Our Summary

This research paper examines the effectiveness of two surgical techniques used to repair posterior hypospadias, a birth defect in boys where the opening of the urethra is not located at the tip of the penis. The two techniques are single stage repair and staged repair.

After comparing the results from 65 children who underwent one of these procedures between 2011 and 2016, the researchers found that the staged repair method, which involves more than one operation, had a higher success rate and fewer complications than the single-stage method.

Out of 40 boys who underwent the single-stage method, only 55% of the operations were successful, with 45% resulting in complications like infection, dehiscence (splitting of the surgical wound), urethrocutaneous fistula (abnormal connection between the urethra and the skin), meatal stenosis (narrowing of the urethral opening), and urethral diverticulum (outpouching of the urethra).

In contrast, the staged repair method had an 80% success rate. Out of 25 boys who underwent this procedure, only 20% experienced complications, which included fistulas and hematomas (collection of blood outside blood vessels).

In conclusion, the researchers suggest that the staged repair method may be a better option for posterior hypospadias repair due to its higher success rate and fewer complications. They stress the need for more research and honest reporting of complications to further improve the treatment of this condition.

FAQs

  1. What are the two surgical techniques used to repair posterior hypospadias?
  2. Based on the research, which surgical technique had a higher success rate and fewer complications?
  3. What are the potential complications of the single-stage repair method for posterior hypospadias?

Doctor’s Tip

A doctor may tell a patient that staged repair may be a more effective option for hypospadias repair, as it has a higher success rate and fewer complications compared to single-stage repair. It is important to discuss all options with your healthcare provider to determine the best treatment plan for your specific situation.

Suitable For

Typically, patients with posterior hypospadias, a birth defect in boys where the opening of the urethra is not located at the tip of the penis, are recommended for hypospadias repair. This research specifically looked at the effectiveness of two surgical techniques for repairing posterior hypospadias in children.

Timeline

Before hypospadias repair:

  1. Birth: The baby boy is born with posterior hypospadias, where the opening of the urethra is not located at the tip of the penis.
  2. Diagnosis: The condition is diagnosed by a healthcare provider during a physical examination.
  3. Consultation: The parents consult with a pediatric urologist to discuss treatment options and surgical repair.

After hypospadias repair:

  1. Pre-operative preparation: The child undergoes pre-operative tests and evaluations to ensure they are healthy enough for surgery.
  2. Surgery: The child undergoes either single-stage repair or staged repair to correct the positioning of the urethral opening.
  3. Recovery: The child is monitored in the hospital for a few days post-surgery to manage pain and monitor for complications.
  4. Follow-up appointments: The child attends follow-up appointments with the surgeon to monitor healing and address any concerns.
  5. Long-term outcomes: The child may experience improved urinary function and cosmetic appearance of the penis after successful hypospadias repair.

What to Ask Your Doctor

  1. What is the success rate of the hypospadias repair surgery?

  2. How many surgeries will be required for the repair, and what is the timeline for each surgery?

  3. What are the potential complications associated with the surgery?

  4. What is the recovery process like after the surgery?

  5. Will there be any long-term effects or complications from the surgery?

  6. Are there any alternative treatment options available for hypospadias?

  7. What is the experience of the surgeon in performing hypospadias repair surgeries?

  8. How should the patient prepare for the surgery, both physically and emotionally?

  9. What is the expected outcome of the surgery in terms of urinary function and aesthetic appearance?

  10. Are there any specific post-operative care instructions that need to be followed for optimal healing and recovery?

Reference

Authors: Badawy H, Orabi S, Hanno A, Abdelhamid H. Journal: J Pediatr Urol. 2018 Feb;14(1):28.e1-28.e8. doi: 10.1016/j.jpurol.2017.07.007. Epub 2017 Aug 9. PMID: 28865886