{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T04:50:59Z","timestamp":1777265459243,"version":"3.51.4"},"reference-count":16,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cAssociazione per il Bambino Nefropatico ABN Onlus\u201d"},{"name":"\u201cCentro di riferimento per le malformazioni congenite del rene e delle vie urinarie: prevenzione e cura del danno renale dal feto al bambino Sergio Bonelli\u201d"},{"name":"Italian Ministry of Health\u2014Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, Milano, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>First described by Duckett in 1981, and initially employed for the surgical correction of mid-penile hypospadias, the onlay preputial island flap urethroplasty has progressively gained increasing popularity, extending its indication to proximal forms. However, with the complexity of the penile anomaly, the rate of postoperative complications related to poor tissue perfusion (including skin and glans dehiscence, urethral stenoses, and fistulas) has also increased. Conventionally, the visual assessment of the onlay preputial island flap is the only option available to establish the appropriate tissue vascularization during surgery. To this end, we have first introduced the EleVision IR system (Medtronic Ltd., Hong Kong, China) to assess the vascular perfusion of the preputial island flap in a 13-month-old boy undergoing the onlay urethroplasty for the surgical correction of a mid-shaft hypospadias. This was possible 80 s after the intravenous injection of indocyanine green (ICG, 0.15 mg\/kg, Diagnostic Green GmbH, Munich, Germany). ICG-based laser angiography helped define the proximal resection margin of the preputial flap, and proved to be safe, effective, and easy to employ. This innovative intraoperative imaging modality can be considered a useful adjunct for tissue perfusion evaluation and intraoperative decision-making during the onlay preputial island flap urethroplasty in children.<\/jats:p>","DOI":"10.3390\/ijerph20136246","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T01:43:13Z","timestamp":1688002993000},"page":"6246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Indocyanine Green (ICG)-Guided Onlay Preputial Island Flap Urethroplasty for the Single-Stage Repair of Hypospadias in Children: A Case Report"],"prefix":"10.3390","volume":"20","author":[{"given":"Irene","family":"Paraboschi","sequence":"first","affiliation":[{"name":"Department of Pediatric Urology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Gnech","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8399-3751","authenticated-orcid":false,"given":"Dario Guido","family":"Minoli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika Adalgisa","family":"De Marco","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7119-651X","authenticated-orcid":false,"given":"Giovanni","family":"Parente","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, ASST Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4361-4523","authenticated-orcid":false,"given":"Guglielmo","family":"Mantica","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianantonio","family":"Manzoni","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Berrettini","sequence":"additional","affiliation":[{"name":"Department of Pediatric Urology, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/S0022-5347(17)43152-1","article-title":"Onlay Island Flap in the Repair of Mid and Distal Penile Hypospadias Without Chordee","volume":"138","author":"Elder","year":"1987","journal-title":"J. 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Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1016\/j.eururo.2011.08.031","article-title":"Trends in hypospadias surgery: Results of a worldwide survey","volume":"60","author":"Springer","year":"2011","journal-title":"Eur. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"300","DOI":"10.4103\/aja.aja_115_18","article-title":"Complications of proximal hypospadias repair with transverse preputial island flap urethroplasty: A 15-year experience with long-term follow-up","volume":"21","author":"Wang","year":"2019","journal-title":"Asian J. Androl."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Paraboschi, I., Mantica, G., Minoli, D.G., De Marco, E.A., Gnech, M., Bebi, C., and Berrettini, A. (2022). Fluorescence-Guided Surgery and Novel Innovative Technologies for Improved Visualization in Pediatric Urology. Int. J. Environ. Res. Publ. Health, 19.","DOI":"10.3390\/ijerph191811194"},{"key":"ref_8","first-page":"1","article-title":"Narrative review on applications of fluorescence-guided surgery in adult and paediatric urology","volume":"7","author":"Parabosch","year":"2022","journal-title":"AME Med. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.jpedsurg.2020.08.004","article-title":"Fluorescence imaging in pediatric surgery: State-of-the-art and future perspectives","volume":"56","author":"Paraboschi","year":"2021","journal-title":"J. Pediatr. Surg."},{"key":"ref_10","first-page":"161","article-title":"Image-guided surgery and novel intraoperative devices for enhanced visualisation in general and paediatric surgery: A review","volume":"6","author":"Privitera","year":"2022","journal-title":"Innov. Surg. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jpurol.2013.03.009","article-title":"Hormone therapy in hypospadias surgery: A systematic review","volume":"9","author":"Netto","year":"2013","journal-title":"J. Pediatr. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.juro.2013.02.3234","article-title":"Effect of Preoperative Hormonal Stimulation on Postoperative Complication Rates After Proximal Hypospadias Repair: A Systematic Review","volume":"190","author":"Wright","year":"2013","journal-title":"J. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.jpurol.2017.06.019","article-title":"Preoperative hormonal stimulation effect on hypospadias repair complications: Meta-analysis of observational versus randomized controlled studies","volume":"13","author":"Chua","year":"2017","journal-title":"J. Pediatr. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"253","DOI":"10.23736\/S0393-2249.16.02634-5","article-title":"Impact of preoperative hormonal stimulation on postoperative complication rates after hypospadias repair: A meta-analysis","volume":"69","author":"Chao","year":"2017","journal-title":"Minerva Urol. Nephrol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"641","DOI":"10.23736\/S2724-6051.22.04967-9","article-title":"Androgen stimulation before the one-stage urethroplasty with preputial island flap (the Duckett\u2019s procedure) for proximal hypospadias repair","volume":"74","author":"Scarpa","year":"2022","journal-title":"Minerva Urol. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1007\/s00345-023-04296-0","article-title":"One-stage repair of proximal hypospadias by in situ tubularization of the transverse preputial island flap","volume":"41","author":"Lyu","year":"2023","journal-title":"World J. Urol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/13\/6246\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:03:04Z","timestamp":1760126584000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/13\/6246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,28]]},"references-count":16,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["ijerph20136246"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20136246","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,28]]}}}