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Iatrogenic hypospadias--a preventable injury?
H O Andrews1, R Nauth-Misir, P J Shah
1Institute of Urology and Nephrology, London, UK.
Spinal Cord
|April 29, 1998
Summary
Iatrogenic hypospadias, a urethral injury from catheter pressure, affects patients despite efforts to avoid catheterization. Surgical reconstruction offers good results for unacceptable penile appearance in affected individuals.
Area of Science:
- Urology
- Surgical Complications
- Male Genitourinary Health
Background:
- Iatrogenic hypospadias results from indwelling urethral catheter pressure.
- This preventable injury affects the ventral male urethra.
- Despite avoiding long-term catheterization, 16 cases were identified over 9 years.
Purpose of the Study:
- To report on the incidence and management of iatrogenic hypospadias.
- To evaluate surgical reconstruction outcomes for cosmetic and functional improvement.
- To explore alternative therapies to urethral catheterization.
Main Methods:
- Review of 16 patients with iatrogenic hypospadias.
- Surgical reconstruction performed in six patients with significant penile deformity.
- Investigation for alternative therapies and catheter-free states.
- Use of suprapubic catheterization when necessary.
Main Results:
- Six patients underwent successful penile reconstruction with good cosmetic results.
- The majority of patients were investigated for alternative therapies.
- Catheter-free states were achieved where possible.
- Suprapubic catheterization was used as an alternative in some cases.
Conclusions:
- Iatrogenic hypospadias is an avoidable complication of urethral catheterization.
- Surgical reconstruction can effectively address the unacceptable penile appearance.
- Management involves investigating alternatives to catheterization and appropriate catheter selection.