title: Comparison of hypospadiac and normal preputial vascular anatomy.
abstract: OBJECTIVE
  Data about the differences between the vascularization of normal and hypospadiac prepuce are lacking. We investigated the course of the preputial arterial blood vessels in normal controls and children with hypospadias by using transillumination, arterial methylene blue injection and 3-dimensional (3-D) reconstruction of serial histological sections focusing on arterial vessels.
  
  
  METHODS
  Prepuce of 48 normal controls and 15 children with hypospadias was transilluminated by a front and back lighting technique and then photographed. All of the normal and 12 of hypospadiac prepuces not used for urethroplasty or penile body skin reconstruction were removed. The blood vessels of normal prepuce were also identified after arterial injection of methylene blue. Selected prepuce of normal controls and children with hypospadias was serially sectioned, and arterial and venous vessels were histologically distinguished. A 3-D computer reconstruction of the arterial system of normal and hypospadiac prepuces was performed.
  
  
  RESULTS
  We confirmed the reliability of the transillumination technique to describe the arterial vascular anatomy of the prepuce by comparing the transillumination to methylene blue injection and 3-D reconstruction of histological sections. We classified the arterial vascular anatomy of normal prepuce as 1 artery predominant (41.67%), 2 arteries predominant (25%), H-type arching artery (12.5%) and net-like arterial system (20.83%). However, hypospadiac prepuce revealed a net-like arterial system more frequently (50%). We noted that the frequency of net-like arterial system was higher in more severe hypospadiac prepuce.
  
  
  CONCLUSIONS
  Understanding the differences between normal and hypospadiac prepuce vascular anatomy is germane to hypospadias surgery. The arterial blood supply of the hypospadiac prepuce is different than normal. A better knowledge of the vascular anatomy of the hypospadiac prepuce may improve the surgical results of hypospadias repair.
authors.affiliation: Department of Urology, Pediatric Surgery and Pathology, Akdeniz University School of Medicine, Antalya, Turkey. syucel@akdeniz.edu.tr
authors.forename: Selcuk
authors.initials: S
authors.lastname: Yucel
authors.forename: Erol
authors.initials: E
authors.lastname: Guntekin
authors.forename: Erdal
authors.initials: E
authors.lastname: Kukul
authors.forename: Gungor
authors.initials: G
authors.lastname: Karaguzel
authors.forename: Akif
authors.initials: A
authors.lastname: Ciftcioglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Melikoglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Baykara
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000473:pathology*; D007223:Infant; D008297:Male; D010413:Penis / Q000098:blood supply*