engleski

Experience in hypospadias surgery at the Department of Urology of University Hospital Osijek: A ten-year review

Introduction & objectives: Hypospadias are one of the most common congenital anomalies in industrialized countries, with incidence of 1 in 125 male births. Currently, the only treatment of hypospadias is surgery and its purpose is not only to produce a good cosmetic appearance or positive psychological effect, but to reduce the risk of infertility in severe forms of hypospadias. The aim of this retrospective study was to present our results of hypospadia repair, with emphasis on operative technique, timing of surgery and complication rate. Material & methods: From 1997 to 2007 we performed 94 primary hypospadias repairs. Median patient age at first hypospadia surgery was 6 years (range 2 to 15). The location of the urethral meatus was glanular in 49 patients (52%), subcoronal in 38 (40%), distal penile in 1, mid-penile in 1 and penoscrotal in 3 patients. One patient had hypospadia sine hypospadia and the urethral meatus remained undetermined in one patient. Of techniques Meatal Advancement and Glanuloplasty (MAGPI) and Mathieu repair were most commonly used, with 48 and 37 procedures, respectively. Three patients with penoscrotal hypospadia underwent two-stage urethroplasty using a buccal mucosa inlay graft. Results: Out of 94 operated patients 78 (83%) had excellent results and were released to house care after 2 to 7 days. Complications were noted in 16 patients, including fistula in 12 patients (13%), hematoma and/or oedema in 2 and other complications in 2 patients. The majority of fistulas occurred after Mathieu repair and were subsequently treated, with good results after single reoperation. Two patients had to undergo up to 4 reoperations due to recurrence of fistula. For MAGPI procedure there was only one fistula (complication rate 2%). Conclusions: Although the diagnosis of hypospadias should usually be made at birth and treatment optimally performed between 6 to 18 months of age, our data suggest that the majority of hypospadias are diagnosed at pre-school physical examination. Such delay may be due to poor education of the parents. However, complication rate found in this study was similar to previously publicized data. Combining our experience in MAGPI and Mathieu procedures with education of population will result in further decrease of complication rate after hypospadias surgery.

hypospadia; surgery; experience

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