masculinized.
2 C. By the end of the first trimester and the beginning of the 2nd trimester the penile urethra and accompanying prepuce are completely formed. D. Abnormalities in this development can lead to hypospadias and associated penile anomalies. E. In hypospadias, incomplete development of the glandular urethra does not allow the preputial folds to fuse. F. Consequently, in hypospadias the foreskin is absent on the ventrum and there is excessive foreskin on the dorsal surface (dorsal preputial hood). III. Classification A. Hypospadias can be classified as to the location of the urethral meatus without taking into account penile curvature. B. A more useful surgical classification is the location of the urethral meatus after penile straightening where: 1. 50% of the patients will have anterior hypospadias with the meatus on the glans or subcoronal (Figure 1) % will have the urethral meatus on the penile shaft % will have the meatus between the perineum and the penoscrotal junction. IV. Incidence, Genetics and Etilogy A. Hypospadias occurs in ~one per three hundred live male births. Recent reports in Europe and the United States suggest that the rate of hypospadias is increasing. B. There is a 14% incidence in male siblings and an 8% incidence in offspring. C. Most cases of hypospadias do not have an identifiable cause. Rare cases can be attributed to abnormalities in androgen metabolism (Type II 5? reductase deficiency) or defects in the androgen receptor. Unproven theories explaining hypospadias currently under study are genetic and environment factors such as endocrine disrupters or environmental toxins.
3 V. Associated Anomalies A. Undescended testes occur in ~9% of patients with hypospadias. B. An increased incidence of up to 30% in patients with penoscrotal or more severe hypospadias. C. Inguinal hernias also occur in ~9% of patients with hypospadias. D. A utricle or Mullerian remnant in the posterior urethra is found in a high percentage of patients with severe hypospadias. E. Associated urinary tract anomalies are infrequent in patients with isolated hypospadias because the external genitalia are formed much later than the kidneys, ureter and bladder. F. Patients with hypospadias and an undescended testicle or an inguinal hernia do not need further urinary tract evaluation such as an ultrasound or echocardiogram. G. Patients who have hypospadias in association with other organ system anomalies such as a cardiac murmur, imperforate anus or pyloric stenosis require renal and bladder imaging with an abdominal ultrasound. H. Patients with severe hypospadias and undescended testes should be investigated for intersex with a karyotype and further endocrinologic work-up. VI. Treatment of Hypospadias A. There are five basic phases for the successful reconstruction of the hypospadiac penis: 1) Creation of a normal urethral meatus and glans penis. 2) A straight penis. 3) A normal urethra. 4) Skin covering. 5) Normal position of the scrotum in relationship to the penis. VII. Timing of Surgery A. Hypospadias surgery is best performed between the ages of six months and eighteen months, prior to toilet training and during the
4 psychologic window when genital awareness has not been recognized by the patient. B. Outpatient surgery is now the standard of care. The majority of hypospadiac defects can be repaired in a single-stage operation, with severe cases requiring a staged procedure. Early hypospadias repair with minimal hospitalization helps to avoid separation anxiety and castration fears. VIII. Anaesthesia A. Hypospadias surgery is performed under general anesthesia. B. A penile nerve block or a caudal supplementation is standard to minimize post-operative discomfort. IX. Hypospadias Operations Hundreds of techniques to correct hypospadias have been published in the medical literature. Some of the standard repairs are listed below. A. Meatal advancement and glanuloplasty procedure (MAGPI). B. Mathieu procedure or Flip-Flap procedure. C. Primary closure of the urethral plate with and without incision. D. Onlay island flap procedure. E. Transverse tubularized island flap. F. Buccal mucosa grafts (taken from the inside of the cheek) can be used for urethral replacement typically in a secondary procedure when local vascular flaps have failed. F. Straightening the penis can be performed with a dorsal tunica plication procedure. X. Complications of Hypospadias Surgery A. Urethral cutaneous fistula. 1. Urethral cutaneous fistula consists of a communication between the new urethra and the penile skin, typically allowing the urine to come out through two separate holes. 2. Fistulas require operative closure ~ 6 months after the initial operation when tissue swelling has subsided.
5 B. Meatal stenosis 1. Stricturing of the new urethra which can occur anywhere along the urethroplasty, but most commonly occurs in the glans penis. C. Urethral diverticulum 1. A large outpouching or ballooning of the urethra secondary to too large of a urethroplasty or an obstruction distally (i.e. meatal stenosis). D. Superficial skin loss 1. A relatively common complication after hypospadias surgery and typically will heal spontaneously without the need for further surgical intervention by secondary penile skin granulation. This can be treated with local wound care and daily bathing. E. Residual penile curvature. If severe reoperation with penile straightening is required. XI. Postoperative Hypospadias Care A. Anterior hypospadias repair such as the MAGPI are often done without the use of a drippy stent or catheter and require no special treatment. B. More severe hypospadias requires the use of an indwelling drippy stent which is typically removed 7-14 days after surgery by cutting a stitch that secures the urethral catheter to the glans penis. C. Prophylactic doses of antibiotics such as Bactrim or Nitrofurantoin are often prescribed while the stent is in place to keep the urine sterile. D. Postoperative Symptoms Include: 1. Bladder spasms which can be treated with Ditropan (oxybutynin).
6 2. Urinary retention is uncommon, but can occur secondary to a stent malfunction such as blockage or kinking. 3. Postoperative pain is controlled with Tylenol and Tylenol and codeine elixir. E. Dressings 1. The most common dressing used after hypospadias is a plastic dressing such as Tegaderm which is used with gauze to sandwich the penis onto the abdomen and is typically removed at home 2-3 days after surgery. See Hypospadias Handout for Figures References 2001 Akman, Y., W. Liu, Y.W. Li and L.S. Baskin, Penile anatomy under the pubic arch: reconstructive implications. J Urol, (1): p Baskin, L.S., Hypospadias: A critical analysis of cosmetic outcomes using photography. British Journal of Urology, Internatioinal, : p Baskin, L.S., A. Erol, P. Jegatheesan, Y. Li, W. Liu and G.R. Cunha, Urethral seam formation and hypospadias. Cell Tissue Res, (3): p Baskin, L.S., K. Himes and T. Colborn, Hypospadias and endocrine disruption: is there a connection? Environ Health Perspect, (11): p Baskin, L.S., Hypospadias: Anatomy, embriology and Reconstructive Techniques. Brazilian Journal of Urology, (6): p Baskin, L.S., Hypospadias and urethral development. J Urol, (3): p
7 Baskin, L.S., Hypospadias Frontiers. Pediatrics Current Medical Literature, (4): p Baskin, L.S., A. Erol, Y.W. Li and W.H. Liu, Anatomy of the neurovascular bundle: is safe mobilization possible? J Urol, (3 Pt 2): p Erol, A., L.S. Baskin, Y.W. Li and W.H. Liu, Anatomical studies of the urethral plate: why preservation of the urethral plate is important in hypospadias repair. BJU Int, (6): p Kurzrock, E.A., P. Jegatheesan, G.R. Cunha and L.S. Baskin, Urethral development in the fetal rabbit and induction of hypospadias: a model for human development. J Urol, (5): p Baskin, L.S., Penile curvature, in Reconstructive and Plastic Surgery of the External Genitalia: Adult and Pediatric, R. Ehrlich and G. Alter, Editors. 1999, Saunders: Philadelphia. Baskin, L.S., Fetal genital anatomy reconstructive implications. J Urol, (2): p Baskin, L.S., A. Erol, Y.W. Li, W.H. Liu, E. Kurzrock and G.R. Cunha, Anatomical studies of the human clitoris. J Urol, (3 Pt 2): p Hinds, A. and L.S. Baskin, Child sexual abuse: what the urologist needs to know. J Urol, (2): p Kurzrock, E.A., L.S. Baskin and G.R. Cunha, Ontogeny of the male urethra: theory of endodermal differentiation. Differentiation, (2): p Kurzrock, E.A., L.S. Baskin, Y. Li and G.R. Cunha, Epithelialmesenchymal interactions in development of the mouse fetal genital tubercle. Cells Tissues Organs, (3): p Baskin, L.S. and J.W. Duckett, Hypospadias, in Pediatric Surgery, J. O'Neil, Editor. 1998, Mosby: St. Louis.
8 Baskin, L.S. and J.W. Duckett, Hypospadias: Long-term outcome, in Long-Term Outcome Pediatric Surgery, P. Mouriquand, Editor. 1998, Saunders: Philadelphia. Baskin, L.S., A. Erol, Y.W. Li and G.R. Cunha, Anatomical studies of hypospadias. J Urol, (3 Pt 2): p ; discussion Baskin, L.S. and B.A. Kogan, Urethral anomalies and obstruction, in Urologic surgery in infants and children, L. King, Editor. 1998, Saunders: Philadelphia. Baskin, L.S. and T.F. Lue, The correction of congenital penile curvature in young men. Br J Urol, (6): p Baskin, L.S., D.A. Canning, H.M. Snyder, 3rd and J.W. Duckett, Jr., Surgical repair of urethral circumcision injuries. J Urol, (6): p Baskin, L.S., Y.T. Lee and G.R. Cunha, Neuroanatomical ontogeny of the human fetal penis. Br J Urol, (4): p Baskin, L.S., R.S. Sutherland, M.J. DiSandro, S.W. Hayward, J. Lipschutz and G.R. Cunha, The effect of testosterone on androgen receptors and human penile growth. J Urol, (3 Pt 2): p Baskin, L.S., Controversies in Hypospadias Surgery: The Urethral Plate, Part 2, in Dialogues in Pediatric Urology, R. Ehrlich, Editor. 1996, Miller: New York. Baskin, L.S., Controversies in Hypospadias Surgery: Penile Curvature, Part 1, in Dialogues in Pediatric Urology, R. Ehrlich, Editor. 1996, Miller: New York. Baskin, L.S., D.A. Canning, H.M. Snyder and J.W. Duckett, Treating complications of circumcision. Pediatr Emerg Care, (1): p
9 Baskin, L.S. and J.W. Duckett, Hypospadias, in Adult and Pediatric Urology, J. Gillenwater, et al., Editors. 1996, Mosby: St. Louis. Baskin, L.S. and J.W. Duckett, The Versatility of the Onlay Island Flap Procedure, in New Techniques in Reconstructive Urology, J. McAninch, Editor. 1996, Igaku-Shion: New York. Baskin, L.S., J.W. Duckett and T.F. Lue, Penile curvature. Urology, (3): p Sides, D., R.B. Goldstein, L. Baskin and B.C. Kleiner, Prenatal Diagnosis of Hypospadias. Journal of Ultrasound in Medicine, (11): p Sutherland, R.S., B.A. Kogan, L.S. Baskin, R.A. Mevorach, F. Conte, S.L. Kaplan and M.M. Grumbach, The effect of prepubertal androgen exposure on adult penile length. J Urol, (2 Pt 2): p ; discussion Baskin, L.S. and J.W. Duckett, The use of bucal mucosa in urethral reconstruction, in Advances in Urology, M.a. Bloom, Editor. 1995, Mosby. Baskin, L.S. and J.W. Duckett, Buccal mucosa grafts in hypospadias surgery. Br J Urol, Suppl 3: p Baskin, L.S. and J.W. Duckett, Dorsal tunica albuginea plication for hypospadias curvature. J Urol, (6): p Baskin, L.S. and J.W. Duckett, Complete Vaginal Reconstruction, in Dialogues in Pediatric Urology. 1994, Miller. Baskin, L.S., J.W. Duckett, K. Ueoka, J. Seibold and H.M. Snyder, 3rd, Changing concepts of hypospadias curvature lead to more onlay island flap procedures. J Urol, (1): p
10 Duckett, J.W. and L.S. Baskin, Genitoplasty for intersex anomalies. Eur J Pediatr, (Suppl 2): p. S80-4.
Our Experience in Chordee without Hypospadias: Results
PEDIATRIC UROLOGY Our Experience in Chordee without Hypospadias: Results of 102 Cases Emre Can Polat, 1 Mehmet Remzi Erdem, 2 Ramazan Topaktas, 3 Cevper Ersoz, 4 Sinasi Yavuz Onol 5 1 Department of Urology,
More informationSnodgrass Urethroplasty for Mid and Distal Penile Hypospadias. Ahmed Z. Zain FIBMS
Iraqi JMS Published by Al-Nahrain College of Medicine P-ISSN 68-659 E-ISSN 2224-49 Email: iraqijms@colmed-alnahrain.edu.iq http://www.colmed-alnahrain.edu.iq http://www.iraqijms.net Iraqi JMS 2; Vol. 5(3)
More informationRedo hypospadias surgery; experience with 27 patients with prior distal or proximal hypospadias repair failure
Redo hypospadias surgery; experience with 27 patients with prior distal or proximal hypospadias repair failure Ula Al-Kawaz FIBMS; FEBU. Abstract Background :Urethral reconstruction in failed hypospadias
More informationCOMPLEX RECONSTRUCTIONS IN HYPOSPADIAS: - - P
COMPLEX RECONSTRUCTIONS IN HYPOSPADIAS: - Penile straightening - Penile lengthening - Glans and penile skin resurfacing Rados P. Djinovic, Belgrade Growing number of adult patients Majority had multiple
More information41 st Scientific Congress. Gdańsk Poland
41 st Scientific Congress Gdańsk Poland 8 10 September 2011 The Team Sl Salvatore Sansalone Giuseppe Romano Sofia Balò Problems of urethral stricture in adult male after penile and urethral reconstructive
More informationAbstract. Keywords. Results of Onlay Flap Versus Durham Smith in Proximal Hypospadias. Ahmad Khaleghnejad Tabri 1
33 Results of Onlay Flap Versus Durham... Noroozi et al. Original 33 Results of Onlay Flap Versus Durham Smith in Proximal Hypospadias Ahmad Khaleghnejad Tabri 1 Leily Mohajerzadeh 1 Saran Lotfollahzadeh
More informationRepair of Bulbar Urethra Using the Barbagli Technique
22 Repair of Bulbar Urethra Using the Barbagli Technique G. Barbagli, M. Lazzeri 22.1 Introduction and Historical Background 182 22.2 Anatomical Remarks 182 22.3 Step-by-Step Surgical Details 183 22.3.1
More informationWhat s not! Imaging i.e CT scan, Sonography to localize testes. Find testes with imaging= surgery/orchiopexy
What s Hot and What s Not in Pediatric Urology Undescended Testes Laurence Baskin, UCSF Children s Hospital Early Surgery MRI in UDT Obesity to localize Testes Bilateral Disease Non-Palpable Testes Refer
More informationA standardized classification of hypospadias
Journal of Pediatric Urology (2012) 8, 410e414 A standardized classification of hypospadias Marek Orkiszewski* Gizinscy Medical Center, Nicolaus Copernicus University, Bydgoszcz, Poland Received 28 September
More informationJapanese Neurogenic Bladder Society Meeting. Kofu - Japan. September 29th - October 1st, 2010
Japanese Neurogenic Bladder Society Meeting Kofu - Japan September 29th - October 1st, 2010 Reconstruction of penile and bulbar urethra Evaluation of anterior urethral stricture Urethrography Retrograde
More informationCombined Use of Mathieu and Incised Plate Technique for Repair of Distal Hypospadias
Original Article Annals of Pediatric Surgery Vol 5, No 2, April 2009, PP 141-145 Combined Use of Mathieu and Incised Plate Technique for Repair of Distal Hypospadias Hisahm Fayad Aly Pediatric Surgery
More informationAbstract: Key words: Epispadias, Male Genitalia, Urinary Bladder, Penis, Reconstructive Surgical Procedures, Urethra. Introduction
JOURNAL OF CASE REPORTS 2013;3(2):344-348 Modified Cantwell-Ransley Repair of Male Penopubic Epispadias: Report of Two Cases and Review of the Literature Bijit Lodh, Somarendra Khumukcham, Bernard Amer,
More informationBuccal mucosa urethroplasty in a reoperative and reconstructive challenge hypospadias: a case report Hayrettin Ozturk
1 Ped Urol Case Rep 2014;1(1):1-5 http://www.pediatricurologycasereports.com ISSN:2148-2969 DOI: 10.14534/PUCR.201412511 Buccal mucosa urethroplasty in a reoperative and reconstructive challenge hypospadias:
More informationOriginal Article - Pediatric Urology. Seong Ho Bae, Jun Nyung Lee, Hyun Tae Kim, Sung Kwang Chung
www.kjurology.org http://dx.doi.org/0.4/kju.204.55..750 Original Article - Pediatric Urology http://crossmark.crossref.org/dialog/?doi=0.4/kju.204.55..750&domain=pdf&date_stamp=204-- Urethroplasty by Use
More informationPERINEAL HYPOSPADIAS IN A CROSS BREED DOG: A CASE REPORT
Indo-Am. J. Agric. & Vet. Sci., 2014 M Gokulakrishnan ISSN 2321 9602 and L Nagarajan, www.iajavs.com 2014 Vol. 2, No. 3, September 2014 2014 Meghana Publications. All Rights Reserved Case Report PERINEAL
More informationTHE USE OF DEEPITHELIALIZATION
THE USE OF DEEPITHELIALIZATION IN URETHROPLASTY - Deepithelialization Stratum corneum - Epidermis Papillary dermis Reticular dermis Skin Healing in any reconstructive surgery depends on not only the intact
More informationCenter for Reconstructive Urethral Surgery Guido Barbagli Center for Reconstructive Urethral Surgery Arezzo - Italy
Guido Barbagli Arezzo - Italy E-mail: info@urethralcenter.it Website: www.urethralcenter.it SHANGHAI February 6 8, 2009 Prof. Qiang FU Professor FU day Professor FU and night Anterior urethroplasty using
More informationOutcome of hypospadias repair - stentless versus stented repair
International Surgery Journal Shenoy NS et al. Int Surg J. 2016 Nov;3(4):2167-2172 http://www.ijsurgery.com pissn 2349-3305 eissn 2349-2902 Original Research Article DOI: http://dx.doi.org/10.18203/2349-2902.isj20163594
More informationManagement of Penile Curvature (Chordee) at CHOP. Christopher J. Long, MD Hypospadias World Congress Moscow, Russia August 30, 2017
Management of Penile Curvature (Chordee) at CHOP Christopher J. Long, MD Hypospadias World Congress Moscow, Russia August 30, 2017 Hypospadiology: Noun. hy po-spayd -ee-ah-low-gee 1. The study of boys
More informationEpispadias Repair after Failed Surgery in Childhood
Original Article 67 Epispadias Repair after Failed Surgery in Childhood Miroslav Djordjevic 1 Vladimir Kojovic 1 Marta Bizic 1 Marko Majstorovic 1 Vojkan Vukadinovic 1 Gradimir Korac 1 Zoran Krstic 1 1
More informationCenter for Reconstructive Urethral Surgery Guido Barbagli Center for Reconstructive Urethral Surgery Arezzo - Italy
Guido Barbagli Arezzo - Italy E-mail: guido@rdn.it Website: www.urethralcenter.it International Congress on Hypospadias Surgery September 2-5, 2007 Prishtina Kosova Failed hypospadias repair presenting
More informationModified Koyanagi Technique in Management of Proximal Hypospadias
Original Article Annals of Pediatric Surgery Vol. 6, No 1, January 2010, PP 22-26 Modified Koyanagi Technique in Management of Proximal Hypospadias Adham Elsaied, Basem Saied, and Mohammed El-Ghazaly Pediatric
More informationSurgery for Female Ambiguous Genitalia
hoofdstuk 05 08-03-2001 15:28 Pagina 59 Surgery for Female Ambiguous Genitalia Neonatal management of female intersex by clitorovaginoplasty CHAPTER 5 Tom P.V.M. de Jong, Thomas M.L. Boemers Journal of
More informationPENOSCROTAL HYPOSPADIAS
Pediatric Urology Brazilian Journal of Urology Official Journal of the Brazilian Society of Urology Vol. 26 (3): 304-314, May - June, 2000 PENOSCROTAL HYPOSPADIAS SAMI ARAP, ANUAR IBRAHIM MITRE Division
More informationPediatric Urology. Access Center 24/7 access for referring physicians (866) 353-KIDS (5437)
Pediatric Urology The Urology practice at Valley Children s provides specialized care for infants, children and adolescents with genital and urological problems. In addition to pediatric urologists, the
More informationEuropean Urology 44 (2003)
European Urology European Urology 44 (2003) 714 719 Comprehensive Analysis of SixYears Experience in Tubularised Incised Plate Urethroplasty and its Extended Application in Primary and Secondary Hypospadias
More informationResearch Article Surgical Repair of Late Complications in Patients Having Undergone Primary Hypospadias Repair during Childhood: A New Perspective
Advances in Urology Volume 2012, Article ID 705212, 5 pages doi:10.1155/2012/705212 Research Article Surgical Repair of Late Complications in Patients Having Undergone Primary Hypospadias Repair during
More informationOur experience of penopubic epispadias repair by modified Cantwell-Ransley technique
Original Research Article Our experience of penopubic epispadias repair by modified Cantwell-Ransley technique G Sudharshan * Assistant Professor, Department of Urology, Osmania Medical College/ Hospital,
More informationCENTER for URETHRAL RECONSTRUCTIVE SURGERY
To remember a great friend CENTER for URETHRAL RECONSTRUCTIVE SURGERY Pediatric urological long-term follow-up: Personal experience and future perspectives Giacinto Marrocco Gianantonio Manzoni UOC Chirurgia
More informationTubularized Incised Plate "Snodgrass" versus Mathieu Technique in treatment of distal hypospadias
Kasr El Aini Journal of Surgery VOL., 11, NO 1 January 2010 93 Tubularized Incised Plate "Snodgrass" versus Mathieu Technique in treatment of distal hypospadias Mohamed Mahmoud Mohamed Ahmed MD & Osama
More informationLong-term Follow-up after Feminizing Genital Reconstruction in Patients with Ambiguous Genitalia and High Vaginal Confluence
ORIGINAL ARTICLE Urology DOI: 0.3346/jkms.20.26.3.399 J Korean Med Sci 20; 26: 399-403 Long-term Follow-up after Feminizing Genital Reconstruction in Patients with Ambiguous Genitalia and High Vaginal
More informationUCSF Pediatric Urology Child and Family Information Material
UCSF Pediatric Urology Child and Family Information Material ------------------------------------------------------------------------ The Undescended Testicle What is an Undescended Testicle? The undescended
More informationRECONSTRUCTIVE SURGERY OF THE ANTERIOR URETHRA
Reprinted from the "British journal of Plastic Surgery," Vol. XXIII, No.3, July 1970 RECONSTRUCTIVE SURGERY OF THE ANTERIOR URETHRA By J. c. VAN DER MEULEN Department of Plastic Surgery, Dijkzigt Hospital,
More informationSHORT TERM OUTCOME OF URETHROPLASTY FOR DISTAL HYPOSPADIAS WITH INTERRUPTED SUTURE COMPARED TO CONTINUOUS SUTURE
Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 26-30 Official organ of the Association of Paediatric Surgeons of Bangladesh Journal of Paediatric Surgeons of Bangladesh Original Article
More informationMulticentric experience on double dartos flap protection in tubularized incised plate urethroplasty for distal and midpenile hypospadias
DOI 10.1007/s00383-011-2978-1 ORIGINAL ARTICLE Multicentric experience on double dartos flap protection in tubularized incised plate urethroplasty for distal and midpenile hypospadias M. Bertozzi A. Yıldız
More informationTubularized Incised Plate Urethroplasty for Primary Hypospadias Repair: Versatility versus Limitations
Tubularized Incised Plate Urethroplasty for Primary Hypospadias Repair: Versatility versus Limitations Original Article Amr A. AbouZeid 1,2 1 Department of Pediatric Surgery, Faculty of Medicine, AinShams
More informationHypospadias In Children Department of Urology King Fahd Hospital of the University University of Dammam
Hypospadias In Children Department of Urology King Fahd Hospital of the University University of Dammam Prepared by: Dr. Ossamah Al Sowayan Assistant Professor Pediatric Urology Consultant Department of
More informationPediatric Urology. Access Center 24/7 access for referring physicians (866) 353-KIDS (5437)
Pediatric Urology The Urology practice at Valley Children s provides specialized care for infants, children and adolescents with genital and urological problems. In addition to pediatric urologists, the
More informationModule Title: GENITO-URINARY TRACT Date: May 2013 Module Rationale and Competencies
Module Title: Date: May 2013 Module Rationale and Competencies A paediatric surgeon is required to have a thorough understanding of normal anatomy and physiology, pathophysiology, investigations, differential
More informationUROLOGY BOARD REVIEW MANUAL. Hypospadias. Contributing Authors: David M. Weiner, MD. Table of Contents. Cover Illustration by Jean Gardner
UROLOGY BOARD REVIEW MANUAL PUBLISHING STAFF PRESIDENT, GROUP PUBLISHER Bruce M. White EXECUTIVE EDITOR Debra Dreger ASSISTANT EDITOR Laurie Garrison EDITORIAL ASSISTANTS Amanda Arkles Meghan Cunningham
More informationA CASE OF DUPLICATION OF PENILE URETHRA. Stoke Mandeville
A CASE OF DUPLICATION OF PENILE URETHRA By J. P. REIDY, F.R.C.S. Stoke Mandeville THIS congenital deformity is of rare occurrence. Gross and Moore (195o) summarised the findings of eighty-three cases.
More informationResearch Article Isolated Male Epispadias: Anatomic Functional Restoration Is the Primary Goal
BioMed Research International Volume 2016, Article ID 6983109, 4 pages http://dx.doi.org/10.1155/2016/6983109 Research Article Isolated Male Epispadias: Anatomic Functional Restoration Is the Primary Goal
More informationDorsal tunica vaginalis graft plus onlay preputial island flap urethroplasty: Experimental study in rabbits
Journal of Pediatric Urology (2009) 5, 93e99 Dorsal tunica vaginalis graft plus onlay preputial island flap urethroplasty: Experimental study in rabbits Bruno Leslie a, Luiz L. Barboza a, Petrus O. Souza
More informationInverted Y on V Meatourethroplasty for Distal Penile Hypospadias: Our Experience in Queen Rania Al-Abdulla Hospital for Children
Inverted Y on V Meatourethroplasty for Distal Penile Hypospadias: Our Experience in Queen Rania Al-Abdulla Hospital for Children Waseem Al-Meflh MD*, Ahmad Al-Remony MD*, Ibrahim AL-Esboo MD*, Samer Karadsheh
More informationCase Report Accurate Diagnosis of Severe Hypospadias Using 2D and 3D Ultrasounds
Case Reports in Obstetrics and Gynecology Volume 2016, Article ID 2450341, 4 pages http://dx.doi.org/10.1155/2016/2450341 Case Report Accurate Diagnosis of Severe Hypospadias Using 2D and 3D Ultrasounds
More informationGuido Barbagli. Center for Reconstructive ti Urethral lsurgery
Guido Barbagli Center for Reconstructive ti Urethral lsurgery Arezzo - Italy E-mail: guido@rdn.it Website: www.urethralcenter.it Portuguese Andrological Association National Meeting June 21-23, 2008 Oporto
More informationHypospadias Information leaflet for parents Child Health Directorate
Hypospadias Information leaflet for parents Child Health Directorate Please note that this information leaflet is designed to give an overview of the experience that you and your son will go through during
More informationHypospadias dilemmas: A round table
Journal of Pediatric Urology (2011) xx, 1e13 + MODEL Hypospadias dilemmas: A round table Warren Snodgrass a, Antonio Macedo b, Piet Hoebeke c, Pierre D.E. Mouriquand d, * a Department of Pediatric Urology,
More informationDepartment of Plastic Surgery, University Hospital, Groningen, The Netherlands
SURGICAL CORRECTION OF FEMALE PSEUDOHERMA- PHRODITISM DUE TO ADRENAL HYPERPLASIA By A. J. C. HUFFSTADT, M.D. Department of Plastic Surgery, University Hospital, Groningen, The Netherlands SINCE the work
More informationChallenges of Surgical Repair of Hypospadias in Ile- Ife, Nigeria
African Journal of Urology 1110-5704 Vol. 15, No. 2, 2009 96-102 Original Article Challenges of Surgical Repair of Hypospadias in Ile- Ife, Nigeria A.O. Olajide 1, A.O. Sowande 1, A.A. Salako 1, F.O. Olajide
More informationTubularized Incised Plate Urethroplasty: 5 Years Experience
European Urology European Urology 46 (2004) 655 659 Tubularized Incised Plate Urethroplasty: 5 Years Experience Mehmet Eliçevik *,Gülay Tireli, Serdar Sander SSK Bakırköy Maternity and Children s Hospital,
More informationUreteral Reimplantation Surgery
Ureteral Reimplantation Surgery What is ureteral reimplantation surgery? The original ureter is surgically re-positioned (reimplanted) in the bladder wall. The end of the ureter is surrounded by bladder
More informationVascularization of vessel pedicle in hypospadias and its relationship to near period complications
2408 Vascularization of vessel pedicle in hypospadias and its relationship to near period complications ZHANG ZHAO 1,2*, NING SUN 3* and XIANGMING MAO 1,4 1 Department of Urology, Southern Medical University,
More informationCenter for Reconstructive Urethral Surgery Guido Barbagli Center for Reconstructive Urethral Surgery Arezzo - Italy
Guido Barbagli Arezzo - Italy E-mail: info@urethralcenter.it Website: www.urethralcenter.it One-stage substitution urethroplasty Oral mucosal grafts 22 cm x 2.5 cm Oral mucosal grafts cheek lip tongue
More informationOutcome of tubularized incised plate (TIP) urethroplasty: A singlecenter experience with 307 cases
Outcome of tubularized incised plate (TIP) urethroplasty: A singlecenter experience with 307 cases Leili Mohajerzadeh 1*, Javad Ghoroubi, Fathollah Roshanzamir 1, Hamidreza Alizadeh 2. 1-Pediatric Surgery
More informationSurgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE
Surgical Care at the District Hospital 1 9 Urinary Tract and Perineum Key Points 2 9.1 Urinary Bladder & Urinary Retention Acute retention of urine is an indication for emergency drainage of the bladder
More informationThe MAGPI Hypospadias Repair in 1111 Patients
The MAGPI Hypospadias Repair in 1111 Patients JOHN W. DUCKETT, M.D., and HOWARD McC. SNYDER III, M.D. The meatal advancement and glanduloplasty (MAGPI) procedure was first described in 1981 for the repair
More informationOriginal Article Therapeutic effects of Snodgrass urethroplasty in the treatment of distal hypospadias
Int J Clin Exp Med 2018;11(9):10015-10020 www.ijcem.com /ISSN:1940-5901/IJCEM0079335 Original Article Therapeutic effects of Snodgrass urethroplasty in the treatment of distal hypospadias Zhengyu Xiong,
More informationIbrahim Ali Ibrahim. Pediatric surgery unit, General Surgery Department, Faculty of Medicine, Assiut university, Assiut, Egypt.
Modified Tubularized incised plate urethroplasty for distal hypospadias without chordate Ibrahim Ali Ibrahim Pediatric surgery unit, General Surgery Department, Faculty of Medicine, Assiut university,
More informationDevelopmental Abnormalities of the Kidneys and GU System
A5 Developmental Abnormalities of the Kidneys and GU System Erin Parilla, MD Neonatologist Pediatrix Medical Group, Tampa, FL The speaker has signed a disclosure form and indicated she has no significant
More informationStaged urethroplasty in the management of complex anterior urethral stricture disease
Review Article Staged urethroplasty in the management of complex anterior urethral stricture disease Ryan L. Mori 1, Kenneth W. Angermeier 2 1 Geisinger Medical Center, Danville, PA 17822, USA; 2 Center
More informationCenter for Reconstructive Urethral Surgery Guido Barbagli Center for Reconstructive Urethral Surgery Arezzo - Italy
Guido Barbagli Arezzo - Italy E-mail: guido@rdn.it Website: www.urethralcenter.it 23 rd ANNUAL EAU CONGRESS EAU CAU Session Joint session of the European Association of Urology (EAU) and the Confederaçion
More informationPatient Information Hypospadias
Patient Information Hypospadias Department of Plastic Surgery Introduction The purpose of this leaflet is to explain what hypospadias is, how it is diagnosed and the treatment available. What is hypospadias?
More informationMEditorial December Kids Urology
MEditorial December 2012 Kids Urology Most childhood illnesses are in the realm of infections, usually viral, which although sometimes frightening to parents, go away on their own without any major intervention.
More informationReconstructive Surgery
Urology Journal UNRC/IUA Vol. 2, No. 4, 206-210 Autumn 2005 Printed in IRAN Reconstructive Surgery Abdorasol Mehrsai, 1 Hooman Djaladat, 2 * Alireza Sina, 1 Sepehr Salem, 1 Gholamreza Pourmand 1 1Department
More informationUrethroplasty for Long Anterior Urethral Strictures Report of Long-term Results
Reconstructive Surgery Urethroplasty for Long Anterior Urethral Strictures Report of Long-term Results Mahmoudreza Moradi, As ad Moradi Introduction: We reviewed the long-term outcome of substitution urethroplasty
More informationMALE GENITAL SURGICAL PROCEDURES
Male Genital Surgical ProceduresDecember 22, 2015 (effective March 1, 201) PENIS Slit of prepuce (complete care) S5 - newborn... 14.35 S58 - infant... 21.50 S59 - adult or child... 30.25 EXCISION Circumcision
More informationPublished Date: 12-Jun-2018
POLICY A written primary care provider s order is required for the placement of a urinary catheter. Insertion and removal is a two person procedure. If unsuccessful after two attempts, notify MRP for further
More informationReceived 27 February 2011 Accepted 15 March 2011
82 Original article Megameatus intact prepuce variety of hypospadias: tips for repair using the modified glanular approximation procedure Akram M. Elbatarny, Sherif M. Shehata and Khaled A. Ismail Background/purpose
More information26 Annual EAU Congress. Vienna - Austria. Advanced management of urethral stricture disease. March 18-22, 2011
European Association of Urology 26 Annual EAU Congress ESU Course 9 Advanced management of urethral stricture disease Vienna - Austria March 18-22, 2011 New developments in urethral stricture disease New
More informationGUIDELINES ON PAEDIATRIC UROLOGY
GUIDELINES ON PAEDIATRIC UROLOGY (Limited update April 2014) S. Tekgül (chair), H.S. Dogan, P. Hoebeke, R. Kocvara, J.M. Nijman (vice-chair), Chr. Radmayr, R. Stein Introduction Due to the scope of the
More informationTubularized Incised Plate Urethroplasty Using Buccal Mucosa Graft for Repair of Penile Hypospadias
Tubularized Incised Plate Urethroplasty Using Buccal Mucosa Graft for Repair of Penile Hypospadias Kamyar Tavakkoli Tabassi, 1 Toktam Mohammadi Rana 2 Reconstructive Surgery 1 Mashhad Center for Reconstructive
More informationHuman Sexuality - Ch. 2 Sexual Anatomy (Hock)
Human Sexuality - Ch. 2 Sexual Anatomy (Hock) penis penile glans corona frenulum penile shaft erection foreskin circumcision corpora cavernosa corpus spongiosum urethra scrotum spermatic cords testicles
More informationA DE-EPITHELIALISED OVERLAP FLAP TECHNIQUE IN THE REPAIR OF HYPOSPADIAS
British ffournal of Plastie Surgery (I973), 26, :ro6-xi 4 A DE-EPITHELIALISED OVERLAP FLAP TECHNIQUE IN THE REPAIR OF HYPOSPADIAS ]3y DURHAM SMITH, M.D., F.R.A.C.S., F.A.C.S. Royal Ghildren's tlospital,
More informationGuido Barbagli Sava Perovic Salvatore Sansalone
Guido Barbagli Sava Perovic Salvatore Sansalone European Center for Failed Hypospadias Repair Arezzo Italy Belgrade Serbia Rome - Italy www.failedhypospadias.com Hypospadias: Problems in the adult patient
More informationOriginal Research Article
Efficacy of Snodgrass Urethroplasty Using Deepithelialised Flap Puneet Kumar, *Sudhir Kumar, **Naveen Sirohi Department of Surgery, *Department of Burns and Plastic Surgery, **Department of Ophthalmology,
More informationCenter for Reconstructive Urethral Surgery. Guido Barbagli. Center for Reconstructive Urethral Surgery. Arezzo - Italy
Guido Barbagli Arezzo - Italy E-mail: info@urethralcenter.it Website: www.urethralcenter.it 22 nd Annual EAU Congress March 21-24, 2007 Berlin Germany Which type of urethroplasty - a critical overview
More informationBladder exstrophy and epispadias
Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families Bladder exstrophy and epispadias This leaflet explains about bladder exstrophy and epispadias and what to expect
More informationUrethral Stricture Management. AUA Guidelines. Michael Coburn, MD Scott Department of Urology Baylor College of Medicine Houston, Texas
Urethral Stricture Management AUA Guidelines Michael Coburn, MD Scott Department of Urology Baylor College of Medicine Houston, Texas Urethral Stricture Guidelines Systematic peer-reviewed literature review
More informationCircumcision. Multimedia Health Education. Disclaimer
Disclaimer This movie is an educational resource only and should not be used to manage genitourinary health. All decisions about undergoing must be made in conjunction with your Physician or a licensed
More informationCenter for Reconstructive Urethral Surgery Guido Barbagli Center for Reconstructive Urethral Surgery Arezzo - Italy
Guido Barbagli Arezzo - Italy E-mail: guido@rdn.it Website: www.urethralcenter.it 23 rd ANNUAL EAU CONGRESS ESU Course 8 Advanced course on urethral stricture surgery 26 29 March 2008 Milan Italy Which
More informationProximal Hypospadias: Meeting the promise to our patients. Christopher J. Long, MD Hypospadias World Congress Moscow, Russia August 31, 2017
Proximal Hypospadias: Meeting the promise to our patients Christopher J. Long, MD Hypospadias World Congress Moscow, Russia August 31, 2017 Goals for Hypospadias Surgery Void with laminar flow Without
More informationIndications and effectiveness of the open surgery in vesicoureteral reflux
Indications and effectiveness of the open surgery in vesicoureteral reflux Suzi DEMIRBAG, MD Department of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, TURKEY Vesicoureteral reflux (VUR)
More informationDisclosure. The Pediatric Penis: A maintenance guide from birth through puberty. The Newborn Genital Exam 9/16/2015
The Pediatric Penis: A maintenance guide from birth through puberty John Gatti, MD Pediatric Urology Disclosure I have no financial relationships with the manufacturers(s) of any commercial products(s)
More informationObstetrics Content Outline Obstetrics - Fetal Abnormalities
Obstetrics Content Outline Obstetrics - Fetal Abnormalities Effective February 2007 10 16% renal agenesis complete absence of the kidneys occurs when ureteric buds fail to develop Or degenerate before
More informationTO EVALUATE THE ROLE OF VASCULARISED DORSAL DARTOS FLAP IN SNODGRASS URETHROPLASTY
Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 31-35 Official organ of the Association of Paediatric Surgeons of Bangladesh Journal of Paediatric Surgeons of Bangladesh Original Article
More informationhoofdstuk :07 Pagina ix Introduction
hoofdstuk 00 08-03-2001 15:07 Pagina ix Introduction Incontinence at pediatric age is a problem that can harm the psychological and physical development of children. Starting in 1986 we have searched for
More informationOriginal Research Article
COMPARATIVE STUDY OF TRANSVERSE PREPUTIAL ONLAY ISLAND FLAP VS TUBULARISED ISLAND FLAP URETHROPLASTY Jayapal Komma 1, Vinodh Kumar Talari 2, Mandakini Talapaneni Kotaiah 3, Kumba Nagarjuna 4 1Assistant
More informationMusculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children
Journal of Pediatric Urology (2006) 2, 333e339 Musculocutaneous latissimus dorsi free transfer flap for total phalloplasty in children Miroslav L. Djordjevic a, *, Marko Z. Bumbasirevic a, Petar M. Vukovic
More informationTreatment of Hypospadias
Advances in Hypospadias ACTA MEDICA Edizioni e Congressi s.r.!. 1986 Treatment of Hypospadias J.C. v.d. Meulen Department ofplastic Surgery, University Hospital, Rotterdam, The Netherlands One of the keys
More informationDevelopment of the urogenital system
Development of the urogenital system Location of the pronephros, mesonephros and metanephros Differentiation of the intermedierm mesoderm into nephrotome and mesonephric tubules Connection between aorta
More informationClinical Commissioning Policy Proposition: Urethroplasty for benign urethral strictures in adult men
Clinical Commissioning Policy Proposition: Urethroplasty for benign urethral strictures in adult men Reference: NHS England B14X06/01 Information Reader Box (IRB) to be inserted on inside front cover for
More informationUniversity of Alberta Reconstructive Urology Fellowship
FACULTY OF MEDICINE AND DENTISTRY DEPARTMENT OF SURGERY DIVISION OF UROLOGY Keith Rourke, MD, FRCSC Reconstructive Urology Professor Chair of Academic Urology Reconstructive Urology Fellowship Director
More informationAPPENDIX 4: ADVERSE EVENT CLASSIFICATIONS AND DEFINITIONS: POST- OPERATIVE PERIOD AFTER DISCHARGE FROM VMMC CLINIC OR DURING OR AFTER DEVICE REMOVAL
APPENDIX 4: ADVERSE EVENT CLASSIFICATIONS AND DEFINITIONS: POST- OPERATIVE PERIOD AFTER DISCHARGE FROM VMMC CLINIC OR DURING OR AFTER DEVICE REMOVAL ADVERSE EVENT MILD MODERATE SEVERE BL: Bleeding DD:
More informationUROLOGY UROLOGY REFERRAL RECOMMENDATIONS
UROLOGY PAGE 1 These referral recommendations are provided for core Urology Services in the public health system. They exclude social or cultural circumcision, vasectomy and vasectomy reversal, and access
More informationFIG The inferior and posterior peritoneal reflection is easily
PSOAS HITCH, BOARI FLAP, AND COMBINATION OF PSOAS 7 HITCH AND BOARI FLAP The psoas hitch procedure, Boari flap, and transureteroureterostomy are useful operative procedures for reestablishing continuity
More informationComparative study of two different procedures for primary hypospadias repair
International Surgery Journal Tawfiq NR et al. Int Surg J. 2017 Aug;4(8):2475-2479 http://www.ijsurgery.com pissn 2349-3305 eissn 2349-2902 Original Research Article DOI: http://dx.doi.org/10.18203/2349-2902.isj20173162
More informationOriginal Article DISTAL PENILE FASCIOCUTANEOUS FLAP FOR STRICTURE DISEASE OF ANTERIOR URETHRA
Original Article DISTAL PENILE FASCIOCUTANEOUS FLAP FOR STRICTURE DISEASE OF ANTERIOR URETHRA Ihsan Ullah Khan 1, Farakh Ahmed Khan 2, M.A. Zaidi 3 1 Department of Urology, GMC Hospital and Research Centre,
More informationPatient and Family Education. Bladder Exstrophy. What is bladder exstrophy? How common is bladder exstrophy? What causes bladder exstrophy?
Patient and Family Education Bladder Exstrophy What is bladder exstrophy? Bladder exstrophy (x-tro-fee) is a bladder that is not formed right. The bladder and genitals are split in half, turned inside
More information