Genitalia

Question 1

VC in all patients with distal and midshaft repairs is

Answer 1

less than 30 degrees

Question 2

Percentages of chordee in hypospadius?

Answer 2

More than 50%

Question 3

Is VC present at birth normally?

Answer 3

The penis exhibits VC during normal development, (which implies that persistent bending in hypospadias
reflects arrested development.

Question 4

How much is the percentage of the chordee that occurs in distal hypospadias?

Answer 4

11%

Question 5

How much is the percentage of the chordee that occurs in mid-shaft hypospadias?

Answer 5

30%

Question 6

How much is the percentage of the chordee that occurs in proximal hypospadias?

Answer 6

81 %

Question 7

the most effective way to assess the severity of Chordee?

Answer 7

Artificial erection induced by saline injection remains the most commonly used means to assess the presence and severity of VC and document successful correction.

Question 8

Midline dorsal plication into the tunica albuginea of the corpora cavernosa can be used to which degree of chordee?

Answer 8

Curvature up to 30 degrees can be corrected by this way

Question 9

The finding that skin adjacent
to the meatus may retract as far as the penoscrotal junction during degloving provides additional proof that relatively short ventral
skin contributes to curvature

Answer 9

T

Question 10

This extent of bending
after skin degloving and ventral dartos dissection is considered
disproportion between the ventral and dorsal aspects of the
corpora cavernosa

Answer 10

T

Question 11

Elevation of the urethral plate
alone hasn’t been reported to correct curvature

Answer 11

F Elevation of the plate
alone has been reported to correct curvature

Question 12

elevating the normal urethra from the corpora which
mobilization of the urethra combined with its inherent elasticity
allows gaps to 5 cm in adults to be bridged

Answer 12

T

Question 13

Rather than a single corporotomy with grafting, two to three transverse incisions can be made into the tunica albuginea without exposing erectile spongy tissue or need for grafting

Answer 13

T

Question 14

The most common cause of VC is shortening of the urethra

Answer 14

F VC is attributed most often
to deficient ventral shaft skin and dartos, followed by corpora
cavernosal disproportion, with a shortened urethra the least
common finding

Question 15

Snodgrass reports TIP repair reliably corrects distal
hypospadias regardless of urethral plate configuration

Answer 15

T

Question 16

The complication rate was 100%, including five
diverticula and two strictures at the flap/urethral plate junction in bayer tech

Answer 16

T

Question 17

overlapping
suture lines from urethroplasty and skin closure potentially
increase likelihood for fistulas dates to Duplay’s first procedure

Answer 17

T

Question 18

factors such as larger suture size (4-0) and different
suture materials (catgut, horsehair) than commonly used could
also have contributed to fistula development

Answer 18

T

Question 19

Technical steps thought to reduce fistula risk include two-layer
subepithelial closure of the neourethra and subsequent coverage
with a barrier flap, usually dartos.

Answer 19

T

Question 20

a dartos flap did significantly reduce fistulas
in mostly distal TIP reoperations

Answer 20

T

Question 21

Fistulas can occur at any location along the urethroplasty and
can be an isolated finding or associated with other complications

Answer 21

T

Question 22

Fistulas occasionally close spontaneously The majority require
reoperation.

Answer 22

T

Question 23

Tubularization of the urethral plate too far distally is most likely the main
cause for meatal stenosis after TIP repair.

Answer 23

T

Question 24

The most common site for neourethral strictures is at the
proximal anastomosis of the neourethra to native urethra in
flap and graft repairs

Answer 24

T

Question 25

Partial or complete wound separation results in recurrent hypospadias

Answer 25

T

Question 26

Causes of wound separation

Answer 26

Causes potentially include technical factors (suture materials and/or technique during glansplasty), glans size, traumatic
catheter displacement, or wound infection

Question 27

distal repairs were significantly more likely to result in glans
dehiscence than proximal shaft repair

Answer 27

F proximal repairs were significantly more likely to result in glans dehiscence than mid-distal shaft repair

Question 28

smaller glans size increases risk of dehiscence

Answer 28

T

Question 29

Cheek grafts, which are visibly
thicker than lip grafts, are more often associated with dehiscence

Answer 29

T

Question 30

Diverticulum are most often noted after tubularization of the urethral plate or buccal grafts

Answer 30

F is most often noted after tubularized preputial flap
repairs and are rarely encountered after tubularization of the urethral plate or buccal grafts

Question 31

Late development of meatal stenosis or urethral stricture
may indicate BXO, especially if the meatus has a whitish
discoloration

Answer 31

T

Question 32

repairof Balanitis Xerotica Obliterans requires excision of all involved tissues and
their replacement with nonskin tissues, usually buccal mucosa,
because reoperation using skin results in high recurrence rates

Answer 32

T

Question 33

Fistulas approximately 5 mm or greater also likely require
reoperative urethroplasty for successful closure without narrowing
the neourethra lumen.

Answer 33

T

Question 34

gross scarring of the plate or
its prior excision contraindications to reoperative TIP

Answer 34

T

Question 35

Grafts harvested from the lip are not sutured to avoid
distorting the vermillion border

Answer 35

T

Question 36

common features of hypospadias

Answer 36

• Dystopic urethral meatus in a ventral position on the penis, scrotum, or perineum
• Urethral plate distal to the dystopic meatus
• Dorsally hooded foreskin (97% to 98%)
• Ventral chordee (more than 50% of cases)

Question 37

Anterior meatus (glanular, subcoronal, distal penile shaft): 65%

Answer 37

T

Question 38

Medial meatus (midshaft): 15%

Answer 38

T

Question 39

What are the goals and components of hypospadias repair?

Answer 39

• Straightening of the penile shaft (orthoplasty)
• Creation of an adequate caliber urethra (urethroplasty)
• Repositioning of the urethral meatus to the tip of the penis and creation of a symmetrical glans (meatoplasty and
  glanuloplasty)
• Achieving a good cosmetic result (skin coverage and scrotoplasty) with normalization of voiding and erection

Question 40

the dorsal plication
should be performed at the 12 o’clock position. In this area, the tunica albuginea is the strongest and potential nerve
injury, which could affect later sexual function, can be avoided

Answer 40

T

Question 41

Urethrocutaneous fistula and urethral stricture complicate approximately 10% to 15% of all hypospadias repairs.

Answer 41

T

Question 42

Routine screening of the upper urinary tract
is not indicated in patients with isolated hypospadias or with hypospadias associated with undescended testes or
inguinal hernia.

Answer 42

T

Question 43

Routine screening of the upper urinary tract
is not indicated in patients with isolated hypospadias or with hypospadias associated with undescended testes or
inguinal hernia.

Answer 43

T

Question 44

The most common anomalies associated with hypospadias are cryptorchidism and inguinal hernia; the incidence
of each is approximately 9%

Answer 44

T

Question 45

Beta-blocking agents also have been associated with the development
of plaques of Peyronie’s disease

Answer 45

T