publication . Article . 2018

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction

Marc Cendron;
Open Access English
  • Published: 01 Mar 2018 Journal: volume 6issn: 2296-2360, eissn: 2296-2360, Copyright policy
  • Publisher: Frontiers Media S.A.
Abstract
Introduction: The megameatus intact prepuce (MIP) variant of hypospadias is a rare variant of hypospadias that is diagnosed either early at the time of circumcision or later as the foreskin is retracted. The true incidence of the anomaly is difficult to determine precisely as some patient never come to medical attention but is felt to under 5% of all cases of hypospadias. The purposes of this study are to review the embryology and clinical findings of MIP and then, in light of a personal experience, present a series of patients evaluated for MIP who were treated with a modification of the Mathieu technique. Materials and methods A PubMed search of all articles i...
Subjects
free text keywords: surgical repair, RJ1-570, Pediatrics, hypospadias, Original Research, megameatus, intact prepuce, Mathieu technique
Related Organizations

1 Juskiewenski S Vaysee P Guitard JK Moscovoci J Traitements des hypospades anterieurs. Place de le balanoplastie. Chir Ped (1983) 24:75–9.

2 Duckett JW Keating MA Technical challenges of the megameatus intact prepuce hypospadias variant: the pyramid procedure. J Urol (1989) 141:1407 10.1016/S0022-5347(17)41325-5 2657110 [PubMed] [DOI]

3 Hatch DA Maizels M Zaontz MR Firlit CF. Hypospadias hidden by a complete prepuce. Surg Gynecol Obstet (1989) 169:233–4.2772793 [PubMed]

4 Austin Hill G Wacksman J Lewis AG Sheldon CA The modified pyramid hypospadias procedure: repair of the megameatus and deep glanular groove variants. J Urol (1993) 150:1208–11.10.1016/S0022-5347(17)35729-4 8371393 [PubMed] [DOI]

5 Bar-Josef Y Binyamini J Mullerad M Matzkin H Ben-Chaim J Megameatus intact prepuce hypospadias variant: application of the tubularized incised plate urethroplasty. Urology (2005) 66(4):861–4.10.1016/j.urology.2005.04.070 16230154 [PubMed] [DOI]

6 Elbartany AM Shehata SM Khaled IA Megameatus intact prepucevariety of hypospadias: tips for a repair using the modified glanular approximation procedure. Ann Ped Surg (2011) 7:82–7.10.1097/01.XPS.0000398026.62997.14 [OpenAIRE] [DOI]

7 Peretz D Westreich M Pseudo-iatrogenic hypospadias; the megameatus intact prepuce hypospadias variant. Plast Reconstr Surg (2003) 111:1182–5.10.1097/01.PRS.0000047561.15211.7B 12621189 [PubMed] [DOI]

8 Docimo SG. Subcutaneous frenulum flap (SCUFF) for iatrogenic or primary megameatus and reoperative hypospadias repair. Urology (2001) 58(2):271–3.10.1016/S0090-4295(01)01181-5 11489717 [PubMed] [DOI]

9 Mathieu P Le traitement de l’hypospadias balanique et juxta-balanique. J Chir (1932) 39:481–4.

10 Castagnetti M Gnech M Angeklini L Rigamonti W Bagnara V Espositi C Does preputial reconstruction increase the complication rate of hypospadias repair? 20-year systematic review and meta-analysis. Front Pediatr (2016) 4:41 10.3389/fped.2016.00041 27200322 [OpenAIRE] [PubMed] [DOI]

11 Belman AB. The de-epithelialized flap and its influence on hypospadias repair. J Urol (1994) 152:2332–4.10.1016/S0022-5347(17)31670-1 7966735 [PubMed] [DOI]

12 Snodgrass WT Khavari R Prior circumcision does not complicate repair of hypospadias with intact prepuce. J Urol (2006) 176(1):296–8.10.1016/S0022-5347(06)00564-7 16753427 [PubMed] [DOI]

13 Pieretti RV Pieretti A Pieretti-Vanmarcke R. Circumcised hypospadias. Pediatr Surg Int (2009) 25(1):53–5.10.1007/s00383-008-2254-1 18850103 [PubMed] [DOI]

Abstract
Introduction: The megameatus intact prepuce (MIP) variant of hypospadias is a rare variant of hypospadias that is diagnosed either early at the time of circumcision or later as the foreskin is retracted. The true incidence of the anomaly is difficult to determine precisely as some patient never come to medical attention but is felt to under 5% of all cases of hypospadias. The purposes of this study are to review the embryology and clinical findings of MIP and then, in light of a personal experience, present a series of patients evaluated for MIP who were treated with a modification of the Mathieu technique. Materials and methods A PubMed search of all articles i...
Subjects
free text keywords: surgical repair, RJ1-570, Pediatrics, hypospadias, Original Research, megameatus, intact prepuce, Mathieu technique
Related Organizations

1 Juskiewenski S Vaysee P Guitard JK Moscovoci J Traitements des hypospades anterieurs. Place de le balanoplastie. Chir Ped (1983) 24:75–9.

2 Duckett JW Keating MA Technical challenges of the megameatus intact prepuce hypospadias variant: the pyramid procedure. J Urol (1989) 141:1407 10.1016/S0022-5347(17)41325-5 2657110 [PubMed] [DOI]

3 Hatch DA Maizels M Zaontz MR Firlit CF. Hypospadias hidden by a complete prepuce. Surg Gynecol Obstet (1989) 169:233–4.2772793 [PubMed]

4 Austin Hill G Wacksman J Lewis AG Sheldon CA The modified pyramid hypospadias procedure: repair of the megameatus and deep glanular groove variants. J Urol (1993) 150:1208–11.10.1016/S0022-5347(17)35729-4 8371393 [PubMed] [DOI]

5 Bar-Josef Y Binyamini J Mullerad M Matzkin H Ben-Chaim J Megameatus intact prepuce hypospadias variant: application of the tubularized incised plate urethroplasty. Urology (2005) 66(4):861–4.10.1016/j.urology.2005.04.070 16230154 [PubMed] [DOI]

6 Elbartany AM Shehata SM Khaled IA Megameatus intact prepucevariety of hypospadias: tips for a repair using the modified glanular approximation procedure. Ann Ped Surg (2011) 7:82–7.10.1097/01.XPS.0000398026.62997.14 [OpenAIRE] [DOI]

7 Peretz D Westreich M Pseudo-iatrogenic hypospadias; the megameatus intact prepuce hypospadias variant. Plast Reconstr Surg (2003) 111:1182–5.10.1097/01.PRS.0000047561.15211.7B 12621189 [PubMed] [DOI]

8 Docimo SG. Subcutaneous frenulum flap (SCUFF) for iatrogenic or primary megameatus and reoperative hypospadias repair. Urology (2001) 58(2):271–3.10.1016/S0090-4295(01)01181-5 11489717 [PubMed] [DOI]

9 Mathieu P Le traitement de l’hypospadias balanique et juxta-balanique. J Chir (1932) 39:481–4.

10 Castagnetti M Gnech M Angeklini L Rigamonti W Bagnara V Espositi C Does preputial reconstruction increase the complication rate of hypospadias repair? 20-year systematic review and meta-analysis. Front Pediatr (2016) 4:41 10.3389/fped.2016.00041 27200322 [OpenAIRE] [PubMed] [DOI]

11 Belman AB. The de-epithelialized flap and its influence on hypospadias repair. J Urol (1994) 152:2332–4.10.1016/S0022-5347(17)31670-1 7966735 [PubMed] [DOI]

12 Snodgrass WT Khavari R Prior circumcision does not complicate repair of hypospadias with intact prepuce. J Urol (2006) 176(1):296–8.10.1016/S0022-5347(06)00564-7 16753427 [PubMed] [DOI]

13 Pieretti RV Pieretti A Pieretti-Vanmarcke R. Circumcised hypospadias. Pediatr Surg Int (2009) 25(1):53–5.10.1007/s00383-008-2254-1 18850103 [PubMed] [DOI]

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publication . Article . 2018

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction

Marc Cendron;