Patient Perspectives and Outcomes in Adult Hypospadias Repair

Area of Science:

• Urology
• Pediatric Surgery
• Congenital Anomalies

Background:

• Hypospadias is a common congenital anomaly typically repaired in infancy.
• Late presentation in India is attributed to healthcare access, poverty, and illiteracy.
• Adult hypospadias repair differs due to patient awareness of aesthetics and potency concerns.

Purpose of the Study:

• To evaluate the perspectives and outcomes of 111 adult hypospadias cases.
• To assess the efficacy of the tubularized incised plate (TIP) urethroplasty technique in adults.
• To correlate surgical outcomes with patient-related outcomes (PROs).

Main Methods:

• Retrospective study of 111 adult hypospadias patients (age >14 years) from January 2010 to December 2020.
• Hypospadias repair using tubularized incised plate (TIP) urethroplasty, with chordee correction techniques.
• Follow-up at 3, 6, and 12 months included physical examination, uroflowmetry, and patient-related outcomes (PROs).

Main Results:

• Mean age was 19.88 years; distal meatus position was most common (57.65%).
• Chordee present in 65.7% of cases, corrected with various techniques.
• One-stage surgery success rate was 74.77%; uroflowmetry generally improved.
• Urethrocutaneous fistula (11.8%) and glanular dehiscence (8.1%) were the most frequent complications.

Conclusions:

• Primary hypospadias repair in adult patients yields generally good outcomes.
• Acceptable residual chordee and torsion correlate well with patient-related outcomes (PROs).
• Urethrocutaneous fistula remains the most common complication following hypospadias surgery in this cohort.