The short-term efficacy of modified plate reconstruction and tubularization urethroplasty for posterior hypospadias.

Abstract

Purpose: To investigate the short-term efficacy of modified plate reconstruction and tubularization urethroplasty for posterior hypospadias.

Material and method: We retrospectively collected the clinical data of posterior hypospadias patients who were newly diagnosed and underwent plate reconstruction and tubularization urethroplasty (PRTU) or modified PRTU. Surgical modifications were to reconstruct the glans segment of the urethra with a free flap, thus presenting an orthotopic urethral opening, and to preserve the Buck's fascia at the coronal sulcus for approximately 1 cm to enhance coverage of the shaped urethra. Regular follow-up was taken in clinic or online. We compared complication rate, HOSE score and uroflowmetry testing results between these two groups.

Results: A total of 107 children underwent either PRTU or modified PRTU, and 102 of them were fully followed-up (55 cases of PRTU and 47 cases of modified PRTU). All of the patients were diagnosed with posterior hypospadias. The age at operation ranged from 1 year to 1 month to 14 years old (mean age 3 years and 2 months). The postoperative follow-up period ranged from six to 63 months, with an average follow-up period of 23.2 months, and 102 patients provided comprehensive post-operative data, exhibiting a comprehensive follow-up rate of 95.3 %. There's a statistically significant difference in the incidence of dehiscence of urethra between PRTU group (10 cases) and modified PRTU group (2 cases).

Conclusion: Modified PRTU is a safe, practical, and effective method for hypospadias. This procedure is appropriate for repairing posterior-type hypospadias combined with penoscrotal transposition, while reducing the risk of postoperative urethral dehiscence and achieve good appearance.