Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country

Appeadu-Mensah, William; Hesse, Afua A. J.; Glover-Addy, Hope; Osei-Nketiah, Samuel; Etwire, Victor; Sarpong, Pokua

doi:10.4103/0189-6725.172538

Cited by 12 publications

(28 citation statements)

References 32 publications

(47 reference statements)

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“…Mammo, et al (2018) showed 34.3% complication rate in their 128 patients of distal hypospadias repair in Ethiopia [5]. A report from Ghana (2020) showed 28% complication rate for TIP repair and another report from Nigeria (2017) showed 33.1% fistula rate [3,18].…”

Section: Discussionmentioning

confidence: 99%

“…Tubularized incised plate (TIP) urethroplasty has become an attractive method worldwide for hypospadias repair since its introduction in 1994 for distal hypospadias and 1998 for mid shaft and proximal hypospadias [1]. Although reports from developed world show excellent outcome of this procedure, the descriptions from many developing countries still show more fistula rates and other complications [2][3][4][5][6]. Moreover, there is still debate about the ultimate outcome of incising a urethral plate and the application of TIP where the urethral plate is narrow.…”

Section: Introductionmentioning

confidence: 99%

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Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Walid¹,

Minhajuddin²,

Rajib³

et al. 2021

Arch of Pedia Surg

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Introduction: Tubularized incised plate (TIP) urethroplasty is the most commonly performed operation for distal and mid shaft hypospadias. There are controversies in the previous reports regarding the association between urethral plate width and complications in TIP repair. The aim of this study was to compare the impact of urethral plate width in TIP repair on the development of complications in the perspective of a developing country.Methods: It was a prospective comparative study carried out in the department of pediatric surgery, Chittagong Medical College Hospital, Bangladesh from December, 2017 to March, 2019. Patients with distal and midshaft hypospadias were divided into 2 groups: Group A-urethral plate less than 8 mm wide and Group B-urethral plate 8 mm or more wide. Age at surgery, penile characteristics, pre-incision urethral plate width, per-operative factors and development of complications were analyzed. Follow up period ranged from 6 months to 2.5 years.Results: A total of 43 patients (21 in group A, 22 in group B), with a mean age of 6.67 ± 3.38 years underwent TIP repair. Twenty-five (58%) patients had distal penile and 18 (42%) had mid shaft hypospadias. Age correlated with glans size and urethral plate width (P = 0.019 and 0.003, respectively) but there was no significant difference in age between patients with or without development of complications (P = 0.71). Complications developed in 18 (41.87%) patients, 9 in each group. Mean urethral plate width was 7.37 ± 0.84 mm and 7.19 ± 1.17 mm in patients who had successful repair and those developed complications, respectively (P = 0.59). Duration of tourniquet, size of catheter, layers of repair, duration of dressing or catheter were not also associated with UC fistula, the most common complication (P = 0.26, 0.58,0.76, 0.38, and 0.56, respectively). Conclusion:Width of urethral plated was not related to development of complications in TIP repair. Complication rates were high in comparison to other studies and skill development and improvement of other factors are necessary in the developing world to improve outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Walid¹,

Minhajuddin²,

Rajib³

et al. 2021

Arch of Pedia Surg

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“…The most common urological conditions observed at the GNCPS were hypospadias (70 cases per year) and cryptorchidism (126 cases per year). Hypospadias cases are sometimes referred after a failed correction by inexperienced adult surgeons [12]. Inguinal hernia/hydrocele (210 cases/year) was the second most frequent discharge diagnosis after appendicectomy (237 cases/year).…”

Section: Hospital Management and Clinical Governancementioning

confidence: 99%

“…"Santo Spirito", Pescara, Italy. 12 Fondazione "Mangiagalli", Milan, Italy. 13 Clinica Pediatrica, Università "Gabriele d'Annunzio", Chieti-Pescara, Italy.…”

Section: Acknowledgmentsmentioning

confidence: 99%

Improving standard of pediatric surgical care in a low resource setting: the key role of academic partnership

et al. 2020

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Background: An epidemiological transition is interesting Sub-Saharan Africa increasing the burden of non-communicable diseases most of which are of surgical interest. Local resources are far from meeting needs and, considering that 50% of the population is less than 14 years of age, Pediatric surgical coverage is specially affected. Efforts are made to improve standards of care and to increase the number of Pediatric surgeons through short-term specialist surgical Missions, facilities supported by humanitarian organization, academic Partnership, training abroad of local surgeons. This study is a half term report about three-years Partnership between the University of Chieti-Pescara, Italy and the University of Gezira, Sudan to upgrade standard of care at the Gezira National Centre for Pediatric Surgery (GNCPS) of Wad Medani. Four surgical Teams per year visited GNCPS. The Program was financed by the Italian Agency for Development Cooperation. Methods: The state of local infrastructure, current standard of care, analysis of caseload, surgical activity and results are reported. Methods utilized to assess local needs and to develop Partnership activities are described. Results: Main surgical task of the visiting Team were advancements in Colorectal procedures, Epispadias/Exstrophy Complex management and Hypospadias surgery (20% of major surgical procedures at the GNCPS). Intensive care facilities and staff to assist more complex cases (i.e. neonates) are still defective. Proctoring, training on the job of junior surgeons, anaesthetists and nurses, collaboration in educational programs, advisorship in hospital management, clinical governance, maintenance of infrastructure together with training opportunities in Italy were included by the Program. Despite ongoing efforts, actions have not yet been followed by the expected results. More investments are needed on Healthcare infrastructures to increase health workers motivation and prevent brain drain. Conclusions: The key role that an Academic Partnership can play, acting through expatriated Teams working in the same constrained contest with the local workforce, must be emphasized. Besides clinical objectives, these types of Global Health Initiatives address improvement in management and clinical governance. The main obstacles to upgrade standard of care and level of surgery met by the Visiting Team are scarce investments on health infrastructure and a weak staff retention policy, reflecting in poor motivation and low performance.

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“…The results of surgery for hypospadias patients are often unsatisfactory, with reported rates of complications reaching 40% and even more (Appeadu-Mensah et al, 2015;Mammo et al, 2018). For distal hypospadias, the highest complication reported reaching 33% (Klijn, Dik, & de Jong, 2001;Stein, 2012).…”

Section: Consideration Of Complicationsmentioning

confidence: 99%

Distal Hypospadias, Treated or Untreated?: A Case Report

Santosa

2020

J. Nurs. Pract

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Background: Treatment for distal hypospadias is a controversy among the experts. Some argue that it does not require any surgery if it does not interfere with the patient's urinary and sexuality. Purpose: This study aimed to determine whether patients with distal hypospadias need treated or untreated.Methods: The method used is a case study. Participants in this study is a 10-year-old male with distal hypospadias—location of the study in Purwokerto city, Banyumas district, Central Java. Participants were interviewed and physically examined by a doctor and nurse. The results of interviews and physical examinations are recorded and analyzed based on a literature review to determine the decision, treatment, or untreated. Results: A 10-year-old patient with hypospadias and the pediatric urologist do not give surgery advice, because the urethral opening is still close to the glans penis, and there are no symptoms of urinary dysfunction. Conclusion: Patients with distal hypospadias may be untreated as long as they do not interfere with urinary function

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Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country

Cited by 12 publications

References 32 publications

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Tabularised Incised Plate (TIP) Urethroplasty in Narrow V/S Wide Urethral Plate: A Comparative Study in a Developing Country Perspective

Improving standard of pediatric surgical care in a low resource setting: the key role of academic partnership

Distal Hypospadias, Treated or Untreated?: A Case Report

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