Morphology and urodynamics after longitudinal urethral plate incision in proximal hypospadias repairs: long-term results.
OBJECTIVE
To determine whether longitudinal neourethra incision disturbs the healing and growth of the neourethra, and to see how it affects the urine flow after proximal hypospadias repairs.


METHODS
Nine patients were examined, in whom longitudinal incision had been performed 9 - 15 years earlier, after previous penis lengthening operations. Calibration, urethrography, endoscopy, and urodynamics were carried out in all patients.


RESULTS
In all but 1 patient the external meatus had steadily been growing in width, and in 8 out of 9 it was within the normal size range. Urethroscopy showed single hairs growing into the lumen in 3 patients. No scarring was demonstrated in any patient. Saccular dilatation of the neourethra was found in 6 out of 9, urethral stricture was shown in only 1 patient. Peak flow rate was within 2 SD in 5 patients, and below 2 SD in 3. Average flow rate was below 2 SD in 6 patients and in all patients it was markedly low. In the patient with urethral stricture both peak flow rate and average flow rate were well below normal.


CONCLUSIONS
Although longitudinal neourethra incision allows for easy and safe closure, longitudinal incision may result in functional meatal stenosis with formation of a wide neourethra. This may be due to disproportional low resistance of the urethral wall, compared with external meatus, to urine flow.
Orkiszewski
M
M
University of Medical Sciences, Bydgoszcz, Department of Paediatric Surgery, Children's Hospital, Torun, Poland.
Leszniewski
J
J
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D013997:Time Factors; D014521:Urethra / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics