Our Summary

This research paper details a study on the best methods to restore the surface of the penis in patients with “hypospadias cripple”. Hypospadias is a birth defect in which the opening of the urethra is not located at the tip of the penis. In some cases, multiple unsuccessful attempts to repair this defect lead to scarring and damage to the local tissue, making it difficult to restore the surface of the penis.

The researchers looked at the medical records of 215 patients with this condition between 1981 and 2014. They tried various techniques to restore the penis surface in 130 patients, such as using local skin flaps. However, in 85 patients, there wasn’t enough healthy local skin available for use.

In these cases, different strategies were employed: scrotal skin was used in 54 cases, 6 patients had their dorsal penile skin expanded over 12 to 16 weeks before the operation, 23 patients received full-thickness skin grafts, and 4 patients got split-thickness skin grafts.

The results were largely positive. Of the 56 patients who had their skin rotated, expanded, or a combination of both, 96.4% had successful outcomes. All 6 patients who had their skin expanded had successful outcomes without complications. All 23 full-thickness skin grafts worked excellently. However, the 4 patients who received split-thickness grafts experienced contraction and ulceration associated with sexual activity.

The researchers concluded that using scrotal skin flaps, expanding the dorsal penile skin, and using full-thickness skin grafts are reliable methods to restore the penis surface in patients with “hypospadias cripple” who lack healthy local skin.

FAQs

  1. What is “hypospadias cripple” and how does it affect the penis surface?
  2. What were the most successful methods used to restore the penis surface in patients with “hypospadias cripple” according to this research?
  3. What complications were experienced by patients who received split-thickness skin grafts in the study?

Doctor’s Tip

A doctor might tell a patient undergoing hypospadias repair to follow post-operative care instructions carefully to ensure proper healing and successful outcomes. This may include keeping the surgical site clean and dry, avoiding strenuous activities or heavy lifting, and taking prescribed medications as directed. It is also important to follow up with the doctor for regular check-ups to monitor progress and address any concerns.

Suitable For

Typically, patients with “hypospadias cripple” who have scarring and damage to the local tissue and lack healthy local skin are recommended for hypospadias repair using techniques such as scrotal skin flaps, expanding dorsal penile skin, and using full-thickness skin grafts. These methods have been shown to be successful in restoring the surface of the penis in such patients.

Timeline

Timeline of patient experience before and after hypospadias repair:

Before surgery:

  1. Patient is diagnosed with hypospadias, a birth defect where the opening of the urethra is not at the tip of the penis.
  2. Patient may undergo multiple unsuccessful attempts to repair the defect, leading to scarring and damage to the local tissue.
  3. Patient may be referred for surgery to restore the surface of the penis.

During surgery:

  1. Surgeon evaluates the extent of scarring and damage to the local tissue.
  2. Surgeon may use techniques such as local skin flaps, scrotal skin, dorsal penile skin expansion, full-thickness skin grafts, or split-thickness skin grafts to restore the penis surface.

After surgery:

  1. Patient undergoes a recovery period to allow the surgical site to heal.
  2. Patient may experience some discomfort or pain post-surgery.
  3. Patient follows up with the surgeon for monitoring and care of the surgical site.
  4. Patient may need to avoid certain activities or behaviors that could affect the healing process.
  5. Patient may experience improved function and appearance of the penis after successful surgery.
  6. Patient may need to attend regular follow-up appointments to monitor long-term outcomes and address any complications that may arise.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about hypospadias repair:

  1. What are the potential complications or risks associated with hypospadias repair surgery?
  2. How many surgeries might be needed to fully repair the hypospadias?
  3. What is the success rate of the different techniques used to restore the surface of the penis in patients with hypospadias cripple?
  4. What is the recovery process like after hypospadias repair surgery?
  5. Will there be any long-term effects or limitations after the surgery?
  6. Are there any non-surgical options or alternative treatments for hypospadias?
  7. How experienced is the surgeon in performing hypospadias repair surgeries?
  8. What can I expect in terms of follow-up care and monitoring after the surgery?
  9. Are there any lifestyle changes or precautions I should take after the surgery?
  10. How soon after the surgery can sexual activity be resumed?

Reference

Authors: Fam MM, Hanna MK. Journal: J Urol. 2017 Mar;197(3 Pt 2):859-864. doi: 10.1016/j.juro.2016.09.075. Epub 2017 Jan 26. PMID: 28131500