Modified Hinderer’s Technique for Serious Proximal Hypospadias with Ventral Curvature: Outcomes and Our Experience
Vol. 16 No. 5 (2019),
21 October 2019
Purpose: Hypospadias is a congenital anomaly that includes defi¬cient ventral structure of the penis. Proximal hypospadias cases make up 20% of all hypospadias cases. The choice of operative technique for hypospadias repair depends on the severity, and it is influenced by the surgeon’s experience and perception of where priorities should lie. Several other factors interact to determine the type of repair, such as meatal site, presence of chordee, availability of the prepuce, and quality of the urethral plate and in addition surgeon’s experience affects the type of repair.
Materials and Methods: The treatment records of 42 penoscrotal and perineal hypospadias cases that were treated in our clinic from 1998 to 2017 were reviewed retrospectively. Cases with penoscrotal and perineal meatus were included in the study at the beginning of the urethroplasty. All cases had surgical intervention via Hinderer’s technique.
Results: Acceptable cosmetic results were obtained in 37 (85%) patients with an objective scoring system (HOSE) for evaluating the results of hypospadias surgery score. The mean score after surgery was 14.8. Fistula and wound breakdown occurred in 7 out of the 42 cases.
Conclusion: In conclusion, the modified Hinderer's technique is a safe and reliable technique for both proximal and perineal hypospadias. Low complication rates and application in a single surgical session increase the comfort of both the patient and the surgeon.
Baskin LS. Hypospadias and urethral development. J Urol 2000;163:951e6
Bracka A. Hypospadias repair: the two-stage alternative. Br J Urol. 1995;76 Suppl 3:31-41. Review.
Erol D, Germiyanoglu C. The factors affecting successful repair of hypospadias. Urol Bull 1995;6:138
Holland AJ, Smith GH, Ross FI, Cass DT. HOSE: an objective scoring system for evaluating the results of hypospadias surgery. BJU Int. 2001;88(3):255-8.
Prasad MM, Marks A, Vasquez E, Yerkes EB, Cheng EY. Published surgical success rates in pediatric urology e fact or fiction? J Urol 2012;188:1643e8.
Kiss A, Sulya B, Sza´sz AM, Romics I, Kelemen Z, To´th J, et al. Long-term psychological and sexual outcomes of severe penile hypospadias repair. J Sex Med 2011;8:1529e39.
Mureau MA, Slijper FM, Slob AK, Verhulst FC, Nijman RJ. Satisfaction with penile appearance after hypospadias surgery: the patient and surgeon view. J Urol 1996;155:703e6.
Snodgrass W: Tubularized, incised plate urethroplasty for distal hypospadias. J Urol 1994; 151: 464.
Elder JS, Duckett JW, Snyder HM. Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol 1987;138(2):376e9.
Chen SC, Yang SS, Hsieh CH, Chen YT. Tubularized incised plate urethroplasty for proximal hypospadias. BJU Int 2000;86(9):1050e3.
Duckett Jr JW. Transverse preputial island flap technique for repair of severe hypospadias. Urol Clin North Am 1980;7:423.
Johal NS, Nitkunan T, O’Malley K, Cuckow PM. The two-stage repair for severe primary hypospadias. Eur Urol 2006;50: 366e71.
Ferro F, Vallasciani S, Borsellino A, Atzori P, Martini L. Snodgrass urethroplasty: grafting the incised plate e10 years later. J Urol 2009;182:1730e5.
Braga LH, Pippi Salle JL, Lorenzo AJ, Skeldon S, Dave S, Farhat WA, Khoury AE, Bagli DJ. Comparative analysis of tubularized incised plate versus onlay island flap urethroplasty for penoscrotal hypospadias. J Urol. 2007;178 (4 Pt 1):1451-6; discussion 1456-7.
Snodgrass WT and Lorenzo A: Tubularized incised-plate urethroplasty for proximal hypospadias. BJU Int 2002; 89: 90.
Castagnetti M, Zhapa E, Rigamonti W. Primary severe hypospadias: comparison of reoperation rates and parental perception of urinary symptoms and cosmetic outcomes among 4 repairs. J Urol 2013;189:1508e13.
Nuhoğlu B, Ayyildiz A, Balci U, Ersoy E, Gürdal M, Germiyanoglu C, Erol D. Surgical treatment options in proximal hypospadias: retrospective analysis of 171 cases at a single institution. Int Urol Nephrol. 2006;38(3-4):593-8. Epub 2006 Dec 7.
. Thiry S, Saussez T, Dormeus S, Tombal B, Wese FX, Feyaerts A. Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood. Urol Int. 2015;95(2):137-41. doi: 10.1159/000430500. Epub 2015 Jul 18.
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