Unsuccessful Hypospadias Repair in Children: An Analysis of Possible Predictive Factors
Abstract:
Background: Functional and cosmetic benefits are the reasons for the surgical repair of hypospadias. However, this can be challenging to the surgeon and the repair is fraught with complications. The aim of this study was to evaluate children who developed complications following primary hypospadias repair.
Materials and Methods: This was a retrospective analysis of children who had primary hypospadias repair, over a 5-year period, at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. The information analyzed included the patients’ age (in months) at surgery, type of hypospadias based on location of the meatus, state of the prepuce (circumcised/uncircumcised), method of urethroplasty, post-operative complications, outcome of treatment and possible predictive factors. The possible predictive factors evaluated included experience of the surgeon, location of the hypospadiac meatus and state of the prepuce.
Results: A total of 39 cases of hypospadias were repaired during the study period. Out of this number, 8 (20.5%) patients developed one complication or the other. The mean age of the patients at surgery was 24 months. Coronal hypospadias was the most common type of hypospadias in the patients. About half the patients were circumcised at presentation and tubularized incised plate was the most common method of urethroplasty. One-fifth of the patients developed complications postoperatively with urethrocutaneous fistula as the most common complication.
Conclusion: Hypospadias repair is a time and energy consuming task that confounds and humbles the surgeon. Some predictive factors such as experience of the surgeon, location of the hypospadiac meatus and circumcision may be predictive of unsuccessful hypospadias repair.
