nach oben

Erschienen in:

25.10.2019 | Original Article

Prevalence, assessment and surgical correction of penile curvature in hypospadias patients treated at one European Referral Center: description of the technique and surgical outcomes

verfasst von: Marco Bandini, Sasha Sekulovic, Bogdan Spiridonescu, Pramod Krishnappa, Anuj Deep Dangi, Milan Slavkovic, Vladislav Pesic, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Rados Djinovic

Erschienen in: World Journal of Urology | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Penile curvature (PC) is a common component of hypospadias, but its presence is inconstantly assessed. We aim to report prevalence of PC in hypospadias patients, as well as to report our method to assess and correct PC, with the associated postoperative outcomes.

Methods

We scrutinized 303 pediatric hypospadias patients operated (2013–2018) at our referral center. PC was routinely assessed and eventually corrected with dorsal plications (DP) as one-stage procedure, or ventral tunica attenuations ± DP as two-stage repair. PC severity and surgical treatment of PC were compared between primary and failed hypospadias. Finally, PC severity, failed repair and PC treatment were tested as predictors of perioperative complications.

Results

PC (> 10°) was identified in 274/303 (90.4%) patients, 86.1% with distal, 91.8% with midshaft, and 100% with proximal hypospadias, respectively. PC was found in 51/64 (79.7%) of failed hypospadias. One-stage and two-stage procedures were adopted in 211/274 (77%) and 63/274 (23%) children, respectively. PC severity (p = 0.1) and PC treatment (p = 0.4) did not differ between primary and failed hypospadias. PC severity (all p > 0.2), failed repair (p = 0.8), and PC treatment (all p > 0.09) were not predictors of perioperative complications. 95.6% of patients achieved a straight penis.

Conclusion

Less than 1/10 patients did not require PC correction. High rate of residual PC in failed hypospadias and similar severity between failed and primary suggest that PC was usually under-corrected. It is possible to correct PC completely and the resulting complication would not be associated with PC severity, failed repair or treatment adopted.

Nur mit Berechtigung zugänglich

Moscardi PRM, Gosalbez R, Castellan MA (2017) Management of high-grade penile curvature associated with hypospadias in children. Front Pediatr 5:189. https://doi.org/10.3389/fped.2017.00189 CrossRefPubMedPubMedCentral

Menon V, Breyer B, Copp HL et al (2016) Do adult men with untreated ventral penile curvature have adverse outcomes? J Pediatr Urol 12:31.e1–31.e7. https://doi.org/10.1016/j.jpurol.2015.09.009 CrossRef

Schlomer B, Breyer B, Copp H et al (2014) Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey. J Pediatr Urol 10:672–679. https://doi.org/10.1016/j.jpurol.2014.01.024 CrossRefPubMedPubMedCentral

Fraumann SA, Stephany HA, Clayton DB et al (2014) Long-term follow-up of children who underwent severe hypospadias repair using an online survey with validated questionnaires. J Pediatr Urol 10:446–450. https://doi.org/10.1016/j.jpurol.2014.01.015 CrossRefPubMed

Snodgrass WT, Bush N, Cost N (2010) Tubularized incised plate hypospadias repair for distal hypospadias. J Pediatr Urol 6:408–413. https://doi.org/10.1016/j.jpurol.2009.09.010 CrossRefPubMed

Snodgrass W, Bush N (2011) Tubularized incised plate proximal hypospadias repair: continued evolution and extended applications. J Pediatr Urol 7:2–9. https://doi.org/10.1016/j.jpurol.2010.05.011 CrossRefPubMed

Snodgrass W, Prieto J (2009) Straightening ventral curvature while preserving the urethral plate in proximal hypospadias repair. J Urol 182:1720–1725. https://doi.org/10.1016/j.juro.2009.02.084 CrossRefPubMed

McNamara ER, Schaeffer AJ, Logvinenko T et al (2015) Management of proximal hypospadias with 2-stage repair: 20-year experience. J Urol 194:1080–1085. https://doi.org/10.1016/j.juro.2015.04.105 CrossRefPubMedPubMedCentral

Hueber P-A, Antczak C, Abdo A et al (2015) Long-term functional outcomes of distal hypospadias repair: a single center retrospective comparative study of TIPs, Mathieu and MAGPI. J Pediatr Urol 11:68.e1–68.e7. https://doi.org/10.1016/j.jpurol.2014.09.011 CrossRef

10.

Cimador M, Vallasciani S, Manzoni G et al (2013) Failed hypospadias in paediatric patients. Nat Rev Urol 10:657–666. https://doi.org/10.1038/nrurol.2013.164 CrossRefPubMed

11.

Barbagli G, De Angelis M, Palminteri E, Lazzeri M (2006) Failed hypospadias repair presenting in adults. Eur Urol 49:887–894. https://doi.org/10.1016/j.eururo.2006.01.027(discussion 895) CrossRefPubMed

12.

Bologna RA, Noah TA, Nasrallah PF, McMahon DR (1999) Chordee: varied opinions and treatments as documented in a survey of the American Academy of Pediatrics, Section of Urology. Urology 53:608–612CrossRef

13.

Springer A, Krois W, Horcher E (2011) Trends in hypospadias surgery: results of a worldwide survey. Eur Urol 60:1184–1189. https://doi.org/10.1016/j.eururo.2011.08.031 CrossRefPubMed

14.

Nesbit RM (1965) Congenital curvature of the phallus: report of three cases with description of corrective operation. J Urol 93:230–232. https://doi.org/10.1016/s0022-5347(17)63751-0 CrossRefPubMed

15.

Bandini M, Sekulovic S, Spiridonescu B et al (2019) Vacuum physiotherapy after first stage buccal mucosa graft (BMG) urethroplasty in proximal hypospadias: a feasibility, safety and protocol compliance assessment study. Eur Urol Suppl 18:e746–e747. https://doi.org/10.1016/S1569-9056(19)30548-2 CrossRef

16.

Bandini M, Sekulović S, Stanojevic N et al (2019) Prevalence and surgical management of pubic hypertrophy in hypospadias patients: results from a high-volume surgeon. Eur Urol Suppl 18:e754–e755. https://doi.org/10.1016/S1569-9056(19)30554-8 CrossRef

17.

Perovic S, Barbagli G, Djinovic R et al (2010) Surgical challenge in patients who underwent failed hypospadias repair: is it time to change? Urol Int 85:427–435. https://doi.org/10.1159/000319856 CrossRefPubMed

18.

Sekulović S, Bandini M, Spiridonescu B et al (2019) Real prevalence and severity of penile curvature in different types of hypospadias. Eur Urol Suppl 18:e750–e751. https://doi.org/10.1016/S1569-9056(19)30551-2 CrossRef

19.

Bandini M, Sekulović S, Dangi AD et al (2019) Corporeal penile curvature (CPC) and surgical complications in hypospadias repairs: associations and outcomes. Eur Urol Suppl 18:e752. https://doi.org/10.1016/S1569-9056(19)30552-4 CrossRef

20.

Vandersteen DR, Husmann DA (1998) Late onset recurrent penile chordee after successful correction at hypospadias repair. J Urol 160:1131–1133 (discussion 1137) CrossRef

Titel: Prevalence, assessment and surgical correction of penile curvature in hypospadias patients treated at one European Referral Center: description of the technique and surgical outcomes
verfasst von: Marco Bandini
Sasha Sekulovic
Bogdan Spiridonescu
Pramod Krishnappa
Anuj Deep Dangi
Milan Slavkovic
Vladislav Pesic
Andrea Salonia
Alberto Briganti
Francesco Montorsi
Rados Djinovic
Publikationsdatum: 25.10.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 8/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02961-x

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2020

Treatment of non-obstructive, non-struvite urolithiasis is effective in treatment of recurrent urinary tract infections

Additional assessment of Acute Cystitis Symptom Score questionnaire for patient-reported outcome measure in female patients with acute uncomplicated cystitis: part II

Transperineal prostate biopsy with cognitive magnetic resonance imaging/biplanar ultrasound fusion: description of technique and early results

Robotic surgery in infants and children: an argument for smaller and fewer incisions

Experience with detrusorotomy in children by open and robotic approach