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An objective assessment of the results of hypospadias surgery
OBJECTIVE To compare the cosmetic result of tubularized incised‐plate urethroplasty (Snodgrass method) with that of two established techniques, the meatal‐based flap and onlay island flap repair. SUBJECTS AND METHODS Photographs of the penis after hypospadias repair in 32 boys were assessed by a pan...
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| Published in: | BJU international 2005-07, Vol.96 (1), p.135-139 |
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| creator | Ververidis, Moschos Dickson, Alan P. Gough, David C.S. |
| description | OBJECTIVE
To compare the cosmetic result of tubularized incised‐plate urethroplasty (Snodgrass method) with that of two established techniques, the meatal‐based flap and onlay island flap repair.
SUBJECTS AND METHODS
Photographs of the penis after hypospadias repair in 32 boys were assessed by a panel of five independent health professionals, including four surgeons with variable paediatric urological experience and a urology nurse. Twenty patients had a distal and 12 a proximal meatus. The Snodgrass technique was applied by one paediatric urologist for either distal (10) or proximal (six) hypospadias. A Mathieu repair was used for distal hypospadias (10) and an onlay preputial island flap for proximal hypospadias (six) by a second paediatric urologist. The panel was asked to grade cosmesis as poor, unsatisfactory, satisfactory or very good (points 1–4) for each of the following aspects of penile appearance: meatus, glans, shaft and overall appearance. Photographs were taken in a standard way, with a standard distance, lighting and two views, one of the dorsal surface and one ventral, for each patient. Signed written consent for the study was obtained from each family.
RESULTS
The mean assessment score for any aspect of cosmesis was significantly higher for the Snodgrass technique (P |
| doi_str_mv | 10.1111/j.1464-410X.2005.05582.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67945026</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67945026</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3972-3f230c6112c6b501c0b56cb315731c4df2d676d873a6547beefba2e9f0d0f9593</originalsourceid><addsrcrecordid>eNqNkDtPwzAQgC0EoqXwF1AW2BL8iJ1m6FAqnqrEQiU2y3HONFXaFF8C7b8noYWuePGd_d1DHyEBoxFrz80iYrGKw5jRt4hTKiMq5ZBHmyPS__s4_o1pqnrkDHFBafug5CnpMZkqwYTqk9F4FVTZAmxdfEJgEAFxCas6qFxQzyHwgE1ZY5fOt-sK1yYvDAbY-Hfw23Ny4kyJcLG_B2R2f_c6eQynLw9Pk_E0tCJNeCgcF9QqxrhVmaTM0kwqmwkmE8FsnDueq0Tlw0QYJeMkA3CZ4ZA6mlOXylQMyPWu79pXHw1grZcFWihLs4KqQa2SNJaUqxYc7kDrK0QPTq99sTR-qxnVnTq90J0V3RnSnTr9o05v2tLL_YwmW0J-KNy7aoGrPWDQmtJ5s7IFHjg1TBJOO260476KErb_XkDfPs-6SHwDteOJxw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67945026</pqid></control><display><type>article</type><title>An objective assessment of the results of hypospadias surgery</title><source>Wiley</source><creator>Ververidis, Moschos ; Dickson, Alan P. ; Gough, David C.S.</creator><creatorcontrib>Ververidis, Moschos ; Dickson, Alan P. ; Gough, David C.S.</creatorcontrib><description>OBJECTIVE
To compare the cosmetic result of tubularized incised‐plate urethroplasty (Snodgrass method) with that of two established techniques, the meatal‐based flap and onlay island flap repair.
SUBJECTS AND METHODS
Photographs of the penis after hypospadias repair in 32 boys were assessed by a panel of five independent health professionals, including four surgeons with variable paediatric urological experience and a urology nurse. Twenty patients had a distal and 12 a proximal meatus. The Snodgrass technique was applied by one paediatric urologist for either distal (10) or proximal (six) hypospadias. A Mathieu repair was used for distal hypospadias (10) and an onlay preputial island flap for proximal hypospadias (six) by a second paediatric urologist. The panel was asked to grade cosmesis as poor, unsatisfactory, satisfactory or very good (points 1–4) for each of the following aspects of penile appearance: meatus, glans, shaft and overall appearance. Photographs were taken in a standard way, with a standard distance, lighting and two views, one of the dorsal surface and one ventral, for each patient. Signed written consent for the study was obtained from each family.
RESULTS
The mean assessment score for any aspect of cosmesis was significantly higher for the Snodgrass technique (P < 0.05). The mean score (95% confidence interval) for the meatus was 0.76 (0.4–1.1) points higher for the patients with a Snodgrass repair than those with a Mathieu or onlay island flap repair (P = 0.002). Correspondingly, the values for the glans were 0.67 (0.38–0.97) (P = 0.003), shaft 0.42 (0.16–0.69) (P = 0.01) and overall appearance 0.62 (0.24–1.0) (P = 0.01) points higher for the Snodgrass repair. The Snodgrass technique was more effective in producing a vertically orientated meatus (87.5%) than the Mathieu and Duckett onlay repairs (37.5%; P = 0.009).
CONCLUSION
The Snodgrass technique, as assessed by this panel, had a better cosmetic outcome than the Mathieu and Duckett onlay island flap repairs. The assessment of cosmesis in hypospadias surgery is potentially more objective when several health professionals, not involved in the surgery, compared the various methods of repair.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/j.1464-410X.2005.05582.x</identifier><identifier>PMID: 15963136</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Biological and medical sciences ; Child, Preschool ; Humans ; hypospadias ; Hypospadias - surgery ; Infant ; Male ; Malformations of the urinary system ; meatal‐based flap ; Medical sciences ; Nephrology. Urinary tract diseases ; onlay island flap ; Reconstructive Surgical Procedures - methods ; Stents ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Surgical Flaps ; Treatment Outcome ; tubularized incised‐plate urethroplasty ; Urinary Catheterization ; Urinary tract. Prostate gland</subject><ispartof>BJU international, 2005-07, Vol.96 (1), p.135-139</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3972-3f230c6112c6b501c0b56cb315731c4df2d676d873a6547beefba2e9f0d0f9593</citedby><cites>FETCH-LOGICAL-c3972-3f230c6112c6b501c0b56cb315731c4df2d676d873a6547beefba2e9f0d0f9593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16877206$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15963136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ververidis, Moschos</creatorcontrib><creatorcontrib>Dickson, Alan P.</creatorcontrib><creatorcontrib>Gough, David C.S.</creatorcontrib><title>An objective assessment of the results of hypospadias surgery</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>OBJECTIVE
To compare the cosmetic result of tubularized incised‐plate urethroplasty (Snodgrass method) with that of two established techniques, the meatal‐based flap and onlay island flap repair.
SUBJECTS AND METHODS
Photographs of the penis after hypospadias repair in 32 boys were assessed by a panel of five independent health professionals, including four surgeons with variable paediatric urological experience and a urology nurse. Twenty patients had a distal and 12 a proximal meatus. The Snodgrass technique was applied by one paediatric urologist for either distal (10) or proximal (six) hypospadias. A Mathieu repair was used for distal hypospadias (10) and an onlay preputial island flap for proximal hypospadias (six) by a second paediatric urologist. The panel was asked to grade cosmesis as poor, unsatisfactory, satisfactory or very good (points 1–4) for each of the following aspects of penile appearance: meatus, glans, shaft and overall appearance. Photographs were taken in a standard way, with a standard distance, lighting and two views, one of the dorsal surface and one ventral, for each patient. Signed written consent for the study was obtained from each family.
RESULTS
The mean assessment score for any aspect of cosmesis was significantly higher for the Snodgrass technique (P < 0.05). The mean score (95% confidence interval) for the meatus was 0.76 (0.4–1.1) points higher for the patients with a Snodgrass repair than those with a Mathieu or onlay island flap repair (P = 0.002). Correspondingly, the values for the glans were 0.67 (0.38–0.97) (P = 0.003), shaft 0.42 (0.16–0.69) (P = 0.01) and overall appearance 0.62 (0.24–1.0) (P = 0.01) points higher for the Snodgrass repair. The Snodgrass technique was more effective in producing a vertically orientated meatus (87.5%) than the Mathieu and Duckett onlay repairs (37.5%; P = 0.009).
CONCLUSION
The Snodgrass technique, as assessed by this panel, had a better cosmetic outcome than the Mathieu and Duckett onlay island flap repairs. The assessment of cosmesis in hypospadias surgery is potentially more objective when several health professionals, not involved in the surgery, compared the various methods of repair.</description><subject>Biological and medical sciences</subject><subject>Child, Preschool</subject><subject>Humans</subject><subject>hypospadias</subject><subject>Hypospadias - surgery</subject><subject>Infant</subject><subject>Male</subject><subject>Malformations of the urinary system</subject><subject>meatal‐based flap</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>onlay island flap</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Stents</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Surgical Flaps</subject><subject>Treatment Outcome</subject><subject>tubularized incised‐plate urethroplasty</subject><subject>Urinary Catheterization</subject><subject>Urinary tract. Prostate gland</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqNkDtPwzAQgC0EoqXwF1AW2BL8iJ1m6FAqnqrEQiU2y3HONFXaFF8C7b8noYWuePGd_d1DHyEBoxFrz80iYrGKw5jRt4hTKiMq5ZBHmyPS__s4_o1pqnrkDHFBafug5CnpMZkqwYTqk9F4FVTZAmxdfEJgEAFxCas6qFxQzyHwgE1ZY5fOt-sK1yYvDAbY-Hfw23Ny4kyJcLG_B2R2f_c6eQynLw9Pk_E0tCJNeCgcF9QqxrhVmaTM0kwqmwkmE8FsnDueq0Tlw0QYJeMkA3CZ4ZA6mlOXylQMyPWu79pXHw1grZcFWihLs4KqQa2SNJaUqxYc7kDrK0QPTq99sTR-qxnVnTq90J0V3RnSnTr9o05v2tLL_YwmW0J-KNy7aoGrPWDQmtJ5s7IFHjg1TBJOO260476KErb_XkDfPs-6SHwDteOJxw</recordid><startdate>200507</startdate><enddate>200507</enddate><creator>Ververidis, Moschos</creator><creator>Dickson, Alan P.</creator><creator>Gough, David C.S.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200507</creationdate><title>An objective assessment of the results of hypospadias surgery</title><author>Ververidis, Moschos ; Dickson, Alan P. ; Gough, David C.S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3972-3f230c6112c6b501c0b56cb315731c4df2d676d873a6547beefba2e9f0d0f9593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Child, Preschool</topic><topic>Humans</topic><topic>hypospadias</topic><topic>Hypospadias - surgery</topic><topic>Infant</topic><topic>Male</topic><topic>Malformations of the urinary system</topic><topic>meatal‐based flap</topic><topic>Medical sciences</topic><topic>Nephrology. Urinary tract diseases</topic><topic>onlay island flap</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Stents</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Surgical Flaps</topic><topic>Treatment Outcome</topic><topic>tubularized incised‐plate urethroplasty</topic><topic>Urinary Catheterization</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ververidis, Moschos</creatorcontrib><creatorcontrib>Dickson, Alan P.</creatorcontrib><creatorcontrib>Gough, David C.S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ververidis, Moschos</au><au>Dickson, Alan P.</au><au>Gough, David C.S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An objective assessment of the results of hypospadias surgery</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2005-07</date><risdate>2005</risdate><volume>96</volume><issue>1</issue><spage>135</spage><epage>139</epage><pages>135-139</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>OBJECTIVE
To compare the cosmetic result of tubularized incised‐plate urethroplasty (Snodgrass method) with that of two established techniques, the meatal‐based flap and onlay island flap repair.
SUBJECTS AND METHODS
Photographs of the penis after hypospadias repair in 32 boys were assessed by a panel of five independent health professionals, including four surgeons with variable paediatric urological experience and a urology nurse. Twenty patients had a distal and 12 a proximal meatus. The Snodgrass technique was applied by one paediatric urologist for either distal (10) or proximal (six) hypospadias. A Mathieu repair was used for distal hypospadias (10) and an onlay preputial island flap for proximal hypospadias (six) by a second paediatric urologist. The panel was asked to grade cosmesis as poor, unsatisfactory, satisfactory or very good (points 1–4) for each of the following aspects of penile appearance: meatus, glans, shaft and overall appearance. Photographs were taken in a standard way, with a standard distance, lighting and two views, one of the dorsal surface and one ventral, for each patient. Signed written consent for the study was obtained from each family.
RESULTS
The mean assessment score for any aspect of cosmesis was significantly higher for the Snodgrass technique (P < 0.05). The mean score (95% confidence interval) for the meatus was 0.76 (0.4–1.1) points higher for the patients with a Snodgrass repair than those with a Mathieu or onlay island flap repair (P = 0.002). Correspondingly, the values for the glans were 0.67 (0.38–0.97) (P = 0.003), shaft 0.42 (0.16–0.69) (P = 0.01) and overall appearance 0.62 (0.24–1.0) (P = 0.01) points higher for the Snodgrass repair. The Snodgrass technique was more effective in producing a vertically orientated meatus (87.5%) than the Mathieu and Duckett onlay repairs (37.5%; P = 0.009).
CONCLUSION
The Snodgrass technique, as assessed by this panel, had a better cosmetic outcome than the Mathieu and Duckett onlay island flap repairs. The assessment of cosmesis in hypospadias surgery is potentially more objective when several health professionals, not involved in the surgery, compared the various methods of repair.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>15963136</pmid><doi>10.1111/j.1464-410X.2005.05582.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Biological and medical sciences Child, Preschool Humans hypospadias Hypospadias - surgery Infant Male Malformations of the urinary system meatal‐based flap Medical sciences Nephrology. Urinary tract diseases onlay island flap Reconstructive Surgical Procedures - methods Stents Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Surgical Flaps Treatment Outcome tubularized incised‐plate urethroplasty Urinary Catheterization Urinary tract. Prostate gland |
| title | An objective assessment of the results of hypospadias surgery |
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