INTRODUCTION: The optimal treatment of @entity4094 remains controversial. Several techniques have been described, but the best approach remains unsettled. OBJECTIVE: To evaluate and compare the complication rates of @entity4094 with and without ventral curvature (VC), according to three different surgical techniques: tubularized incised plate (TIP) uretroplasty, @entity4434 ( @entity4434 ), and staged preputial repair (SR). It was hypothesized that SR performs better than TIP and @entity4434 for @entity4094 . METHODS: Single-center, retrospective chart review of all @entity1 with primary @entity4094 reconstructed between 2003 and 2013. The @entity4434 was selectively employed in cases with narrow urethral plate (UP) and @entity942 . Extensive urethral plate (UP) mobilization (UPM), dorsal plication (DP) and/or deep transverse incisions of tunica albuginea (DTITA) were selectively performed when attempting to spare transecting the UP. Division of UP and SR was favored in cases with severe VC (>50  ), which was often concurrently managed with DTITA if intrinsic curvature was present. For SR, tubularization of the graft was performed 6 months later. RESULTS: A total of 140 @entity1 were included. Tubularized incised plate (TIP), @entity4434 , and SR techniques were performed in 57, 23, and 60 @entity1 , respectively. The TIP and @entity4434 techniques achieved similar success rates, although @entity4434 was performed in cases of narrow and spongiosum-deficient plates. Reoperation rates with TIP and @entity4434 techniques was 52.6% and 52.1% (NS). Urethro-cutaneous @entity292 were seen in 31.5% and 13% of TIP and @entity4434 techniques, respectively. Staged repair accomplished better results than both TIP and @entity4434 techniques, despite being performed in the most unfavorable cases (reoperation rate 28%). After technical modifications, the @entity4434 technique achieved similar outcomes of SR. CONCLUSIONS: @entity4094 remains challenging, regardless of the technique utilized for its repair. Urethro-cutaneous @entity292 were more commonly seen after long TIP repairs. Approximately half of the @entity1 undergoing long TIP and @entity4434 procedures needed re-intervention, although the percentage decreased significantly with late modifications in the @entity4434 group. Recurrence of VC after TIP and @entity4434 techniques seemed to be a significant and under-reported complication. Staged repairs, despite being performed for the most severe cases, resulted in overall better outcomes.

XXXX : A persistent challenge. Single institution outcome analysis of three surgical techniques over a 10-year period.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity4094 :: ('MESH:D009468', 'Disease') :: ['Proximal hypospadias', 'proximal hypospadias'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistulas'] @entity4434 :: ('MESH:D005198', 'Disease') :: ['dorsal inlay graft TIP', 'DIG'] @entity942 :: ('MESH:D003677', 'Disease') :: ['deficient spongiosum']
@entity4094 :: (MESH:D009468,Disease) :: ['Proximal hypospadias']
