D Acosta Fariña | PubMed Health

PubMed2004

[Treatment of proximal hypospadias: the onlay technique].

UNLABELLED: In 1987 Elder and Duckett published a modification of the Duckett technique for hypospadias repair, substituting the transverse preputial island flap for the onlay island. This modification preserves the urethral plate and has no circular anastomoses, the most common cause of fistulas and stenosis. MATERIAL AND METHODS: We present our experience in 67 cases with hypospadias (60 with chordee). The meatus was in the superior third of the penis in 15 cases, in the middle third in 29, at the base of the penis in 11, and interscrotal in 12 patients. Preoperative hormonal substitution was administer in 12 patients, correction of the chordee was possible in 66 cases, the urethral plate was dissected in 18 cases, and the Nesbit procedure in 16 cases. RESULTS: A good result was obtained in 59 cases a straight penis, meatus at the tip of the penis, good calibre of the urinary stream and a satisfactory esthetic result. Our rate of complication was of 12%, five fistulas, two partial deshicences of the preputioplasty and in one case a discrete chordee. CONCLUSIONS: We believe this is an surgical technique for one stage procedure in severe cases of proximal hypospadias with chordee with a good functional and esthetic result and few complications.

Child↗

PubMed2003

[Severe epispadias: the Mitchell's technique].

UNLABELLED: Epispadias associated or not to bladder extrophy is a congenital malformation with a difficult surgical correction. Mitchell published his technique in 1996, and it's based in the complete dissection of the uretheral band, ventral peneal skin and both corporas including their proximal insertion, that in next steps will be separated in all the length. These manoeuvres permit to: 1) Correct the dorsal incurvation; 2) Locate the urethra in a ventral position; 3) Locate the meatus at the tip of the penis with a vertical orientation. MATERIAL AND METHODS: We have performed these surgical procedure in 6 patients, 4 of them were epispadias (a 23 years old patient who had there surgical procedure, with persistent incurvation), the others two were associated with bladder extrophy, 3 had hormonal treatment previous surgery, due to a hypoplastic penis. In the two patients with bladder extrophy we used a labial mucosa graft sutured to the tubularized urethral plate to relocate the meatus at the tip of the penis. RESULTS: The esthetic results were good in all cases, 2 had a fistula that was corrected surgically.

Adult↗