One-stage complex primary hypospadia repair combining buccal mucosa graft, preputial flap and tunical vaginalis flap (the three-in-one technique)

One-stage complex primary hypospadia repair combining buccal mucosa graft, preputial flap and tunical vaginalis flap (the three-in-one technique)

Author Macedo, Antonio Autor UNIFESP Google Scholar
Liguori, Riberto Autor UNIFESP Google Scholar
Garrone, Gilmar Autor UNIFESP Google Scholar
Ottoni, Sergio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: Complex hypospadia repair can be performed according to different strategies, mostly in one or two stages. We present a detailed video of one patient operated according to the three-in-one technique, which combines dorsal buccal mucosa grafting for reconstruction of the incised urethral plate and a preputial flap onlay urethroplasty covered by a tunica vaginalis graft.Method: After sectioning of the urethral plate to correct ventral curvature, the original plate is anchored to the proximal penile shaft. Buccal mucosa is harvested from the lower lip and sutured to the ventral penile shaft area. A transverse preputial flap is obtained and anastomosed 'onlay' to the reconstructed neouretha. the scrotal fascia is opened at the site opposite to the placement of the pedicle of the preputial flap and a careful dissection of the tunica vaginalis and cremasteric tissue is performed. This second flap is used to cover the neourethra and is fixed to the corpora by angular interrupted 6-0 PDS sutures.Results: Our series of 35 patients resulted in 68.5% success after a single operation, whereas 31.5% needed a second repair.Conclusion: the technique gives excellent results and can be considered an alternative to one-stage repair in primary cases. (C) 2010 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved.
Keywords Hypospadia
Urethra
Reconstruction
Penile surgery
Language English
Date 2011-02-01
Published in Journal of Pediatric Urology. Oxford: Elsevier B.V., v. 7, n. 1, p. 76-76, 2011.
ISSN 1477-5131 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 76-76
Origin http://dx.doi.org/10.1016/j.jpurol.2010.10.006
Access rights Closed access
Type Editorial
Web of Science ID WOS:000291195600015
URI http://repositorio.unifesp.br/handle/11600/33415

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