Correction of hypospadias with the use corpus spongiosum

1. The value of the
corpous spongiosum
in hypospadias repair
Sameh Shehata
Alexandria
Egypt

2. Contents
1 Corpous spongiosum
2 Hypoplastic urethra.
3 Chordee correction.
4 Best second layer.
Seoul 2012

3. METHODS
 Degloving in all.
 Thin ventral /Deep dorsal.
 Identify Corpous spongiosum bifurcation
 Continuity between C.S. And glans tissue .
 2nd layer covering Corpous spongiosum.
Seoul 2012

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5. METHODS
 Degloving in all.
 Thin ventral /Deep dorsal.
 Identify Corpous spongiosum bifurcation
 Continuity between C.S. And glans tissue .
 2nd layer covering Corpous spongiosum.
Seoul 2012

6. Thin on ventral
Seoul 2012

7. METHODS
 Degloving in all.
 Thin ventral /Deep dorsal.
 Identify Corpous spongiosum.
 Continuity between C.S. And glans tissue .
 2nd layer covering Corpous spongiosum.
Seoul 2012

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12. Don’t!!
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13. HYDRODISSECTION
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15. METHODS
 Degloving in all.
 Thin ventral /Deep dorsal.
 Identify Corpous spongiosum bifurcation
 Continuity between C.S. And Glans.
 2nd layer covering Corpous spongiosum.
Seoul 2012

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18. NO CHORDEE
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20. MILD CHORDEE
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22. SEVERE CHORDEE
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24. METHODS
 Degloving in all.
 Thin ventral /Deep dorsal.
 Identify Corpous spongiosum bifurcation
 Continuity between C.S. And glans tissue .
 Spongioplasty.
Seoul 2012

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28. W Spongiosum
hy
 Natural .
 Thick , vascular.
 Fixed NOT floating .
 No bulk at the Glans.
Seoul 2012

29. RESULTS
 2008- 2011
 152 cases of distal hypospadias.
 AGE: 9 months - 7 years (2.3 yrs).
 Coronal: 33
 Distal : 84
 Proximal: 35

Seoul 2012

30. Techniques
 MAGPI 37
 TIP (Snodgrass) 98
 Mathieu . 17
 Dorsal Plication 5
Seoul 2012

31.  152 cases of hypospadias were operated
upon .Age ranged between 1 and 6 years with a
mean of 3.2 yrs.
Seoul 2012

32.  The location of the meatus:
 Coronal: 33
 Distal : 84
 Proximal: 35
Seoul 2012

33.  Complications encountered:
 Fistula: 7%
 Stenosis 5.6%
 Repair disruption: 0%
 Meatal regression 3%
Seoul 2012

34. Fistula in relation to 2nd layer
Seoul 2012

35. Conclusion
 Corpous Spongiosum is always there ,
 only if you look for it!!
Seoul 2012

36. CONCLUSION
 Level of bifurcation : Degree of Chordee
Seoul 2012

37. Hypoplsastic urethra
 Can be preserved!
Seoul 2012

38. Conclusion
 Degloving in all even apparently minor
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39. Conclusion
 Best 2nd layer
 Corpous spongiosum
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40. To be preserved !
 Urethral plate .
 Corpous spongiosum.
Seoul 2012

41. Thank you
Seoul 2012