Hypospadias repair using a modification of Beck's operation: followup

We reviewed the results of 64 cases of hypospadias repair using a modified Beck's operation with mobilization of the anterior urethra.

Patient age at correction ranged from 10 months to 12 years (mean 3.83 years). Six patients had undergone previous surgical treatments. Uroflowmetry and evaluation of the urinary stream, meatus, glans, shaft and scar formations were used as objective criteria, and grading of management and results by parents was considered subjective criteria.

An average of 2.1 years postoperatively 59 patients were available for this followup study. The urethral meatus was positioned satisfactorily onto the distal glans in all cases and no urethrocutaneous fistulas developed. Meatal stenosis requiring meatal dilation occurred in 2 boys. In 2 cases a curved glans, and curved penis and glans, respectively, were caused by cicatricial tissue, necessitating surgical correction. Uroflowmetry was possible in 46 cases (78%). One patient with meatal stenosis had pathological flow values. All other flow rates were within the normal range. In the second case of meatal stenosis objective evaluation was impossible. In 55 cases (93%) parents judged management and results as optimal.

Mobilization of the anterior urethra for correction of distal hypospadias with or without chordee is highly successful, less extensive, and provides an excellent cosmetic and functional result with a minimal risk of complication. Uroflowmetry is a noninvasive, objective diagnostic tool for evaluating the functional results of hypospadias repair.