Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children
Objectives. To review cases of hypospadias that were repaired with TIPU method and consequently resulted in the necrosis of ventral penile skin flaps. Methods. Eighty-three patients with hypospadias underwent TIPU procedure by two surgeons. Neourethra in all patients was covered with dartos flap pre...
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| Format: | Article |
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Wiley
2015-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2015/452870 |
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| author | Ünal Bakal Musa Abeş Mehmet Sarac |
| author_facet | Ünal Bakal Musa Abeş Mehmet Sarac |
| author_sort | Ünal Bakal |
| collection | DOAJ |
| description | Objectives. To review cases of hypospadias that were repaired with TIPU method and consequently resulted in the necrosis of ventral penile skin flaps. Methods. Eighty-three patients with hypospadias underwent TIPU procedure by two surgeons. Neourethra in all patients was covered with dartos flap prepared from the preputium or penile shaft. In cases where ventral skin could not be covered primarily, closure was ensured by using preputial Ombredanne or Byars’ flaps to repair ventral defects. Results. The median age of patients was 4 years. Twenty-five (30.12%) patients that underwent hypospadias repair had urethral opening at the coronal level, 33 (39.75%) at the distal penis, 10 (12.04%) at the midpenis, and 15 (18.07%) at the proximal penis. The ventral skin defect could not be primarily covered in 10 patients with penile shaft hypospadias. Consequently, Byars’ method was used in 8 of these patients to cover the defect and the Ombredanne method was used in the remaining 2. Ventral skin flap necrosis developed in 5 patients (4 Byars and 1 Ombredanne). It was medically treated in 4 patients. Urethral fistula developed in the other patient whose necrosis was deeper. The mean hospital stay was 7 days for patients without necrosis, and 14 for those with necrosis. Conclusion. We are of the opinion that dartos flaps used in the TIPU method in order to cover neourethra and decrease the incidence of fistula development lead to necrosis in the Ombredanne or Byars’ flaps by causing low blood supply to the preputium and thus extend hospital stay. |
| format | Article |
| id | doaj-art-54801e7384c7458d81c8b2906a4afcfb |
| institution | OA Journals |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
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| series | Advances in Urology |
| spelling | doaj-art-54801e7384c7458d81c8b2906a4afcfb2025-08-20T02:05:45ZengWileyAdvances in Urology1687-63691687-63772015-01-01201510.1155/2015/452870452870Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in ChildrenÜnal Bakal0Musa Abeş1Mehmet Sarac2Department of Pediatric Surgery, Faculty of Medicine, Firat University, 23119 Elazig, TurkeyDepartment of Pediatric Surgery, Faculty of Medicine, Adiyaman University, 23119 Elazig, TurkeyDepartment of Pediatric Surgery, Faculty of Medicine, Firat University, 23119 Elazig, TurkeyObjectives. To review cases of hypospadias that were repaired with TIPU method and consequently resulted in the necrosis of ventral penile skin flaps. Methods. Eighty-three patients with hypospadias underwent TIPU procedure by two surgeons. Neourethra in all patients was covered with dartos flap prepared from the preputium or penile shaft. In cases where ventral skin could not be covered primarily, closure was ensured by using preputial Ombredanne or Byars’ flaps to repair ventral defects. Results. The median age of patients was 4 years. Twenty-five (30.12%) patients that underwent hypospadias repair had urethral opening at the coronal level, 33 (39.75%) at the distal penis, 10 (12.04%) at the midpenis, and 15 (18.07%) at the proximal penis. The ventral skin defect could not be primarily covered in 10 patients with penile shaft hypospadias. Consequently, Byars’ method was used in 8 of these patients to cover the defect and the Ombredanne method was used in the remaining 2. Ventral skin flap necrosis developed in 5 patients (4 Byars and 1 Ombredanne). It was medically treated in 4 patients. Urethral fistula developed in the other patient whose necrosis was deeper. The mean hospital stay was 7 days for patients without necrosis, and 14 for those with necrosis. Conclusion. We are of the opinion that dartos flaps used in the TIPU method in order to cover neourethra and decrease the incidence of fistula development lead to necrosis in the Ombredanne or Byars’ flaps by causing low blood supply to the preputium and thus extend hospital stay.http://dx.doi.org/10.1155/2015/452870 |
| spellingShingle | Ünal Bakal Musa Abeş Mehmet Sarac Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children Advances in Urology |
| title | Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children |
| title_full | Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children |
| title_fullStr | Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children |
| title_full_unstemmed | Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children |
| title_short | Necrosis of the Ventral Penile Skin Flap: A Complication of Hypospadias Surgery in Children |
| title_sort | necrosis of the ventral penile skin flap a complication of hypospadias surgery in children |
| url | http://dx.doi.org/10.1155/2015/452870 |
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