My Son Needs Surgery - Page 2

[mamaverdi]

Followed the links, but it was just a bibliography under hypospadius repair preserving the foreskin. (Or my computer is being wonky.) But...what do they use to repair hypospadius, etc if they do not use the foreskin?

[Revamp]

Originally Posted by mamaverdi

Followed the links, but it was just a bibliography under hypospadius repair preserving the foreskin. (Or my computer is being wonky.) But...what do they use to repair hypospadius, etc if they do not use the foreskin?

Hmm... Good question.

My guess would be skin grafts from other bits of the body. Although my worst case scenario generator predicts other poor boy's foreskin.

[mamaverdi]

I thought these techniques were developed in countries with extremely low circ rates. I would tend to think that it's mucosal skin from somewhere else on the boy's own body. While skin grafts from another person's body can work, it is has a much higher risk of complications. I was thinking maybe his cheek?

[Frankly Speaking]

Actually, there is no graft at all. In the more extreme forms of hypospadias, the glans and depending on the extent or severity, the shaft appear to be butterflied and spread open. In the Scottish procedure, they just bring the two sides together over a tube and stitch them together. Once the surgery is complete, the tube is removed and what remains is a urethra. The skin in the butterflied area is mucosal skin and there is no need for more from else where on the body.




Frank

[Pandora114]

Originally Posted by Marilyn Milos, RN

Greetings,

I thought you might like to speak with a couple of our pediatricians before subjecting your baby to surgery.

Robert Van Howe, MD, was a consultant to the American Academy of Pediatrics 1999 Task Force Committee on Circumcision. He's done extensive research and has written many articles on the subject. His number is 906-250-4317.

Paul Fleiss, MD, is the author of two excellent Mothering articles and, with Frederick Hodges, What Your Doctor May Not Tell You About Circumcision. His number is 323-664-1977.

Please tell them I sent you.

Good luck. I'm sure this is not easy for you...

Best wishes,

Marilyn

Marilyn Fayre Milos, RN, Executive Director
National Organization of Circumcision Information Resource Centers

We're not worthy! We're not worthy!!!!!

[mamaverdi]

Originally Posted by Frankly Speaking

Actually, there is no graft at all. In the more extreme forms of hypospadias, the glans and depending on the extent or severity, the shaft appear to be butterflied and spread open. In the Scottish procedure, they just bring the two sides together over a tube and stitch them together. Once the surgery is complete, the tube is removed and what remains is a urethra. The skin in the butterflied area is mucosal skin and there is no need for more from else where on the body.

Do you have a link to surgeon information for how to do this? Is "the skin in the butterflied area" a preexisting urethra? (Bear with me, I'm not too familiar with hypospadius, but I need the information to take to my son's surgeon about another condition.)

mv

[Frankly Speaking]

Originally Posted by mamaverdi

Do you have a link to surgeon information for how to do this? Is "the skin in the butterflied area" a preexisting urethra? (Bear with me, I'm not too familiar with hypospadius, but I need the information to take to my son's surgeon about another condition.)

mv

http://www.cirp.org/library/restoration/gray1/

As you probably already know, up until about 8 weeks gestation, the male and female are the same. After that point, the penis expands greatly and develops. Part of that development is that the underside of the penis joins the two sides to form an urethra. The ventral raphe, the little ridge along the underside of the penis is the result of this joining of the two sides. It is similar to a scar. Hypospadias is simply where the joining process is not complete and the urethral opening is somewhat further down than normal. It may be just slightly off center and appear as an elongated meatus, a cleft glans or it may be further down at the base of the glans, anywhere along the shaft or even below the scrotum. Regardless of where the opening is, from that point to the tip of the penis will be mucosal skin that would have been the urethral tube. To fashion a urethra from the current opening to the tip of the penis is simply a matter of bringing the two sides of the mucosal skin together. The skin in the butterflied area is the urethra that just didn't lap over to form the tube. All of the material is there, the process is just not complete. Any surgeon that has used foreskin or mouth lining as donor material can do the Scottish procedure with no problem.





Frank

[mamaverdi]

Arg. Well, then, no matter how talented my surgeon, which I'm pretty sure he could do/has done that procedure, this won't help my son.

If they need mucosal skin from somewhere other than the foreskin...where do they get it?

[Frankly Speaking]

Usually the linning of the mouth is a prime mining site for mucosal donor tissue.



Frank

[mamaverdi]

Is there anything else they can use?

mv