The microvessel density of the hypospadiac prepuce in children.

OBJECTIVE

The blood supply of the hypospadiac prepuce is crucial for success in surgery. Although the vascular anatomy of the hypospadiac prepuce has been previously documented, data on microvessel density are missing. It was aimed to document the microvessel density of the normal and hypospadiac prepuce.

METHODS

After ethical approval of the study, prepuces from 24 children with hypospadias undergoing surgical repair and from 9 healthy age-matched controls were stained by immunohistochemical methods using panendothelial cell antigen CD31 in order to assay their microvessel density.

RESULTS

The microvessel density was significantly decreased in hypospadiac children when compared to controls (P<0.05). A gradual decrease in microvessel density was observed as the severity of the condition increased, indicating a significant negative correlation (r=-0.585; P<0.05).

CONCLUSION

Our findings should be taken into account when considering preoperative treatments such as topical testosterone application or operative strategies for hypospadias using prepucial flaps, and also during the postoperative course, especially when it is complicated. Further studies are needed to clarify the role of vascularity in the pathogenesis of hypospadias and its consequences for surgical repair.