The key for assessing the outcome of hypospadias repair is a long-term;
continuous follow-up. We report our 20-year experience of hypospadias repairs carrying by one
surgeon. From January 1986 to December 2005; 235 patients with hypospadias underwent
surgical correction by one surgeon. We analyzed the changing patterns and complications of our
major procedures. During the first 10 years; a total of 99 hypospadias repairs (27 for anterior
type; 72 mid or posterior type) were performed; 8 meatal advancement and glanuloplasties
(MAGPI); 8 Mathieues; 5 meatal advancements; 4 pyramids; and 2 onlay island flaps (OIF) for
anterior type; 31 transverse preputial island flaps (TPIF); 18 OIFs; 17 staged repairs; and 6
Thiersch-Duplays for mid or posterior type. During the latter 10 years; a total of 136 repairs (70
for anterior type; 66 for mid or posterior type) were performed; 24 meatal advancements; 22
tubularized incised plate (TIP); 15 MAGPIs; 4 pyramids; 2 OIFs; 2 Kings; and 1 Mathieu for
anterior type; 32 OIFs; 18 staged repairs; 10 TIPs; and 6 TPIFs for mid or posterior type.
Complication rates were 37.8% in TPIFs; 24.1% in OIFs; 20.0% in staged repairs; and 9.4% in
TIPs. In mid and posterior type with severe ventral curvature; the rates of redo operation due to
residual or recurrent curvature were 2.9% in staged repairs and 24.9% in TPIFs. Urethral plate
preserving procedure have extended its application into posterior hypospadias. TIP showed best
results
in correcting essentially all anterior and many posterior hypospadias. For posterior
hypospadias with fibrotic chordee; staged repair resulted in better outcome compared to TPIFs in
our hand. |
PDF Links
Full text via DOI
Download Citation
