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Complex and Redo Hypospadias Repairs: Management of 402 Patients

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Hypospadias Surgery

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Abstract

Correction of complex hypospadias repair may be performed as one- or two-stage repair. There are three principles that must be followed: correction of the chordee, construction of the urethra, and resurfacing of the urethroplasty by skin. Complications occur due to choosing the wrong technique or performing the right technique wrongly or poor postoperative care. Dorsal plication is associated with high incidence of chordee recurrence. Dermal graft has been a reliable method to correct severe chordee. Sources of epithelium for urethral reconstruction included skin grafts and bladder mucosa, but the best is buccal mucosa. Nitroglycerine ointment and hyperbaric oxygen have proven to reduce tissue ischemia and improve oxygenation of the tissues. Sources of skin to cover the penis after urethroplasty include scrotal skin flaps, tissue expansion, and full-thickness and split-thickness skin grafts.

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Abbreviations

AE:

Artificial erection

BXO:

Balanitis xerotica obliterans

GTIP:

Grafted tubularized incised plate

HAD:

Human acellular dermis

HBO:

Hyperbaric oxygen

HBOT:

Hyperbaric oxygen therapy

NTG:

Nitroglycerine ointment

SIS:

Small intestinal submucosa

STSG:

Split-thickness skin grafts

T-D:

Thiersch-Duplay

TIP:

Tubularized incised plate

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Authors and Affiliations

  1. Institute of Pediatric Urology, New York Weill Cornell College, New York Hospital-Cornell University, New York, NY, USA

    Moneer K. Hanna

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Correspondence to Moneer K. Hanna .

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Editors and Affiliations

  1. Hypospadias Center and Pediatric Surgery Department, Sana Klinikum Offenbach, Academic Teaching Hospital of the Johann Wolfgang Goethe University, Offenbach, Frankfurt, Germany

    Ahmed T. Hadidi

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Hanna, M.K. (2022). Complex and Redo Hypospadias Repairs: Management of 402 Patients. In: Hadidi, A.T. (eds) Hypospadias Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-94248-9_64

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  • DOI: https://doi.org/10.1007/978-3-030-94248-9_64

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