Pediatric penile biometry guides the surgical outcome following tubularised incised plate urethroplasty for hypospadias: a single centre study

Debjani Das; Arindam Ghosh; Aloke Kumar Sinhababu; Sujay Pal; Rishavdeb Patra; Debojyoti Sasmal

doi:10.18203/2349-3291.ijcp20230083

Authors

Debjani Das Department of Pediatric Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
Arindam Ghosh Department of Pediatric Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
Aloke Kumar Sinhababu Department of Pediatric Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
Sujay Pal Department of Pediatric Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
Rishavdeb Patra Department of Pediatric Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
Debojyoti Sasmal Department of Pediatric Surgery, IPGMER and SSKM Hospital, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20230083

Keywords:

TIP urethroplasty, Pediatric penile biometry, Pediatric glans diameter, Urethral plate length and width

Abstract

Background: In hypospadias urethral meatus opens onto the ventral surface of the penis proximal to tip of glans and its surgery is challenging. Recent focus of hypospadias surgery is on reduction of postoperative complications and objective assessment of penile anthropometry which can affect outcome. Aim of study was to assess the surgical outcome of tubularised incised plate urethroplasty on penile biometric parameters among children with coronal, distal penile and mid penile hypospadias.

Methods: Study was conducted in the department of pediatric surgery in IPGMER and SSKM Hospital in Kolkata during November 2019 to October 2021.

Results: Among 42 boys mean urethral plate length is 4.286 (coronal), 7.643 (distal penile) and 8.846 (mid penile), mean urethral plate width is 3.321 (coronal), 5.786 (distal penile) and 5.923 (mid penile), mean diameter at mid glans level is 4 (coronal), 5.071 (distal penile) and 5.923 (mid penile), mean diameter at coronal level is 5.75 (coronal), 6.429 (distal penile) and 6.769 (mid penile), mean stretched penile length is 39.2143 (coronal), 41.857 (distal penile) and 40.308 (mid penile) hypospadias respectively. P value is less than 0.05 for all except urethral plate depth which has a non-significant p value.

Conclusions: Urethral plate length, urethral plate width, mid glans diameter, glans diameter at coronal sulcus level and stretched penile length affect the outcome of the surgical process TIP urethroplasty in coronal, distal penile and mid penile type hypospadias but urethral plate depth does not.

Metrics

Metrics Loading ...

References

Snodgrass W. Tubularized incised plate urethroplasty for distal hypospadias. J Urol. 1994,151(2):464-5.

Bhat A, Mandal AK. Acute postoperative complications of hypospadias repair. Indian J Urol. 2008;24(2):241-8.

Retik AB, Atala A. Complications of hypospadias repair. Urol Clin North Am. 2002;29(2):329-39.

Shapiro SR. Complications of hypospadias repair. J Urol. 1984;131(3):518-22.

Weber DM. The penile perception score: an instrument enabling evaluation by surgeons and patient self-assessment after hypospadias repair. J Urol. 2013; 189(1):189-93.

Archana P. Pediatric penile and glans anthropometry nomograms: an aid in hypospadias management. J Indian Assoc Pediatr Surg. 2017;22(1):9-12.

Amilal B. Penile anthropometry in North Indian children. Indian J Urol. 2015;31(2):106-10.

Rogers B. History of external genital surgery. In: Horton C, eds. Plastic and Reconstructive surgery of the Genital area. Boston: Little Brown; 1973:3-7.

Horton CE, Devine CJ, Baran N. Pictorial history of hypospadias repair techniques. In: Horton C, eds. Plastic and Reconstructive surgery of the Genital area. Boston: Little Brown; 1973:3-47

Panjwani K. A colour atlas of Hypospadias surgery. 1st ed. USA: Springer; 1998:1-213.

Browne D. An operation for hypospadias. Proc R Soc Med. 1949;41:466.

Murphy JP. Hypospadias, Aschcraftʾs Pediatric Surgery 6ʾth ed. USA: Springer; 2014:794-809

Byars LT. A technique for consistently satisfactory repair of hypospadias. Surg Gynecol Obstet 1955;100: 184-190

Coleman JW, McGovern JH, Marshal VF. The bladder mucosal graft technique for hypospadias repair. Urol Clin North Am. 1981;8:457-62

Bush NC, Holzer M, Zhang S, Snodgrass W. Age does not impact risk for urethroplasty complications after tubularized incised plate repair of hypospadias in prepubertal boys. J Pediatr Urol. 2013;9:252-6.

Bush NC, Villanueva C, Snodgrass W. Glans size is an independent risk factor for urethroplasty complications after hypospadias repair. J Pediatr Urol. 2015;11(355): e351-5.

Snodgrass W, Villanueva C, Bush N. Primary and reoperative hypospadias repair in adults are results different than in children? J Urol. 2014;192:1730-3.

Rynja SP, de Jong TP, Bosch JL, de Kort LM. Functional, cosmetic and psychosexual results in adult men who underwent hypospadias correction inchildhood. J Pediatr Urol. 2011;7:504-15.

Sheldon CA, Duckett JW. Hypospadias. Pediatric Clin North Am. 1987;34:1259-72.

Nicol B, Daniel D, Warren S. Glans Penis Width. In: Patients with hypospadias compared to healthy controls. J Pediatr Urol. 2013;5:4.

Da Silva EA, Lobountchenko T, Marun MN, Rondon A, Damiao R. Role of penile biometric characteristics on surgical outcome of hypospadias repair. Pediatr Surg Int. 2014;30:339-44.

Andrew H, Grahame S, Francis R, Dillon C. HOSE: An objective scoring system for evaluating the results of hypospadias surgery. BJU Int. 2001;88:255-8.

Dhua AK. Comparison of anatomical landmarks and dimensions in a hypospadiac glans with those of a normal glans. J Indian Assoc Pediatr Surg. 2018;23(3): 144-7.