Our Summary

This research study examines the long-term results of redoing a specific type of surgery called hypospadias, which is performed when the first attempt has failed. The study involves 164 patients who had their surgeries redone at a certain medical center. These patients had their surgeries redone successfully and had been followed up for at least three years after their surgeries.

The average age of the patients was about 91 months, or around 7.5 years. The average time they were followed up after their successful surgery was about 41 months, or around 3.4 years. Of these patients, 92 of them had one previous surgery, while 72 had two or three previous surgeries.

The type of surgery performed the second time around depended on several factors, such as the remaining healthy skin and the surgeon’s expertise. For those who had one failed surgery, six different surgical techniques were used. For those who had two or three failed surgeries, four different techniques were used.

The study concludes that the type of surgery chosen for redoing hypospadias would depend on various factors. However, certain techniques appear to be safer for redoing hypospadias after its first failure. After a second or third failure, different techniques can be performed.

Hypospadias is a birth defect in boys where the opening of the tube that carries urine from the bladder (urethra) is not located at the tip of the penis, and this surgery aims to correct that.

FAQs

  1. What were the inclusion criteria for the individuals in the retrospective cohort study on redo-hypospadias?
  2. What were the main types of repair methods used for individuals in group A and group B in the study on redo-hypospadias?
  3. What factors influence the selected type of repair in redo-hypospadias procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include keeping the surgical area clean, avoiding strenuous activities, and attending follow-up appointments as scheduled. Additionally, it is important to communicate any concerns or unusual symptoms to the doctor promptly.

Suitable For

Patients who are typically recommended hypospadias repair are those who have had a previous unsuccessful repair and are experiencing complications such as urethral stricture, fistula formation, or curvature of the penis. These patients may have residual healthy local skin and may require more complex surgical techniques for successful repair. The type of repair recommended will depend on factors such as the location of the hypospadias, the extent of the previous repair, and the expertise of the surgical team. Safe techniques for repair of redo hypospadias after its 1st failure include TIPU, Mathieu, UM, OIF, and DIGU for distal varieties, while staged BMG can be applied for proximal ones after 2nd or 3rd repair.

Timeline

  • Patient undergoes initial hypospadias repair surgery
  • Patient experiences complications or unsatisfactory results from initial repair
  • Patient is referred to tertiary referral center for redo-hypospadias repair
  • Patient undergoes successful redo-hypospadias repair surgery
  • Patient has at least three years of follow-up at the last hospital visit
  • Patient experiences improvement in symptoms and satisfaction with results of redo-hypospadias repair

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with the hypospadias repair procedure?
  2. What is the success rate of the specific repair technique being recommended for my case?
  3. How long is the recovery period after the hypospadias repair surgery?
  4. Will there be any long-term effects or implications of the hypospadias repair surgery?
  5. Are there any alternative treatment options for hypospadias repair that I should consider?
  6. How many times has the doctor performed this specific type of hypospadias repair procedure?
  7. What is the expected outcome or result of the hypospadias repair surgery in my case?
  8. How will the hypospadias repair surgery impact my daily activities and lifestyle?
  9. Are there any special precautions or post-operative care instructions I should follow after the hypospadias repair surgery?
  10. What is the follow-up care plan after the hypospadias repair surgery?

Reference

Authors: Hammouda HM, Shahat AA, Safwat AS, Taha TM. Journal: BMC Pediatr. 2024 Jan 19;24(1):58. doi: 10.1186/s12887-024-04534-3. PMID: 38243172