The features of the normal anatomy of the balanus and distal urethra were evaluated. It was found that there is a physiological mechanism of stretching of distal urethra during urination owing to the scaphoid fossa, bridle and hippocrepiform-located corpus spongiosum of balanus. Based on these data, modified balanoplasty was proposed, which consisted in mobilization and increase the length of corpus spongiosum of wings of balanus by longitudinal incisions, followed by suturing wings of balanus with separate inside sutures on a short distance not above 3-5 mm and their dipping at a depth not above 1-2 mm. Between 2005 and 2010, 410 patients aged 1 to 18 years underwent surgeries. 90 (22%) patients underwent reoperation. Boys with glandular and coronal hypospadias (n = 69) underwent MAGPI surgery. Patients with penile hypospadias (n = 243) underwent TIP-Snodgrass (n = 72), onlay (n = 23), Mathuie (n = 123), and GTIP (n = 25) surgeries. In children with scrotal and perineal hypospadias (n = 98), method of transverse tubularized foreskin flap was used. All patients were arbitrarily divided into two groups. The study group consisted of patients (n = 210) who underwent modified balanoplasty. The comparison group consisted of 200 patients who underwent conventional balanoplasty. Complication rate after hypospadias correction was reduced from 18 to 12% in penile hypospadias, and from 28 to 18% in scrotal and perineal hypospadias. It is shown that modified balanoplasty excludes formation of obstructive ring of corpus spongiosum in the distal urethra. The results of urodynamic examinations in follow-up period showed improvement of mean urinary flow rates.
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World J Urol
January 2025
Department of Urology, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200233, China.
Purpose: To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.
Materials And Methods: The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile-scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o'clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.
Dev Biol
January 2025
Institute for Stem Cell Science and Regenerative Medicine (iBRIC-inStem), GKVK-Post, Bellary Road, Bengaluru, Karnataka 560065, India. Electronic address:
Mymensingh Med J
January 2025
Dr Md Abdullah Al Mahmud, Assistant Professor, Pediatric Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Hypospadias is the absence of external urethral meatus in the tip of the glans but present in the ventral surface of the penis. Hypospadias surgery is challenging and changing. Many modifications have been done to reduce the complications.
View Article and Find Full Text PDFFr J Urol
December 2024
Centres médicaux-chirurgicaux Ambroise Paré, Hartmann, Pierre Cherest, 26, boulevard Victor-Hugo, 92200 Neuilly-sur-Seine, France. Electronic address:
Introduction: Numerous anatomical theories have been developed to explain women stress urinary incontinence (SUI) and improve its management. The transperineal ultrasound is an efficient and non-invasive exam that perfectly studies the bladder neck movement and the urethral anatomy. The measurement of the static portion of the distal urethral length, considered as the functional urethral length (FUL), and of the posterior urethral closure angle (PUCA) have not been studied before and could be of interest.
View Article and Find Full Text PDFBeijing Da Xue Xue Bao Yi Xue Ban
December 2024
Department of Urology, Beijing Jishuitan Hospital, Capital Medical Universitay, Beijing 100035, China.
Objective: To evaluate the surgical methods for treating distal urethral stricture.
Methods: The clinical data of 80 patients with distal urethral stricture in Beijing Jishuitan Hospital, Captial Medical University between January 2018 and December 2022 were retrospectively collected. Including male genital lichen sclerosus (MGLS) 33 cases, iatrogenic injury 25 cases, postoperative hypospadias 12 cases, and other causes such as trauma 10 cases.
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