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Abstract

Volume 23, Issue 5 (September 2021) 23, 532–536; 10.4103/aja.aja_19_21

Spongiosum-combined glanuloplasty reduces glans complications after proximal hypospadias repair

Yi-Qing Lyu, Lin Yu, Hua Xie, Yi-Chen Huang, Xiao-Xi Li, Li Sun, Yan Liang, Fang Chen

Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China

Correspondence: Dr. F Chen (doctorchenfang@126.com)

Date of Submission 08-Jun-2020 Date of Acceptance 21-Jan-2021 Date of Web Publication 12-Mar-2021

Abstract

We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair. Patients who underwent urethroplasty by dorsal preputial island flap for proximal hypospadias between January 2014 and December 2016 were reviewed in this retrospective cohort study. Those who underwent spongiosum-combined glanuloplasty comprised the new-maneuver group, whereas those who underwent conventional glanuloplasty comprised the control group. The incidence of complications was then compared. In the new-maneuver group, dysplastic corpus spongiosum alongside lateral Buck's fascia (0.3–0.4 cm wide) on both sides of the urethral plate was separated from the proximal normal spongy tissue, joining into the glans wings to increase tissue volume and covering the neourethra in the glans penis. In the control group, the neourethra was covered with superficial fascia under the coronal sulcus. As a result, the new-maneuver and control groups comprised 47 and 28 patients, respectively. In the new-maneuver group, no glans dehiscence was detected; however, two (4.3%) patients had coronal fistula, two (4.3%) had urethral stricture, and four (8.5%) had diverticulum. In the control group, two (7.1%) patients had glans dehiscence, eight (28.6%) had coronal fistula, four (14.3%) had urethral stricture, one (3.6%) had diverticulum, and one (3.6%) had penile curvature recurrence. The new-maneuver group had less incidences of coronal fistula (P < 0.001), glans dehiscence (P = 0.033), and urethral stricture (P = 0.008) but had a higher incidence of diverticulum than the control group (P = 0.040). It clearly demonstrates that spongiosum-combined glanuloplasty can significantly reduce the incidences of coronal fistula and glans dehisce.

Keywords: glans dehiscence; glanuloplasty; hypospadias; urinary fistula

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