[Complications in hypospadias repair: 20 years of experience].
We report a comparative study of the complications in hypospadias repair of 1185 patients treated in our hospital in the last 20 years. They are divided in three well-defined groups: from 1974 to 1981 (265 p.); from 1982 to 1986 (281 p.) and from 1987 to 1993 (624 p.). These were the more frequent complications seen: a) Early as cutaneous necrosis, a severe complication that had an incidence of 3% in the first period. In the second and third period this percentage diminished to 1.9% and 1.1%, respectively. Only one patient developed a total necrosis of the cutaneous island flap that required a new urethroplasty. b) Late: Persistent chordee. It was present in 10% of the children in the first period and it was secondary to an inadequate release of the chordee and cutaneous necrosis. The incidence of the second period was 3.5% and only 2% of patients of the third group suffered it because of a non appropriate selection of the surgical technique. Fistula. It was the most common complication and it was present in 18%, 10% and 7.3% of the patients of each period. We think that the introduction of the cutaneous island flap procedure helped to the improvement in the rate of fistulas. Urethral structure. The incidence was 12% in the first period, 6.5% in the second one and it fall down to 4.4% in the third group due to the triangular flap of the glans. Megaurethra. The incidence was of 6.8% in the first period, 6.5% in the second one and only the 2.9% in the last years.(ABSTRACT TRUNCATED AT 250 WORDS)
Castañón García-Alix
M
M
Unidad Integrada Hospital Sant Joan de Déu-Hospital Clínic, Barcelona.
Martín Hortigüela
M E
ME
Rodó Salas
J
J
Morales Fochs
L
L
D002648:Child; D002675:Child, Preschool; D005402:Fistula / Q000209:etiology; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D009336:Necrosis / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities / Q000601:surgery*
Complicaciones de los hipospadias y su tratamiento: veinte años de experiencia.