During 1997-1999, 19 pediatric patients with ages of 3-5 (10 cases) and ages of 6-11 (9 cases) and hypospadias in the institute of pediatric operated as mustarded technique the results have shown that early complications (4) were conservative treated well. The follow up duration of 1-16 months showed good outcome.
Hypospadias ; Complications ; Surgery

We performed original and modified technique of Mays' glanuloplasty in 6 and 12 cases respectively. The results were as follows: 1. 6 cases of mild from of hypospadias (2 cases of coronal, 4 cases of dist. penile) and 12 cases of severe form of hypospadias (5 cases of prox. penile, 6 cases of penoscrotal, 1 case of perineal) on pre-chordectomy but all cases became severe from of hypospadias (2 cases of prox. penile, 15 cases of penoscrotal, 1 case of perineal) on post-chordectomy. 2. The postoperative complications were 3 cases (50.0%) (1 case of meatal stenosis, 2 cases of meatal necrosis) in original technique of Mays' glanuloplasty and 2 cases of meatal stenosis (16.7%) in modified technique of Mays' glanuloplasty.
Constriction, Pathologic ; Female ; Hypospadias* ; Male ; Postoperative Complications

Two hundred cases of surgically repaired hypospadias at Pusan University Hospital in the past sixteen half years were surveyed and analyzed. Of 200 patients, 99(49.5%) were corrected in their preschool age. The number of patients with the distal type and proximal type of hypospadias performed in 134(67%) of 200 and the success rate was 84.3 per cent(113 of 134). One stage repair was performed in 66(33.0%) of 200 and the success rate are as follows : King, 100%(7 of 7), MAGPI, 100.0% (4 of 4), Mathieu, 100.0%(5 of 5), Hodgson ( I , III), 75%(12 of 16), and preputial island flap including Duckett, Hodgson XX and double faced technique, 67.6% (23 of 34). The most common postoperative complication was fistula.
Busan ; Female ; Fistula ; Humans ; Hypospadias* ; Male ; Postoperative Complications

OBJECTIVETo study the concurrence of congenital heart disease and hypospadias and the relationship between the two diseases.

METHODSWe investigated the incidence and types of congenital heart disease accompanied by hypospadias in male children received in our hospital from January 2002 to December 2012, compared them with those in the general population, and analyzed the correlation of different types of heart disease with the incidence rate of hypospadias.

RESULTSOf the 7 385 male children with congenital heart disease, 134 (1.81%) were found with hypospadias, with a significantly higher morbidity than in the general population (0.33% -0.40%) (P < 0.01). The incidence rates of hypospadias were significantly higher in the groups of ventricular septal defect (65/3 275, 1.98%), Fallot's tetralogy (17/770, 2.21%), macroangiopathy (15/788, 1.90%) and other congenital heart abnormalities (21/972, 2.16%) than in the atrial septal defect (10/1 015, 0.99%) and patent ductus arteriosus (6/565, 1.06%) groups (P < 0.05). There were no statistically significant differences in the type of hypospadias among different heart disease groups (P > 0.05).

CONCLUSIONHypospadias is a common concurrent condition in male children with congenital heart disease. The incidence rate of hypospadias is related with the type of congenital heart disease, and the two conditions may have some common pathogenic or susceptive factors.

Child ; Child, Preschool ; Heart Defects, Congenital ; complications ; epidemiology ; Heart Diseases ; complications ; congenital ; epidemiology ; Humans ; Hypospadias ; complications ; epidemiology ; Incidence ; Infant ; Male

PURPOSE: The onlay island flap and tubularized incised plate (TIP) urethroplasty commonly preserve the urethral plate during each procedure, but there is a dearth of comparative data. Thus, we retrospectively reviewed our clinical data to compare the surgical outcome of the onlay and TIP urethroplasty for hypospadias correction. MATERIALS AND METHODS: We performed onlay urethroplasty in 23 patients and TIP urethroplasty in 28 patients between 1995 and 2002. The age at the time of surgery, operation time, postoperative complications, and the duration for the development of complications in each procedure were compared. RESULTS: Among the 28 cases of TIP urethroplasty, 21 were primary, 6 were secondary, and the last case was a tertiary repair, while all of the 23 cases of onlay urethroplasty were primary (age range: 8 month to 11 year). The most common complication in both procedures was urethrocutaneous fistula. Residual curvature was more common in the onlay urethroplasty group. Delayed complications, which developed later than 6 months after surgery, were 30% in both groups. The success rate was similar between the two groups, but the TIP urethroplasty group illustrated a significantly shorter operation time than the onlay group. CONCLUSIONS: The most common complication was fistula in both the onlay and TIP urethroplasty groups. Even though the success rate was similar in both groups, the operation time of the TIP urethroplasty group was shorter than that of the onlay group. Also, the TIP urethroplasty procedure resulted in more acceptable cosmetic results including a slit like neourethral meatus.
Female ; Fistula ; Humans ; Hypospadias* ; Inlays* ; Male ; Postoperative Complications ; Retrospective Studies ; Urethra

Currently improving results of hypospadias repair depend on careful application of surgical principles. Optical magnification. microsurgical instruments, fine suture materials, less reactive tubes and bio-occlusive dressings have been used to decrease postoperative complications requiring secondary surgery. We evaluated the effectiveness of microscopic surgery which was performed in 28 children with hypospadias from December, 1991 to June, 1994. Nine patients underwent hypospadias repair before 2 years-old whereas 19 patients after 2 years-old, whose success rate was 78% and 63% respectively. One-stage repair was performed in 19 patients and two-stage repairs in 9 patients, whose success rate was 69% and 67% each other. In chronological review, success rate was 50%, 29%, 77% and 100% in 1991, 1992, 1993 and 1994 respectively, which showed a rapidly increasing success rate. According to dressings and catheters, excellent results were obtained when we used Duodenum dressings and silastic Foley catheters, of which each complication rate was 7% and 0% respectively. In 9 patients(32 %), we experienced 20 surgical complications which included urethrocutaneous fistula (9), meatal stenosis(4) stricture(2) and others(5). The success rate of fistula repair was 61% in initial, 40% in secondary and 33% in tertiary repair. From these data, we think that the use of operating microscope with microsurgical principles and proper postoperative managements can improve success rate of hypospadias repair.
Bandages ; Catheters ; Child ; Child, Preschool ; Duodenum ; Female ; Fistula ; Humans ; Hypospadias* ; Male ; Postoperative Complications ; Sutures

PURPOSE: Numerous operative techniques have been developed to correct proximal hypospadias. Transverse preputial island flap urethroplasty have provided reliable results for the repair of proximal hypospadias, and the versatility of the preputial flap led to its adaptation as an onlay flap that could be sewn onto an intact or preserved urethral plate. Recently, tubularized incised plate urethroplasty(Snodgrass procedure) have been reported with good results. We retrospectively analyzed our experiences with these three techniques to know which procedure is recommendable for repair of proximal hypospadias. MATERIALS AND METHODS: Between January, 1994 and June, 1998, 44 patients underwent repair for the proximal hypospadias by a single surgeon using an transverse preputial island flap(21), onlay flap(16) and tubularized incised plate(7) procedure. We analysed the surgical outcome such as surgical complications according to each procedures. RESULTS: Postoperative complication rate was 57% for transverse preputial island flap, 13% for onlay flap and 14% for tubularized incised plate procedure. The rate of fistula formation were 42%, 13% and 14%, respectively. One diverticulum and two strictures were developed in three patients who underwent transverse preputial island flap procedure, whereas no diverticulum or stricture was developed after onlay or tubularized incised plate procedure. Cosmetic results were excellent in tubularized incised plate urethroplasty. CONCLUSIONS: Onlay or tubularized incised plate urethroplasty using an preserved urethral plate had better outcomes compared to the transverse preputial island flap procedure. The technique using urethral plate could be recommendable as first choice for proximal hypospadias although transverse preputial island flap procedure is worthy to be considered for more complicated cases.
Constriction, Pathologic ; Diverticulum ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays* ; Male ; Postoperative Complications ; Retrospective Studies

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.
Female ; Fistula ; Foreskin ; Humans ; Hypospadias* ; Male ; Postoperative Complications ; Skin ; Transplants ; Urethra ; Urethral Stricture ; Urinary Bladder

Penoscrotal transposition is one of the rare congenital anomalies. We experienced 12 cases of incomplete penoscrotal transposition during the period from January 1978 to September 1983. The obtained results were as follows: 1. The age distribution ranged from 5 to 33 years old, and the average was 15 years old. The n. umber of patients whose age was below 10 years was 5. 2. The associated anomalies were as follows; hypospadia in all cases, undescended testis in 3 cases, utriculus masculine in 3 cases, hydrocele in 1 case and double corpus spongiosum in 1 case. 3. We performed the chordectomy and the scrotoplasty simultaneously as 1st staged operation, and the urethroplasty as 2nd staged operation. In the 1st staged operation, Glenn-Anderson's method was applied in 7 cases, and the combined technique of Glenn-Anderson's method and Byars chordectomy method was applied in 5 cases. 4. The postoperative complications were as follows; Of the 7 cases of Glenn-Anderson's method, 1 case was complicated by ventral curvature of the penis due to scar formation after 1st staged operation, and 2 cases were complicated by urethral fistula after 2nd staged operation. Of the 5 cases of the combined technique of Glenn-Anderson's method and Byars chordectomy method, no complications were found in all cases after 1st and 2nd staged operations.
Adolescent ; Adult ; Age Distribution ; Cicatrix ; Cryptorchidism ; Female ; Fistula ; Humans ; Hypospadias ; Male ; Penis ; Postoperative Complications

PURPOSE: Numerous operative techniques have been developed to correct hypospadias. Tubularized incised plate (TIP) urethroplasty has recently been reported with good results. We analyzed the surgical outcome and complications in children with hypospadias using TIP urethroplasty. MATERIALS AND METHODS: Between July 1998 and July 2001, 28 patients with hypospadias were primarily corrected using TIP urethroplasty by one surgeon. The mean age of the patients was 4.2 years. A position of the meatus was coronal in six boys, at the posterior penile shaft in five, glandular in four, penoscrotal in four, at the anterior penile shaft in three, at the midshaft in three and the perineal in three. An 8 or 10 Fr Foley catheter was used as a urethral stent, which was removed at day 12 (10-15). RESULTS: Of the 28 patients, 23 were corrected with TIP urethroplasty only, and the other 5 combined with an onlay island flap. For the management of penile curvature, skin and ventral releases were used in 14 patients; with tunica albuginea placation used in the other 14. Postoperative complications were noted in 3 patients, of whom 2 developed urethrocutaneous fistula and one developed meatal stricture. The cosmetic results were very good in most patients. CONCLUSIONS: TIP urethroplasty can be used for all type of hypospadias. It has advantages, such as an excellent cosmetic appearance, preservation of the urethral plate and a lower complication rate than other urethroplasty techniques. Our results suggest that this technique is recommendable for the management of primary hypospadias as a first choice.
Catheters ; Child ; Constriction, Pathologic ; Female ; Fistula ; Humans ; Hypospadias* ; Inlays ; Male ; Postoperative Complications ; Skin ; Stents ; Urethra