Our Summary

This research compares the outcomes of two different surgical procedures used to correct a common male birth defect called proximal hypospadias. This condition affects the position of the urethra on the penis. The two procedures are called double-face onlay-tube-onlay transverse preputial island flap (DFOTO) and two-stage repair.

The study looks at boys who had either the DFOTO or two-stage repair between 2008 and 2021. It excluded those who had previously had surgery for hypospadias. The factors considered were surgical complications, the number of surgical procedures, the length of the surgery, and results of tests done after the operation.

The study found that although those who had the DFOTO procedure had a slightly higher rate of certain complications and a higher rate of unplanned return to surgery, they also had fewer total procedures and shorter total surgery time. The urine flow rates after surgery were similar for both groups.

In summary, while both techniques can produce similar results, the DFOTO method, despite having a higher rate of unplanned return to surgery, usually requires fewer total procedures. This information should be considered when choosing a surgical method for repairing proximal hypospadias.

FAQs

  1. What is proximal hypospadias and how is it corrected?
  2. What are the differences between the DFOTO procedure and the two-stage repair for hypospadias?
  3. What were the findings of the comparison study between DFOTO and two-stage repair procedures?

Doctor’s Tip

A helpful tip a doctor might give a patient about hypospadias repair is to discuss with their healthcare provider the different surgical techniques available, such as DFOTO and two-stage repair, and consider factors such as the risk of complications, number of procedures needed, and total surgery time when making a decision. It is important to weigh the potential benefits and risks of each procedure to determine the best option for the individual patient.

Suitable For

Patients with proximal hypospadias are typically recommended for hypospadias repair surgery. Proximal hypospadias refers to a more severe form of the condition where the opening of the urethra is located closer to the base of the penis rather than at the tip. These patients may experience difficulties with urination, sexual function, and overall appearance of the genitalia. Repair surgery is often recommended to improve these issues and restore proper function and appearance.

Timeline

Before the hypospadias repair:

  1. Patient is diagnosed with proximal hypospadias, a common male birth defect affecting the position of the urethra on the penis.
  2. Patient undergoes consultation with a urologist to discuss treatment options.
  3. Patient and their family make a decision on the surgical procedure to correct the condition.

After the hypospadias repair:

  1. Patient undergoes either the DFOTO or two-stage repair surgical procedure.
  2. Patient may experience complications such as urethral fistula, meatal stenosis, or urethral stricture.
  3. Patient may need to undergo additional surgeries if complications arise.
  4. Patient undergoes follow-up tests to assess the success of the surgery, including urine flow rate tests.
  5. Patient continues to be monitored by their urologist for long-term outcomes and potential complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair include:

  1. What are the potential risks and complications associated with the DFOTO procedure compared to the two-stage repair?
  2. How many total procedures are typically needed with each surgical technique?
  3. What is the expected length of surgery for each procedure?
  4. What is the success rate of each procedure in terms of achieving proper urethral positioning?
  5. Are there any long-term implications or considerations for future sexual function or fertility with either surgical technique?
  6. How will follow-up care be managed after the surgery, and what should I expect in terms of recovery and healing time?
  7. Are there any specific factors or individual characteristics that may make one procedure more suitable for me than the other?
  8. Can you provide me with information or resources to help me better understand the differences between the DFOTO and two-stage repair techniques?
  9. What is the experience and expertise of the surgical team in performing these procedures, and what outcomes have they typically seen with each method?
  10. Are there any alternative treatment options or considerations that I should be aware of before making a decision on which surgical technique to pursue?

Reference

Authors: Huen KH, Macaraeg A, Davis-Dao CA, Williamson SH, Boswell TC, Suhale Z, Chamberlin JD, Chuang KW, Stephany HA, Wehbi EJ, Khoury AE. Journal: J Pediatr Urol. 2023 Dec;19(6):701.e1-701.e8. doi: 10.1016/j.jpurol.2023.08.007. Epub 2023 Aug 12. PMID: 37633824