{
    "abstract": "To evaluate two established soft tissue interposition techniques used during redo surgery for selected post-urethroplasty complications of hypospadias surgery.\nPatients with complications who had interposition of scrotal fat, tunica vaginalis fascia, or external spermatic fascia identified from all hypospadias patients presenting to a single institute treated by a single surgeon between 2003 and 2019 (n=217) were reviewed retrospectively. Urethrocutaneous fistula repair and minor cosmetic corrections were excluded.\nEight cases had 10 complications: residual penile curvature >30 degrees (n=5), urethral diverticulum >15mm (n=3), urethral dehiscence (n=1), and urethral stricture (n=1). All were Japanese. Hypospadias was perineal/penoscrotal (n=7) or mid-shaft (n=1). Initial procedures performed in infancy were single-stage urethroplasty (n=4) or multi-stage urethroplasty (n=4). Ages at first soft tissue interposition during redo single-stage urethroplasty (n=1) or multi-stage urethroplasty (n=7; two-stage: n=4, three-stage: n=3) ranged from 4.2 to 46.5 years old. All had their neourethras covered and 4 also had their scarred urethral plates reinforced laterally. There have been no complications during a mean of 5.6 years follow-up after the last procedure (range: 3.4 to 8.3 years) and all expressed satisfaction with cosmetic and functional outcomes including standing urination. Tissues for interposition were harvested easily without injuring surrounding structures such as the vas deferens or testicular vessels even though previous surgery had caused extensive adhesions and structural disruption.\nUnlike reinforcement with tunica dartos fascia, soft tissue interposition specifically boosts tissue thickness and perfusion at the operative site during redo surgery for technically challenging post-urethroplasty complications.",
    "authors": [
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Yuichiro",
            "initials": "Y",
            "lastname": "Miyake"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Shogo",
            "initials": "S",
            "lastname": "Seo"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Urayasu, Japan.",
            "firstname": "Junya",
            "initials": "J",
            "lastname": "Ishii"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Masahiro",
            "initials": "M",
            "lastname": "Takeda"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Yuta",
            "initials": "Y",
            "lastname": "Yazaki"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Takanori",
            "initials": "T",
            "lastname": "Ochi"
        },
        {
            "affiliation": "Pediatirc General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Go",
            "initials": "G",
            "lastname": "Minano"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Bunkyo-ku, Japan.",
            "firstname": "Hiroyuki",
            "initials": "H",
            "lastname": "Koga"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.",
            "firstname": "Geoffrey J",
            "initials": "GJ",
            "lastname": "Lane"
        },
        {
            "affiliation": "Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.",
            "firstname": "Atsuyuki",
            "initials": "A",
            "lastname": "Yamataka"
        }
    ],
    "conclusions": "Unlike reinforcement with tunica dartos fascia, soft tissue interposition specifically boosts tissue thickness and perfusion at the operative site during redo surgery for technically challenging post-urethroplasty complications.",
    "copyrights": "Thieme. All rights reserved.",
    "doi": "10.1055/a-2590-5767",
    "journal": "European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie",
    "keywords": [],
    "methods": null,
    "publication_date": "2025-04-18",
    "pubmed_id": "40245945",
    "results": "Eight cases had 10 complications: residual penile curvature >30 degrees (n=5), urethral diverticulum >15mm (n=3), urethral dehiscence (n=1), and urethral stricture (n=1). All were Japanese. Hypospadias was perineal/penoscrotal (n=7) or mid-shaft (n=1). Initial procedures performed in infancy were single-stage urethroplasty (n=4) or multi-stage urethroplasty (n=4). Ages at first soft tissue interposition during redo single-stage urethroplasty (n=1) or multi-stage urethroplasty (n=7; two-stage: n=4, three-stage: n=3) ranged from 4.2 to 46.5 years old. All had their neourethras covered and 4 also had their scarred urethral plates reinforced laterally. There have been no complications during a mean of 5.6 years follow-up after the last procedure (range: 3.4 to 8.3 years) and all expressed satisfaction with cosmetic and functional outcomes including standing urination. Tissues for interposition were harvested easily without injuring surrounding structures such as the vas deferens or testicular vessels even though previous surgery had caused extensive adhesions and structural disruption.",
    "title": "A retrospective assessment of soft tissue interposition during redo surgery for postoperative hypospadias repair-related complications.",
    "xml": "<Element 'PubmedArticle' at 0x7885036ff2e0>"
}