Our Summary

This study looks at the reasons why some patients need multiple surgeries after a procedure to fix a condition called hypospadias, where the opening of the urethra (the tube that carries urine out of the body) is not at the tip of the penis. The researchers looked back at patient records from a single hospital over a period of nine years.

Out of 507 patients who needed additional surgeries following their initial hypospadias repair, the researchers identified some common problems that led to these additional surgeries: severe recurrent ventral curvature (a condition where the penis curves downward), urethral stricture (a narrowing of the urethra), dehiscence (a surgical wound that reopens), and those who had a specific type of initial repair called a primary staged hypospadias repair.

In contrast, they found that having a diverticulum (a small pouch in the urethra) actually decreased the risk of needing multiple surgeries.

Knowing these risk factors can help doctors anticipate which patients may need more surgeries in the future and may improve the results of the surgery.

FAQs

  1. What is hypospadias and how is it repaired?
  2. What are the common problems that lead to additional surgeries after an initial hypospadias repair?
  3. How can understanding these risk factors improve the results of hypospadias surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to closely follow post-operative care instructions, including proper wound care and avoiding activities that may put strain on the surgical site. Additionally, it is important to attend all follow-up appointments with the surgeon to monitor healing progress and address any potential complications early on.

Suitable For

Typically, patients who are recommended hypospadias repair are those who have a urethral opening located on the underside of the penis rather than at the tip. These patients may experience difficulty with urination, sexual function, and self-esteem due to the appearance of the penis. Hypospadias repair is often recommended for infants and young children, but can also be performed in older children and adults. In some cases, multiple surgeries may be needed to achieve the desired outcome, especially if complications arise or if the initial repair was not successful.

Timeline

Before hypospadias repair:

  1. Patient is diagnosed with hypospadias, where the opening of the urethra is not at the tip of the penis.
  2. Patient undergoes initial consultation with a urologist to discuss treatment options.
  3. Surgery is scheduled to repair the hypospadias and reposition the urethral opening to the tip of the penis.

After hypospadias repair:

  1. Patient undergoes surgery to correct the hypospadias and reposition the urethral opening.
  2. Recovery period following surgery, which may include pain management and wound care.
  3. Follow-up appointments with the urologist to monitor healing and address any complications.
  4. Some patients may experience complications such as recurrent ventral curvature, urethral stricture, dehiscence, or need for additional surgeries.
  5. Patients who require additional surgeries may undergo procedures to address these complications and improve the outcome of the initial repair.
  6. Long-term follow-up to monitor for any further complications and ensure optimal outcomes.

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 hypospadias repair surgery?
  2. What is the success rate of the surgery in terms of correcting the condition?
  3. How many surgeries might be needed to achieve the desired outcome?
  4. What is the expected recovery time and post-operative care plan?
  5. Are there any long-term effects or complications that I should be aware of?
  6. Will additional surgeries be needed in the future, and if so, what are the reasons for this?
  7. What are the alternative treatment options available for hypospadias?
  8. What is the experience and success rate of the surgeon in performing hypospadias repair surgeries?
  9. How can I best prepare for the surgery and what should I expect during the recovery process?
  10. Are there any lifestyle changes or precautions I should take after the surgery to ensure the best possible outcome?

Reference

Authors: Ru W, Tang D, Wu D, Tao C, Chen G, Wei J, Tian H, Shu Q. Journal: J Pediatr Urol. 2021 Feb;17(1):61.e1-61.e5. doi: 10.1016/j.jpurol.2020.11.010. Epub 2020 Nov 12. PMID: 33246830