Can a Graft Be Placed over a Flap in Complex Hypospadias Surgery? An Experimental Study in Rabbits

Overview

Journal Int Braz J Urol

Specialty Urology

Date 2016 Sep 21

PMID 27649106

Citations 3

Authors

Ricardo Marcondes de Mattos

Sergio R R de Araujo

Juliany Gomes Quitzan

Bruno Leslie

Herick Bacelar

Joao Luiz Gomes Parizi

Gustavo Marconi Caetano Martins

Marcela Leal da Cruz

Antonio Macedo Jr

Affiliations

Soon will be listed here.

Abstract

Purpose: To develop a rabbit experimental study to test the hypothesis that surgical repair of hypospadias with severe ventral curvatures might be completed in one stage, if a graft, such as buccal mucosa, could be placed over the tunica vaginalis flap used in corporoplasty for ventral lengthening, with the addition of an onlay preputial island. flap to complete the urethroplasty.

Materials And Methods: The experimental procedure with rabbits included a tunica vaginalis flap for reconstruction of the corpora after corporotomy, simulating a ventral lengthening operation. A buccal mucosa graft was placed directly on top of the flap, and the urethroplasty was completed with an onlay preputial island flap. Eight rabbits were divided into 4 groups, sacrificed at 2, 4, 8 and 12 weeks postoperatively, and submitted to histological evaluation.

Results: We observed a large number of complications, such as fistula (75%), urinary retention (50%) and stenosis (50%). There were two deaths related to the procedure. Histological evaluation demonstrated a severe and persistent inflammatory reaction. No viable tunica vaginalis or buccal mucosa was identified.

Conclusions: In this animal model, the association of a buccal mucosa graft over the tunica vaginalis flap was not successful, and resulted in complete loss of both tissues.

Citing Articles

Preclinical Experiments for Hypospadias Surgery: Systematic Review and Quality Assessment.

Abbas T, Elawad A, Kareem A, S A, Ali M, Alnaimi A Front Pediatr. 2021; 9:718647.

PMID: 34458213 PMC: 8386350. DOI: 10.3389/fped.2021.718647.

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model.

Guo H, Jia Z, Wang L, Bao X, Huang Y, Zhou J Asian J Androl. 2019; 21(4):381-386.

PMID: 31267985 PMC: 6628739. DOI: 10.4103/aja.aja_43_19.

Correction of Residual Ventral Penile Curvature After Division of the Urethral Plate in the First Stage of a 2-Stage Proximal Hypospadias Repair.

Schlomer B Curr Urol Rep. 2017; 18(2):13.

PMID: 28213855 DOI: 10.1007/s11934-017-0659-x.

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