Outcome of proximal hypospadias repair using three different techniques.
OBJECTIVE
To evaluate the outcome of proximal hypospadias repair using three different techniques.


METHODS
The study involved 194 boys with primary proximal hypospadias. The meatus was proximal penile, penoscrotal, scrotal and perineal in 98, 64, 30 and 2 patients, respectively. Tubularized incised plate (TIP) urethroplasty, onlay island flap (OIF) urethroplasty and two-stage repair were used in 96, 57 and 41 patients, respectively. Preoperative anatomical description and postoperative complications were recorded with evaluation of the final functional and cosmetic outcomes for each technique.


RESULTS
Mean age at presentation was 14.43 months (range 6-31). Mean follow-up after second stage was 32.9 months (range 11-54). Complications were encountered in 27 cases (13.9%) with no statistically significant differences between techniques; however, a significantly higher complication rate was found among patients with scrotal and perineal hypospadias and in patients with associated scrotal lesions. Urethrocutaneous fistula was the most common complication, being encountered in 7.7% of patients with a significantly higher rate among patients with scrotal hypospadias (16.7%).


CONCLUSIONS
Single-stage repair of proximal hypospadias can be successfully performed when plate preservation is possible, while two-stage repair is applicable when plate transection is necessary. Functional and cosmetic outcomes are satisfactory, with no statistically significant advantage with any technique.
Moursy
Essam E
EE
Department of Urology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt. esalem2008@gmail.com
D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008297:Male; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods