title: Failed hypospadias in paediatric patients.
abstract: Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs ranges from 5-70%, but the actual incidence of failed hypospadias is unknown as complications can become apparent many years after surgery and series with lifelong follow-up data do not exist. Moreover, little is known about uncomplicated repairs that fail in terms of patient satisfaction. Risk factors for complications include factors related to the hypospadias (severity of the condition and characteristics of the urethral plate), the patient (age at surgery, endocrine environment, and wound healing impairment), the surgeon (technique selection and surgeon expertise), and the procedure (technical details and postoperative management). The most important factors for preventing complications are surgeon expertise (number of cases treated per year), interposition of a barrier layer between the urethroplasty and the skin, and postoperative urinary drainage. Major complications associated with failed hypospadias include residual curvature, healing complications (preputial dehiscence, glans dehiscence, fistula formation, and urethral breakdown), urethral obstruction (meatal stenosis, urethral stricture, and functional obstruction), urethral diverticula, hairy urethra, and penile skin deficiency.
authors.affiliation: Section of Paediatric Urology and Paediatric Surgery Unit, Department for Mother and Child Care and Urology, University of Palermo, Via A. Giordano 3, 90127 Palermo, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Cimador
authors.forename: Santiago
authors.initials: S
authors.lastname: Vallasciani
authors.forename: Gianantonio
authors.initials: G
authors.lastname: Manzoni
authors.forename: Waifro
authors.initials: W
authors.lastname: Rigamonti
authors.forename: Enrico
authors.initials: E
authors.lastname: De Grazia
authors.forename: Marco
authors.initials: M
authors.lastname: Castagnetti
mesh_terms: D002648:Child; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D017211:Treatment Failure
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