Retrospective Comparative Study between Duplay and Koff Methods in Repair of Distal Hypospadias

Area of Science:

• Urology
• Pediatric Surgery
• Surgical Outcomes Research

Background:

• Hypospadias repair is a complex surgical procedure with no universally agreed-upon optimal technique.
• Choosing the best surgical method for primary anterior hypospadias remains a challenge due to varying outcomes.

Purpose of the Study:

• To compare the outcomes and complication rates of two single-stage surgical techniques for primary anterior hypospadias repair.
• Evaluate the effectiveness of Thiersch-Duplay Tubularized Plate Urethroplasty versus Koff Urethral Mobilisation and Advancement.

Main Methods:

• Retrospective analysis of medical records from 120 patients with primary anterior hypospadias.
• Patients were divided into two groups: 60 undergoing Thiersch-Duplay (Group A) and 60 undergoing Koff (Group B).
• Statistical comparison using Chi-squared or Fisher's exact test (P < 0.05) to assess technique-related complications.

Main Results:

• No intraoperative or acute post-operative complications were observed in either group.
• Late post-operative complications occurred in 28.3% of patients (38.3% in Group A, 18.3% in Group B), suggesting a trend favoring the Koff procedure (P = 0.102).
• Identified late complications included meatal stenosis, urethro-cutaneous fistula, and wound dehiscence.

Conclusions:

• The study did not definitively establish the superiority of one technique over the other.
• The Koff urethral mobilization and advancement technique demonstrated versatility, satisfactory cosmetic and functional results, and low rates of meatal stenosis and urethro-cutaneous fistula in primary anterior hypospadias repair.