Titre
A lower fistula rate in hypospadias surgery.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Gapany, C.
Auteure/Auteur
Grasset, N.
Auteure/Auteur
Tercier, S.
Auteure/Auteur
Ramseyer, P.
Auteure/Auteur
Frey, P.
Auteure/Auteur
Meyrat, B.J.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1477-5131
Statut éditorial
Publié
Date de publication
2007
Volume
3
Numéro
5
Première page
395
Dernière page/numéro d’article
397
Langue
anglais
Résumé
OBJECTIVE: To determine whether specific steps taken after a critical quality control of our results in hypospadias surgery lead to a decrease in fistula rate. PATIENTS AND METHODS: Retrospective review of prospectively collected data. Between 1994 and 2001, our series of 85 tubularized plate urethroplasties (modified Duplay or Duplay-Snodgrass procedure) had a fistula rate of 25.9%. In 2001, we modified our approach by systematically padding the urethral suture with a layer of vascularized subcutaneous preputial tissue, as described by Snodgrass. Scrotal hypospadias were excluded. Surgical outcome was assessed at 1 and 12months. In both groups, all repairs were performed by or under direct supervision of the senior author (BJM). RESULTS: After 2001, 57 hypospadias repairs were performed in 57 patients aged 8months to 14years (median 1.4years). Fistula occurred in two cases, one of which closed spontaneously within 6months. Our fistula rate had dropped to 3.5%, with a minimum follow up of 12months. CONCLUSION: Covering the urethral suture with a padding flap of vascularized preputial tissue helps avoid fistula formation. Technique modification after critical appraisal of our own series led to a much better outcome in this demanding surgery.
PID Serval
serval:BIB_64F894946734
PMID
Date de création
2009-09-18T12:44:05.790Z
Date de création dans IRIS
2025-05-20T18:55:13Z