Our Summary

The research paper is about a study conducted to evaluate the long-term results of a certain type of surgery called “hypospadias repair” using a method known as the “onlay preputial graft”. This surgery is performed to correct a condition where the opening of the urethra is not at the tip of the penis.

Between 1989 and 2013, a single surgeon performed this operation on 62 patients. The patients were followed up for an average of roughly four years. The location of the urethral opening was categorized into three types: distal (near the tip), midshaft (middle), and proximal (near the base).

Out of the 62 patients, 22 (about 36%) experienced complications after the surgery. These complications included narrowing of the urethral opening, urethral stricture (narrowing), and fistula (an abnormal connection between the urethra and the skin).

The study found that the size of the graft used could affect the likelihood of complications. Specifically, the wider the graft, the less likely complications would occur. This was the case even when other factors such as age at surgery, length of the graft, presence of chordee (bending of the penis), or location of the urethral opening were considered.

In conclusion, the study suggests that hypospadias repair with an onlay preputial graft can be a good option for certain cases, and using wider grafts may reduce the risk of complications.

FAQs

  1. What is hypospadias repair and what method was used in this study?
  2. What were the common complications experienced by patients after the surgery?
  3. How does the size of the graft used in the surgery affect the likelihood of complications?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair using the onlay preputial graft method is to ensure proper follow-up care to monitor for any potential complications. It is important to attend all scheduled follow-up appointments and to report any unusual symptoms or issues to your healthcare provider promptly. Additionally, maintaining good hygiene and following post-operative care instructions can help promote proper healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for hypospadias repair using the onlay preputial graft method are those with a urethral opening located in the midshaft or proximal position of the penis. These patients may experience difficulties with urination, sexual function, and self-esteem due to the abnormal position of the urethral opening.

Additionally, patients with a history of recurrent urinary tract infections, difficulty with voiding, or cosmetic concerns may also be good candidates for hypospadias repair. It is important for these patients to undergo a thorough evaluation by a qualified surgeon to determine if they are suitable candidates for the surgery.

Overall, the study suggests that hypospadias repair using the onlay preputial graft method can be a successful option for patients with certain types of hypospadias, particularly when wider grafts are used to reduce the risk of complications.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with hypospadias, a condition where the opening of the urethra is not at the tip of the penis.
  • Patient and their family consult with a surgeon to discuss the possibility of surgery to correct the condition.
  • Surgery is scheduled and the patient undergoes pre-operative evaluations and preparations.

After hypospadias repair:

  • Patient undergoes surgery using an onlay preputial graft method to correct the position of the urethral opening.
  • Patient is monitored post-operatively for any complications or issues.
  • Patient follows a post-operative care plan, which may include wound care, follow-up appointments, and potential interventions for any complications that arise.
  • Patient is followed up over a period of time to evaluate the long-term results of the surgery and assess for any complications that may develop.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair using onlay preputial graft include:

  1. What are the potential risks and complications associated with this surgery?
  2. How long is the recovery period after the surgery?
  3. Will there be any long-term effects or limitations after the surgery?
  4. How many times have you performed this specific type of surgery?
  5. What is the success rate of this surgery in correcting hypospadias?
  6. Will there be a need for additional surgeries or follow-up procedures in the future?
  7. How will the size of the graft used during the surgery affect the outcome?
  8. Are there any alternative treatment options available for hypospadias correction?
  9. What can I expect in terms of post-operative care and follow-up appointments?
  10. Are there any lifestyle changes or precautions I need to take after the surgery?

Reference

Authors: Cambareri GM, Yap M, Kaplan GW. Journal: BJU Int. 2016 Sep;118(3):451-7. doi: 10.1111/bju.13419. Epub 2016 Feb 17. PMID: 26780179