title: Outcome of hypospadias repair in toilet-trained children and adolescents.
abstract: OBJECTIVE
  To review a leading causes and surgical outcome of hypospadias repair in toilet-trained children and adolescents in our department.
  
  
  METHODS
  Over the period from 1987 to 2010, 84 toilet-trained children and adolescents with a median age of 13 years (range 4-18) underwent hypospadias repair. Voiding symptoms were a cause for referral in 31(36%) patients, difficulties in self-appraisal or patient desire in 49(55.7%) and 4(4.8%) patients with DSD underwent male genitoplasty as a part of sex reassignment. Of those 43(51.2%) had glanular hypospadias, 36(42.9%) distal and 5(5.9%) had proximal type of hypospadias. Meatoplasty was performed in 18(21.4%) patients, MAGPI in 24(28.6%), Mathieu flip-flap in 20(23.8%), preputial pedicled flap as onlay in 2(2.4%) and as tubularized in 2(2.4%) patients, and TIP procedure was done in 16(19%). Two (2.4%) patients required two stage repair.
  
  
  RESULTS
  Twenty-three (27.4%) developed surgery-related complications such as meatal stenosis in 3(15.5%), breakdown of primary repair in 7(8.3%), and urethral fistula in 13(15.5%) patients, respectively.
  
  
  CONCLUSIONS
  There are clear differences in terms of complications rate and overall success compared with the repair in the earlier ages.
authors.affiliation: Department of Pediatric Urology, Faculty of Medical Science, Shaare Zedek Medical Center, Hebrew University, 91031, P.O.B. 3235, Jerusalem, Israel.
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kocherov
authors.forename: Dan
authors.initials: D
authors.lastname: Prat
authors.forename: Dmitry
authors.initials: D
authors.lastname: Koulikov
authors.forename: Alexander
authors.initials: A
authors.lastname: Ioscovich
authors.forename: Ofer Z
authors.initials: OZ
authors.lastname: Shenfeld
authors.forename: Amicur
authors.initials: A
authors.lastname: Farkas
authors.forename: Boris
authors.initials: B
authors.lastname: Chertin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D014039:Toilet Training; D016896:Treatment Outcome