Is only meatoplasty a legitimate surgical solution for extreme distal hypospadias? A long-term follow-up after adolescence.
OBJECTIVE
To review the long-term outcome of glanular hypospadias repair for extreme distal hypospadias based on simple dorsal Browne meatoplasty and circumcision, with particular attention to patient satisfaction.


METHODS
A review of medical records identified 124 patients who underwent surgery for hypospadias between 1970 and 1979. Their age at operation ranged from 3 months to 13 years. The operation, performed as a day-case, included dorsal Browne meatoplasty for meatal advancement, based upon the Heineke-Mikulicz principle, using three absorbable sutures and often circumcision. There were no immediate complications. A questionnaire was sent to 111 patients whose present address was available. Two patients had died since the operation and of the 109 remaining patients, 43 (39%) replied.


RESULTS
The patients were aged 16-31 years at the time of assessment, giving a follow-up of 18 (13-23) years. Seven of the 43 patients were married. Seven patients had complained of some difficulties with urination, four reporting a poor urinary flow. The stream was directed forward in 32 patients and to some degree downwards in 11, still enabling all the patients to urinate while standing with a single stream. Thirty-two patients had had sexual experience, with no functional problems. Twenty-three defined their penile appearance as normal and 20 as abnormal. Overall, 24 (56%) reported complete satisfaction, 11 (25%) partial satisfaction and eight (19%) were dissatisfied with the surgical result.


CONCLUSIONS
As there are few published reports about the long-term outcome and patient satisfaction after hypospadias repair, it is difficult to draw clear conclusions. However, this simple procedure is a legitimate surgical option for extremely distal glanular hypospadias.
Mor
Y
Y
Department of Urology, The Chaim-Sheba Medical Center, Tel-Hashomer, Israel.
Ramon
J
J
Jonas
P
P
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D013518:Surgery, Plastic; D014554:Urination / Q000502:physiology