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Circumcision, meatotomy, meatoplasty, and preputioplasty
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rachel Harwood, Simon E. Kenny
Contraindications for circumcision include hypospadias and buried penis. Meatal stenosis can arise following circumcision, particularly in boys with BXO and those who have a circumcision while still in diapers. Most of these patients can be treated by gentle meatal dilatation or meatotomy.
Urinary
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
Meatal stenosis – abnormal narrowing of the urethral opening (meatus) – may be congenital or acquired, e.g. after circumcision. The condition is characterised by upward, deflected urine, dysuria, urgency, and frequency and prolonged urination.
Miscellaneous conditions affecting the genitalia
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Treatment is necessary to prevent meatal stenosis of the urethra (stricture of the urethral opening). Local oestrogen or anti-inflammatory cream.Surgical removal of the lesion.Catheterisation – to improve dysuria.
Penile Sparing Techniques For Penile Cancer
Published in Postgraduate Medicine, 2020
Glansectomy can be considered for penile cancer confined to the glans [3,4]. The procedure involves developing a surgical plane between the tips of the corporal bodies and the glans penis. Frozen sections are obtained from the dorsal surface of the corporal bodies and the urethra. A split-thickness skin graft may then be mobilized to provide coverage of the corporal tips [63–65]. In the largest retrospective cohort of 177 patients with a significant proportion of >T1 disease (56 [32%] T1, 98 [56%] T2, and 21 [12%] T3) that underwent glansectomy and split-thickness skin graft (STSG), Parnham et al. [66] reported a local recurrence rate of 9.3% at a median follow-up of 41.4 months. 9% of patients developed complications requiring surgical intervention including meatal stenosis and loss of the tissue graft. Of note, STSG to the penis often requires up to 5 days of immobilization in the hospital postoperatively to prevent graft shearing and loss.
Repair of panurethral stricture: Proximal ventral and distal dorsal onlay technique of buccal mucosal graft urethroplasty
Published in Arab Journal of Urology, 2018
Subbarao Chodisetti, Yogesh Boddepalli, Malakondareddy Kota
Meatal stenosis was treated by ventral lay open of the urethra until healthy buccal mucosa was seen dorsally. Re-stenosis was ring-shaped at the site of the overlapping BMG in two patients, which was treated by DVIU 3 months after the primary reconstructive surgery. One of these patients had re-stenosis again during the follow-up period and currently carries out self-dilatation. In three patients with proximal stricture dilatation was performed, but they all developed recurrent stricture during follow-up. Amongst them, two patients proceeded with perineal urethrostomy in view of advanced age, and in the other patient repeat dilatation was performed to allow him to carry out self-dilatation (Fig. 5 for algorithm). Amongst the six failed cases at 3 months, two were successfully treated, and cystourethroscopy for them at the 1-year follow-up was normal. During the mean follow-up period of 11 months, no patient was lost to follow-up. In the success group at the 1-year follow-up there were no recurrent strictures. The ultimate success rate was 89.5% (34/38) at the end of 1-year after single interventions such as DVIU and ventral lay open.
Use of an Autologous Platelet-Rich Concentrate in Hypospadias Repair: A Systematic Review and Meta analysis
Published in Arab Journal of Urology, 2023
Nitinkumar Borkar, Charu Tiwari, Debajyoti Mohanty, Arvind Sinha, Vijai Datta Upadhyaya
Meatal stenosis has been reported in three out of four included studies. In the study by Guinot et al. [16], incidence of MS was not reported. There are six patients with meatal stenosis among 158 patients (3.79%) in APC group and 14 patients developed meatal stenosis among 197 patients (7.10%) in without APC group. Pooled analysis of all four included studies showed a statistically significant reduction in the incidence of MS in the group where APC was used during hypospadias repair (RR-0.43, CI 0.19, 0.99) (Figure 4). There was no heterogeneity observed between the studies (I2 = 0%). The pooled analysis for MS in all the patients repaired with the TIP technique in the three studies also yielded the same result, i.e. RR-0.43, CI 0.19, 0.99.