Our Summary

This research paper focuses on studying the complications that can occur in adults who had a specific type of penile surgery (called hypospadias repair) when they were children. The complications they looked at were not related to the urethra, but rather issues such as deformities of the head of the penis, curving of the penis, and a “trapped” penis due to not having enough skin.

They studied 97 patients over a period of 12 years and used a comprehensive surgical approach to fix these issues. This could be done in either one or two stages. They considered the surgery successful if the patient had a straight penis of a good length, a regular-shaped head of the penis, and an appearance that was acceptable to the patient, without needing any more surgeries.

In the majority of cases, they were able to fix the issues in one stage, and this had a higher success rate than the two-stage process. Some complications did occur though, including late onset curvature and some issues with the head of the penis and skin.

They found that these complications can occur many years after the original surgery, and can have a big impact on quality of life. About a quarter of the patients experienced erectile dysfunction. The treatment is tailored to the individual and aims to fix all the issues and result in a good cosmetic appearance and positive sexual health outcomes.

FAQs

  1. What are non-urethral complications that can occur after hypospadias repair in childhood?
  2. How is the success of the surgical treatment for non-urethral complications after hypospadias repair measured?
  3. What percentage of patients experienced erectile dysfunction after the surgical treatment for non-urethral complications after hypospadias repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to ensure they follow their post-operative care instructions carefully, including keeping the surgical site clean and dry, avoiding strenuous activities that may put strain on the repair, and attending follow-up appointments as scheduled. It is also important for patients to communicate any concerns or changes they notice in their recovery to their healthcare provider promptly.

Suitable For

Patients who are typically recommended hypospadias repair are those who have undergone previous hypospadias repair in childhood and are experiencing non-urethral complications such as glans deformity, residual curvature, and trapped penis due to insufficient penile skin. These patients may present with cosmetic and psychosexual concerns that impact their quality of life. Surgical treatment for these complications often involves a radical approach to correct all deformities and achieve successful outcomes, including a straight penis with good length, anatomically regular glans, and cosmetically acceptable appearance. It is important to individualize treatment for each patient and consider the long-term impact on sexual function.

Timeline

  • Childhood: Patient undergoes hypospadias repair surgery to correct the abnormal placement of the urethral opening on the penis.
  • Adolescent/Young Adult: Patient begins to experience non-urethral complications such as glans deformity, residual curvature, or trapped penis due to insufficient penile skin.
  • Consultation: Patient seeks consultation with a urologist to discuss surgical treatment options for the complications.
  • Surgical Treatment: Radical surgical approach is used to correct all deformities in a one-stage or two-stage procedure.
  • Post-Surgery: Patient undergoes follow-up appointments to monitor healing and outcomes of the surgery.
  • Follow-Up: Mean follow-up period is 75 months, during which the success rate of the surgery is evaluated.
  • Complications: Some patients may experience complications such as penile curvature with late onset, glans dehiscence, partial skin necrosis, and erectile dysfunction.
  • Long-Term Impact: Non-urethral complications may have a significant impact on the patient’s quality of life and psychosexual well-being.
  • Outcome: Successful outcome is defined as a straight penis with good length, anatomically regular glans, and cosmetically acceptable appearance without the need for additional surgeries.

What to Ask Your Doctor

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

  1. What are the potential complications of hypospadias repair surgery?
  2. What is the success rate of the surgical approach you recommend for my specific case?
  3. How long is the recovery period after hypospadias repair surgery?
  4. Will I require additional surgeries or treatments in the future?
  5. What are the potential long-term effects on sexual function after hypospadias repair?
  6. How experienced are you in performing hypospadias repair surgeries?
  7. Are there any lifestyle or activity restrictions I should be aware of after surgery?
  8. What are the expected cosmetic and functional outcomes of the surgery?
  9. How will my follow-up care be managed after the surgery?
  10. Are there any alternative treatment options for my condition?

Reference

Authors: Stojanovic B, Bizic M, Bencic M, Djordjevic ML. Journal: Front Endocrinol (Lausanne). 2023 Jun 8;14:1184948. doi: 10.3389/fendo.2023.1184948. eCollection 2023. PMID: 37361543