Our Summary

The researchers in this study were examining the effectiveness of a specific type of operation (TIPU) for treating a condition called distal hypospadias in adults. Hypospadias is a birth defect in boys where the opening of the urethra (the tube that drains urine from the bladder) is on the underside, rather than the end, of the penis.

The researchers looked back at the medical records of 620 adult patients who had this operation for hypospadias between 2016 and 2020. The surgery usually took between 35 and 65 minutes. Out of these, 79 patients (around 13%) had complications after the surgery, including issues like urethral fistulas (an abnormal opening), meatal stenosis (narrowing of the urethra), anastomotic stenosis (narrowing of a connection made during surgery) and in 7 cases, the surgery completely failed.

Despite these issues, the researchers concluded that this surgery is generally safe and fairly straightforward for adults with hypospadias. The rate of complications was similar to the rate in children who have the surgery. They also found that as surgeons gain more experience with this operation, they are more successful in performing it.

FAQs

  1. What is the success level of hypospadias repair in adults?
  2. What complications can occur after hypospadias repair surgery in adults?
  3. How does the success rate of hypospadias repair in adults compare to the pediatric group?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to follow post-operative care instructions carefully to minimize the risk of complications such as urethral fistulas, meatal stenosis, and anastomotic stenosis. This may include keeping the surgical area clean and dry, avoiding strenuous activities that could put strain on the surgical site, and attending follow-up appointments as scheduled. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended hypospadias repair are those who have distal hypospadias and are adults over the age of 16. These patients may experience complications such as urethral fistulas, meatal stenosis, anastomotic stenosis, or complete failure, which can be addressed through surgery. The success level of hypospadias repair in adults is still being studied, but primary adult distal hypospadias surgery has been shown to be safe and effective, with complication rates similar to those seen in the pediatric population. As surgical techniques continue to improve, the success of hypospadias repair in adults is expected to increase.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with distal hypospadias after the age of 16
  • Patient undergoes consultation with a urologist to discuss treatment options
  • Patient schedules surgery date and prepares for the procedure

After hypospadias repair:

  • Surgery is performed, typically lasting between 35 and 65 minutes
  • Patient may experience complications such as urethral fistulas, meatal stenosis, anastomotic stenosis, or complete failure
  • Follow-up appointments are scheduled to monitor healing and address any complications
  • As surgical experience advances, success of the operation increases in direct proportion
  • Overall, primary adult distal hypospadias surgery is deemed safe and effective, with complication rates similar to those seen in pediatric patients.

What to Ask Your Doctor

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

  1. What is the success rate of hypospadias repair in adults?
  2. What is the typical recovery time after hypospadias repair surgery?
  3. What are the potential complications or risks associated with hypospadias repair surgery?
  4. What is the expected outcome of the surgery in terms of appearance and function?
  5. How experienced are you in performing hypospadias repair surgery?
  6. Are there any alternative treatment options for hypospadias?
  7. Will I need follow-up appointments or additional procedures after the initial surgery?
  8. How soon after surgery can I resume normal activities and sexual function?
  9. Are there any specific precautions or care instructions I should follow post-surgery?
  10. What should I do if I experience any complications or concerns after the surgery?

Reference

Authors: Sahin C, Yesildal C. Journal: Andrologia. 2022 Jun;54(5):e14398. doi: 10.1111/and.14398. Epub 2022 Feb 27. PMID: 35224744