Hypospadias
Conditions
Brief summary
We aime to compare between Snodgrass and grafted Snodgrass repair in the outcome in distal penile hypospadias with urethral plate less than 8mm
Detailed description
The main goal for hypospadias repair is to achieve both cosmetic and functional normality. Several surgical techniques for hypospadias repair have been developed that depend on the site of the urethral meatus in children The effect of the urethral plate characteristics on the surgical outcome of Snodgrass repair has been studied in many series. Some documented that urethral plate width has a significant impact on the complication rates Holland and Smith reported a high complication rate in Snodgrass repair with a urethral plate width of less than 8 mm 7 The augmentation of the urethral plate either with inlay graft (DIGU, Snodgraft, or G-TIP), Onlay preputial flap, or other flaps carries a better outcome than the original TIP in many studies Others denied any effect of the narrow urethral plate on the success rate We aim in this study to determine which is better in narrow urethral plate in distal penile hypospadias, as regarding surgical and cosmetic outcomes; Snodgrass or combined inner preputial graft with Snodgrass
Interventions
PROCEDURESnodgrass repair
A relaxing incision is made in the midline by using scalpel or scissors A 6 F stent is passed into the bladder. The neourethra is closed
PROCEDURESnodgrass repair with graft
A relaxing incision is made in the midline by using scalpel or scissors In grafted Snodgrass repairA free graft was measured and harvested from the inner prepuce and was defatted and sutured onto the incised urethral plate The graft was sutured overlying the incision line A 6 F stent is passed into the bladder. The neourethra is closed
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
6 Months to 16 Years
Healthy volunteers
Yes
Inclusion criteria
Children age: \> 6m up to 16y * Distal penile hypospadias(distal shaft,coronal,subcoronal ) * mid penile hypospadias with mild chordae les 30 degree * Urethral plate \<8 mm in maximum transverse diameter before the midline urethral plate incision .Primary non-circumcised cases of hypospadias
Exclusion criteria
* Proximal and mid penile hypospadias with marked chordae * previous hypospadias repair
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional outcome | 12 months | Investigators want to compare between Snodgrass and combined inner preputial graft with Snodgrass in functional outcome by evaluation of the stream an ideal stream of urine (single, compact, rifled, non-dispersed urinary stream of adequate caliber) without straining. |
| Cosmetic outcome | 12 months | Investigators want to compare between Snodgrass and combined inner preputial graft with Snodgrass in cosmetic outcome By Hypospadias Objective penile Evaluation (HOPE) Score 1.meatus position 2.meatus shape 3.glans shape 4.penile skin shape 5.penile axis secreal 6.Torsion |
Countries
Egypt
Contacts
Primary ContactAhmed S Gebaly Adam, Resident
Backup ContactTarek A Siefin, Lecturer
Outcome results
None listed