Our Summary

This research paper is comparing two surgical methods used to treat a condition called hypospadias in boys. Hypospadias is a birth defect where the opening of the urethra is on the underside of the penis, instead of at the tip. The two methods being compared are the Mathieu and the Tubularized Incised Plate (TIP) repair methods.

The researchers were specifically interested in how often two complications occurred after these surgeries: urethrocutaneous fistula (an abnormal connection between the urethra and the skin) and urethral stricture (a narrowing of the urethra). They looked at 17 different studies that involved a total of 1,572 patients.

They found that the chances of a urethrocutaneous fistula happening after surgery were about the same for both methods. However, urethral stricture was less likely to occur after the Mathieu method than the TIP method.

Overall, they concluded that the Mathieu method had a lower risk of causing a urethral stricture, but both methods had a similar risk of causing a urethrocutaneous fistula.

FAQs

  1. What is hypospadias and how is it treated?
  2. What are the two surgical methods compared in this research for treating hypospadias?
  3. What were the findings of the research regarding the occurrence of complications after using the Mathieu and TIP methods?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to follow post-operative care instructions carefully to reduce the risk of complications such as urethrocutaneous fistula or urethral stricture. This may include avoiding strenuous activities, keeping the surgical site clean and dry, and attending follow-up appointments to monitor healing progress. It is also important to communicate any concerns or changes in symptoms to the healthcare provider promptly.

Suitable For

Patients who are typically recommended hypospadias repair are male infants or young boys with a congenital condition where the opening of the urethra is on the underside of the penis. This condition can cause difficulties with urination and sexual function, as well as psychological and social issues as the child grows older.

Surgery is usually recommended to correct hypospadias in order to improve the appearance and function of the penis and prevent long-term complications. The decision to undergo surgery and the choice of surgical method are typically based on factors such as the severity of the condition, the location of the urethral opening, the presence of other genital abnormalities, and the age and overall health of the patient.

In general, patients who are healthy enough to undergo surgery and who have a good chance of achieving a successful outcome are recommended for hypospadias repair. It is important for patients and their families to discuss the potential risks and benefits of surgery with their healthcare provider in order to make an informed decision about the best treatment option for their specific situation.

Timeline

Before hypospadias repair surgery:

  • Diagnosis of hypospadias at birth or during early childhood
  • Pre-operative consultations with pediatric urologist and surgical team
  • Discussion of surgical options and risks with parents/guardians
  • Pre-operative tests and evaluations such as blood tests, urine tests, and physical examination

After hypospadias repair surgery:

  • Immediate post-operative care in hospital including pain management and monitoring for complications
  • Catheter placement to help drain urine and promote healing
  • Follow-up appointments with surgical team for wound care and monitoring of healing progress
  • Removal of catheter after a few days to a week
  • Monitoring for potential complications such as infection, urethrocutaneous fistula, or urethral stricture
  • Long-term follow-up appointments to monitor growth and development of the repaired urethra and penis

Overall, the timeline for a patient with hypospadias undergoing repair surgery involves pre-operative consultations and evaluations, the surgical procedure itself, immediate post-operative care, and long-term follow-up to monitor for complications and ensure proper healing and development.

What to Ask Your Doctor

  1. What is hypospadias and why is surgery necessary to repair it?

  2. What are the differences between the Mathieu and TIP repair methods for hypospadias?

  3. What are the potential complications of hypospadias repair surgery, specifically urethrocutaneous fistula and urethral stricture?

  4. What is the likelihood of experiencing urethrocutaneous fistula or urethral stricture after surgery with each method?

  5. What are the factors that may increase the risk of complications after hypospadias repair surgery?

  6. What is the recovery process like after hypospadias repair surgery and what kind of follow-up care is needed?

  7. Are there any long-term effects or risks associated with hypospadias repair surgery?

  8. How successful are the Mathieu and TIP repair methods in terms of achieving good cosmetic and functional outcomes?

  9. Are there any alternative treatment options for hypospadias that should be considered?

  10. What is the surgeon’s experience and success rate with performing hypospadias repair surgeries using the Mathieu and TIP methods?

Reference

Authors: Winberg H, Arnbjörnsson E, Anderberg M, Stenström P. Journal: Pediatr Surg Int. 2019 Nov;35(11):1301-1308. doi: 10.1007/s00383-019-04523-z. Epub 2019 Aug 1. PMID: 31372729