Long-term follow-up of hypospadias repair

A long-term follow-up study was carried out on the results of the van der Meulen one stage (vdMI) and two stage (vdMII) technique as well as the combination of a Byars orthoplasty with a Denis Browne urethroplasty (By/DB) for hypospadias. Special attention was paid to the functional outcome (spraying, dribbling, urinary deviation), findings at physical examination (curvature, skin surplus, stenosis, fistula, torsion, etc) and the correlation between complaints on function and physical abnormalities. An attendance score of 32% was achieved out of 567 patients. With the primary referred patients, spraying was encountered infrequently (vdMI 8%, vdMII 12% and By/DB 12%). Postmicturitional dribbling was reported by 16% of patients treated with vdMI repairs, 24% of the vdMII operations and after 30% of the By/DB repairs. Deviation of urinary stream was mentioned by 32% of the vdMI patients, 18% of the vdMII patients and 21% of the By/DB patients. There was no correlation between the findings at physical examination and the functional complaints. Mild torsion of the penile body and skin surplus were observed without having clinical consequences. Fistulae were not seen at follow-up and six patients had mild residual curvature of the penile body without clinical significance. Surplus of skin was observed in approximately 20% of patients, but none of the patients requested correction of this cosmetic problem.