Glanular Hypospadias Management with Modified Circumcision and Firlit Procedure.

OBJECTIVE To document the results of using simple technique of Firlit procedure with modified circumcision for treatment of glanular hypospadias. STUDY DESIGN Descriptive case series. PLACE AND DURATION OF STUDY Department of Urology, Shifa International Hospital, Islamabad, from January 2011 till May 2017. METHODOLOGY The subjects included pediatric patients who underwent repair of glanular hypospadias by using modified circumcision and Firlit procedure. Patients were analyzed for operative time, age, hospital stay, and peroperative and postoperative complications. Chart review was done for collection of data on specified proforma. RESULTS There were 73 patients with mean age of 1.81 ±0.92 years. Children were discharged on the same day. None of them needed catheterization and dressing. Temporary dressing was used for mild bleeding immediate post op in 13 (17.80%) cases only. Postoperative complication such as urinary retention, fever, severe pain, or urinary tract infection were not seen in children. Meatal stenosis was not seen on a 2-24 months' follow-up. Satisfactory urine stream and good cosmesis was noted by the parents. CONCLUSION The Firlit technique for the repair of glanular hypospadias was simple and satisfactory in terms of urine stream and cosmesis with minimal complications.

[1]  C. Ji,et al.  Correcting Glanular Dislocation in Hypospadias With Up-to-Tip Technique and Double Wing Flaps , 2016, Annals of plastic surgery.

[2]  R. Hamid,et al.  Comparative Study of Snodgrass and Mathieu's Procedure for Primary Hypospadias Repair , 2014, ISRN urology.

[3]  A. Bracka,et al.  Medium to long term results following single stage Snodgrass hypospadias repair. , 2013, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[4]  O. Adorisio,et al.  The importance of patient selection in the treatment of distal hypospadias using modified Koff procedure. , 2010, Journal of pediatric urology.

[5]  A. Hadidi Double Y glanuloplasty for glanular hypospadias. , 2010, Journal of pediatric surgery.

[6]  M. Youssif,et al.  Corporeal body grafting using buccal mucosa for posterior hypospadias with severe curvature. , 2009, The Journal of urology.

[7]  H. Sørensen,et al.  Prevalence of hypospadias in Danish boys: a longitudinal study, 1977-2005. , 2009, European urology.

[8]  M. Alkan,et al.  Evaluation of the results of eccentric circummeatal-based flap with combined limited urethral mobilization technique for distal hypospadias repair. , 2008, Journal of pediatric urology.

[9]  A. Stenzl,et al.  The meatal mobilization technique for coronal/subcoronal hypospadias repair , 2007, BJU international.

[10]  J. Redman A favorable experience with rotational flap techniques for fashioning the Firlit preputial collar. , 2006, The Journal of urology.

[11]  M. Hiradfar,et al.  Urethral advancement and glanuloplasty with V flap of the glans in the repair of anterior hypospadias. , 2006, Asian journal of surgery.

[12]  Nilofer,et al.  Comparative study of Mathieu and Snodgrass repair for anterior hypospadias. , 2006, Journal of Ayub Medical College, Abbottabad : JAMC.

[13]  R. Mieusset,et al.  Hypospadias: psychosocial, sexual, and reproductive consequences in adult life. , 2005, Journal of andrology.

[14]  Zia-ur-Rehman,et al.  An audit of single stage hypospadias repair at Ayub Hospital Complex, Abbottabad. , 2004, Journal of Ayub Medical College, Abbottabad : JAMC.

[15]  R. Méndez,et al.  [New Modern Magpi: meatal advancement and glanuloplasty clinical course]. , 2004, Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica.

[16]  C. Firlit,et al.  The mucosal collar revisited. , 2000, Urology.

[17]  John R Taylor,et al.  The prepuce: specialized mucosa of the penis and its loss to circumcision. , 1996, British journal of urology.

[18]  M. Zaontz The GAP (glans approximation procedure) for glanular/coronal hypospadias. , 1989, The Journal of urology.

[19]  C. Firlit The mucosal collar in hypospadias surgery. , 1987, The Journal of urology.

[20]  J. Duckett MAGPI (meatoplasty and glanuloplasty): a procedure for subcoronal hypospadias. , 1981, The Urologic clinics of North America.