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Hypospadias surgery: when, what and by whom?
Gianantonio Manzoni1, Aivar Bracka, Enzo Palminteri
1Department of Urology and Section of Paediatric Urology, Ospedale di Circolo, Varese, Italy. gianantoniomanzoni@virgilio.it
BJU International
|December 23, 2004
Summary
This review offers a unified hypospadias management policy from four surgical specialties. It details a surgical protocol emphasizing functional and cosmetic outcomes for reliable hypospadias repair.
Area of Science:
- Pediatric Surgery
- Urology
- Plastic Surgery
Background:
- Hypospadias repair involves multiple surgical specialties.
- A unified management policy is needed for consistent outcomes.
- Surgeons should have specialized interest and high case volume.
Purpose of the Study:
- To present a unified policy for hypospadias management.
- To outline a surgical protocol for functional and cosmetic refinement.
- To ensure reliable correction of hypospadias deformities.
Main Methods:
- Review representing pediatric surgeons, pediatric urologists, adult reconstructive urologists, and plastic surgeons.
- Presentation of a surgical protocol for primary and secondary repairs.
- Description of one-stage, two-stage, and modified two-stage (Snodgrass) procedures.
Main Results:
- A logical progression of procedures reliably corrects most hypospadias.
- One-stage repair is suitable when urethral plate integrity is maintained.
- Two-stage repairs, including modified Snodgrass procedures, offer reliable solutions for complex cases.
Conclusions:
- The presented protocol combines function, cosmesis, and reliability.
- Active follow-up through genital maturity is recommended to ensure long-term results.
- This multidisciplinary approach aims for optimal hypospadias correction.