Corporeal Grafting for Severe Hypospadias

A Single Institution Experience With 3 Techniques

Jeffrey A. Leslie, Mark P. Cain, Martin Kaefer, Kirstan K. Meldrum, Rosalia Misseri, Richard C. Rink

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose: Correction of severe chordee by corporeal body grafting has been successfully performed using various grafts and biomaterials. We report a single institution comparison of our experience using small intestinal submucosa, tunica vaginalis and dermal grafts at stage 1 hypospadias repair. Materials and Methods: A retrospective chart review was performed of the records of all patients who underwent staged hypospadias repair from 1985 to 2006 with corporeal body grafting at stage 1 with small intestinal submucosa, tunica vaginalis or dermal grafts. Age at grafting, time between stages, residual chordee at stage 2 repair and the need for additional plication or chordee correction at stage 2 were recorded. Results: A total of 71 patients were identified with a median age of 10 months at stage 1 repair and a median of 7.6 months between stages 1 and 2 repair. Dermal grafts, tunica vaginalis and small intestinal submucosa grafts were used in 29, 21 and 20 patients, respectively. One patient received a combination of small intestinal submucosa and tunica vaginalis. None of the patients receiving tunica vaginalis graft required any further correction of chordee. One patient with a dermal graft and 1 receiving small intestinal submucosa required Nesbit plication at stage 2 repair for minor ventral chordee. One patients receiving small intestinal submucosa showed severe fibrosis at the graft site, requiring excision and repeat grafting with tunica vaginalis. This patient has been previously described. The 2 patients with small intestinal submucosa related complications had 4-ply grafts. We have seen no complications associated with 1-ply small intestinal submucosa. At limited followup we have not seen residual chordee after stage 2 repair. Conclusions: In a large group of children requiring corporeal grafting for severe chordee we observed successful chordee correction with 1-ply small intestinal submucosa, tunica vaginalis or dermal grafts.

Original languageEnglish
Pages (from-to)1749-1752
Number of pages4
JournalJournal of Urology
Volume180
Issue number4 SUPPL.
DOIs
StatePublished - Oct 2008

Fingerprint

Hypospadias
Transplants
Skin
Biocompatible Materials
Fibrosis

Keywords

  • abnormalities
  • dermis
  • intestine, small
  • penis
  • transplants

ASJC Scopus subject areas

  • Urology

Cite this

Corporeal Grafting for Severe Hypospadias : A Single Institution Experience With 3 Techniques. / Leslie, Jeffrey A.; Cain, Mark P.; Kaefer, Martin; Meldrum, Kirstan K.; Misseri, Rosalia; Rink, Richard C.

In: Journal of Urology, Vol. 180, No. 4 SUPPL., 10.2008, p. 1749-1752.

Research output: Contribution to journalArticle

Leslie, Jeffrey A. ; Cain, Mark P. ; Kaefer, Martin ; Meldrum, Kirstan K. ; Misseri, Rosalia ; Rink, Richard C. / Corporeal Grafting for Severe Hypospadias : A Single Institution Experience With 3 Techniques. In: Journal of Urology. 2008 ; Vol. 180, No. 4 SUPPL. pp. 1749-1752.
@article{f1c65a03a6da408d819848531eed0a0a,
title = "Corporeal Grafting for Severe Hypospadias: A Single Institution Experience With 3 Techniques",
abstract = "Purpose: Correction of severe chordee by corporeal body grafting has been successfully performed using various grafts and biomaterials. We report a single institution comparison of our experience using small intestinal submucosa, tunica vaginalis and dermal grafts at stage 1 hypospadias repair. Materials and Methods: A retrospective chart review was performed of the records of all patients who underwent staged hypospadias repair from 1985 to 2006 with corporeal body grafting at stage 1 with small intestinal submucosa, tunica vaginalis or dermal grafts. Age at grafting, time between stages, residual chordee at stage 2 repair and the need for additional plication or chordee correction at stage 2 were recorded. Results: A total of 71 patients were identified with a median age of 10 months at stage 1 repair and a median of 7.6 months between stages 1 and 2 repair. Dermal grafts, tunica vaginalis and small intestinal submucosa grafts were used in 29, 21 and 20 patients, respectively. One patient received a combination of small intestinal submucosa and tunica vaginalis. None of the patients receiving tunica vaginalis graft required any further correction of chordee. One patient with a dermal graft and 1 receiving small intestinal submucosa required Nesbit plication at stage 2 repair for minor ventral chordee. One patients receiving small intestinal submucosa showed severe fibrosis at the graft site, requiring excision and repeat grafting with tunica vaginalis. This patient has been previously described. The 2 patients with small intestinal submucosa related complications had 4-ply grafts. We have seen no complications associated with 1-ply small intestinal submucosa. At limited followup we have not seen residual chordee after stage 2 repair. Conclusions: In a large group of children requiring corporeal grafting for severe chordee we observed successful chordee correction with 1-ply small intestinal submucosa, tunica vaginalis or dermal grafts.",
keywords = "abnormalities, dermis, intestine, small, penis, transplants",
author = "Leslie, {Jeffrey A.} and Cain, {Mark P.} and Martin Kaefer and Meldrum, {Kirstan K.} and Rosalia Misseri and Rink, {Richard C.}",
year = "2008",
month = "10",
doi = "10.1016/j.juro.2008.03.091",
language = "English",
volume = "180",
pages = "1749--1752",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4 SUPPL.",

}

TY - JOUR

T1 - Corporeal Grafting for Severe Hypospadias

T2 - A Single Institution Experience With 3 Techniques

AU - Leslie, Jeffrey A.

AU - Cain, Mark P.

AU - Kaefer, Martin

AU - Meldrum, Kirstan K.

AU - Misseri, Rosalia

AU - Rink, Richard C.

PY - 2008/10

Y1 - 2008/10

N2 - Purpose: Correction of severe chordee by corporeal body grafting has been successfully performed using various grafts and biomaterials. We report a single institution comparison of our experience using small intestinal submucosa, tunica vaginalis and dermal grafts at stage 1 hypospadias repair. Materials and Methods: A retrospective chart review was performed of the records of all patients who underwent staged hypospadias repair from 1985 to 2006 with corporeal body grafting at stage 1 with small intestinal submucosa, tunica vaginalis or dermal grafts. Age at grafting, time between stages, residual chordee at stage 2 repair and the need for additional plication or chordee correction at stage 2 were recorded. Results: A total of 71 patients were identified with a median age of 10 months at stage 1 repair and a median of 7.6 months between stages 1 and 2 repair. Dermal grafts, tunica vaginalis and small intestinal submucosa grafts were used in 29, 21 and 20 patients, respectively. One patient received a combination of small intestinal submucosa and tunica vaginalis. None of the patients receiving tunica vaginalis graft required any further correction of chordee. One patient with a dermal graft and 1 receiving small intestinal submucosa required Nesbit plication at stage 2 repair for minor ventral chordee. One patients receiving small intestinal submucosa showed severe fibrosis at the graft site, requiring excision and repeat grafting with tunica vaginalis. This patient has been previously described. The 2 patients with small intestinal submucosa related complications had 4-ply grafts. We have seen no complications associated with 1-ply small intestinal submucosa. At limited followup we have not seen residual chordee after stage 2 repair. Conclusions: In a large group of children requiring corporeal grafting for severe chordee we observed successful chordee correction with 1-ply small intestinal submucosa, tunica vaginalis or dermal grafts.

AB - Purpose: Correction of severe chordee by corporeal body grafting has been successfully performed using various grafts and biomaterials. We report a single institution comparison of our experience using small intestinal submucosa, tunica vaginalis and dermal grafts at stage 1 hypospadias repair. Materials and Methods: A retrospective chart review was performed of the records of all patients who underwent staged hypospadias repair from 1985 to 2006 with corporeal body grafting at stage 1 with small intestinal submucosa, tunica vaginalis or dermal grafts. Age at grafting, time between stages, residual chordee at stage 2 repair and the need for additional plication or chordee correction at stage 2 were recorded. Results: A total of 71 patients were identified with a median age of 10 months at stage 1 repair and a median of 7.6 months between stages 1 and 2 repair. Dermal grafts, tunica vaginalis and small intestinal submucosa grafts were used in 29, 21 and 20 patients, respectively. One patient received a combination of small intestinal submucosa and tunica vaginalis. None of the patients receiving tunica vaginalis graft required any further correction of chordee. One patient with a dermal graft and 1 receiving small intestinal submucosa required Nesbit plication at stage 2 repair for minor ventral chordee. One patients receiving small intestinal submucosa showed severe fibrosis at the graft site, requiring excision and repeat grafting with tunica vaginalis. This patient has been previously described. The 2 patients with small intestinal submucosa related complications had 4-ply grafts. We have seen no complications associated with 1-ply small intestinal submucosa. At limited followup we have not seen residual chordee after stage 2 repair. Conclusions: In a large group of children requiring corporeal grafting for severe chordee we observed successful chordee correction with 1-ply small intestinal submucosa, tunica vaginalis or dermal grafts.

KW - abnormalities

KW - dermis

KW - intestine, small

KW - penis

KW - transplants

UR - http://www.scopus.com/inward/record.url?scp=51049109199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=51049109199&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2008.03.091

DO - 10.1016/j.juro.2008.03.091

M3 - Article

VL - 180

SP - 1749

EP - 1752

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4 SUPPL.

ER -