Distal penile hypospadias repair in cases of narrow plate less than 8 mm is chalanging with TIP, Snodgraft, two stage repaire or other flaps. What do you prefer as I am considering the two stage repair with perpetual graft in the last year?
if you mean glanular H.S. , MAGPI is a good solution .
in the anterior penile , you can do mobilized latral flap
Dr. Khalifa, thanx for the interaction. My problem is in cases of coronal and subcoronal hypoplasia in which the plate is not nice fot TIP
If it is coronal or glanular then Snod graft is the most appropriate procedure of choice in expert hands. In most of the sub coronal hypospadias I go for Snod Grass, if glans is wide enough (in most of the cases it is).
If the plate is wide enough TIP is a good solution, but I really want to have the personal experience of
In case of narrow plate,I prefer meatal based flap or lateral flap or lateral preputal flap covers by 2nd layer of dartos fascia and skin with non overlapping suture lines
the problem is how to define narrow urethra plate! Please read our article; https://www.frontiersin.org/articles/10.3389/fped.2018.00326/full
The other difficulty comes from how to define (narrow or unfavorable) urethral plate! To answer this question, i introduced a new scoring tool named POST; https://www.jpurol.com/article/S1477-5131(20)30453-8/pdf
In cases of unfavorable urethral plate with ventral penile curvature less than 50 degrees, dorsal inlay TIP. Please read our articles:
https://www.jpurol.com/article/S1477-5131(20)30453-8/pdf
and
https://www.sciencedirect.com/science/article/abs/pii/S1477513121000991?dgcid=rss_sd_all
This article describes how to objectively classify Urethral plates!
Abbas TO, Vallasciani S, Elawad A, Elifranji M, Leslie B, Elkadhi A, Pippi Salle JL. Plate Objective Scoring Tool (POST); An objective methodology for the assessment of urethral plate in distal hypospadias. J Pediatr Urol. 2020 Oct;16(5):675-682. doi: 10.1016/j.jpurol.2020.07.043. Epub 2020 Aug 5. PMID: 32830060.
- Badges
- Science topic
- Similar topics
- Chemistry