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Published on: January 7, 2019
The outcome of one-stage hypospadias repairs
Hayrettin Ozturk1, Abdurrahman Onen, Selcuk Otçu
1Department of Pediatric Surgery, Dicle University, Medical School, 21280 Diyarbakir, Turkey. ozturkhayrettin@hotmail.com
Insights
This study reviewed 107 hypospadias repairs, finding that severe chordee and specific hypospadias locations increase complication risks. Individualized surgical approaches are crucial for optimal outcomes in hypospadias correction.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Congenital Abnormalities
Background:
- Hypospadias is a common congenital condition requiring surgical correction.
- Numerous surgical techniques exist for hypospadias repair, with varying outcomes.
- One-stage repair is a common approach for hypospadias correction.
Purpose of the Study:
- To review the experience with different one-stage hypospadias repair techniques.
- To evaluate functional and cosmetic outcomes of hypospadias surgery.
- To identify predictors of postoperative complications in hypospadias repair.
Main Methods:
- Retrospective review of 107 hypospadias repairs in boys under 15.
- Evaluation of patient age, hypospadias type, associated anomalies, surgical technique, and morbidity.
- Assessment of functional and cosmetic results at 1, 6, and 12 months postoperatively.
Main Results:
- Complications included 15% fistulae and 10% meatal stenosis.
- Severe chordee, middle/posterior hypospadias, and pedicle island flap use were linked to higher complication rates.
- Cosmetic and functional results were satisfactory in most patients.
Conclusions:
- Risk factors for hypospadias repair complications include severe chordee, specific hypospadias locations, and certain surgical techniques.
- No single gold-standard technique exists; individualized surgical planning is essential.
- Long-term outcomes require further evaluation after puberty.
Objective:
Hypospadias is an increasingly common condition, and many procedures have been described for operative correction. We reviewed our experience of different techniques of one-stage hypospadias repair.
Materials And Methods:
We retrospectively reviewed 107 hypospadic boys who were younger than 15 years between January 1986 and June 2003. We included all patients who underwent one-stage hypospadias repair. All patients were evaluated for age, type of hypospadias, associated anomalies, surgical technique, and morbidity rate. The functional and cosmetic results were evaluated at 1 month, 6 months and 1 year postoperatively. Univariate analysis was done to identify those variables that might serve as interdependent predictors of postoperative complications.
Results:
The median age was 7 years (6 months to 13 years). Severe chordee was observed in 15 patients. The majority of cases were anterior hypospadias (53%), while the majority of complications were observed in the middle group (62%). Cosmetic and functional results were satisfactory in the majority of the patients. Complications included 16 fistulae (15%) and 11 meatal stenoses (10%). Some prognostic factors such as age, insertion of a suprapubic cystostomy tube, suture structure, and time of catheter removal did not significantly affect the risk of complication, whereas some other factors such as associated anomalies, severe chordee, middle and posterior hypospadias, and use of a pedicle island flap were significant in their relation to the complication rate.
Conclusion:
Such possible risk factors as severe chordee, middle and posterior localized hypospadias, and use of a pedicle island flap may increase the postoperative complication rate. There is no gold-standard technique for hypospadias repair; the procedure of choice should depend on the individual anatomy of the penis. The long-term outcome after puberty has to be awaited.
