Our Summary

This research paper examines the factors that make it more likely for a patient to need penile resurfacing techniques (PRSTs) during repeat hypospadias surgeries. Hypospadias is a condition where the hole through which urine leaves the body, or the urethra, is on the underside of the penis instead of at the tip. Sometimes, the first surgery to correct this doesn’t fully resolve the issue, requiring additional surgeries.

The researchers studied the medical records of patients who had repeat hypospadias surgeries between 2010 and 2020. They specifically looked at the techniques used to cover the penis after surgery, as having good, healthy skin cover can reduce complications and improve satisfaction with the surgery.

They found that patients were more likely to need PRSTs if they were older, had more severe hypospadias, had had more surgeries in the past, had the whole surgery done in one stage, used penile skin in the repair, particularly with flap techniques, had more than one complication during the same surgery, and if the skin appearance after surgery was unsatisfactory.

In fact, each additional surgery increased the likelihood of needing PRSTs by 1.9 times for penile resurfacing and 3.2 times for non-penile resurfacing. If the whole surgery was done in one stage, it increased the likelihood of needing PRSTs by 4 times.

In conclusion, the number of previous surgeries and whether the repair was done in one stage are the biggest factors in whether a patient will need PRSTs during repeat hypospadias surgeries.

FAQs

  1. What is hypospadias and why might it require repeat surgeries?
  2. What factors make it more likely for a patient to need penile resurfacing techniques during repeat hypospadias surgeries?
  3. How does the number of previous surgeries and whether the repair was done in one stage affect the likelihood of needing PRSTs during repeat hypospadias surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to make sure to follow post-operative care instructions carefully to promote proper healing and reduce the risk of complications. This may include keeping the surgical site clean, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. Additionally, discussing with your doctor the potential need for penile resurfacing techniques based on your individual risk factors can help ensure the best outcome for your surgery.

Suitable For

Additionally, patients with more severe hypospadias and those who experience multiple complications during surgery are also more likely to require PRSTs. It is important for healthcare providers to take these factors into consideration when planning and performing hypospadias repair surgeries, in order to achieve the best possible outcomes for patients.

Timeline

Before hypospadias repair:

  1. Diagnosis of hypospadias during infancy or childhood
  2. Consultation with a pediatric urologist to discuss treatment options
  3. Pre-operative assessments and evaluations
  4. Consent for surgery obtained from parents or guardians
  5. Surgical procedure to correct the position of the urethral opening

After hypospadias repair:

  1. Post-operative care including pain management and wound care
  2. Follow-up appointments to monitor healing and address any complications
  3. Potential need for additional surgeries or procedures if the initial repair is not successful
  4. Long-term follow-up to monitor for any complications or issues related to the surgery
  5. Potential need for penile resurfacing techniques if the initial repair is not successful or if complications arise

Overall, the timeline for a patient before and after hypospadias repair involves a series of assessments, surgeries, and follow-up care to ensure the best possible outcome for the patient.

What to Ask Your Doctor

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

  1. What is the likelihood that I may need additional surgeries or penile resurfacing techniques in the future?
  2. What factors contribute to the need for penile resurfacing techniques during repeat surgeries?
  3. How many surgeries have you performed for hypospadias repair, and what is your success rate?
  4. What are the potential complications associated with hypospadias repair surgery, and how are they typically managed?
  5. What are the expected outcomes and recovery time for this surgery?
  6. Are there any long-term effects or risks associated with hypospadias repair surgery?
  7. Will I need to follow any specific post-operative care instructions or undergo any additional procedures after surgery?
  8. Are there any alternative treatment options available for my specific case of hypospadias?
  9. How can I best prepare for the surgery and what should I expect during the recovery process?
  10. Are there any resources or support groups available for individuals undergoing hypospadias repair surgery?

Reference

Authors: Omran M, Elgalaly H, Sakr A, Azab AA, Said MA, Abdalla M. Journal: J Pediatr Urol. 2022 Jun;18(3):366.e1-366.e9. doi: 10.1016/j.jpurol.2022.04.001. Epub 2022 Apr 18. PMID: 35474166