Our Summary

This research paper is about a surgery called STAG (staged tubularized autograft repair) used to treat a condition called proximal hypospadias (PPH). PPH is a birth defect in boys where the opening of the urethra (the tube that carries urine from the bladder to the outside of the body) is on the underside of the penis, not at the tip. There’s been debate about whether to fix this in one operation or in stages.

Between 2011 and 2018, the researchers performed this surgery on 43 boys with PPH. They used tissue from the inner foreskin to help straighten the penis if the bend was more than 30 degrees. The first stage of the surgery was successful in about 91% of the boys. The second stage was completed in 37 children, with a success rate of about 57%. However, there were some complications like holes forming in the urethra or the head of the penis splitting open.

After a third surgery to fix these complications, the overall success rate was about 78%. After an average follow-up of 3.2 years, the success rate was about 73%, with two boys experiencing a recurrence of curvature. No other complications were noted and the cosmetic appearance was excellent.

In conclusion, while STAG does a good job of straightening the penis and rebuilding the urethra, there are still complications to consider such as holes in the urethra and the head of the penis splitting open. Long-term follow-up is important to monitor and treat these issues.

FAQs

  1. What is STAG and what condition does it treat?
  2. What is the success rate of the STAG procedure for treating proximal hypospadias?
  3. What complications can arise from the STAG procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair using STAG surgery is to follow post-operative care instructions carefully to minimize the risk of complications. This may include keeping the surgical area clean, avoiding strenuous activities, and attending follow-up appointments with the healthcare provider. It’s also important to communicate any concerns or changes in symptoms to the healthcare team promptly.

Suitable For

Patients who are typically recommended for hypospadias repair are boys with proximal hypospadias (PPH), where the opening of the urethra is on the underside of the penis. In the study mentioned above, boys with PPH underwent the STAG surgery to correct this birth defect. The surgery was successful in the majority of cases, with a high success rate after the third surgery to address complications. Patients with PPH can benefit from hypospadias repair to improve the function and appearance of the penis.

Timeline

Overall, the timeline for a patient before and after hypospadias repair surgery can be summarized as follows:

Before surgery:

  1. Diagnosis of proximal hypospadias
  2. Consultation with a pediatric urologist to discuss treatment options
  3. Pre-operative testing and preparation

During surgery:

  1. Staged tubularized autograft repair (STAG) surgery performed
  2. Use of tissue from inner foreskin to straighten the penis and rebuild the urethra
  3. First stage of surgery successful in majority of cases
  4. Second stage of surgery completed in some cases, with a lower success rate
  5. Complications such as holes in the urethra or splitting of the penis head may occur

After surgery:

  1. Follow-up appointments to monitor progress and address any complications
  2. Third surgery may be necessary to fix any issues that arise
  3. Overall success rate of surgery around 73-78%, with good cosmetic appearance
  4. Long-term follow-up is important to monitor for recurrence of curvature or other complications

In summary, the timeline for a patient with proximal hypospadias undergoing STAG surgery involves pre-operative consultation, staged surgery, and post-operative monitoring to ensure successful outcomes and address any complications that may arise.

What to Ask Your Doctor

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

  1. What is the success rate of STAG surgery for proximal hypospadias?
  2. What are the potential complications of STAG surgery for hypospadias repair?
  3. How many stages of surgery are typically required for STAG surgery?
  4. What is the average recovery time after each stage of STAG surgery?
  5. How long should I expect to be in follow-up care after STAG surgery?
  6. Are there any long-term risks or concerns associated with STAG surgery for hypospadias repair?
  7. What is the cosmetic outcome typically like after STAG surgery for hypospadias repair?
  8. Are there any alternative treatment options for proximal hypospadias that I should consider?
  9. How experienced is the surgical team in performing STAG surgery for hypospadias repair?
  10. What can I do to help ensure a successful outcome following STAG surgery for hypospadias repair?

Reference

Authors: Badawy H, Dawood W, Soliman AS, Fahmy A, Mahfouz W, Moussa A, Assem A, Aboulfotouh Eid A, Elsayed S, Gawan A, Hanno A, Youssef M. Journal: J Pediatr Surg. 2020 Dec;55(12):2710-2716. doi: 10.1016/j.jpedsurg.2020.07.023. Epub 2020 Jul 28. PMID: 32854924