Retrospective Descriptive Analysis of 1,176 Patients With Failed Hypospadias Repair (original) (raw)
Related papers
Urethroplasty for failed hypospadias repair: A matched cohort analysis
Journal of Pediatric Urology, 2011
To determine the outcome of urethroplasty for failed hypospadias repair and to compare this with a matched cohort of patients treated with urethroplasty for other reasons. Patients and methods: Between January 2000 and August 2007, 25 patients with a failed hypospadias repair were treated with urethroplasty (A). This cohort of patients was matched with a cohort of 25 patients who underwent urethroplasty for other reasons (B). The patients were matched for stricture location, stricture length, duration of follow up and type of urethroplasty. The outcomes were analysed and compared. A P-value < 0.05 was considered statistically significant. Results: There were no significant differences between the two cohorts in stricture location, stricture length, follow up and previous interventions. Patients in cohort A however were significantly younger. The surgical technique used was exactly the same in A and B. Failure was observed in 7 patients (28%) in A compared to 4 patients (16%) in B (P Z 0.45). Conclusions: Although a higher failure rate was observed after failed hypospadias repair, this is not proof of a worse outcome for urethroplasty after failed hypospadias repair due to the lack of statistical significance.
Which type of urethroplasty in failed hypospadias repair? An 8-year follow up
Journal of Pediatric Urology, 2013
To report our 8-year follow up for redo hypospadias repair. Methods: A total of 56 patients with previous failed hypospadias repair were included in our study. Patients' data were analyzed regarding age, number of previous repairs, meatal location, procedure performed, operative time and complications. Patients were followed up for 3 to 102 (mean 52) months. Results: Patient age ranged from 15 to 204 (mean 90.7) months. Forty-two patients had a single previous hypospadias repair, eleven had two previous repairs and three had four previous repairs. Of the 56 patients, 16 underwent oral mucosal graft urethroplasty, 15 onlay island flap, 14 parameatal flap, 10 tubularized incised plate urethroplasty, and 1 tubularized preputial flap. Complications were encountered in 16 (28.5%) patients in the form of graft contracture in 3, meatal stenosis in 2, urethral stricture in 2 including the patient with tubularized flap, urethra-cutaneous fistula in 7, bleeding in 1 and skin disruption in 1. The final complication rate was 25%. Conclusions: Decision making in redo hypospadias surgery depends mainly on local tissue availability and the degree of tissue scarring. The characteristics of oral mucosal graft make it suitable for urethroplasty in the absence of local donor tissues. A long-term follow up for redo hypospadias repair is required to assess the late neourethral stricture and residual penile curvature.
Surgical Challenge in Patients Who Underwent Failed Hypospadias Repair: Is It Time to Change?
Urologia Internationalis, 2010
Prof. Sava Perovic was a shining example of a scientist and surgeon. He was a master of life who always urged his pupils to do better and to reach excellence, within the parameters he set as a very humane and compassionate person. As a surgeon he was innovative indeed, he was one of the pioneers of reconstructive urological surgery in both adults and children. He developed multiple surgical procedures that are used today all over the world. I had the pleasure and privilege to work with him in Perugia and Belgrade and what I remember most about him was the enormous enthusiasm and passion he put into his work every day and the great energy he emanated that involved every person that was cooperating with him. With his demise we have lost a great surgeon, an innovator, a teacher and a sincere friend.
2020
Introduction: Surgical management for the severe proximal hypospadias remains controversial and it might be challenging. In this study, we evaluated the surgical outcome of patients with proximal hypospadias managed by two staged repair with dorsal prepucial flaps. Methods: Forty one boys with proximal hypospadias are enrolled between January 2006 and September 2016. The location of the urethral meatus was at the penoscrotal junction (PSH), at the scrotum (SH) or at the perineum (PRH). First stage; chordee was released and the prepucial flaps were constructed. Second stage; urethroplasty was performed according to Thiersch-Duplay principle. We assessed postoperative complication rates and utilized Hypospadias Objective Penile Evaluation (HOPE) scoring to evaluate the cosmetic outcome. Results: There are a total of 41 boys (31 PSH (%76), 3 SH (%7) and 7 PRH (%17). The mean age at first operation was 15±5.3 months. The mean interval between the stages of the surgical procedures was 10.1±4.9 months. Sixteen patients had various enzyme deficiency or dysgenesis. In two patients, diverticulum is developed after the repair. stenosis has encountered in 10 patients and fistula in 5. Two patients had dehiscence at glanular level. Relation did not demonstrated between the severity of hypospadias and development of fistula, stricture and diverticulum (p>0.05). HOPE scores; 9.4 for the position of the meatus, 5.8 for shape of the meatus, 7.2 for shape of the glans penis, 9.3 for penile torsion and 9.8 penile curvature. Discussion and Conclusion: Incorporating the dorsal prepucial skin flaps in staged procedures has both satisfactory cosmetic and functional success rates.
Comparative Study of Snodgrass and Mathieu’s Procedure for Primary Hypospadias Repair
ISRN Urology, 2014
Objective. Present study was undertaken to compare the results of two single stage hypospadias repairs, namely, Tubularized Incised Plate (TIP) repair and Mathieu’s repair.Methods. The study included 100 patients of distal penile hypospadias, from January, 2008 to January, 2013. After a detailed history, local examination was performed with reference to the site of meatus, shape of glans, and presence of chordee. TIP repair was performed in 52 patients and Mathieu’s repair in 48 patients. On follow-up, the patients were examined for the position of meatus, shape of meatus, urinary stream, urethrocutaneous fistula, and stricture formation.Results. The mean age of presentation was 6.2 ± 3.2 years (range 1.5–15years). The mean operative time was 63.7 ± 14.3 (45–90) minutes and 95.0 ± 19.1 (70–125) minutes in TIP and Mathieu’s repair, respectively.Complications after surgery were urethero cutaneous fistula in 3(5.76%) and 7 (14.5%), meatal stenosis in 3(5.33%) and 4(8.33%), wound infect...
Outcomes of Hypospadias Repair Based on Surgical Techniques: A 4-Year Retrospective Study
Research and reports in urology, 2024
This study aimed to report the outcomes of hypospadias repair performed at a tertiary-level hospital during 2018 to 2021. Methods: A retrospective chart review of 119 patients was performed. Results: The most frequent coronal hypospadias cases were distal. However, the most common scrotal hypospadias cases were proximal. The average age at the time of the first surgery was 2.4 years (standard deviation, ±2.3 years). The tubularised incised plate technique was performed for 57 of these 119 patients. Urethral fistula was the most common complication associated with distal and proximal cases (23.96% and 30.43%, respectively). No significant correlation was observed between any complication and the surgical technique. Based on the logistic regression model, the duration of urethral stenting was statistically significant (p=0.025), indicating that a urinary catheter duration of more than 5 days resulted in a 2.9-times increased risk of postoperative urethral fistula. Conclusion: Prolonged urethral stenting for more than 5 days may result in subsequent urethral fistula development. Neither the severity of hypospadias nor the surgical technique seems to affect postoperative complications.
COMPARATIVE STUDY OF TWO DIFFERENT PROCEDURES FOR PRIMARY HYPOSPADIAS REPAIR.
Background: Different modalities of procedures for hypospadial repair have been described in the literature. Data about the outcome of two main different procedure of repair are scares from Iraq. The aim of this study is to compare the results of these two methods of hypospadias repairs. The present study compared two single stage hypospadias repairs, namely, tubularized incised plate (Snodgrass) repair and Mathieu?s repair. Methods: It involved 50 patients diagnosed with penile hypospadias, from March 2011 to April 2015 at the Department of Surgery, Al-Karama Teaching Hospital. After a detailed history, local examination was performed with reference to the site of meatus, shape of glans, and presence of chordee, patients were randomly assigned as Group A of 26 patients in whom Snodgrass repair was accomplished and Group B having 24 patients in whom Mathieu?s repair was performed. On follow-up, the patients were examined for the position of meatus, shape of meatus, urinary stream, urethra-cutaneous fistula, and stricture formation. Results: The results showed that the mean age of presentation was 7?6 years (range 1-13years). The mean operative time was 90?15 (75-105) minutes and 60?15 (45-75) minutes in Snodgrass and Mathieu?s repair respectively. Complications after surgery were urethero-cutaneous fistula in 2(7.69%) and 4 (16.67%), meatal stenosis in 1(3.84%) and 2(8.33%), wound infection in 4(15.38%) and 3(12.5%) cases in Snodgrass repair and Mathieu repair, respectively, wound dehiscence was equal in Snodgrass repair and Mathieu repair. Conclusions: It can be concluded that the cosmetic results were excellent with Snodgrass repair with a normal looking slit like meatus.