URETHRAL MOBILIZATION AND ADVANCEMENT

K. Ravi

Abstract


Introduction: Hypospadias is one of the most common congenital anomalies occurring in 1:250 to 1:300 live births. If left uncorrected patients with hypospadias may need to sit down to void and tend to shun intimate relationships because of the fears related to normal sexuality.

Aims: The aim of this study is to evaluate urethral mobilization and advancement procedure in the management of different types of distal hypospadias and analyse the results.

Methods: This prospective study was done from March 2018 to August 2019. Urethral mobilization and advancement procedure was used in the management of distal hypospadias in 25 children whose ages range from 2years to 12 years. Children with distal hypospadias were chosen for this study. Most of the cases were operated by a single surgeon.

Results: In this study, thirteen cases had associated findings like chordee and meatal stenosis. Out of the 25 cases, 21 (84%) cases had successful outcome. The follow up period ranges from 6 months to 2 years. Based on the length of urethra to be mobilized the operating time for this procedure ranges from 45 minutes to 60 minutes. The overall hospital stay ranged from 7 days to 13 days.

Conclusion: The ratio of the gap between hypospadiac meatus and the glans tip to the length of urethra mobilized should be 1:3. The main indications are presence of glanular chordee, failed meatal advancement and glanuloplasty incorporated procedure (MAGPI), circumcised children with distal hypospadias, immobile fibrotic urethral meatus and as an alternative to MAGPI.

Keywords


Hypospadias, urethral mobilization, urethral advancement

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