Iatrogenic hypospadias--a preventable injury?
Iatrogenic hypospadias is a preventable injury to the ventral male urethra produced by the downward pressure of an indwelling urethral catheter. In spite of avoiding long-term urethral catheterisation, we have acquired 16 patients with this injury in the last 9 years either in our unit or discovered in patients referred to our unit. Although not a life endangering complication, the majority of such patients find the penile appearance so produced unacceptable. We have reconstructed any penis that has more than meatal cleavage in a total of six patients, with good results. The majority of patients have been fully investigated so that an alternative therapy to catheterisation may be provided. Where possible a catheter free state has been achieved. If not, a suprapubic catheter has been inserted. Those not reconstructed were due to reasons of ill health, and in two instances, due to patient choice.
Andrews
H O
HO
Institute of Urology and Nephrology, London, UK.
Nauth-Misir
R
R
Shah
P J
PJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D007021:Hypospadias / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery*; D007049:Iatrogenic Disease / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000473:pathology / Q000601:surgery*; D014546:Urinary Catheterization / Q000009:adverse effects*