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A modified onlay island flap vs. Mathieu urethroplasty for distal hypospadias repair: A prospective randomised study.

ElGanainy EO - Arab J Urol (2015)

Bottom Line: The duration of follow-up was insignificantly different between the groups.Patients treated with the MOIF had a statistically significant lower complication rate (P = 0.036), and a better cosmetic outcome, urinary stream and relatives' satisfaction (P < 0.001 for all).Further studies including more patients, and a longer follow-up with an objective evaluation of functional outcome should be encouraged to confirm these early results.

View Article: PubMed Central - PubMed

Affiliation: Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.

ABSTRACT

Objective: To compare the outcome of a modified onlay island flap (MOIF) with that of the Mathieu urethroplasty for distal hypospadias repair.

Patients and methods: In a prospective randomised study, 60 patients with coronal, subcoronal and distal penile hypospadias, with a urethral plate width of ⩽6 mm, and minimal or no chordee, underwent either MOIF using a midline longitudinal outer preputial skin flap passed ventrally by penile buttonholing through dartos fascia incision, or a Mathieu urethroplasty. Closed envelopes were used for randomly selecting patients for each procedure. The operative duration, complications, cosmetic outcome, urinary stream and relatives' satisfaction were reported for each procedure.

Results: Preoperative data (patients' age and site of urethral meatus) and operative duration were insignificantly different between the groups (P = 0.653, 0.786 and 0.710, respectively). There were no intraoperative complications in either group. The duration of follow-up was insignificantly different between the groups. Patients treated with the MOIF had a statistically significant lower complication rate (P = 0.036), and a better cosmetic outcome, urinary stream and relatives' satisfaction (P < 0.001 for all).

Conclusions: The MOIF urethroplasty seemed to be better than the Mathieu urethroplasty in patients with distal hypospadias and narrow urethral plates. Further studies including more patients, and a longer follow-up with an objective evaluation of functional outcome should be encouraged to confirm these early results.

No MeSH data available.


Related in: MedlinePlus

Cosmetic results of the MOIF urethroplasty show: (A) a vertical slit-like UM (score 3). (B) A disfigured UM, excellent CS and PS (score = 1 + 3 + 3 = 7; satisfactory PCA).
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f0015: Cosmetic results of the MOIF urethroplasty show: (A) a vertical slit-like UM (score 3). (B) A disfigured UM, excellent CS and PS (score = 1 + 3 + 3 = 7; satisfactory PCA).

Mentions: The patients’ age, site of native UM and the operative duration (Table 2) were not significantly different between the groups (P = 0.653, 0.786 and 0.710, respectively). There were no intraoperative complications in either group. The mean (SD, range) follow-up in group 1 was 12.7 (4.3, 6–22) months and in group 2 was 11.7 (3.5, 6–19) months, and was not significantly different between the groups (P = 0.282). There were significantly fewer postoperative complications in the MOIF group (P = 0.036). The MOIF group had a highly statistically significantly better cosmetic appearance, shape of urinary stream and relatives’ satisfaction rating (P < 0.001 for all). Fig. 3 shows the postoperative cosmetic results after MOIF urethroplasty. No patient in either group had a significant postvoid residual urine volume on abdominal ultrasonography.


A modified onlay island flap vs. Mathieu urethroplasty for distal hypospadias repair: A prospective randomised study.

ElGanainy EO - Arab J Urol (2015)

Cosmetic results of the MOIF urethroplasty show: (A) a vertical slit-like UM (score 3). (B) A disfigured UM, excellent CS and PS (score = 1 + 3 + 3 = 7; satisfactory PCA).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563012&req=5

f0015: Cosmetic results of the MOIF urethroplasty show: (A) a vertical slit-like UM (score 3). (B) A disfigured UM, excellent CS and PS (score = 1 + 3 + 3 = 7; satisfactory PCA).
Mentions: The patients’ age, site of native UM and the operative duration (Table 2) were not significantly different between the groups (P = 0.653, 0.786 and 0.710, respectively). There were no intraoperative complications in either group. The mean (SD, range) follow-up in group 1 was 12.7 (4.3, 6–22) months and in group 2 was 11.7 (3.5, 6–19) months, and was not significantly different between the groups (P = 0.282). There were significantly fewer postoperative complications in the MOIF group (P = 0.036). The MOIF group had a highly statistically significantly better cosmetic appearance, shape of urinary stream and relatives’ satisfaction rating (P < 0.001 for all). Fig. 3 shows the postoperative cosmetic results after MOIF urethroplasty. No patient in either group had a significant postvoid residual urine volume on abdominal ultrasonography.

Bottom Line: The duration of follow-up was insignificantly different between the groups.Patients treated with the MOIF had a statistically significant lower complication rate (P = 0.036), and a better cosmetic outcome, urinary stream and relatives' satisfaction (P < 0.001 for all).Further studies including more patients, and a longer follow-up with an objective evaluation of functional outcome should be encouraged to confirm these early results.

View Article: PubMed Central - PubMed

Affiliation: Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.

ABSTRACT

Objective: To compare the outcome of a modified onlay island flap (MOIF) with that of the Mathieu urethroplasty for distal hypospadias repair.

Patients and methods: In a prospective randomised study, 60 patients with coronal, subcoronal and distal penile hypospadias, with a urethral plate width of ⩽6 mm, and minimal or no chordee, underwent either MOIF using a midline longitudinal outer preputial skin flap passed ventrally by penile buttonholing through dartos fascia incision, or a Mathieu urethroplasty. Closed envelopes were used for randomly selecting patients for each procedure. The operative duration, complications, cosmetic outcome, urinary stream and relatives' satisfaction were reported for each procedure.

Results: Preoperative data (patients' age and site of urethral meatus) and operative duration were insignificantly different between the groups (P = 0.653, 0.786 and 0.710, respectively). There were no intraoperative complications in either group. The duration of follow-up was insignificantly different between the groups. Patients treated with the MOIF had a statistically significant lower complication rate (P = 0.036), and a better cosmetic outcome, urinary stream and relatives' satisfaction (P < 0.001 for all).

Conclusions: The MOIF urethroplasty seemed to be better than the Mathieu urethroplasty in patients with distal hypospadias and narrow urethral plates. Further studies including more patients, and a longer follow-up with an objective evaluation of functional outcome should be encouraged to confirm these early results.

No MeSH data available.


Related in: MedlinePlus