Comparison of Snodgrass Tubularised Incised Plate Urethroplasty and Duckett Onlay Transverse Preputial Patch Urethroplasty for Correction of Penile Hypospadias

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Authors

  • Associate Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003 ,IN
  • Former PG Resident, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003 ,IN
  • Assistant Professor, Department of Surgery, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003 ,IN

Keywords:

Snodgrass Urethroplasty, Duckett Onlay, Transverse Preputial, Patch Urethroplasty, Penile, Hypospadias, Ventral Penile Curvature

Abstract

Introduction: Hypospadias is defined as a condition where the urethra opens on the ventral aspect of the penis. It is commonly associated with penile curvature, usually ventral and is one of the most common genital birth defects in males. Hypospadias can be treated with numerous different surgical approaches numbering upto 200, and historically has been treated with procedures like Trans-Verse Island Flap (TVIF) on lay, Tubularised Incised-Plate (TIP), vertical preputial island flap, tubularised preputial flap, vertical preputial flap with double skin island etc. Present study was conducted to compare Snodgrass Tubularised Incised Plate Urethroplasty (TIP procedure) and Duckett Onlay Transverse Preputial Patch Urethroplasty for penile hypospadias correction. Material and Methods: Male patients between the age of 2-14 years who underwent correction of penile hypospadias by either of the two techniques viz. TIP (procedure) Urethroplasty and Duckett Onlay Transverse Preputial Patch Urethroplasty were included in the present prospective observational study after written informed consent. Results: The study was carried out with 40 patients and sorted into two groups, i.e. Snodgrass (S) and Duckett (D) group with 20 patients each. No difference was observed among study groups withregards to incidence of individual complications like urethrocutaneous fistula, stricture, or wound infection (p>0.05). However, total complication rate was marginally higher (55%) in Snodgrass’ procedure as compared to Duckett’s procedure (35%). All the cases of stricture (10%) and wound dehiscence (5%) were reported in Snodgrass group.

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2021-01-01

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References

Nelson CP, Park JM, Wan J, Bloom DA, Dunn RL, Wei JT. The increasing incidence of congenital penile anomalies in the United States. J Urol. 2005; 174:1573-1576. https://doi. org/10.1097/01.ju.0000179249.21944.7e. PMid:16148654.

Schnack TH, Poulsen G, Myrup C, Wohlfahrt J, Melbye M. Familial coaggregation of cryptorchidism and hypospadias. Epidemiology. 2010; 21:109-113. https://doi.org/10.1097/ EDE.0b013e3181c15a50. PMid:19901839.

Keays MA, Dave S. Current hypospadias management: Diagnosis, surgical management, and long-term patientcentred outcomes. Canadian Urological Association Journal. 2017 Jan; 11(1-2Suppl1):S48. https://doi.org/10.5489/ cuaj.4386. PMid:28265319 PMCid:PMC5332236.

van der Horst HJ, de Wall LL. Hypospadias, all there is to know. Eur J Pediatr. 2017; 176:435. https://doi.org/10.1007/ s00431-017-2864-5. PMid:28190103 PMCid: PMC5352742.

Schneuer FJ, Holland AJ, Pereira G, Bower C, Nassar N. Prevalence, repairs and complications of hypospadias: an Australian population-based study. Arch Dis Child. 2015; 100:1038. https://doi.org/10.1136/archdischild- 2015-308809. PMid:26310454.

Snodgrass W. Tubularised incised plate urethroplasty for distal hypospadias. J Urol. 1994; 151:464-465. https://doi. org/10.1016/S0022-5347(17)34991-1.

Elder JS, Duckett JW, Snyder HM (1987) Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol. 138:376-379. https://doi.org/10.1016/ S0022-5347(17)43152-1.

Santanelli F, D’Andrea F, Savanelli A, Molea G, Scuderi N. Reconstruction of hypospadias with a vertical preputial island flap. A follow-up study of 127 patients. Scand J Plast Reconstr Surg Hand Surg. 1990; 24:67-73. https://doi. org/10.3109/02844319009004523. PMid:2389126.

Duckett JW Jr. Transverse preputial island flap technique for repair of severe hypospadias. Urol Clin North Am. 1980; 7:423-430. https://doi.org/10.1016/S0094- 0143(21)01243-X.

Santanelli F. Vertical preputial flap with double skin island for correction of hypospadias with severe recurvatum. Ann Plast Surg. 1994; 33:305-312. https://doi. org/10.1097/00000637-199409000-00012. PMid:7985968.

DeLair SM, Tanaka ST, Yap SA, Kurzrock EA. Training residents in hypospadias repair: Variations of involvement. J Urol. 2008; 179:1102-1106. https://doi.org/10.1016/j. juro.2007.10.090. PMid:18206935.

Esposito C, Savanelli A, Escolino M, Giurin I, Iaquinto M, Alicchio F, Roberti A, Settimi A. Preputioplasty associated with urethroplasty for correction of distal hypospadias: A prospective study and proposition of a new objective scoring system for evaluation of esthetic and functional outcome. J Pediatr Urol. 2014; 10:294-299. https://doi. org/10.1016/j.jpurol.2013.09.003. PMid:24145174.

Standoli L. Correzione dell’ipospadiain un unico tempo: Técnica dell’uretroplastica con lembo ad isolaprepuziale. Rass Ital Chir Pediatr. 1979; 21:82.

Chen SC, Yang SS, Hsieh CH, Chen YT. Tubularised incised plate urethroplasty for proximal hypospadias. BJU Int. 2000; 86:1050-1053. https://doi.org/10.1046/j.1464- 410x.2000.00966.x. PMid:11119100.

Baskin LS, Erol A, Jegatheesan P, Li Y, Liu W, Cunha GR. Urethral seam formation and hypospadias. Cell Tissue Res. 2001; 305:379. https://doi.org/10.1007/s004410000345. PMid:11572091.

Baskin LS. Anatomical studies of the fetal genitalia: Surgical reconstructive implications. Adv Exp Med Biol. 2002; 511:239. https://doi.org/10.1007/978-1-4615-0621-8_14. PMid:12575765.