Outcome of pediatric hypospadias repair in adulthood

Abstract

Purpose:To review the evolution of the technique of hypospadias repair. Methods: A search of Pubmed, Medline and the Journal of Pediatric Urology was performed, and papers dealing with surgical techniques for hypospadias repair were critally reviewed. Special emphasis was given to papers on the effects in the long term of hypospadias repair on voiding and sexual dysfunction. Results:The techniques for hypospadias repair have evolved over the years. The most popular technique now is tubularized incised plate urethroplasty. Long-term results with the use of the new techniques of the hypospadias repair in terms of voiding and sexual problems should be addressed. Conclusion:There is a need for valid studies on the outcomes of hypospadias repair in adults that were performed in childhood in terms of cosmetic appearance, voiding and sexual performance. Keywords: hypospadias, hypospadias surgery, adult, later outcome Surgical techniques for hypospadias repairHypospadias may be defined as a ventral penile hypoplasia with some associated anomalies such as the following: opening of the meatus below the tip of the penis, ventral penile curvature (chordee) and a hooded foreskin with excessive dorsal part. The incidence of hypospadias in the Western countries has been in rise tremendously and is approximately 1 to 150,300 male births. 1The first description of urethral hypoplasia and hypospadias malformation is related to Celsius and Galen, and dates as far back as to the first and second centuries AD.2 The renaissance of hypospadias surgery was established by Thiersch 3 and Duplay 4 during the second part of the 19th century. Since then, hundreds of techniques have evolved, mostly to answer the challenge of creating a functional neourethra. Hypospadias surgical procedure is characterized by three steps: 1. Correction of chordee -straightening of the penis; 2. Urethroplasty -reconstruction of the missing part of the urethra; 3. Restoration of the tissues forming the ventral radius of the penis -the glans, corpus spongiosum, and skin, which finally will lead to the normal cosmetic appearance of the penis. In the majority of cases simple degloving of the penile skin may solve the penile curvature. If chordee persists after penile degloving, dorsal corporal plication is performed in order to straighten the penis. Many surgeons prefer to avoid freeing the urethral plate in order to avoid injury to the blood supply. The authors have previously Research and Reports in Urology downloaded from https://www.dovepress.com/ by 34.214.212.150 on 13-May-2018 For personal use only.

Urethral Hair Bezoar Management With Transcutaneous Neodymium-Doped Yttrium Aluminum Garnet Laser Post-hypospadias Repair: A Clinical Case

“…Surgical correction, typically performed in early childhood, aims to relocate the urethral meatus to its typical position and achieve a more conventional penile appearance. However, post-surgical complications can arise, one of which is the growth of hair within the urethra when hair-bearing skin is used in the repair [ 3 ].…”

Hypospadias repair and outcome in Abuja, Nigeria: A 5-year single-centre experience

“…Since Celsius and Galen's first description of urethral hypoplasia and hypospadias malformation,[ 9 ] numerous techniques of repair have evolved in response to the challenge of creating a functional neo-urethra and aesthestic meatus. [ 10 ] The most favourable age for hypospadias repair is reported as 6-18 months. [ 11 12 ] The present study reports our experience with the pattern of presentation, techniques and outcomes of repair of hypospadias in children.…”