Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique)
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/33718 http://dx.doi.org/10.1016/j.jpurol.2011.02.024 |
Resumo: | Purpose: Complex primary hypospadias repair that warrants urethral plate division is treated mostly in two steps, not necessarily in two surgeries. Our aim was to review long-term results with a one-stage strategy based on reconstruction of the urethral plate with buccal mucosa graft and onlay transverse preputial flap anastomosis protected by a tunica vaginalis flap (the three-in-one concept).Material and methods: We were able to report on 35 patients operated for primary scrotal, penoscrotal and perineal hypospadias between March 2002 and June 2008. We reviewed all charts and had phone interviews with patients not seen for the last 24 months. We investigated parameters such as UTI occurrence, fistula, residual curvature, meatal stenosis, urethral diverticula, dehiscence, orchitis and parental perception.Results: Surgical complications occurred in 13 patients (37%): 4 meatal stenosis, 4 diverticula, 5 fistulae and 2 residual penile curvatures (total 42%). Meatal dilatation was successful in 2 cases, reflected in fistula resolution. the reoperation rate was 31.5% consisting mostly of simple procedures like fistula closure, meatotomy and penile curvature release, and complex diverticula repair in 4 cases. Parental perception was excellent for 57% (20 patients) and good or acceptable for the remaining. Mean follow-up was 4.6 years.Conclusions: the one-step strategy is associated with 68.5% success in a single operation, whereas 31.5% will need a second repair. We recognize that meatal problems are mostly associated with fistulae and diverticula; therefore, we recommend a final acceptable proximal glandar opening that will not compromise the neourethra. (C) 2011 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved. |
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Macedo, Antonio [UNIFESP]Liguori, Riberto [UNIFESP]Ottoni, Sergio L. [UNIFESP]Garrone, Gilmar [UNIFESP]Damazio, Eulalio [UNIFESP]Mattos, Ricardo M. [UNIFESP]Ortiz, Valdemar [UNIFESP]Universidade Federal de São Paulo (UNIFESP)2016-01-24T14:16:47Z2016-01-24T14:16:47Z2011-06-01Journal of Pediatric Urology. Oxford: Elsevier B.V., v. 7, n. 3, p. 299-304, 2011.1477-5131http://repositorio.unifesp.br/handle/11600/33718http://dx.doi.org/10.1016/j.jpurol.2011.02.02410.1016/j.jpurol.2011.02.024WOS:000292666200015Purpose: Complex primary hypospadias repair that warrants urethral plate division is treated mostly in two steps, not necessarily in two surgeries. Our aim was to review long-term results with a one-stage strategy based on reconstruction of the urethral plate with buccal mucosa graft and onlay transverse preputial flap anastomosis protected by a tunica vaginalis flap (the three-in-one concept).Material and methods: We were able to report on 35 patients operated for primary scrotal, penoscrotal and perineal hypospadias between March 2002 and June 2008. We reviewed all charts and had phone interviews with patients not seen for the last 24 months. We investigated parameters such as UTI occurrence, fistula, residual curvature, meatal stenosis, urethral diverticula, dehiscence, orchitis and parental perception.Results: Surgical complications occurred in 13 patients (37%): 4 meatal stenosis, 4 diverticula, 5 fistulae and 2 residual penile curvatures (total 42%). Meatal dilatation was successful in 2 cases, reflected in fistula resolution. the reoperation rate was 31.5% consisting mostly of simple procedures like fistula closure, meatotomy and penile curvature release, and complex diverticula repair in 4 cases. Parental perception was excellent for 57% (20 patients) and good or acceptable for the remaining. Mean follow-up was 4.6 years.Conclusions: the one-step strategy is associated with 68.5% success in a single operation, whereas 31.5% will need a second repair. We recognize that meatal problems are mostly associated with fistulae and diverticula; therefore, we recommend a final acceptable proximal glandar opening that will not compromise the neourethra. (C) 2011 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Dept Urol, BR-01323000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Urol, BR-01323000 São Paulo, BrazilWeb of Science299-304engElsevier B.V.Journal of Pediatric Urologyhttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policyinfo:eu-repo/semantics/openAccessHypospadiaUrethroplastyBuccal mucosaLong-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique)info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlereponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/337182022-11-03 10:40:49.744metadata only accessoai:repositorio.unifesp.br:11600/33718Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-11-03T13:40:49Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
title |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
spellingShingle |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) Macedo, Antonio [UNIFESP] Hypospadia Urethroplasty Buccal mucosa |
title_short |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
title_full |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
title_fullStr |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
title_full_unstemmed |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
title_sort |
Long-term results with a one-stage complex primary hypospadias repair strategy (the three-in-one technique) |
author |
Macedo, Antonio [UNIFESP] |
author_facet |
Macedo, Antonio [UNIFESP] Liguori, Riberto [UNIFESP] Ottoni, Sergio L. [UNIFESP] Garrone, Gilmar [UNIFESP] Damazio, Eulalio [UNIFESP] Mattos, Ricardo M. [UNIFESP] Ortiz, Valdemar [UNIFESP] |
author_role |
author |
author2 |
Liguori, Riberto [UNIFESP] Ottoni, Sergio L. [UNIFESP] Garrone, Gilmar [UNIFESP] Damazio, Eulalio [UNIFESP] Mattos, Ricardo M. [UNIFESP] Ortiz, Valdemar [UNIFESP] |
author2_role |
author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Macedo, Antonio [UNIFESP] Liguori, Riberto [UNIFESP] Ottoni, Sergio L. [UNIFESP] Garrone, Gilmar [UNIFESP] Damazio, Eulalio [UNIFESP] Mattos, Ricardo M. [UNIFESP] Ortiz, Valdemar [UNIFESP] |
dc.subject.eng.fl_str_mv |
Hypospadia Urethroplasty Buccal mucosa |
topic |
Hypospadia Urethroplasty Buccal mucosa |
description |
Purpose: Complex primary hypospadias repair that warrants urethral plate division is treated mostly in two steps, not necessarily in two surgeries. Our aim was to review long-term results with a one-stage strategy based on reconstruction of the urethral plate with buccal mucosa graft and onlay transverse preputial flap anastomosis protected by a tunica vaginalis flap (the three-in-one concept).Material and methods: We were able to report on 35 patients operated for primary scrotal, penoscrotal and perineal hypospadias between March 2002 and June 2008. We reviewed all charts and had phone interviews with patients not seen for the last 24 months. We investigated parameters such as UTI occurrence, fistula, residual curvature, meatal stenosis, urethral diverticula, dehiscence, orchitis and parental perception.Results: Surgical complications occurred in 13 patients (37%): 4 meatal stenosis, 4 diverticula, 5 fistulae and 2 residual penile curvatures (total 42%). Meatal dilatation was successful in 2 cases, reflected in fistula resolution. the reoperation rate was 31.5% consisting mostly of simple procedures like fistula closure, meatotomy and penile curvature release, and complex diverticula repair in 4 cases. Parental perception was excellent for 57% (20 patients) and good or acceptable for the remaining. Mean follow-up was 4.6 years.Conclusions: the one-step strategy is associated with 68.5% success in a single operation, whereas 31.5% will need a second repair. We recognize that meatal problems are mostly associated with fistulae and diverticula; therefore, we recommend a final acceptable proximal glandar opening that will not compromise the neourethra. (C) 2011 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved. |
publishDate |
2011 |
dc.date.issued.fl_str_mv |
2011-06-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:16:47Z |
dc.date.available.fl_str_mv |
2016-01-24T14:16:47Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Journal of Pediatric Urology. Oxford: Elsevier B.V., v. 7, n. 3, p. 299-304, 2011. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/33718 http://dx.doi.org/10.1016/j.jpurol.2011.02.024 |
dc.identifier.issn.none.fl_str_mv |
1477-5131 |
dc.identifier.doi.none.fl_str_mv |
10.1016/j.jpurol.2011.02.024 |
dc.identifier.wos.none.fl_str_mv |
WOS:000292666200015 |
identifier_str_mv |
Journal of Pediatric Urology. Oxford: Elsevier B.V., v. 7, n. 3, p. 299-304, 2011. 1477-5131 10.1016/j.jpurol.2011.02.024 WOS:000292666200015 |
url |
http://repositorio.unifesp.br/handle/11600/33718 http://dx.doi.org/10.1016/j.jpurol.2011.02.024 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Journal of Pediatric Urology |
dc.rights.driver.fl_str_mv |
http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
299-304 |
dc.publisher.none.fl_str_mv |
Elsevier B.V. |
publisher.none.fl_str_mv |
Elsevier B.V. |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
_version_ |
1802764178806538240 |