Failed hypospadias repair presenting in adults.
OBJECTIVE
To evaluate the results of one-stage and multistage urethroplasty in adults with complications following multiple failed hypospadias repairs.


METHODS
Sixty adults underwent reconstructive surgery of the following complications after hypospadias repair: stricture (34), residual hypospadias (26), fistula (18), meatal stenosis (11), penile curvature (9), hair (4), diverticula (2), and stone (1). A total of 36% of the patients had one complication and 64% had two or more complications. Twenty-nine patients underwent one-stage repair with buccal or skin grafts or direct repair, and 31 underwent multistage repairs with buccal or skin grafts.


RESULTS
Mean follow-up was 33.8 mo. Of the 60 cases, 45 (75%) had a final successful outcome and 15 (25%) failed. One-stage repair provided 24 (82.7%) successes and 5 (17.3%) failures. Multistage repair provided 21 (67.7%) successes and 10 (32.3%) failures. Buccal mucosa grafts provided 81% of success in one-stage procedures and 82.3% in multistage procedures. Penile skin grafts provided 80% of success in one-stage procedures and 50% in multistage procedures.


CONCLUSIONS
Adults with complications following childhood hypospadias repair are still a difficult population to treat with a high failure rate for reoperative surgery.
Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
Guido
G
Barbagli
Michele
M
De Angelis
Enzo
E
Palminteri
Massimo
M
Lazzeri
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation; D017211:Treatment Failure; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects*