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Operative Trends bei sekundären Hypospadien

Surgical trends in secondary hypospadias

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Zusammenfassung

Die Ausprägung einer sekundären Hypospadie kann von einer leichten kosmetischen Beeinträchtigung bis zu einer schweren Funktionseinschränkung reichen. Dementsprechend kann die jeweilige operative Behandlung simpel oder auch extrem anspruchsvoll sein. In jedem Fall sollte der Penis bei der Operation als eine funktionelle Einheit betrachtet werden, so dass das Behandlungsziel eines guten kosmetischen und funktionellen Ergebnisses erreicht werden kann. Außerdem sollte der Operateur über ein reichhaltiges Repertoire an operativen Techniken und über gute Kenntnisse im Bereich der Hautplastik verfügen, um bei Bedarf das Vorgehen dem intraoperativen Befund optimal anpassen zu können. Werden außerdem bestimmte „Do’s“ und „Dont’s“ der Hypospadiekorrektur beachtet, können auch komplizierte, multipel voroperierte Hypospadiepatienten in der Regel erfolgreich operiert werden. Insuffiziente Techniken und Kenntnisse führen dagegen meist zu einer weiteren Verschlechterung des Befunds bis hin zum Erscheinungsbild eines sog. „Hypospadie-Krüppels“.

Abstract

The severity of secondary hypospadias can range from a mild cosmetic problem to severe functional impairment. Accordingly, surgical management of the defect can be either simple or extremely demanding. During the operation the penis should always be regarded as a functional unit so that the treatment goal of a good cosmetic and functional result can be achieved. In addition, the surgeon should have an extensive repertoire of operative techniques at his disposal and should be well versed in skin grafting methods so that he is able to adapt the procedure optimally to the intraoperative findings as necessary. If certain do’s and don’ts of hypospadias correction are additionally observed good results can usually be obtained even in complicated hypospadias patients with multiple previous operations. Unreflected treatment, on the other hand, usually leads to further worsening of the problem resulting in the so-called hypospadias cripple.

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Literatur

  1. Abu-Arafeh W, Chertin B, Zilberman M, Farkas A (1998) One-stage repair of hypospadias, experience with 856 cases. Eur Urol 34:365–367

    Article  PubMed  CAS  Google Scholar 

  2. Bhargava S, Patterson JM, Inman RD et al (2008) Tissue-engineered buccal mucosa urethroplasty-clinical outcomes. Eur Urol 53:1263–1269

    Article  PubMed  Google Scholar 

  3. Bracka A (1995) A versatile two-stage hypospadias repair. Br J Plast Surg 48:345–352

    Article  PubMed  CAS  Google Scholar 

  4. Bracka A (1989) A long term view of hypospadias. Br J Plast Surg 42:251–255

    Article  PubMed  CAS  Google Scholar 

  5. Burger RA, Muller SC, el-Damanhoury et al (1992) The buccal mucosal graft for urethral reconstruction, a preliminary report. J Urol 147:662–664

    PubMed  CAS  Google Scholar 

  6. Elder JS, Duckett JW (1987) Urethral reconstruction following an unseccesful one-stage hypospadias repair. World J Urol 5:19–24

    Article  Google Scholar 

  7. Fichtner J, Macedo A, Fisch M et al (1995) Konzept der Hypospadie-Korrektur mittels Mundschleimhaut-Onlay-Flap. Akt Urol 26:1–10

    Google Scholar 

  8. Hendren WH, Reda EF (1986) Bladder mucosa graft for construction of male urethra. J Pediatr Surg 21:189–192

    Article  PubMed  CAS  Google Scholar 

  9. Husmann DA, Rathbun SR (2006) Long-term followup of visual internal urethrotomy for management of short (less than 1 cm) penile urethral strictures following hypospadias repair. J Urol 176:1738–1741

    Article  PubMed  CAS  Google Scholar 

  10. Jordan GH, Schlossberg SM, McCraw JB (1988) Tissue transfer techniques for geinitourinary reconstructive surgery. Part I: Principles, definitions, basic techniques and graft techniques. AUA update series vol 7, lesson 9

    Google Scholar 

  11. Kröpfl D, Meyer-Schwickerath M, Fey S, Rübben H (1994) Behandlung komplizierter Hypospadierezidive. Urologe A 33:490–496

    PubMed  Google Scholar 

  12. Kröpfl D, Verweyen A (2002) Behandlung der Hypospadierezidive. In: Kröpfl D, Novak R, Tucak A (Hrsg) Rekonstruktive urologische Chirurgie. Pabst Science Publishers, Lengerich Berlin, S 447–458

  13. Kröpfl D, Tucak A, Prlic D, Verweyen A (1998) Using of buccal mucosa for urethral reconstruction in primary and re-operative surgery. Eur Urol 34:216–220

    Article  PubMed  Google Scholar 

  14. Leslie JA, Cain MP, Kaefer M et al (2008) Corporeal grafting for severe hypospadias: a single institution experience with 3 techniques. J Urol 180:1749–1752

    Article  PubMed  Google Scholar 

  15. Lumen N, Hoebeke P, Willemsen P et al (2009) Etiology of urethral stricture disease in the 21st century. J Urol 182:983–987

    Article  PubMed  Google Scholar 

  16. Markiewicz MR, Lukose MA, Margarone JE et al (2007) The oral mucosa graft: a systematic review. J Urol 178:387–394

    Article  PubMed  Google Scholar 

  17. Paulozzi LJ, Erickson JD, Jackson RJ (1997) Hypospadias trends in two US surveillance systems. Pediatrics 100:831–834

    Article  PubMed  CAS  Google Scholar 

  18. Perlmutter AD, Montgomery BT, Steinhard GF (1985) Tunica vaginalis free graft for the correction of chordee. J Urol 134:311–313

    PubMed  CAS  Google Scholar 

  19. Retik AB, Keating M, Mandell J (1988) Complications at hypospadias repair. Urol Clin North Am 15:223–236

    PubMed  CAS  Google Scholar 

  20. Schreiter F, Noll F (1987) Meshgraft urethroplasty. World J Urol 5:41–46

    Article  Google Scholar 

  21. Schwentner C, Gozzi C, Lunacek A et al (2006) Interim outcome of the single stage dorsal inlay skin graft for complex hypospadias reoperations. J Urol 175:1872–1877

    Article  PubMed  CAS  Google Scholar 

  22. Secrest CL, Jordan GH, Winslow BH et al (1993) Repair of the complications of hypospadias surgery. J Urol 150:1415–1418

    PubMed  CAS  Google Scholar 

  23. Shapiro SR (1984) Complications of hypospadias repair. J Urol 131:518–522

    PubMed  CAS  Google Scholar 

  24. Simonato A, Gregori A, Lissiani A et al (2006) The tongue as an alternative donor site for graft urethroplasty: a pilot study. J Urol 175:589–592

    Article  PubMed  Google Scholar 

  25. Snodgrass WT, Bush N, Cost N (2009) Algorithm for comprehensive approach to hypospadias reoperation using 3 techniques. J Urol 182:2885–2891

    Article  PubMed  Google Scholar 

  26. Stecker JF, Horton EC, Devine JE, McCraw J (1981) Hypospadias cripples. Urol Clin North Am 8:539–545

    PubMed  Google Scholar 

  27. Xu YM, Qiao Y, Sa YL et al (2004) 1-stage urethral reconstruction using colonic mucosa graft for the treatment of a long complex urethral stricture. J Urol 171:220–223

    Article  PubMed  Google Scholar 

  28. Yachia D (1990) Modified corporoplasty for the treatment of penile curvature. J Urol 143:80–82

    PubMed  CAS  Google Scholar 

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  1. Klinik für Urologie, Kinderurologie und urologische Onkologie, Kliniken Essen-Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Henricistraße 92, 45136, Essen, Deutschland

    M. Musch, M. Mosters, V. Klevecka &  D. Kröpfl

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  1. M. Musch
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  2. M. Mosters
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  3. V. Klevecka
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  4. D. Kröpfl
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Correspondence to D. Kröpfl.

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Musch, M., Mosters, M., Klevecka, V. et al. Operative Trends bei sekundären Hypospadien. Urologe 50, 584–592 (2011). https://doi.org/10.1007/s00120-011-2530-x

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