Our Summary

This study looks at a complication known as Glans dehiscence (GD) that often occurs after surgery to correct a birth defect in boys where the urinary opening is not at the usual location. This complication is common, but whether it requires additional surgery is debatable.

To understand this better, the researchers looked at patients who had this type of surgery between 2000 and 2011. These patients were asked whether they thought they had GD and could submit a photograph for a surgeon to evaluate as well.

Out of 219 patients, 34 participated in the study. 14 of these patients reported having GD. However, when the surgeon reviewed the photos, they found that more patients had GD than had self-reported it. There was disagreement between the patients’ reports and the surgeons’ assessments.

The study also found that patients who reported having GD were more likely to have had a curved penis at the time of their initial diagnosis and were more likely to have had a certain type of surgical repair. However, there was no significant difference in the patients’ satisfaction with the cosmetic and functional outcomes of their surgery, regardless of whether they had GD or not.

In conclusion, while GD is a common complication after surgery for this birth defect, it doesn’t appear to have a significant impact on the patient’s satisfaction or quality of life. Therefore, the researchers suggest that additional surgery to correct GD should only be considered if the patient specifically requests it.

FAQs

  1. What is Glans dehiscence (GD) and how common is it after hypospadias repair surgery?
  2. What were the key findings of this study about GD and hypospadias repair surgery?
  3. What is the recommended course of action if a patient has GD after hypospadias repair surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about hypospadias repair is to be aware of the potential complication of Glans dehiscence (GD) and to inform their surgeon if they notice any issues with the healing process after surgery. It’s important for patients to communicate openly with their healthcare provider about any concerns or changes they experience post-surgery to ensure the best possible outcome.

Suitable For

Typically, patients who have undergone hypospadias repair surgery are recommended for further evaluation if they experience complications such as Glans dehiscence. However, based on the findings of this study, additional surgery to correct GD may not necessarily be required unless specifically requested by the patient. Patients who have had a curved penis at the time of their initial diagnosis or a certain type of surgical repair may be more likely to experience GD, but overall, the presence of GD does not seem to significantly impact the cosmetic or functional outcomes of the surgery.

Timeline

Before hypospadias repair, a patient may experience difficulty with urination, abnormal placement of the urinary opening, and potential psychological distress due to the appearance of the genitalia. After hypospadias repair, the patient may experience some discomfort and swelling in the surgical area, as well as the need for a catheter for a period of time. Over the following weeks and months, the patient will likely need to attend follow-up appointments with their surgeon to monitor healing and ensure proper function of the repaired urinary opening. In the long term, the patient should experience improved urinary function and a more aesthetically pleasing appearance of the genitalia.

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, including Glans dehiscence (GD)?
  2. How common is GD after hypospadias repair surgery?
  3. How is GD typically treated or managed?
  4. How will GD affect the cosmetic and functional outcomes of the surgery?
  5. Are there any specific risk factors that may increase the likelihood of developing GD?
  6. What are the signs and symptoms of GD that I should watch out for after surgery?
  7. How will GD be diagnosed and monitored post-surgery?
  8. If GD does occur, when should I seek medical attention and what treatment options are available?
  9. Will additional surgery be necessary to correct GD, and if so, what are the potential risks and benefits of this procedure?
  10. What can I do to prevent or minimize the risk of developing GD after hypospadias repair surgery?

Reference

Authors: Durante L, Ghidini F, Panchieri F, Bovolenta E, Bagnara V, Esposito C, Castagnetti M. Journal: Pediatr Surg Int. 2023 Feb 3;39(1):101. doi: 10.1007/s00383-023-05387-0. PMID: 36737577