Our Summary

The research paper discusses a surgical technique for treating a condition called proximal hypospadias. This is a birth defect in boys where the opening of the urethra is not at the tip of the penis, but near the base. The study tracked 17 boys who received this two-stage surgery between 2016 and 2021.

During the first stage, the curve in the penis was corrected and the area was covered with skin flaps or a skin graft. After six months, the second stage was performed, where a new urethra was created and covered using a specific technique called the de-epithelialized overlap flap. In some cases, a flap from the scrotum was also used to cover the new urethra.

Out of the 17 boys, 7 (or 41%) had some complications after the surgery. Most of these were disruptions at the tip of the penis, with one boy developing a hole between the penis and scrotum that needed to be closed surgically, and another developing a narrowing of the urethra 21 months after the second stage of the surgery.

The study concluded that the de-epithelialized overlap flap technique could be a good way to cover the new urethra during the second stage of the surgery to treat proximal hypospadias.

FAQs

  1. What is proximal hypospadias and how is it treated?
  2. What is the de-epithelialized overlap flap technique used in the second stage of the surgery?
  3. What were the complications reported after the surgery and how common were they?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to closely follow post-operative care instructions to reduce the risk of complications. This can include keeping the area clean and dry, avoiding strenuous activities, and attending follow-up appointments with the surgeon for proper monitoring of the healing process. It is also important to communicate any concerns or changes in symptoms to the healthcare provider promptly.

Suitable For

Patients who are typically recommended for hypospadias repair are male infants or young boys with the condition, especially those with proximal hypospadias where the opening of the urethra is located near the base of the penis. These patients may experience difficulty with urination, potential sexual dysfunction, and psychological issues related to the appearance of their genitalia. Surgery is usually recommended to correct the positioning of the urethral opening and improve the overall function and appearance of the penis.

Timeline

Before hypospadias repair:

  1. Diagnosis of proximal hypospadias in a boy during infancy.
  2. Consultation with a pediatric urologist to discuss treatment options.
  3. Preparation for surgery, including pre-operative tests and evaluations.

After hypospadias repair:

  1. First stage surgery to correct the curve in the penis and cover the area with skin flaps or a skin graft.
  2. Recovery period of six months before the second stage surgery.
  3. Second stage surgery to create a new urethra and cover it using the de-epithelialized overlap flap technique.
  4. Post-operative care and monitoring for complications.
  5. Follow-up appointments with the pediatric urologist to assess the success of the surgery and address any issues that may arise.
  6. Long-term monitoring for potential complications such as urethral narrowing or disruptions at the surgical site.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hypospadias repair surgery?

  2. How long is the recovery period after each stage of the surgery?

  3. Will my child need additional surgeries or follow-up procedures in the future?

  4. What are the success rates of this particular surgical technique for treating proximal hypospadias?

  5. Are there any long-term implications or considerations for my child’s health and development after this surgery?

  6. What can I expect in terms of post-operative care and rehabilitation for my child?

  7. How experienced are you in performing this specific type of hypospadias repair surgery?

  8. Are there any alternative treatment options or approaches that we should consider?

  9. What are the expected outcomes and prognosis for my child after undergoing this surgery?

  10. Are there any specific precautions or lifestyle changes that my child will need to follow after the surgery?

Reference

Authors: AbouZeid AA, Habak RA, Hamad MM, Shahin AM. Journal: BMC Urol. 2023 Aug 30;23(1):143. doi: 10.1186/s12894-023-01312-8. PMID: 37648994