A single center experience of Hypospadias Repair in Dar es Salaam, Tanzania

Abstract

Background: Hypospadias is one of the common congenital anomaly that affects children. It can present classically with abnormal ventral opening, chordee and dorsal hood however isolate hypospadias do also exist. Hypospadias repair is one of the commonly performed surgical procedures at Muhimbili National Hospital (MNH) and the outcome of repair is influenced by several factors. Our study aimed to assess the Profile and Early Outcome of Hypospadias repair at Muhimbili National Hospital. Methodology: This was a cross sectional study which involved all children with hypospadias aged ≥6 months and underwent first repair recruited by convenient sampling at Muhimbili national Hospital from March 2018 to January 2019 with a follow up of 30 days from surgery. We excluded children who had Repair before, those who underwent hypospadias repair and died within 24 hours post-operative. Mothers of each participating patient gave an informed consent. Data were collected by a standardized questionnaire and analyzed by using SPSS program version 20. Results: Sixty-three children were enrolled in the study with mean age of 3.7 years. Majority of our patient had Subcorona hypospadias with Snodgrass tubularized incised plate urethroplasty being the common surgical technique. Thirty-seven (58.7%) patients had successful hypospadias repair while 26(41.3%) had complications. The most commonly found early complications were surgical site infection, hematoma, oedema, flap necrosis, urethrocutenous fistula, urethral stricture, wound dehiscent and meatal stenosis. Age>3.5 years at repair, previous circumcised, type and duration of urine drainage< 7 days, type of dressing and changing the 1st dressing < 3 days were found to influence complications rate. Conclusion: Hypospadias is still the common pediatric urological condition with Snodgrass technique being preferred for repair. The outcome of the repair can be influence by different factors regardless of the technique of repair.

Factors associated with clinically apparent congenital urethra anomalies among pediatric patients attending Muhimbili National Hospital, Dar Es Salaam, Tanzania

“…Interestingly, one descriptive study in Tanzania reported distal hypospadias in general as the commonest type of hypospadias different from the index study; however, their classification was generalized as proximal, mid-shaft, and distal [9]. Nyongole et al reported 33.3% occurrence rate of sub-coronal type among 63 patients with hypospadias at the same settings which nearly the same as in this study [15]. A study in Israel found anterior and mid-shaft hypospadias being the common type among 163 hypospadias patients almost similar to the findings in this study [16].…”

“…The finding is slightly lower with Friedman et al with regard to urogenital-associated anomalies that were such anomalies accounted for 20.6% of associated anomalies with undescended testis and micro-penis being the commonest occurring by 3.7% each [16]. Similarly, Nyongole reports undescended testis as the only associated anomaly by 3.2% among patients with hypospadias; however, his study involved 63 patients about two-third of hypospadias patients in this study [15]. Similar findings have been reported in two other different studies at almost the same rate ranges [9,18].…”

Surgical Repair of Mid-penile to Distal Hypospadias in Children; Report of 93 Cases

“…Our mean operative time of 70 minutes is similar to the reported operative time in the literature using TIP technique. [24][25][26][27][28] We used dorsal fore skin to harvest dartos flap in between suture lines. There is always a learning curve for this technically demanding procedure.…”