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Revision Hypospadias Repair in Adolescence: A Scoping Review
Colton Bohonos1, Roshan Ajeet Singh1, Elaine Joanne Redmond1
1School of Medicine, University College Cork, Cork, Ireland; Department of Urology, Cork University Hospital, Cork, Ireland.
Objective:
To assess the outcomes from revision hypospadias surgery in adolescence.
Methods:
A comprehensive literature search of PubMed and Embase was performed to identify articles that focused on revision hypospadias surgeries in adolescence. Two authors screened abstracts and identified articles suitable for inclusion. Publication characteristics including authorship, objectives, study design, cohort, surgical methods, and outcomes were recorded.
Results:
A total of 36 full length articles were included in the final review. Nineteen articles focused on recurrent hypospadias, 15 on urethrocutaneous fistula, and a single study each on urethral stricture and glans dehiscence. There was significant heterogeneity of reported surgeries, cohorts, and outcomes throughout.
Conclusion:
The wide variability in reported outcomes highlights the knowledge gaps that persist in hypospadias revision surgery. Distal hypospadias recurrence is often managed with tubularized incised plate procedures, while proximal is often performed with two staged buccal mucosal grafting. Growth adaptation of such grafts during puberty remains uncertain. Future well designed studies should aim to clarify the effect of pubertal change on such reconstructive procedures, as well as the psychological implications of revision surgery in childhood.
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