Our Summary

This research was conducted to assess the results of a surgical procedure used to correct a birth defect in boys known as hypospadias with chordee. Hypospadias is when the opening of the urethra (the tube that carries urine from the bladder out of the body) is not at the tip of the penis. Chordee is a condition where the penis curves downward. The surgery involves using a free graft, a piece of tissue taken from one part of the body and placed in another.

The study looked at 56 patients aged between 16 months and 9 years, who underwent this surgery between May 2005 and November 2017. The average time they were followed up was 7 years.

After the surgery, the location of the urethral opening moved to different locations depending on the patient. In most cases (57%), it moved to the penis, in 32% of the cases, it moved to the area between the penis and scrotum, and in 11% of the cases, it moved to the scrotum.

The one-step surgery was successful without any complications in 75% of the cases. The remaining 25% experienced some post-surgery complications that required further intervention. These included narrowing of the urethral opening, formation of an abnormal connection between the urethra and skin, a pouch-like formation in the urethra, and regression of the urethral opening. One patient needed another surgery because they were urinating upwards.

In all cases, the surgery resulted in a normal-looking opening to the urethra at the tip of the penis.

The study concludes that using a free graft is a good method to correct hypospadias with chordee, as it gave good functional and cosmetic results with a low rate of post-surgery complications.

FAQs

  1. What is the success rate of single-stage repair of hypospadias with chordee using a free graft?
  2. What are the postoperative complications of free tube graft urethroplasty for hypospadias repair?
  3. How does a free graft urethroplasty affect the urine stream and appearance of the penis in patients with hypospadias and chordee?

Doctor’s Tip

A helpful tip a doctor might give a patient about hypospadias repair is to follow postoperative care instructions carefully to ensure optimal healing and minimize the risk of complications. This may include keeping the surgical site clean and dry, avoiding strenuous activities that could disrupt the healing process, and attending follow-up appointments as scheduled. Additionally, it is important to communicate any concerns or changes in symptoms to the medical team promptly.

Suitable For

Patients who are typically recommended for hypospadias repair are children with hypospadias and chordee. Chordee is a condition in which the penis curves downward or to the side, and it often occurs in conjunction with hypospadias. This study specifically focused on children between 16 months and 9 years old who underwent free tube graft urethroplasty for single-stage repair of hypospadias with chordee. The procedure was found to achieve favorable functional and cosmetic outcomes with a low postoperative morbidity rate.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with hypospadias, a congenital condition in which the opening of the urethra is located on the underside of the penis
  • Patient may experience difficulties with urination and sexual function
  • Consultation with a pediatric urologist to discuss treatment options
  • Preoperative evaluation to assess the severity of the condition and determine the best surgical approach

After hypospadias repair:

  • Surgical correction of the hypospadias and chordee (curvature of the penis)
  • Postoperative care to monitor for complications such as meatal stenosis, urethrocutaneous fistula, or urethral diverticulum
  • Follow-up appointments to assess the healing process and functional outcomes
  • Gradual improvement in urinary function and cosmetic appearance of the penis
  • Long-term follow-up to ensure the success of the surgical repair and address any late-onset complications or concerns

What to Ask Your Doctor

  1. What is the success rate of free tube graft urethroplasty for hypospadias repair in children?
  2. What is the expected recovery time following the surgery?
  3. What are the potential complications of the procedure?
  4. How long will it take for my child to fully heal and resume normal activities?
  5. Are there any long-term effects or risks associated with this type of surgery?
  6. Will my child need any additional surgeries or follow-up appointments in the future?
  7. How can I help care for my child during the recovery process?
  8. Are there any lifestyle changes or restrictions my child will need to follow after the surgery?
  9. How will the appearance of the genitalia be affected by the surgery?
  10. What are the expected functional outcomes for my child following the procedure?

Reference

Authors: Obara K, Hoshii T, Hoshino S, Yamana K, Anraku T, Maruyama R, Kuroki H, Ishizaki F, Yamazaki H, Tomita Y. Journal: Urol Int. 2020;104(5-6):386-390. doi: 10.1159/000504146. Epub 2019 Dec 4. PMID: 31801150