Mathieu repair of distal and midshaft hypospadias: risks and benefits of foreskin reconstruction versus circumcision
Identifieur interne : 004277 ( Pmc/Curation ); précédent : 004276; suivant : 004278Mathieu 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.
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DOI: 10.2147/OAJU.S21577
PubMed: 24198642
PubMed Central: 3818950
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Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Urology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran</wicri:regionArea></affiliation></author><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></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24198642</idno><idno type="pmc">3818950</idno><idno 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Qom, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Department of Urology, Kamkar Hospital, School of Medicine, Qom, University of Medical Science, Qom</wicri:regionArea></affiliation></author><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><wicri:regionArea>Department of Urology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran</wicri:regionArea></affiliation></author><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></affiliation></author></analytic><series><title level="j">Open Access Journal of Urology</title><idno type="eISSN">1179-1551</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Snodgrass, Wt" uniqKey="Snodgrass W">WT Snodgrass</name></author><author><name sortKey="Koyle, Ma" uniqKey="Koyle M">MA Koyle</name></author><author><name sortKey="Baskin, Ls" uniqKey="Baskin L">LS Baskin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mousavi, Sa" uniqKey="Mousavi S">SA Mousavi</name></author><author><name sortKey="Salehifar, E" uniqKey="Salehifar E">E Salehifar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kazem, Mm" uniqKey="Kazem M">MM Kazem</name></author><author><name sortKey="Mehdi, Aa" uniqKey="Mehdi A">AA Mehdi</name></author><author><name sortKey="Golrasteh, Kz" uniqKey="Golrasteh K">KZ Golrasteh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Snodgrass, Wt" uniqKey="Snodgrass W">WT Snodgrass</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bhatti, Az" uniqKey="Bhatti A">AZ Bhatti</name></author><author><name sortKey="Naveed, M" uniqKey="Naveed M">M Naveed</name></author><author><name sortKey="Adeniran, A" uniqKey="Adeniran A">A Adeniran</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cold, Cj" uniqKey="Cold C">CJ Cold</name></author><author><name sortKey="Taylor, Jr" uniqKey="Taylor J">JR Taylor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rickwood, Am" uniqKey="Rickwood A">AM Rickwood</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Haseebuddin, M" uniqKey="Haseebuddin M">M Haseebuddin</name></author><author><name sortKey="Brandes, Sb" uniqKey="Brandes S">SB Brandes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klijn, Aj" uniqKey="Klijn A">AJ Klijn</name></author><author><name sortKey="Dik, P" uniqKey="Dik P">P Dik</name></author><author><name sortKey="De Jong, Tp" uniqKey="De Jong T">TP de Jong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Snodgrass, W" uniqKey="Snodgrass W">W Snodgrass</name></author><author><name sortKey="Ziada, A" uniqKey="Ziada A">A Ziada</name></author><author><name sortKey="Yucel, S" uniqKey="Yucel S">S Yucel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gray, J" uniqKey="Gray J">J Gray</name></author><author><name sortKey="Boston, Ve" uniqKey="Boston V">VE Boston</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aminsharifi, A" uniqKey="Aminsharifi A">A Aminsharifi</name></author><author><name sortKey="Taddayun, A" uniqKey="Taddayun A">A Taddayun</name></author><author><name sortKey="Assadolahpoor, A" uniqKey="Assadolahpoor A">A Assadolahpoor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Snodgrass, Wt" uniqKey="Snodgrass W">WT Snodgrass</name></author><author><name sortKey="Khavari, R" uniqKey="Khavari R">R Khavari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pieretti, Rv" uniqKey="Pieretti R">RV Pieretti</name></author><author><name sortKey="Pieretti, A" uniqKey="Pieretti A">A Pieretti</name></author><author><name sortKey="Pieretti Vanmarcke, R" uniqKey="Pieretti Vanmarcke R">R Pieretti-Vanmarcke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mousavi, Sa" uniqKey="Mousavi S">SA Mousavi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moslemi, Mk" uniqKey="Moslemi M">MK Moslemi</name></author><author><name sortKey="Firoozabadi, Mhd" uniqKey="Firoozabadi M">MHD Firoozabadi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bracka, A" uniqKey="Bracka A">A Bracka</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mureau, Mam" uniqKey="Mureau M">MAM Mureau</name></author><author><name sortKey="Slijper, Fme" uniqKey="Slijper F">FME Slijper</name></author><author><name sortKey="Van Der Meulen, Jc" uniqKey="Van Der Meulen J">JC van der Meulen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Moslemi, Mk" uniqKey="Moslemi M">MK Moslemi</name></author><author><name sortKey="Abedinzadeh, M" uniqKey="Abedinzadeh M">M Abedinzadeh</name></author><author><name sortKey="Aghaali, M" uniqKey="Aghaali M">M Aghaali</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Open Access J Urol</journal-id><journal-id journal-id-type="iso-abbrev">Open Access J Urol</journal-id><journal-title-group><journal-title>Open Access Journal of Urology</journal-title></journal-title-group><issn pub-type="epub">1179-1551</issn><publisher><publisher-name>Dove Medical Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24198642</article-id><article-id pub-id-type="pmc">3818950</article-id><article-id pub-id-type="doi">10.2147/OAJU.S21577</article-id><article-id pub-id-type="publisher-id">oaju-3-105</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research</subject></subj-group></article-categories><title-group><article-title>Mathieu repair of distal and midshaft hypospadias: risks and benefits of foreskin reconstruction versus circumcision</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Moslemi</surname><given-names>Mohammad Kazem</given-names></name><xref ref-type="aff" rid="af1-oaju-3-105">1</xref><xref ref-type="corresp" rid="c1-oaju-3-105"></xref></contrib><contrib contrib-type="author"><name><surname>Gilani</surname><given-names>Mohammad Ali Sadighi</given-names></name><xref ref-type="aff" rid="af2-oaju-3-105">2</xref></contrib><contrib contrib-type="author"><name><surname>Shahrokh</surname><given-names>Hossein</given-names></name><xref ref-type="aff" rid="af3-oaju-3-105">3</xref></contrib></contrib-group><aff id="af1-oaju-3-105"><label>1</label>Department of Urology, Kamkar Hospital, School of Medicine, Qom, University of Medical Science, Qom, Iran</aff><aff id="af2-oaju-3-105"><label>2</label>Department of Urology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran</aff><aff id="af3-oaju-3-105"><label>3</label>Department of Urology, Hasheminejad Kidney Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran</aff><author-notes><corresp id="c1-oaju-3-105">Correspondence: Mohammad Kazem Moslemi Department of Urology, Kamkar Hospital, School of Medicine, Qom University of Medical Science, Qom, Iran 3715694978, Tel +98 251 783 6646, Fax +98 251 783 6646, Email <email>mkmoslemi@gmail.com</email></corresp></author-notes><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>17</day><month>6</month><year>2011</year></pub-date><volume>3</volume><fpage>105</fpage><lpage>108</lpage><permissions><copyright-statement>© 2011 Moslemi et al, publisher and licensee Dove Medical Press Ltd</copyright-statement><copyright-year>2011</copyright-year><license><license-p>This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.</license-p></license></permissions><abstract><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></abstract><kwd-group><title>Keywords</title><kwd>hypospadias</kwd><kwd>circumcision</kwd><kwd>preputioplasty</kwd><kwd>distal</kwd><kwd>midshaft</kwd><kwd>Mathieu repair</kwd></kwd-group></article-meta></front><floats-group><fig id="f1-oaju-3-105" position="float"><label>Figure 1</label><caption><p>Adequate parameatal ventral cutaneous flap release.</p></caption><graphic xlink:href="oaju-3-105Fig1"></graphic></fig><fig id="f2-oaju-3-105" position="float"><label>Figure 2</label><caption><p>Release of vacularized second layer flap for neourethral coverage.</p></caption><graphic xlink:href="oaju-3-105Fig2"></graphic></fig><fig id="f3-oaju-3-105" position="float"><label>Figure 3</label><caption><p>The completed Mathieu repair with synchronous circumcision.</p></caption><graphic xlink:href="oaju-3-105Fig3"></graphic></fig><table-wrap id="t1-oaju-3-105" position="float"><label>Table 1</label><caption><p>Type and number of complications in the two groups of Mathieu repair</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" valign="top" rowspan="1" colspan="1"></th><th align="left" valign="top" rowspan="1" colspan="1">Meatal stenosis</th><th align="left" valign="top" rowspan="1" colspan="1">Urethrocutaneous fistula</th><th align="left" valign="top" rowspan="1" colspan="1">Dehiscene</th><th align="left" valign="top" rowspan="1" colspan="1">Phimosis</th><th align="left" valign="top" rowspan="1" colspan="1">Preputial edema</th><th align="left" valign="top" rowspan="1" colspan="1">Preputial necrosis</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Group A</td><td align="left" valign="top" rowspan="1" colspan="1">1 case (2.3%)</td><td align="left" valign="top" rowspan="1" colspan="1">5 cases (11.6%)</td><td align="left" valign="top" rowspan="1" colspan="1">0</td><td align="left" valign="top" rowspan="1" colspan="1">–</td><td align="left" valign="top" rowspan="1" colspan="1">–</td><td align="left" valign="top" rowspan="1" colspan="1">–</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Group B</td><td align="left" valign="top" rowspan="1" colspan="1">1 case (2.3%)</td><td align="left" valign="top" rowspan="1" colspan="1">6 cases (14%)</td><td align="left" valign="top" rowspan="1" colspan="1">0</td><td align="left" valign="top" rowspan="1" colspan="1">0</td><td align="left" valign="top" rowspan="1" colspan="1">19 cases (44%)</td><td align="left" valign="top" rowspan="1" colspan="1">1 case (2.3%)</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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