Late surgical correction of hypospadias increases the risk of complications: a series of 501 consecutive patients

Abstract

ObjectivesTo evaluate the outcomes of hypospadias surgery according to age and to determine if some complications are agerelated. Patients and MethodsThis retrospective study was based on 722 boys with hypospadias undergoing primary repair. A total of 501 boys underwent urethroplasty and were included in the study. Complications requiring an additional procedure (stenosis, fistula, dehiscence, relapse of curvature, urethrocele) were included in the analysis, as well as healing problems, infections, haematomas and detrusor-sphincter dyssynergy. Logistic regression analysis was performed. ResultsHypospadias was anterior in 63.1%, mid-penile in 20.5%, posterior in 8.4% and scrotal in 7.9% of the boys. The median (range) age was 4 (1-16) years. The overall rates of re-intervention and complications were 22.8% and 36.2%, respectively. Age >2 years was a significant predictor of complications (P = 0.002, odds ratio 1.98 [95% confidence interval 1.26-3.13]). Some periods of time appeared to be associated with a specific complication: dyssynergy was more common between the ages of 24 and 36 months (12.5 vs 3.6%; P = 0.01) and healing problemswere more common in boys aged >13 years (1.5 vs 28.5%; P = 0.06).

Long term complications of hypospadias repair: A ten-year experience from Northern Zone of Tanzania.

“…However, the nding is different from the study done in France where by the prevalence was 36.2% and UCF accounted for 12.9%, meatal stenosis 8.2% and relapse of chordee was 4.5% (9) . Our gures in the current study are higher probably because we do not use magnifying glasses in these delicate surgeries and therefore predisposes to higher complication rates.…”

“…Age below two years had 26% and that of more than two years had 41% long-term complication, this is due to easibility of post-operative management and lower psychological impacts with better healing process in children below two years (9) .…”

“…There are many risk factors for long term complication of hypospadias repair, such as severity of hypospadias, location of hypospadias, surgical repair technique, age at operation, preoperative hormonal therapy, dressing technique and type of suture material (9) . At our Centre we perform one to two hypospadias surgery per month, some of them develop various complications.…”

<p>Long-Term Complications of Hypospadias Repair: A Ten-Year Experience from Northern Zone of Tanzania</p>

“…This is most likely due to feasibility of post-operative management and lower psychological impacts with better healing process in children below 2 years. 3,7…”

“…As a result, long-term complications of hypospadias repair are reported in 30% of these operations globally. [4][5][6][7][8] There are many risk factors for long-term complications of hypospadias repair, such as severity of hypospadias, location of hypospadias, surgical repair technique, age at operation, preoperative hormonal therapy, dressing technique and type of suture material. 7 At our Centre we perform one to two hypospadias operations per month, and some of them develop various complications.…”