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Organo Oficial de la Sociedad Mexicana de Urología

2018, Number 4

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Rev Mex Urol 2018; 78 (4)

Surgical treatment of hypospadias. Ten-year experience

González-Maldonado AA, Manzo-Pérez G, Vanzzini-Guerrero MA, Manzo-Pérez BO, Lozada-Hernández EE, Sánchez-López HM

Language: Spanish
References: 31
Page: 263-272
PDF size: 299.95 Kb.


ABSTRACT

Background: Hypospadias is the second most frequent congenital anomaly in newborn males and its frequency in Mexico is reported at 2.6 per 10,000 births. Despite the fact that hundreds of surgical techniques have been described, none of them have been standardized as ideal treatment.
Objective: The aim of the present study was to analyze our 10 years of experience in the surgical treatment of hypospadias and describe its characteristics, surgical techniques, and complications.
Materials and Methods: We conducted a retrospective, descriptive, observational, and cross-sectional study on the patients that underwent hypospadias repair over the past 10 years (2008-2017). The characteristics of the hypospadias, surgical techniques employed, short-term and long-term complications, and success rates were evaluated. The categorical variables were reported as frequency and percentage and the qualitative variables were compared using the chi-square test or the Fisher’s exact test, as required. Measures of association were calculated through the odds ratio with a 95% confidence interval. Statistical significance was set at a p < 0.05.
Results: We analyzed the data of 190 patients that underwent hypospadias repair. The pathology was classified in accordance with urethral meatus location as distal (42.6%), medial (29%), and proximal (29%). Mean patient age was 38.9 ± 30.6 months. The most widely used surgical technique was tubularization with incision of the urethral plate (46.3%). Postoperative complications presented in 52.1%, mainly urethrocutaneous fistula (24.2%) associated with the tubularized incised plate technique (38.9%), followed by the Thiersch-Duplay (20.3%), onlay (16.9%), Duckett (13.5%), glans approximation procedure (5.08%), Mathieu (3.39%), and meatal advancement with glanuloplasty (1.69%) techniques. Dehiscence of the glans penis presented in 15.79% of the patients and meatal stricture in 7.89%.
Conclusions: Hypospadias surgery and its complications continue to be a surgical challenge. The present study serves as a precedent for identifying failures and weaknesses at the time of carrying out surgical corrections and the identification of factors associated with complication reduction continues to be studied.


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