Study of Hypospadias in a Tertiary Care Hospital in Coastal Andhra Pradesh

Abstract

BACKGROUND Hypospadias is the commonest paediatric urological condition with an incidence of 1 in 125 male children. The condition can be easily recognized by the attending neonatologist/ paediatrician in the neonatal period. The ideal time for urethral reconstruction is at one year of age and all the staged repairs are to be completed by the time the child goes to school. METHODS We wanted to study the clinical features and outcome of hypospadias cases in the paediatric age group. Children with hypospadias in the age group of 1-10 years are taken up for the study. 51 children were admitted for hypospadias repair with Proximal as well as Distal hypospadias. They were surgically reconstructed with time tested procedures. These children are observed and are on regular follow up for 6 months in the post-operative period. RESULTS 46 new and 5 redo hypospadias repairs were done from January 2017 to August 2018 with 6 months post-operative follow up till February 2019. Satisfactory surgical outcome was achieved with an acceptable complication rate of 9 percent and 20 percent for fresh and redo hypospadias cases respectively.

Comparative Study of Sondgrass and Bracka’s Surgical Techniques for Hypospodias Repair

“…Urethrocutaneous fistula was 4.0% in Snodgrass surgical technique, where as 8.0% in Bracka's technique. The prevalence of fistula in this study was in line with the findings reported by Hashish et al and Poondla et al (7,15) Whereas, studies by Shah et. al.…”

“…On pre-operative examination, 52% patients had coronal meatal position, 21% had sub-coronal and 18% had distal penile. While over two-third (75.0%) don't underwent circumcision these is similar to the results reported by Poondla et al and Hashish MS et al (7,15) In every surgery, the duration of the surgery is an important component that may vary from technique to technique and expertise to expertise of surgeon. As far as concern with the duration of surgery, there was a statistically significant difference (p<0.05) was observed between the two used surgical techniques, with the longer duration (79.7±15.6 minutes) in Snodgrass approach compared with the Bracka's technique (66.1±7.23 minutes).…”

“…(13) A number of complications like urethra-cutaneous fistula and even the complete breakdown of neo-urethra may develop after hypospadias repair surgery even by the most experienced surgeons. (15) This study was conducted with an aim to compare the outcomes of anterior urethral advancement and TIP (Snodgrass) The present study demonstrated that there was no significant difference between the age groups of both group participants. In contrary of our study findings, Badr et al reported a significant difference between the studied groups as regard to age.…”