Surgical Outcome of Proximal Hypospadias with Penoscrotal Transposition.
- Author:
Tae Yung JEONG
1
;
Seong Ha YOO
;
Jong Jin LEE
;
Ki Yong SHIN
;
Hae Young PARK
;
Tcuhn Yong LEE
;
Young Nam WOO
Author Information
1. Department of Urology, College of Medicine, Hanyang University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Proximal hypospadias;
Penoscrotal transposition;
One-stage repair
- MeSH:
Female;
Fistula;
Foreskin;
Humans;
Hypospadias*;
Male;
Postoperative Complications;
Skin;
Transplants;
Urethra;
Urethral Stricture;
Urinary Bladder
- From:Korean Journal of Urology
1999;40(6):756-759
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Penoscrotal transposition is found in cases with severe form of hypospadias. In those cases, severe chordee generally coexists and a long length of urethra may be necessary for its correction. We evaluated the clinical outcome of surgical repairs for 12 patients of proximal hypospadias with penoscrotal transposition. MATERIALS AND METHODS: Out of 12 cases, there were 2 with penoscrotal type, 7 with scrotal type and 3 with perineal type hypospadias. All cases had moderate to severe chordee. Five cases were treated with one-stage repair and seven cases with multi-stage repair. We analysed operative methods, postoperative complications and those managements between the cases of one-stage and multi-stage repairs. RESULTS: For one-stage repair, we used transverse preputial island flap method in 3 cases and urethroplasty using scrotal skin flap in 2 cases. For multi-stage repair, we performed Thiersh-Duplay urethroplasty in 2 cases, bladder mucosal graft in 2 cases and Belt-Fugua urethroplasty in 3 cases. Correction of penoscrotal transposition was performed successfully in all cases. In all cases, a paucity of skin was the most difficult problem. The overall complication rate was 50.0%. In cases treated with one-stage repair, there were two cases with urethrocutaneous fistulas. However, in cases treated with multi-stage repair, there were four cases with complications such as urethral strictures, urethrocutaneous fistulas with or without large skin defect. Overall the complications in cases with multi-stage repair were more severe than those in cases with one-stage repair. CONCLUSIONS: Our experience suggests that multi-stage operation may be not superior to one-stage operation in cases with proximal hypospadias associated with penoscrotal transposition. Thus we recommand one-stage repair in those cases despite a paucity of foreskin.
