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A comparative study of the use of a transverse preputial island flap (the Duckett technique) to treat primary and secondary hypospadias in older Chinese patients with severe chordee

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Abstract

Objective

To investigate the outcome between the primary and secondary hypospadias with severe chordee in older patients by the transverse preputial island flap (TPIF).

Materials and methods

We retrospectively analyzed 53 hypospadias patients who were performed with TPIF for urethroplasty, including 25 primary hypospadias (Group 1) and 28 secondary hypospadias (Group 2). The mean age in Group 1 was 12.12 ± 10.709 and 18.64 ± 8.727 in Group 2 (P = 0.0181). The mean follow-up time was 38.7 months (22–60 months).

Results

All of the foreskin flaps survived after the operation without necrosis. The overall complication rate was 24 % in Group 1 and 53.57 % in Group 2 (P = 0.0280). All the patients were also divided into two cohorts according to their ages in surgery. In the 0–10-yr cohort, there was a significant difference in the overall complication rate between the primary and secondary groups (P = 0.0173). But in the cases who were over 11 year old, there was no significant difference in the overall complications between two groups (P = 0.1603). Also no significant difference was found in the mean length of the urethral defect between two groups (P = 0.8312).

Conclusion

The Duckett technique is an optional choice for some older Chinese patients undergoing primary operations, but it has a higher complication rate in those who have undergone previous failed urethroplasties. The unsatisfactory results found in the reoperative group were supposed to be linked to the older age, the lack of subcutaneous flap coverage and local scar tissue, but not to the length of the urethral defect.

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Abbreviations

TIP:

Tubularized incised plate urethroplasty

BMG:

Bladder mucosa-skin grafts

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Acknowledgments

The authors thank Fei Ye, Li-min Ma and Hua Jiang for their help with the foundation of the hypospadias database. This work was supported by grants from the National Natural Science Foundation of China (Grant No. 81070544 and No. 81070605) and Biomedical Engineering Research Fund of Shanghai Jiaotong University (No. YG2011MS14).

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Urology, Shanghai 9th People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200011, People’s Republic of China

    Da-chao Zheng, Hao Wang, Mu-jun Lu, Qi Chen, Yan-bo Chen, Xiao-min Ren, Hai-jun Yao, Ming-xi Xu, Ke Zhang, Zhi-kang Cai & Zhong Wang

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  1. Da-chao Zheng
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  2. Hao Wang
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  3. Mu-jun Lu
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  4. Qi Chen
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  5. Yan-bo Chen
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  7. Hai-jun Yao
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  8. Ming-xi Xu
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  9. Ke Zhang
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  10. Zhi-kang Cai
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  11. Zhong Wang
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Corresponding authors

Correspondence to Mu-jun Lu or Zhong Wang.

Additional information

Da-chao Zheng and Hao Wang contributed equally to this study and share the first authorship.

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Zheng, Dc., Wang, H., Lu, Mj. et al. A comparative study of the use of a transverse preputial island flap (the Duckett technique) to treat primary and secondary hypospadias in older Chinese patients with severe chordee. World J Urol 31, 965–969 (2013). https://doi.org/10.1007/s00345-012-0990-2

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  • DOI: https://doi.org/10.1007/s00345-012-0990-2

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