Hypospadias repair in a resource-poor region: Coping with the challenges in 5 years

Osifo, OD; Mene, Andrew O.

doi:10.1016/j.jpurol.2009.04.014

Cited by 9 publications

(9 citation statements)

References 23 publications

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“…In this study, nearly two-thirds (63.5%) of hypospadias had some degree of chordee which is in line with the reported range (25%–88%) ( 9 , 12 , 14 , 17 , 20 ). However, the occurrence of a severe form of chordee is higher in our patients (37%) than studies done in Ethiopia (31%), Tanzania (20%), Nigeria (29.9%) and Pakistan (7.5%) ( 9 , 12 , 16 , 22 ). The lowest rate in the latter study could be due to the involvement of adult patients in their study, hence patients with mild disease tend to seek medical attention late.…”

Section: Discussioncontrasting

confidence: 75%

“…Literature also reported positive body image and improved psychosexual outcomes in patients operated early in life ( 1 , 2 , 6 , 23 ). This review and similar studies done in Ethiopia and other developing countries demonstrated late presentation and higher mean age (older than 2 years) at the time of hypospadias repair ( 8 , 9 , 16 , 17 , 20 , 22 ). In contrast, studies from developed nations reported early surgical intervention ( 2 , 24 ).…”

Section: Discussionsupporting

confidence: 72%

“…In line with this, more than two-thirds (74%) of our cases underwent one stage hypospadias repair and two-staged procedures were done for the majority (87.7%) of posterior/proximal defects. A worldwide survey on hypospadias surgery revealed 52.9%–71.0% of surgeons prefer TIP for the repair of distal (anterior and midshaft) defects.28 Similarly, the recent study and reports from other literature found agreeable results ( 12 – 14 , 16 , 18 , 20 , 22 ). Springer A et reported 0.9–16.7% of surgeons use TIP for proximal hypospadias repair.28 This is consistent with the finding of our review which is 12.3%.…”

Section: Discussionmentioning

confidence: 91%

“…Furthermore, an Indonesian study demonstrated a similar finding. Studies done in Nigeria and Pakistan found the middle type as the dominant form ( 9 , 18 , 22 ). This discrepancy could be explained by differences in study subjects and setup.…”

Section: Discussionmentioning

confidence: 99%

“…During this period the child has no genital awareness, not yet started toilet training and ambulation. Furthermore, perioperative management like urinary drainage, hospitalization and separation anxiety are easier in this age group ( 1 , 2 , 6 , 8 , 9 , 20 – 22 ). Literature also reported positive body image and improved psychosexual outcomes in patients operated early in life ( 1 , 2 , 6 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

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Clinical Profiles and Surgical Outcome of Hypospadias Repair at a Teaching Hospital in Ethiopia

Gama

Abitew

Abebe

2022

Ethiop J Health Sci

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BACKGROUND: Hypospadias repair is one of the commonest and challenging surgery done in pediatric age groups. This study was conducted to assess clinical profiles and surgical outcomes of hypospadias repair.METHODS: A retrospective analysis of pediatric hypospadias repairs at St. Paul’s hospital millennium medical college from September 2015 to August 2019 was conducted.RESULTS: A total of 277 patients with hypospadias repair were investigated. The mean age was 3.7+/- 3.5 years (Range, 0.5-14 years) and only one-third (98,35.4%%) of patients were operated on in the recommended age group (6-18 months). Anterior/distal hypospadias was the commonest (123,44.4%) variant identified. The majority (176,63.5%) had chordee and 105(37.9%) were severe forms. Tubularized incised plate repair was the major (164,59.2%) surgical technique employed followed by staged urethroplasty (61,22%). Post-operative complications occurred in 135(48.7%) patients and the commonest was urethrocutanous fistula (95,34.3%). No significant correlation was found betweenthe occurrence of these complications and factors such as age at repair, the severity of hypospadias, presence of concomitant urogenital anomaly, type of procedure and duration of urinary diversion. However, the presence of severe chordee (AOR=3.09; 95%CI 1.21-7.54; p=0.013) was an independent factor found to be associated with postoperative complications on multivariate analysis.CONCLUSION: Higher rate of complications following hypospadias repair was observed in our study. Our study also demonstrated no significant advantage of any repair technique in reducing operative complications. Extensive preoperative evaluation, proper operative plan and regular follow-up of such patients is paramount for a better outcome.

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