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J Pediatr Urol 2021 May 17. Epub 2021 May 17.

Pediatric Surgery, Pediatric Urology and MAS, Ankura Hospitals for Women and Children, Hyderabad, Telangana, India.

Background: Despite many technical advances the debate continues on single versus staged procedures for proximal hypospadias. In this systematic review and meta-analysis we have compared the contemporary outcomes of proximal hypospadias repair: single stage foreskin pedicle tube (FPT) versus two stage foreskin free graft (FFG) and two-stage foreskin pedicled flap (FPF) over the last decade.

Methods: A systematic literature review of publications in English of the following electronic databases was conducted: Cochrane Database, PUBMED, MEDLINE and EMBASE. Read More

Am J Clin Exp Urol 2021 15;9(2):163-169. Epub 2021 Apr 15.

Department of Pediatric Surgery, Bangalore Medical College and Research Institute Bengaluru, India.

Transureteroureterostomy (TUU) is a urinary reconstructive procedure seldom used but has a role when conventional reconstructive techniques are not possible. However, the concern is whether it places the opposite, non-diseased ureter and kidney at risk. Hence a retrospective study was conducted to evaluate indications, methods, and outcomes of transureteroureterostomy in children. Read More

J Pathol Transl Med 2021 Jun 1. Epub 2021 Jun 1.

Department of Pathology, Ewha Womans University Seoul Hospital, Seoul, Korea.

A sarcomatoid variant of urothelial carcinoma in the female urethral diverticulum has not been reported previously. A 66-year-old woman suffering from dysuria presented with a huge urethral mass invading the urinary bladder and vagina. Histopathological examination of the resected specimen revealed predominantly undifferentiated pleomorphic sarcoma with sclerosis. Read More

J Pediatr Surg 2021 Apr 18. Epub 2021 Apr 18.

Department of Pediatric Surgery, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

INTRODUCTION;: Hypospadias is a congenital disorder of urethra in which meatus is not at its correct place and occurs in 1 of 250 live male birth. Many techniques have been used for the repair of hypospadias and to decrease the incidence of fistula. Alloderm has been recently used for the repair of urologic congenital defects, and reconstructive surgeries, but not used in hypospadias in a randomized controlled trial. Read More

World J Urol 2021 May 26. Epub 2021 May 26.

Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 33, Badachu Road, Shijingshan, Beijing, 100144, China.

Objective: Urethrocutaneous fistula is the most prevalent complication after hypospadias repair. The aim of this study was to evaluate whether incised urethral diversion was superior to traditional transurethral diversion in minimizing complications.

Patients And Methods: We retrospectively collected and analyzed 113 cases with proximal penile or penoscrotal hypospadias that were repaired by one-stage transverse preputial island flap urethroplasty between January 2016 and January 2020. Read More

J Pediatr Urol 2021 Apr 28. Epub 2021 Apr 28.

Kenyatta National Hospital, Kenya.

Introduction: Children who have undergone urethroplasty procedure for hypospadias are at a higher risk of getting urinary tract infections (UTI). This may be due to urethral scarring following urethroplasty that acts as a nidus for UTI. The risk is also attributed to urine stasis due to complications of urethroplasty such as urethral diverticulum, urethral stricture, meatal stenosis or breakdown of urethroplasty. Read More

Transl Pediatr 2021 Apr;10(4):843-850

Department of Urology, Children's Hospital of Nanjing Medical University, Nanjing, China.

Background: To evaluate a novel two-stage method of urethroplasty using a transected urethral plate and transverse preputial island flap (TPIF) for proximal hypospadias with severe chordee.

Methods: We retrospectively analyzed 91 cases of proximal hypospadias, who had undergone either one-stage or two-stage urethroplasty. Comparisons between the two groups were made based on age, glans diameter, the length of the urethral defect, and the rate of complications. Read More

Cent European J Urol 2021 15;74(1):89-94. Epub 2021 Jan 15.

University Hospital, School of Medicine, Department of Urology, Minia, Egypt.

Introduction: Reconstruction of proximal hypospadias with chordee remains a difficult task. Our work aims to evaluate the role of two-stage transverse preputial island flap urethroplasty for repair of proximal hypospadias with chordee.

Material And Methods: This is a retrospective study including 57 children who underwent two-stage transverse preputial island flap urethroplasty. Read More

Pediatr Surg Int 2021 Apr 26. Epub 2021 Apr 26.

Department of Pediatric Surgery, Capital Institute of Pediatrics, No.2 Yabao Road, Chaoyang District, Beijing, 100020, People's Republic of China.

Purpose: Laparoscopic-assisted anorectoplasty (LAARP) is becoming a more popular procedure for anorectal malformation (ARM) repair. However, the conventional technique for creating pull-through tunnel between the perineal skin and the pelvic floor has been criticized as being semi-blind. This study aims to present a refined version of our previously reported clamp introduction technique for visualized tunnel formation in the center of the sphincter muscle complex (SMC) for rectal pull- through for ARMs. Read More

Int Urogynecol J 2021 Apr 19. Epub 2021 Apr 19.

Department of Urology and Pediatric Urology, University Hospital Essen, Essen, Germany.

Introduction And Hypothesis: The objective was to establish a model to predict the presence of a female urethral diverticulum (UD) based on symptoms.

Methods: A prospective CHECK-UD study (check of female urethral diverticulum) was conducted. Female patients presenting with symptoms such as lower urinary tract symptoms (LUTS), postmicturition dribble or urinary incontinence (UI), dyspareunia or pain in the pelvic area, and recurrent urinary tract infection (UTI) treated between 2015 and 2020 were included. Read More

Urol Case Rep 2021 Sep 29;38:101659. Epub 2021 Mar 29.

King Faisal Specialist Hospital and Research Center, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Urethral clear cell carcinoma is very rare disease affecting both sexes, however it is mostly described in female urethra. The origin of this cancer is yet to be discovered. We report a 57 years old lady who presented to our clinic with obstructive lower urinary tract symptoms and found to have a urethral diverticulum containing a soft tissue lesion found to be a clear cell carcinoma after excision. Read More

Urol Case Rep 2021 Jul 23;37:101654. Epub 2021 Mar 23.

UWA Medical School, The University of Western Australia, Crawley, WA, Australia.

Urethral adenocarcinoma (UA) is a rare type of urethral cancer with a poor prognosis. We present a case of UA of intestinal subtype in a 57-year-old patient who initially had lower urinary tract symptoms and was subsequently found to have a urethral lesion in a urethral diverticulum on pelvic MRI which was confirmed on biopsy. She had neoadjuvant chemotherapy followed by open anterior pelvic exenteration, complete urethrectomy and ileal conduit urinary diversion. Read More

Urology 2021 Apr 11. Epub 2021 Apr 11.

Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9110. Electronic address:

Objective: To review the rates of persistent and de novo stress urinary incontinence (SUI) following urethral diverticulum (UD) repairs performed without concomitant SUI surgical procedures.

Methods: Following IRB approval, charts of women who underwent UD excision by three FPMRS surgeons were reviewed. Data collected from the electronic medical record included demographic information, preoperative symptoms and evaluation (validated questionnaires [UDI-6, QoL]), imaging studies, operative details, post-operative symptoms, and subsequent surgical interventions. Read More

J Pediatr Surg 2021 Mar 26. Epub 2021 Mar 26.

Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Purpose: To report the sequelae of and preventive strategies for selected lower urinary tract (LUT) complications, i.e., posterior urethral diverticulum (PUD), intraoperative LUT injuries, postoperative dysuria, and fistula recurrence in male imperforate anus (IA) with rectourethral/rectovesical (RU/RV) fistula after laparoscopy-assisted anorectoplasty (LAARP) or posterior sagittal anorectoplasty (PSARP). Read More

Urol Case Rep 2021 Jul 17;37:101641. Epub 2021 Mar 17.

Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan.

Congenital anterior urethrocutaneous fistula (CAUF) is a rare anomaly, commonly observed in the mid-shaft or more distal position of the penis. It can be seen in the perineum in anorectal anomalies or in cases of duplicated urethra. However, isolated CAUF opening into the perineum has not been reported. Read More

Urol Case Rep 2021 Jul 13;37:101638. Epub 2021 Mar 13.

Department of Surgery, RG KAR Medical College and Hospital, Kolkata, India.

Periurethral lesions are common in post-menopausal women. The differential diagnosis includes urethral caruncle, urethral prolapse, urethral diverticulum and the notorious urethral malignancy. Non-invasive squamous lesion of the urethra is rare with limited data on clinical significance. Read More

BMC Surg 2021 Apr 2;21(1):179. Epub 2021 Apr 2.

Department of General Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Beijing, 100045, China.

Background: Postoperative rectourethral fistula (RUF) in patients with congenital anorectal malformation (ARM) remains a challenge for paediatric surgeons, among them persistent fistula is the most common. Various techniques have been proposed, only a few reports based on different causes are available, and there is no consensus so far. This study is to evaluate the application, advantages and limitations of transanal fistulectomy approach in repairing persistent RUF in ARM patients. Read More

Asian J Androl 2021 Mar 12. Epub 2021 Mar 12.

Department of Urology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.

We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair. Patients who underwent urethroplasty by dorsal preputial island flap for proximal hypospadias between January 2014 and December 2016 were reviewed in this retrospective cohort study. Those who underwent spongiosum-combined glanuloplasty comprised the new-maneuver group, whereas those who underwent conventional glanuloplasty comprised the control group. Read More

Int Urogynecol J 2021 Mar 4. Epub 2021 Mar 4.

Department of Gynecology and Obstetrics, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.

Int Urogynecol J 2021 Feb 26. Epub 2021 Feb 26.

Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Introduction And Hypothesis: Urethral diverticula are rare but clinically significant entities among female patients. Ventrally located, mid-to distal, simple or horseshoe diverticula are most commonly observed and are usually repaired via a transvaginal approach with varying levels of difficulty but high success rates. Dorsally (anteriorly) located urethral diverticula are more challenging to repair secondary to the need to access the side of the urethra opposite the vaginal lumen, abutting the external urethral sphincter. Read More

Surg Endosc 2021 Apr 1;35(4):1921-1926. Epub 2021 Feb 1.

Department of Paediatric Surgery, Monash Children's, Monash Medical Center, Southern Health, Clayton, Australia.

Background: For the last 20 years, laparoscopy management of anorectal malformations (ARM) has been challenged due to the development of postoperative urethral diverticulum or injury caused by the imprecise transection of rectourethral fistulae, particularly rectobulbar fistulae situated deep in the pelvis. We have developed a combined approach of enteroscopy and laparoscopy for intraluminal incision of a rectourethral fistula.

Methods: We retrospectively reviewed 47 ARM patients who underwent surgical corrections using the combined approach between January 2019 and June 2020. Read More

Urology 2021 Jun 8;152:129-135. Epub 2021 Jan 8.

Department of surgery, EHU of Oran, Faculty of medicine, University of Oran, Algeria.

Objective: To present the results of Koyanagi-Snow-Hayashi urethroplasty in severe hypospadias repair.

Methods: From June 2015 to December 2019, 43 patients with severe hypospadias associated with curvature underwent Koyanagi- Snow-Hayashi urethroplasty. All patients were treated for the first time and by a single surgeon. Read More

J Pediatr Urol 2021 04 11;17(2):225.e1-225.e8. Epub 2020 Dec 11.

Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address:

Introduction: Proximal hypospadias repair remains challenging. Our approach to the first stage of two-stage proximal hypospadias repairs has evolved from using Byars' flaps to preputial inlay grafts in anatomically suitable cases and pedicled preputial flaps in more complex repairs. We reviewed our outcomes, hypothesizing that inlay grafts and pedicled preputial flaps were associated with lower complication risks than Byars' flaps. Read More

Zhonghua Nan Ke Xue 2020 Jan;26(1):54-58

Department of Urology, Children's Hospital of Anhui Medical University / Anhui Provincial Children's Hospital, Hefei, Anhui 230051, China.

Objective: To compare the effect of midline urethral-plate incision followed by Mathieu urethroplasty (MUPI-MU) with that of tubularized incised-plate (TIP) urethroplasty in the treatment of distal hypospadias.

Methods: We retrospectively analyzed the clinical date on 72 cases of distal hypospadias treated in our hospital from August 2016 to January 2019, of which 21 (including 5 cases with a narrow urethral plate, small flat glans and shallow urethral groove) underwent MUPI-MU and the other 51 received TIP urethroplasty. We followed up the patients postoperatively and compared the shape and position of the urethral meatus and incidences of glanular dehiscence, fistula, stenosis and diverticulum between the two groups. Read More

J Pediatr Urol 2021 04 25;17(2):216.e1-216.e8. Epub 2020 Nov 25.

Department of Urology, Faculty of Medicine, Zagazig University, Sharkia Governorate, Zagazig City, 44519, Egypt.

Introduction: The measurement of the urethral plate width (as an objective parameter) and its effect of this width on the results of tubularized incised plate urethroplasty (TIPU) have been reported in two series and both authors reported that a urethral plate width < 8 mm is associated with higher complication rates. The augmentation of the urethral plate either by dorsal inlay graft urethroplasty (DIGU) or Onlay flap has been compared with the original TIPU in different degrees of hypospadias with better surgical results in augmented cases.

Objective: To evaluate the surgical results of longitudinal Onlay preputial flap (LOF) vs (DIGU) techniques in augmentation of the narrow urethral plate. Read More

Indian J Radiol Imaging 2020 Jul-Sep;30(3):409-414. Epub 2020 Oct 15.

Department of Urology and Renal Transplant, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

Male urethral diverticulum is an uncommon entity, the abnormality being more frequently encountered in females. The pathology may be congenital or acquired and the more frequent acquired type usually occurs following trauma. Afflicted patients usually lack specific symptoms, although in a few instances, symptoms of lower urinary tract obstruction, calculi, or infection may prevail. Read More

J Pediatr Urol 2021 02 12;17(1):61.e1-61.e5. Epub 2020 Nov 12.

Department of Pediatric Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China. Electronic address:

Introduction: Complications remain the top evaluation priority subsequent to hypospadias repair. Complications vary in further management, and usually require one or more reoperations. Patients and/or their parents concern not only with the success rate of reoperation, but also with the risk of numerous reoperations. Read More

J Pediatr Urol 2021 Feb 4;17(1):101.e1-101.e9. Epub 2020 Nov 4.

Department of Radiodiagnosis, DODA Imaging, PUSA Road, New Delhi, India.

Background: Anterior urethral valve (AUV) and anterior urethral diverticulum (AUD) are two rare causes of anterior urethral obstruction with variable presentation and anatomy. Their existence as the same or different entity is still debatable, and management has not yet been standardized.

Objective: This study is a retrospective review of cases diagnosed with anterior urethral obstruction and correlation of radiological and endoscopic anatomy of AUV and AUD. Read More

Int J Surg Case Rep 2020 24;77:45-47. Epub 2020 Oct 24.

Children's Hospital Bechir Hamza of Tunis, Tunisia; Pediatric Surgery Department B, Tunis, Tunisia.

Introduction: Congenital urethrocele is a rare disease in children. The diagnosis is often easy but the management remain difficult due to the risk of urethral stenosis form.

Case Presentation: We report a case of a 19-month-old child presenting with a penoscrotal mass. Read More

Can Urol Assoc J 2021 May;15(5):E276-E280

Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

Introduction: We sought to review outcomes of urethrovaginal fistula (UVF) repair, with or without concurrent fascial sling placement.

Methods: All patients diagnosed with UVF at our center from 1988-2017 were included in this study. Patient charts were reviewed from a prospectively kept fistula database, and patient characteristics and surgical outcomes were described. Read More