Ahmet ATİCİ, Mehmet Emin CELİKKAYA, Cigdem EL, Bulent AKCORA

Results of Surgery Performed on 151 Patients of Hypospadias: Single Center Experience

Background: Hypospadias is defined as the hypoplasia of the ventral side of the penis such as the abnormal ventral opening of urethral meatus, chordee, and abnormal distribution of circumcision skin. The purpose of this study is to share our experiences with patients who underwent hypospadias repair surgery in a university hospital. Materials and Methods: After obtaining approval from the hospitals ethical review board, the files of 151 patients with hypospadias who underwent surgery between March 2013 and October 2018, were examined retrospectively. One hundred thirty-five patients 89% had anterior, and 16 patients 10.6% had posterior hypospadias. Results: The average age of patients was 4,2 years 1-14 . While 30% of the patients with anterior hypospadias had cordee below 30 degrees, 100% of patients with posterior hypospadias had chordee. In terms of complications, 15 9,9% patients had urethro-cutaneous fistula, 20 13,2% patients had meatal stenosis, 3 patients 1.9% glans dehiscence, and 1 patient 0.6% had ventral skin necrosis. Conclusion: Hypospadias surgery is still challenging due to being associated with certain complications. As one single surgery does not yield good results for any hypospadias, these patients should be managed with specific operations selected according to the patient.

Keywords:

Hypospadias, complication, children, surgery,

PDF

___

1. Thapa B, Pun M. Snodgrass tubularized incised plate urethroplasty for distal and midpenile hypospadias. J Nepal Paediatr Soc. 2014;34:1
2. Saiad MO. The Modified Multilayer Coverage of Urethroplasty for Distal Hypospadias. Journal of Indian Association of Pediatric Surgeons. 2018;23(3):140-43. doi:10.4103/jiaps.JIAPS_164_17
3. Appeadu-Mensah W, Hesse AA, Glover-Addy H, OseiNketiah S, Etwire V, Sarpong PA. Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country. Afr J Paediatr Surg. 2015 Oct-Dec; 12(4): 211–16
4. Baskin LS, Ebbers MB. Hypospadias: Anatomy, etiology, and technique. J Pediatr Surg. 2006;41:463–72
5. Shukla AK, Singh AP, Sharma P, Shukla J. Two stages repair of proximal hypospadias: Review of 700 cases. J Indian Assoc Pediatr Surg 2017; 22:158-62
6. Joshi RS, Bachani MK, Uttarwar AM, Ramji JI. The Bracka two-stage repair for severe proximal hypospadias: A single center experience. Journal of Indian Association of Pediatric Surgeons,2015; 20(2): 72
7. Snodgrass W.T. Hypospadias. In: Wein A.J., Kavoussi L.R., Novick A.C., Partin A.W., Peters C.A., editors. CampbellWalsh urology. 10th ed. Elsevier Saunders; Philadelphia: 2012;3502–3536
8. Perlmutter AE, Morabito R, Tarry WF. Impact of patient age on distal hypospadias repair: A surgical perspective. Urology. 2006;68:648–51
9. Snodgrass W, Bush N. TIP hypospadias repair: A pediatric urology indicator operation. J Pediatr Urol. 2016;12:11–8
10.Snodgrass W. Tubularized, incised plate urethroplasty for distal hypospadias. J Urol. 1994;151:464–5
11.Dhua AK, Aggarwal SK, Sinha S, Ratan SK. Soft tissue covers in hypospadias surgery: Is Tunica vaginalis better than dartos flap J Indian AssocPediatr Surg. 2012;17:16-9
12.Snodgrass WT, Nguyen MT. Current technique of tubularized incised plate hypospadias repair. Urology 2002;60:157-62
13.Bracka A. A versatile two-stage hypospadias repair. Br J Plast Surg. 1995;48:345–52
14.Snodgrass W, Bush N. Recent advances in understanding /management of hypospadias. 2014;6
15.Omar RG, Khalil MM, Sherif H, Elezaby H. Pedicled preputial island flap for double functions in hypospadias surgery. Turkish journal of urology. 2018;1
16.Snodgrass WT, Bush N, Cost N. Tubularized incised plate hypospadias repair for distal hypospadias. J Pediatr Urol. 2010;6:408–13
17.Duckett JW. MAGPI (meatoplasty and glanuloplasty): a procedure for subcoronal hypospadias. The Urologic clinics of North America,1981;8(3): 513-19
18.Kadian YS, Singh M, Rattan KN. The role of tunica vaginalis flap in staged repair of hypospadias. Asian journal of urology 2017;4(2): 107-10
19.Bracka A. Hypospadias repair: The two-stage alternative. Br J Urol. 1995;76(Suppl 3):31–41
20.Snodgrass W, Bush N. Primary hypospadias repair techniques: A review of the evidence Urol Ann. 2016 OctDec; 8(4): 403–08
21.Braga LH, Lorenzo AJ, Salle JL. Tubularized incised plate urethroplasty for distal hypospadias: A literature review. Indian J Urol. 2008;24:219–25
22.Snow BW, Cartwright PC, Unger K. Tunica vaginalis blanket wrap to prevent urethra-cutaneous fistulas an eight year experience. J Urol. 1995;153:472–3