Hypospadias. A review of 299 cases operated 1957-69

A review of 299 unselected primary cases of hypospadias of all types treated during the period 1957 to 1969 is presented. The same indications for operation and the same surgical principles were applied in all cases. The surgical treatment was performed in two stages: meatotomy or meatotomy combined with straightening in the first stage and urethral construction according to Denis Browne's method in the second stage. Complications occurred after the urethral construction in 11/289 cases (separation of the skin flaps in 5/289 and fistulas in 6/289). All 11 patients were reoperated with fully satisfactory results. The long-term results were followed up in a series of 220/299 cases. This series was used to study different problems affecting hypospadias. The mean age at the first operation was 8.5 years and the median age 4.4. The mean age at the latest control was 15.1 years and the median age 18.4. At the latest control no relapses with regard to curvature were observed during erection in the 151/220 cases in which straightening was performed. The meatus was adequate in all cases and the urinary flow, measured with a uroflowmeter, was normal.