Hipospadias tedavisinde uygulanan cerrahi tekniklerin retrospektif karşılaştırılması

Objectives: The aim of this study was to investigate the results of hypospadias surgery. Methods: In this study the results of 87 patients who underwent hypospadias repair surgery between 2005 and 2010 were evaluated retrospectly. Results: 21 patients; Meatal Advancement and Glanuloplasty (MAGPI), 33 patients; Tubularized Incised Plate Urethroplasty (TIPU), 21 patients; Parameatal Based Flap (Mathieu), 6 patients; Mathieu and Incision Sutured (MAVIS) and the other 6 patients were operated via Transvers Tubularized Preputial Island Flap (TTPIF). To prevent fistula formation double layer dartos flap (DLDF) was applied to all patients to whom MAVIS had been applied and to 27 of the patients to whom TIPU had been applied, and tunica vaginalis flap over neourethra was placed to the patients to whom TTPIF was applied. While fistula was not seen in the patients to whom flap was used, it was seen that the urethrocutaneous fistula ratio was high in the patients without flap uses. Conclusion: TIPU is a kind of method which can be easily applied and preferred regardless of localization of urethral meatus. A barrier layer placed between skin and neourethra to prevent fistula formation significantly decreases the fistula ratio. Preputial dartos flap is a good preference, But tunica vaginalis must be kept in mind as an alternative to this flap in the patients who underwent urethroplasty with preputial dartos flap or who had circumflex before. TTPIF can be used as an alternative method to TIPU method in patients with more proximal localized hypospadias, especially if the urethral plate was exiced because of chordee and it is successful when combined with tunica vaginalis flap.

Key words: Hypospadias, urocutaneous fistula, flap

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