Know Various Techniques of Hypospadias Surgery
October 18, 2022 | By admin
Hypospadias is a condition that often goes unnoticed in several patients across the globe. This condition can be treated only by experienced medical professionals.
Hypospadias is a very common malformation that occurs in nearly 1 in 250 male births. This condition consists of an abnormal opening of the urethral meatus at some point in its dorsal aspect. It is associated with an incomplete semi-circumferential foreskin. It is also accompanied by a curvature of the penile shaft called chordee in almost half of the patients.
This condition can be differentiated between distal, middle, and proximal presentations. There are different techniques that can be used for treating this condition. Let’s go over what those techniques are and how one can find the right treatment for this medical condition.
Various Techniques of Hypospadias Surgery
According to studies, there are over 300 techniques that can be used for treating hypospadias. The average hypospadias surgeon concentrates on mastering a basic arsenal with a certain number of flexible options. Let’s look at some of those techniques now.
The correction of the chordee should precede any hypospadias surgery to estimate the real length of the straightened urethra. A common classification can be used for differentiating different severity of the condition.
Type I is an easy skin tethering. Type II includes a fibrotic fascia. Type III includes corporal disproportion. And Type IV consists of true urethral tethering. The techniques involved in correcting all of these conditions will be different. Many surgeons prefer a two-stage repair in cases of hypospadias with severe chordee.
Meatal Advancement and Glanuloplasty (MAGPI)
The MAGPI technique was described by Duckett in 1981. It is useful in the more distal types of hypospadias without chordee that presents good skin quality. After liberating the ventral skin, the surgeon performs a triangular suprameatal incision from the point where the new meatus is intended.
The center of the hypospadiac meatus is sutured to the vertex of the triangle in order to achieve ascension. The preputial frenulum is simulated by suturing in an inverted ‘V’.
This technique was described by Mathieu in 1932. It bears a strong resemblance to previous operations and has undergone subtle modifications and refinements by surgeons to adapt to diverse situations.
This technique uses a flap of the perimeatal skin to create the missing wall of the urethra in a tubularized way. This is done when the meatus lies subcoronal or even in the most distal third of the penile shaft.
Byars Procedure and Snodgrass Adaptation
This technique was described in 1955 and is still used on penoscrotal or proximal third types. It was inspired by the concepts of Thiersch and Duplay. The incised edges of the open urethral plate are sewn together and tubularized. There are also many variations to this technique.
Warren Snodgrass also introduced a substantial variation that is quite popular now. He proposed a longitudinal incision of the urethral plate all along the midline. This incision allows easier approaching of the edges of the open urethral plate.
Island Flap Techniques
These are delicate procedures that involve the crafting of a new urethra by using the foreskin. The vascularization of the preputial flap stems from the basis of the penis and must be preserved to avoid flap necrosis and failure. The size of the flap is precisely measured having in sight an undesired retraction or diverticula.
Penoscrotal transposition (PST) represents a rare congenital abnormality of external genitalia in which the scrotum is positioned superiorly or anteriorly in relation to the penis. It consists of a large spectrum of anomalies, ranging from the mild bifid scrotum form to the complete penoscrotal transposition (CPST) where the scrotum is located.
There are also other associated anomalies with this particular technique and condition. Hypospadias, chordee, and renal dysplasia along with anal abnormalities are frequently associated with most patients.
These are all the major techniques that can be used for correcting hypospadias surgery. It should be noted that this condition can also be treated by using other techniques that are not mentioned here.
At the end of the day, one must remember to get the treatment done by an experienced and qualified medical professional. Further, one must follow the post-surgery instructions provided by the doctor. This will ensure that the patient gets the best possible results from the surgery.
Why Should You Get Hypospadias Surgery at Divine Cosmetic Surgery?
At Divine Cosmetic Surgery, we have a team of medical professionals who excel at providing patients with the treatments that they need. The team has a collective experience of over three decades and works under the guidance of Dr. Amit Gupta.
Dr. Amit Gupta is a qualified plastic surgeon who has over two decades of experience. He ensures that all his patients get the results that they want without any hassle. So, what are you waiting for? Contact us today and schedule your first consultation!