Hypospadias in Sudan, clinical and surgical review

Hypospadias is one of the commonest penile abnormalities in new born males, and occurs as a result of a birth defect resulting in a urethral opening anywhere from the glans penis along the ventral aspect of the shaft of the penis up to the scrotum or the perineum in extreme cases. The condition has a huge impact on the patient's psychological, emotional and sexual well being. This study aimed to evaluate the current trend in the treatment of hypospadias in Sudan.

The was a retrospective study done in Elribat university hospital, department of Paediatrics surgery, for patients who underwent hypospadias surgical repair in the period January 2006 to June 2007.

There were 50 patients in this study. Regional distribution of the patients showed that 52% of the patients live in Khartoum state, the capital, while 48% were from the peripheries; 12% of patients had family history of similar condition (Hypospadias) and 54% were of low socioeconomic status. Anterior hypospadias was the commonest type (46%), and associated chordee occurred in most of the patients (88%). The most common associated anomalies found were undescended testicles (20%) and inguinal hernia only in 2%. The most common type of repair was MAGPI (meatal advancement and glanuloplasty) with 42% of cases, anterior hypospadias commonest type with 46% of cases, 12% of cases had a family history of the condition and an overall complication rate of 26%. Chordee was the most prevalent association in 88% of cases.

There is a high familial tendency for hypospadias in Sudan. Associated chordee and other anomalies are in keeping with other reports. Corrective surgery for hypospadias is associated with high complication rate in our setting. Collaboration between surgical specialties such as plastic surgeons, paediatrics urologist and general surgeons may improve the present complication scenario.