The Success Level of Hypospadias Repair in Adults

Ullah, Sami; Karimi, Sundas; Khan, Haroon Sabir; Farooque, Umar; Cheema, Omer; Kumari, Priyanka; Girdhari, Komal; Kumar, Naresh; Sheikh, Fahad N; Basham, Maleeha Ali; Yasmin, Farah; Farooque, Rizwan

doi:10.7759/cureus.9108

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…The literature on adult hypospadiology is scarce. Al Taweel et al [ 14 ] reported a 71% success rate in their series of primary hypospadias after the first surgery, while in a study by Adayener et al [ 18 ], the success rate was 91.3% for primary adult cases and was comparatively higher to a similar series of hypospadias repair by Ullah et al [ 19 ], who reported successful outcomes in 52 (69.33%) patients. Hemant et al reported a success rate of 63.16% in primary adult hypospadias cases [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Patient Perspectives and Outcomes in Adult Hypospadias Repair

Arya,

Singh,

Moharjal

et al. 2023

Cureus

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BackgroundHypospadias is a common congenital anomaly that needs repair at an early age (six months to one year). Ironically, many cases in India present late due to a lack of healthcare facilities, poverty, and illiteracy. Adult patients are different from children as they are aware of their genitalia. They are concerned with the aesthetics and, predominantly, the potency. In this study, we present the perspectives and outcomes of 111 adult cases of hypospadias. MethodologyIn this retrospective study conducted between January 2010 and December 2020, 111 patients aged more than 14 years who were diagnosed with hypospadias of any level with or without mild-to-moderate chordee were included. Hypospadias repair using a tubularized incised plate (TIP) urethroplasty technique was performed, and patients after surgery were followed up at three months, six months, and 12 months for any complications with physical examination, uroflowmetry, and patient-related outcomes (PROs). ResultsAge varied from 14 years to 32 years (mean = 19.88 years, SD = 5.93). The most frequent meatus positions after chordee adjustment were distal (n = 64, 57.65%), middle (n = 25, 22.52%), and proximal (n = 22, 19.82%). Among these, four patients had penoscrotal transposition. Chordee was present in 65.7% (n = 73) of the cases. (<30° in 38.7%, n = 43; 30°-60° in 23.4%, n = 26, and >60° in 3.6%, n = 4). Chordee was corrected using many techniques, including ventral corporotomies. Urethroplasty was done using TIP and spongioplasty in 89% (n = 99), and one patient underwent inner preputial onlay flap urethroplasty. Snodgraft was used to augment the urethral plate in 10 cases. The success rate of one-stage surgery was 74.77% in our series, which significantly correlated with PROs. Uroflow varied from 12 mL/second to 18 mL/second, and in the majority of the cases, the flow rate improved over time. The most common complication was urethrocutaneous fistula in 11 (11.8%) patients, followed by glanular dehiscence in nine (8.1%) patients. ConclusionsAdult patients undergoing primary hypospadias repair generally show good outcomes. Patients can have an acceptable mild degree of residual chordee and torsion, which correlate well with PROs. In our series, hypospadias fistula was the most common complication of hypospadias surgery, followed by glanular dehiscence.

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Section: Discussionmentioning

confidence: 99%

Patient Perspectives and Outcomes in Adult Hypospadias Repair

Arya,

Singh,

Moharjal

et al. 2023

Cureus

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“…Patients who have not been circumcised is one of the causes of diagnosis at that age because hypospadias will be clearly visible during circumcision or after the prepuce is retracted. 9 The incidence of hypospadias accompanied by congenital abnormalities undesensus testiculorum (UDT) in Dr. Moewardi General Hospital was 10.7% (Table 3). This finding is consistent with Chen et al's study in 89 subjects where the three most common anomalies associated with hypospadias were inguinal hernia (12.4%), cryptorchidism (9%), and low birth weight prematurity (7.9%).…”

Section: Discussionmentioning

confidence: 99%

Profile of hypospadias patients at Dr. Moewardi General Hospital Surakarta period 2015-2020

Hariyono

Wibisono²

2022

Int Surg J

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Background: Hypospadias is the second most common congenital malformation in males and the most common congenital malformation of the penis. This malformation is characterized by the anatomical position of the urinary tract opening on the ventral or anterior part of the penis. The prevalence of hypospadias in western countries around 8 of 1000 live births and is reported to increase every year.Methods: This study is a descriptive study with a retrospective cross-sectional approach. All data were retrieved from RSUD Dr. Moewardi Surakarta using hypospadias patients medical records from January 2015 – December 2020. The hypospadias case were classified into mild, moderate, and severe hypospadia based on location. The age of being diagnosed, concomitant congenital disease, surgery technique, and surgical complication were described.Results: There were 120 cases of hypospadias, consisted of 47.5% severe hypospadias, 34.9% moderate hypospadias and 17.4% mild hypospadias. Patients’ age of being diagnosed was most in the 1-5 years group (35.9%). Seventy-eight (75.7%) cases without concomitant congenital disease, 10.7% with undecensus testiculorum, 4.8% with cyanotic congenital disease, and 3.8% with cloacal. There were 68.9% cases repaired with first-stage surgical technique and 31.1% repaired with two-stage surgical technique. Most surgical complications were meatal stenosis 9%.Conclusions: Majority of hypospadias cases were severe hypospadia. Other profile like age of being diagnosed, concomitant congenital disease, surgery technique, and surgical complication were found in this study.

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“…They think this is because the tissue quality is low, and the insufficient vascular supply is seen in adulthood. In addition, some studies emphasize, genital secretions, nocturnal erection negatively affect adult hypospadias surgery (Dodson et al, 2007; Ullah et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Adult distal hypospadias repair is safe and easy

Şahin¹,

Yeşildal²

2022

Andrologia

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Hypospadias is a congenital disease, and its incidence is 0.5%.Hypospadias is defined as opening the urethral meatus more proximally than where it should be opened (Sheldon & Duckett, 1987). The definition and treatment of the disease date back to ancient Greek.Hypo means under, and spadon means fissure in Greek (Baskin, 2000;Duckett, 1996). Hypospadias is classified according to their location. Distal hypospadias is more common. The incidence of proximal ones is less, and they are more complicated cases (Duckett, 1989). Factors affecting the aetiology are still unknown. Advanced maternal and paternal age, drug use during pregnancy and high maternal alcohol consumption are blamed (Carmichael et al., 2012;Xu et al., 2014). A familial predisposition has been reported at a rate of 4%-10%. In addition, nearly 200 syndromes have been associated with hypospadias (Calzolari et al., 1986;Kavoussi & Wein, 2011). The aim of hypospadias surgery is cosmetically gaining the normal penis. To ensure the ability to urinate while standing and also to contribute to fertility. Successful surgery will bring psychosocial and physical well-being (Bracka, 1999;Gul et al., 2021;Rynja et al., 2011). In choosing the surgical technique, there are too many parameters. Whether the case is either primary or secondary, the degree of the hypospadias, the experience and the surgeon's preference are decisive (Eassa et al., 2011;Korvald & Stubberud, 2008;Perlmutter et al., 2006;Snodgrass et al., 2014). The success level of hypospadias repair in adults still needs to be established on a more extensive scaled study. Therefore, we conducted this study to document the success level of hypospadias repair in adults. This study presents the results of 620 adult distal hypospadias patients treated with TIPU operation. | MATERIAL AND ME THODA retrospective study was performed for adult patients who underwent TIPU operations from February 2016 to September 2020.Patients who had distal hypospadias after the age of 16 were included in our study. Those who had previous surgery and comorbid diseases were excluded from the study. Consequently, 620 patients operated by a single surgeon's data were evaluated.The cases operated in general or regional anaesthesia according to the preference of the patients and the anaesthesiologist. In the anamnesis, chordee was questioned. If so, an artificial erection was done at the beginning of the operation.

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The Success Level of Hypospadias Repair in Adults

Abstract: Open Access Original Article

Cited by 3 publications

References 16 publications

Patient Perspectives and Outcomes in Adult Hypospadias Repair

Patient Perspectives and Outcomes in Adult Hypospadias Repair

Profile of hypospadias patients at Dr. Moewardi General Hospital Surakarta period 2015-2020

Adult distal hypospadias repair is safe and easy

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