Acute postoperative complications of hypospadias repair

Abstract

PurposeComplications in hypospadias surgery are higher than other reconstructive procedures. The incidence of complications can be reduced if proper preventive measures are taken. The review aims to highlight incidences, causes, and preventive measures of acute complications of hypospadias repair.Materials and MethodsLiterature reports were reviewed in Pubmed by giving the key word acute complications of hypospadias repair, wound infection, wound dehiscence, flap necrosis, edema, penile torsion, urethral fistula, bleeding and hematoma and urethral stents problems. Summaries of all articles were reviewed with full text of relevant article and results were analyzed.ResultsBesides mentioning the complications of hypospadias repair in individual articles on the subject, we did not come across any separate article on this subject in the published English literature. Fistula is the commonest complication followed by edema and penile torsion.ConclusionsMost acute complications can be prevented with adherence to principles of plastic and microsurgery, meticulous preoperative planning, and judicious postoperative care. Deviation from these principles may lead to disaster and even failure of the repair. The aim in hypospadias surgery should be following these principles and bring down the complication rates < 5% in distal hypospadias and < 10% in proximal hypospadias.

The role of preoperative prophylactic antibiotics in hypospadias repair

“…The aim of hypospadias repair is to achieve normal urinary and sexual function with good esthetic result and self-confidence of the child. 2 Perioperative and postoperative antibiotics are widely used by pediatric urologists, particularly in hypospadias surgery. 3 The rationale was to reduce the risk of urinary tract infection (UTI) in the early postoperative period following the placement of a catheter, [4][5][6][7][8] Moreover, antibiotics were effective at reducing the risk of meatal stenosis and fistula.…”

Hypospadias: an algorithm for repair with the aid of the microscope in 102 patients

“…Postoperative edema was not observed in any of our cases. Bhat and Mandal [10] found that edema was the second most common early complication after hypospadias surgery. Urethro-cutaneous fistula remains the most common complication encountered by all.…”

A Complication in Hypospadias Surgery Due to Anchoring Suture

“…Acute complications include bleeding, hematoma, oedema, infection, wound dehiscence, skin or flap necrosis, fistula, penile torsion, penile erection, inadvertent removal of urethral stent and bladder spasm [3]. Chronic complications can be classified as occurring in the skin or penile shaft, urethral, glanular and other.…”

“…Balanitis xerotica obliterans, meatal stenosis, prolapsus, retraction, tissue defect, glans necrosis, glans dehiscence, figure distractions are the reported complications of glans penis. Other complications are vesicosphincteric dyssynergy, bad cosmesis and urinary flow disorders [1][2][3][4][5].…”