An increased incidence of hypospadias is found globally, and the current management techniques and research studies of hypospadiology face significant challenges and limitations. This book sheds light on the recent struggles encountered in hypospadias-related clinical practice and research methodologies. Various writings were incorporated by people on different disciplines linked to the overall phases of diagnosis and care of hypospadias patients.
Special attention is given to new perspectives from different interrelated disciplines trying to overcome these obstacles. This book fills in a void in the new related discoveries traditionally given scant consideration in the currently dominated literature. It provides a useful source for the recent updates, ongoing controversies, and future research trajectories in hypospadiology, which benefits pediatric, plastic, reconstructive, and urology surgeons and trainees and helps examiners focus on updated materials.
Author(s): Tariq Abbas
Publisher: Springer
Year: 2023
Language: English
Pages: 167
City: Singapore
Acknowledgment
About the Editor
Contents
1: Toward an Ecosystem Model of Hypospadiology
1.1 Background
1.1.1 Etiology
1.1.2 Classification
1.1.3 Severity Stratification
1.2 Current Challenges
1.2.1 Etiology
1.2.2 Classification of Hypospadias
1.2.3 Severity Stratification
1.3 Future Perspectives
1.3.1 Etiological Factors
1.3.2 Classification
1.3.3 Severity Stratification
1.4 Conclusion
References
2: Urethral Anatomy, Physiology, and Regeneration
2.1 Anatomy and Blood Supply of the Penis in Health and Hypospadias
2.2 Urethral Injury
2.3 Urethral Wound Healing in Animal Models
2.4 Effect of Androgens and Estrogen on Urethral Wound Healing
2.5 Future Perspectives
2.6 Conclusion
References
3: The Rabbit Model in Preclinical Hypospadias Research: Strengths and Limitations
3.1 Animal Models for Urethral Repair Research
3.2 The Rabbit Urethroplasty Model
3.2.1 Rabbit Penile Anatomy
3.2.2 Relationship Between Rabbit and Human Age
3.2.3 Mechanical Properties of the Rabbit Urethra
3.3 Limitations of Rabbit Urethra Models
3.3.1 General Inherent Limitations
3.3.2 Structural and Biomechanical Differences Between Rabbit and Human Urethra
3.3.3 Lack of Sample Size Calculation
3.3.4 Short Follow-Up Durations in Rabbit Urethroplasty Models
3.3.5 Lack of Optimized Assessment Methods for the Structural and Functional Outcomes
3.3.6 Poor Reporting of Rabbits’ Animal Experiments for Hypospadias Surgery
3.4 Concluding Remarks
References
4: General Perioperative Considerations
4.1 Ongoing and Emerging Perioperative Dilemmas
4.1.1 What is the Ideal Age to Perform Hypospadias Repair?
4.1.2 What is the Current Status of Preoperative Hormonal Supplementation?
4.1.3 What is the Effect of Transurethral Stenting on Postoperative Outcomes?
4.1.4 Are Antibiotics Needed for Hypospadias Repair?
4.1.5 What is the Role of Hyperbaric Oxygen Therapy in Hypospadias Repair?
4.1.6 Does Caudal Block Influence Urethroplasty Outcome?
4.2 Conclusion
References
5: Management of Distal Hypospadias: New Insights and Stepwise Management Algorithm
5.1 Background and Challenges
5.1.1 How to Proceed with Distal Hypospadias?
5.1.2 How to Classify Hypospadias?
5.1.3 How to Quantify the Urethral Plate Characteristics?
5.1.4 How to Quantify the Degree of Penile Curvature?
5.2 A Future Perspective Model
5.3 Redo Hypospadias Operations
References
6: Management of Proximal Hypospadias: Current Challenges and Future Directions
6.1 Introduction
6.2 Objectives for Reconstruction
6.3 Staged Preputial Graft: Tips and Tricks!
6.4 Challenges Encountered During Management of “Proximal” Hypospadias
6.5 What are the Future Perspectives?
6.5.1 Structured Follow-Up Database
6.5.2 Standardized Assessment Tools and Management Protocols
6.5.3 Structured Training and Coaching
6.5.4 Tissue Engineering and Biological Adjuvants
6.6 Conclusion
References
7: Penile Curvature Assessment in Hypospadias
7.1 Background
7.1.1 Why Measure PC?
7.1.2 How is Curvature Measured?
7.2 Current Challenges
7.2.1 Challenges of PC Measurement
7.2.2 The Challenge of Arc-Type Curvatures
7.3 Future Perspectives
7.4 Conclusion
References
8: Evaluating the Results of Hypospadias Repair: What? Why? When? And How?
8.1 Introduction
8.2 Why?
8.2.1 Preoperative Evaluation of Tissue Availability and Planning
8.2.2 Technical Factors
8.2.2.1 Suture Materials
8.2.2.2 Tissue Handling
8.2.2.3 Catheters/Stents and Diversions
8.2.2.4 Postoperative Dressing
8.3 How?
8.3.1 Cosmetic Results
8.3.2 Functionality
8.4 What and When?
8.4.1 Short-Term Complications
8.4.1.1 Bleeding and Hematoma
8.4.1.2 Surgical Edema
8.4.1.3 Urethrocutaneous Fistula (UF)
8.4.1.4 Wound Infection/Local Sepsis
8.4.1.5 Penile Torsion
8.4.2 Long-Term Cosmetic and Functional Outcomes
8.5 Future Perspectives
8.5.1 Objective Quantification of Hypospadias Anatomic Variables Using Artificial Intelligence and Machine Learning Tools
8.5.2 Structured Transition of Child Patients into Adult Support
8.5.3 Centralizing Hypospadias Registry Data to Improve Patient Care
8.5.4 Structured Training and Coaching
8.6 Conclusion
References
9: Tissue Engineering and Regenerative Medicine in Hypospadias Management
9.1 Introduction and Background
9.2 Tissue Engineering
9.3 Future Perspectives
9.4 Concluding Remarks
References
10: Artificial Intelligence in Hypospadiology: Role, Applications, and Benefits
10.1 Introduction
10.2 Machine Learning Advances in the Field of Biomedical Engineering
10.2.1 The Relationship Between AI, ML, and DL
10.2.2 A Brief History of AI in Medicine
10.2.3 Guidelines for Applying AI in Biomedical Engineering
10.3 ML in Adult Urology
10.4 ML in Pediatric Urology
10.5 Machine Learning in Hypospadias
10.6 Challenges and Future Directions
References
