Mathieu repair of distal and midshaft hypospadias: risks and benefits of foreskin reconstruction versus circumcision
Identifieur interne : 004D61 ( Main/Merge ); précédent : 004D60; suivant : 004D62Mathieu repair of distal and midshaft hypospadias: risks and benefits of foreskin reconstruction versus circumcision
Auteurs : Mohammad Kazem Moslemi [Iran] ; Mohammad Ali Sadighi Gilani [Iran] ; Hossein Shahrokh [Iran]Source :
- Open Access Journal of Urology [ 1179-1551 ] ; 2011.
Abstract
The purpose of this study was to compare the risks and benefits of Mathieu repair of hypospadias with or without circumcision in consecutive operated cases.
Eighty-six children with midshaft or distal hypospadias were randomly divided into two groups and underwent circumcision (Group A) or preputial reconstruction (Group B) during hypospadias repair. Postoperative complications, outcomes, and parental satisfaction were assessed for circumcised and uncircumcised patients. All patients with midshaft or distal hypospadias with or without minimal chordee were included.
No statistically significant differences in urethral complications were found between the two groups. Meatal stenosis occurred in one case in Group A and one case in Group B. Fistulae occurred in five cases in Group A and six cases in Group B. Urethral dehiscence occurred in no case in either group. No case of phimosis was seen in Group B. After a mean follow-up of 6 months, all parents of Group A cases stated that they were satisfied with the circumcision for religious and/or social reasons, but no parents of Group B cases were satisfied with preputioplasty (
Mathieu repair with synchronous circumcision is feasible in all patients with distal or midshaft hypospadias with or without minimal chordee, and should be considered in accordance with surgeon preference. In the case of prepuce preservation, parents should be informed that there is a benefit of tissue banking for probable redo hypospadias repair but with an increased risk of complications and a need for another procedure, ie, circumcision.
Url:
DOI: 10.2147/OAJU.S21577
PubMed: 24198642
PubMed Central: 3818950
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<author><name sortKey="Moslemi, Mohammad Kazem" sort="Moslemi, Mohammad Kazem" uniqKey="Moslemi M" first="Mohammad Kazem" last="Moslemi">Mohammad Kazem Moslemi</name>
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<author><name sortKey="Gilani, Mohammad Ali Sadighi" sort="Gilani, Mohammad Ali Sadighi" uniqKey="Gilani M" first="Mohammad Ali Sadighi" last="Gilani">Mohammad Ali Sadighi Gilani</name>
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<author><name sortKey="Shahrokh, Hossein" sort="Shahrokh, Hossein" uniqKey="Shahrokh H" first="Hossein" last="Shahrokh">Hossein Shahrokh</name>
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<author><name sortKey="Moslemi, Mohammad Kazem" sort="Moslemi, Mohammad Kazem" uniqKey="Moslemi M" first="Mohammad Kazem" last="Moslemi">Mohammad Kazem Moslemi</name>
<affiliation wicri:level="1"><nlm:aff id="af1-oaju-3-105">Department of Urology, Kamkar Hospital, School of Medicine, Qom, University of Medical Science, Qom, Iran</nlm:aff>
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<author><name sortKey="Gilani, Mohammad Ali Sadighi" sort="Gilani, Mohammad Ali Sadighi" uniqKey="Gilani M" first="Mohammad Ali Sadighi" last="Gilani">Mohammad Ali Sadighi Gilani</name>
<affiliation wicri:level="1"><nlm:aff id="af2-oaju-3-105">Department of Urology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
<country xml:lang="fr">Iran</country>
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<author><name sortKey="Shahrokh, Hossein" sort="Shahrokh, Hossein" uniqKey="Shahrokh H" first="Hossein" last="Shahrokh">Hossein Shahrokh</name>
<affiliation wicri:level="1"><nlm:aff id="af3-oaju-3-105">Department of Urology, Hasheminejad Kidney Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff>
<country xml:lang="fr">Iran</country>
<wicri:regionArea>Department of Urology, Hasheminejad Kidney Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran</wicri:regionArea>
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<series><title level="j">Open Access Journal of Urology</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The purpose of this study was to compare the risks and benefits of Mathieu repair of hypospadias with or without circumcision in consecutive operated cases.</p>
</sec>
<sec><title>Methods</title>
<p>Eighty-six children with midshaft or distal hypospadias were randomly divided into two groups and underwent circumcision (Group A) or preputial reconstruction (Group B) during hypospadias repair. Postoperative complications, outcomes, and parental satisfaction were assessed for circumcised and uncircumcised patients. All patients with midshaft or distal hypospadias with or without minimal chordee were included.</p>
</sec>
<sec><title>Results</title>
<p>No statistically significant differences in urethral complications were found between the two groups. Meatal stenosis occurred in one case in Group A and one case in Group B. Fistulae occurred in five cases in Group A and six cases in Group B. Urethral dehiscence occurred in no case in either group. No case of phimosis was seen in Group B. After a mean follow-up of 6 months, all parents of Group A cases stated that they were satisfied with the circumcision for religious and/or social reasons, but no parents of Group B cases were satisfied with preputioplasty (<italic>P</italic>
≤ 0.05). No case of hypospadias repair failure was seen in our operated cases. Finally, no cases in Group B required redo hypospadias surgery.</p>
</sec>
<sec><title>Conclusion</title>
<p>Mathieu repair with synchronous circumcision is feasible in all patients with distal or midshaft hypospadias with or without minimal chordee, and should be considered in accordance with surgeon preference. In the case of prepuce preservation, parents should be informed that there is a benefit of tissue banking for probable redo hypospadias repair but with an increased risk of complications and a need for another procedure, ie, circumcision.</p>
</sec>
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