Our Summary

This study looked at the relationship between the age of boys when they have surgery to fix a condition called hypospadias (where the opening of the urethra is not at the tip of the penis) and the complications they experience after the surgery. The researchers looked at the records of 98 patients who had this surgery between 2019 and 2022. They divided the patients into two groups: those who had the surgery before they were 2 years old, and those who had the surgery after they were 2 years old.

The study found that the boys who had the surgery after they were 2 years old were more likely to have complications after the surgery. These included problems with the tube used to help them pee (called a stent), severe pain causing a longer hospital stay, and not being able to pee. More than half of the boys with complications needed another procedure to put in a different kind of tube to help them pee.

The researchers suggest that doctors need to take extra steps to prevent these complications for older boys having this surgery. This could include educating parents about how to take care of the stent and the surgical area, making sure the boys take their medicine as directed, and making the stent and the surgical area more secure to prevent the boys from pulling at the stent.

FAQs

  1. Does the age at which a child undergoes hypospadias repair affect the likelihood of early post-operative complications?
  2. What kinds of complications were reported in children who underwent hypospadias repair after the age of 2 years?
  3. What recommendations are given for post-operative care in older children undergoing hypospadias repair?

Doctor’s Tip

A doctor might tell a patient undergoing hypospadias repair to carefully follow post-operative care instructions, especially regarding dressing/stent care and medication compliance. They might also emphasize the importance of preventing the child from pulling at the stent to avoid complications such as dislodgement. Additionally, the doctor may recommend close monitoring and immediate medical attention if any signs of complications such as urinary retention or spasmodic pain occur.

Suitable For

Patients with hypospadias, a congenital condition where the urethra opening is located on the underside of the penis instead of the tip, are typically recommended for surgical repair. This study suggests that patients who undergo hypospadias repair after the age of 2 years may be at a higher risk for early post-operative complications. Therefore, it is important to consider the age of the patient when recommending hypospadias repair and to provide tailored post-operative care to older children to minimize the risk of complications.

Timeline

Timeline of patient experience before and after hypospadias repair:

Before surgery:

  • Patient is diagnosed with hypospadias, a congenital condition where the opening of the urethra is on the underside of the penis.
  • Consultation with a pediatric urologist to discuss treatment options.
  • Pre-operative assessments and tests may be conducted to ensure the patient is healthy enough for surgery.

After surgery:

  • Patients may experience pain, swelling, and discomfort in the genital area immediately after surgery.
  • Stent or catheter may be placed to help with healing and drainage of urine.
  • Patients are typically monitored closely in the hospital for the first few days post-surgery.
  • Follow-up appointments with the urologist to monitor healing and remove any catheters or stents.
  • Patients may need to avoid strenuous activities and follow specific post-operative care instructions to ensure proper healing.
  • Some patients may experience complications such as dislodged stents, spasmodic pain, urinary retention, or infections in the early post-operative period.
  • Older children (aged over 2 years) may be at higher risk for complications and may require additional interventions such as supra-pubic catheter insertion.
  • Parents are educated on dressing and stent care, medication compliance, and other post-operative care instructions.
  • Continued follow-up care with the urologist to monitor long-term outcomes and address any concerns.

What to Ask Your Doctor

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

  1. What is the recommended age for hypospadias repair surgery?
  2. What are the potential complications associated with hypospadias repair surgery?
  3. How can I best prepare for the surgery and post-operative care?
  4. What is the expected recovery time after hypospadias repair surgery?
  5. Are there any specific risks or considerations for older children undergoing hypospadias repair surgery?
  6. What measures can be taken to prevent or minimize complications during the post-operative period?
  7. How will pain management be handled after the surgery?
  8. What signs or symptoms should I watch for that may indicate a complication after surgery?
  9. Will additional procedures, such as supra-pubic catheter insertion, be necessary in some cases?
  10. Are there any long-term considerations or follow-up care needed after hypospadias repair surgery?

Reference

Authors: Dale J, Woodward B, Elagami H. Journal: Pediatr Surg Int. 2023 Feb 11;39(1):115. doi: 10.1007/s00383-023-05388-z. PMID: 36773206