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Snodgrass Hypospadias Repair with Vascularized Dartos Flap: The Perfect Repair for Virgin Cases of Hypospadias?

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 4 Part 2 Linguagem: Inglês

10.1016/s0022-5347(05)64398-4

1527-3792

Earl Y. Cheng, Sreenivas Vemulapalli, Bradley P. Kropp, John C. Pope, PETER D. FURNESS, William E. Kaplan, D. Preston Smith,

Congenital Anomalies and Fetal Surgery

No AccessJournal of UrologyHypospadias1 Oct 2002Snodgrass Hypospadias Repair with Vascularized Dartos Flap: The Perfect Repair for Virgin Cases of Hypospadias? Earl Y. Cheng, Sreenivas N. Vemulapalli, Bradley P. Kropp, John C. Pope, Peter D. Furness, William E. Kaplan, and D. Preston Smith Earl Y. ChengEarl Y. Cheng More articles by this author , Sreenivas N. VemulapalliSreenivas N. Vemulapalli More articles by this author , Bradley P. KroppBradley P. Kropp More articles by this author , John C. PopeJohn C. Pope More articles by this author , Peter D. FurnessPeter D. Furness More articles by this author , William E. KaplanWilliam E. Kaplan More articles by this author , and D. Preston SmithD. Preston Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64398-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Since its introduction, the Snodgrass hypospadias repair has been applied to virtually all forms of hypospadias repair. However, fistula rates have still been reported to be as high as 5% from large center, multiple surgeon studies and 16% from smaller center studies. We report on the use of the Snodgrass repair in conjunction with routine use of a vascularized dartos flap and 2-layer closure of the neourethra from multiple institutions. Materials and Methods: Records of patients who underwent a primary 1-stage hypospadias repair with the Snodgrass technique in conjunction with vascularized dartos flap coverage were reviewed. Nearly identical surgical technique was used by all 6 surgeons in each case, which included a 2-layer closure of the neourethra, preservation of the well vascularized periurethral tissue and routine use of vascularized dartos flap coverage. A total of 514 cases were identified, including 414 with distal and 100 with midshaft or proximal hypospadias. Stents were used in 292 of the 514 repairs. Results: Of the 414 distal cases there were no fistulas and 1 case of meatal stenosis. Of the 100 proximal cases there were 3 fistulas and 1 case of meatal stenosis. The overall complication rate was less than 1% for all cases combined. Conclusions: This series represents the largest reported multi-institutional experience with the Snodgrass technique. When used in conjunction with vascularized dartos flap coverage, 2-layer closure of the neourethra and special attention to preservation of the periurethral vascular supply, this repair can be performed with a near 0 complication rate. 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Importance of Interaction and Confounding in Hypospadias AnalysisJournal of Urology, VOL. 184, NO. 6, (2510-2515), Online publication date: 1-Dec-2010.Snodgrass W and Yucel S (2018) Tubularized Incised Plate for Mid Shaft and Proximal Hypospadias RepairJournal of Urology, VOL. 177, NO. 2, (698-702), Online publication date: 1-Feb-2007.Dodson J, Baird A, Baker L, Docimo S and Mathews R (2007) Outcomes of Delayed Hypospadias Repair: Implications for Decision MakingJournal of Urology, VOL. 178, NO. 1, (278-281), Online publication date: 1-Jul-2007.Sedberry-Ross S, Stisser B, Henderson C, Rushton H and Belman A (2007) Split Prepuce In Situ Onlay Hypospadias Repair: 17 Years of ExperienceJournal of Urology, VOL. 178, NO. 4S, (1663-1667), Online publication date: 1-Oct-2007.Braga L, Pippi Salle J, Lorenzo A, Skeldon S, Dave S, Farhat W, Khoury A and Bagli D (2007) Comparative Analysis of Tubularized Incised Plate Versus Onlay Island Flap Urethroplasty for Penoscrotal HypospadiasJournal of Urology, VOL. 178, NO. 4, (1451-1457), Online publication date: 1-Oct-2007.RADOJICIC Z and PEROVIC S (2018) CLASSIFICATION OF PREPUCE IN HYPOSPADIAS ACCORDING TO MORPHOLOGICAL ABNORMALITIES AND THEIR IMPACT ON HYPOSPADIAS REPAIRJournal of Urology, VOL. 172, NO. 1, (301-304), Online publication date: 1-Jul-2004.AMUKELE S, WEISER A, STOCK J and HANNA M (2018) RESULTS OF 265 CONSECUTIVE PROXIMAL HYPOSPADIAS REPAIRS USING THE THIERSCH-DUPLAY PRINCIPLEJournal of Urology, VOL. 172, NO. 6 Part 1, (2382-2383), Online publication date: 1-Dec-2004.FURNESS P (2018) Successful Hypospadias Repair With Ventral Based Vascular Dartos Pedicle for Urethral Coverage.Journal of Urology, VOL. 169, NO. 5, (1825-1827), Online publication date: 1-May-2003.CHENG E, KROPP B, POPE J and BROCK J (2018) Proximal Division of the Urethral Plate in Staged Hypospadias RepairJournal of Urology, VOL. 170, NO. 4 Part 2, (1580-1584), Online publication date: 1-Oct-2003.JAYANTHI V (2018) The Modified Snodgrass Hypospadias Repair: Reducing the Risk of Fistula and Meatal StenosisJournal of Urology, VOL. 170, NO. 4 Part 2, (1603-1605), Online publication date: 1-Oct-2003. Volume 168Issue 4 Part 2October 2002Page: 1723-1726 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.KeywordsfistulahypospadiaspenisabnormalitiesurethraMetricsAuthor Information Earl Y. Cheng More articles by this author Sreenivas N. Vemulapalli More articles by this author Bradley P. Kropp More articles by this author John C. Pope More articles by this author Peter D. Furness More articles by this author William E. Kaplan More articles by this author D. Preston Smith More articles by this author Expand All Advertisement PDF downloadLoading ...