Megameatus Intact Prepuce: Families May Find it Diffucult to Give A Consent to Surgery in Non-Severe Cases, and the Surgery Can be More Difficult in Late Presentation
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Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objective: We presented rare 8 megameatus intact pre- puce (MIP) hypospadias variants and perspectives of families and pa- tients regarding the surgery and our outcomes.Material and Methods: The 8 glanular MIP cases were admitted to our clinic between 2020- 2023, aged between 3 to 17. The 6 cases were presented for circumci- sion, 2 were admitted with self suspicions. A 17-year-old was admitted for abnormal meatal appearance, considering self-awareness in ad- vanced age; an 11-year-old family had suspected an anomaly after cir- cumcision. Meatuses were glanular in 5, coronal in two, and distal penile in one. Mathieu flap techniques for uncircumcised and meatal ad- vancement and glanuloplasty (MAGPI) for circumcised cases were pre- ferred. Results: In four cases, the family declined to have the operation, due to a perceived lack of abnormalities. Two uncircumcised MIP cases were successfully treated using Mathieu flap techniques. The one cir- cumcised glanular MIP was repaired by the MAGPI technique, result- ing in late fistula formation. The 17-year-old case was treated with Matheus techniques using prepuce flaps, but ended up with a late fis- tula formation due to unpreventable erection episodes. Conclusion: MIP ıs a rare hypospadias variant and ıs commonly concealed by the foreskin causing difficulty in detection, delayed diagnosis, sometimes even after circumcision, and may cause families to reject surgical cor- rection due to a perceived lack of abnormalities. However, as it is shown in our series, a lack of preputial tissue or advanced age may neg- atively impact the operation's success. Families should be informed about the surgical difficulty in late presentation. The Mathieu tech- niques can be safely applied in non-circumcised MIP cases.
Açıklama
Anahtar Kelimeler
Anatomi ve Morfoloji, Cerrahi
Kaynak
Journal of Reconstructive Urology
WoS Q Değeri
Scopus Q Değeri
Cilt
13
Sayı
3
