Distal Hypospadias Repair in Adults: The Results of 97 Cases

Abstract

Introduction: We reviewed our 9-year experience on 97 men with distal hypospadias who had undergone hypospadias surgeries. Subjects and Methods: Patients were divided into two groups: group 1 included 17 men who had one or more unsuccessful surgeries in their childhood, and group 2 included 80 men with no previous hypospadias repairs. Meatal positions were glanular in 6, coronal in 35 and subcoronal in 56 patients. Our 97 hypospadias surgeries involved 42 meatal advancement and glanuloplasty, 41 Mathieu and 14 tubularized incised plate urethroplasty procedures. Results: The overall success rate was 88% (86 of the 97 patients). The success rate was 76.5% for group 1 (13 of the 17 patients) and 91.3% for group 2 (73 of the 80 patients). Better voiding function and good cosmetic appearance was achieved in all patients. Urinary flow rates were significantly higher in all groups postoperatively. The success rates were 91.4 and 85% for the patients with preoperative coronal and subcoronal meatal positions, respectively. The success rate was significantly lower in crippled cases and in cases with longer neourethra. Conclusion: Although the same techniques are used for children and adults in hypospadias surgery, the results in adults differ from those in children. The success rate for primary adult cases is quite acceptable, but it is decreased in patients having longer neourethra and having multiple previous interventions.

Both dorsal and ventral flaps can be used in previously circumcised hypospadic adults with comparable success rates

“…In this highly selected population, the overall success rate in our series seems higher than or similar to most series reported in literature. [5,[7][8][9][10] Senkul et al reported an overall success rate of 89.6% in 88 adult hypospadias patients with various techniques which is similar to ours. [6] Their postoperative complication rate was higher compared to children, and these patients more often required multiple interventions.…”

“…Previous circumcision history is not mentioned in majority. [5][6][7][8][9][10][11]. In our prospective study, all patients underwent primary repair with TIPU by a single surgeon.…”

“…Most of the results in the literature about tubularized incised-plate urethroplasty (TIPU) repair are in preschool age children. Few have addressed the results of adult hypospadias [5][6][7][8][9][10][11].…”

Primary and Reoperative Hypospadias Repair in Adults—Are Results Different than in Children?

“…Adayener and Akyol described 12 men who underwent TIP in a cohort of 80 with a mean age of 22 years with distal hypospadias. 6 The other patients were repaired by meatal advancement and glanuloplasty or the Mathieu technique. In 1 of the 12 men (8%) a fistula developed during followup at a mean of 19 months for a complication rate that was the same as the overall complication rate of 9%.…”

Repair of Adult Hypospadias Under Local Anesthesia: The Technique and Outcomes

“…Experience with hypospadias repair in adults is generally limited in developed countries [7]. However, hypospadias repair is frequently performed during adulthood in developing countries as a result of difficult economic and social conditions [8,9]. Because of the presence of the foreskin and proximity to the meatus to the glans, parents might not consider this situation as a problem.…”