Our Summary

This research paper examines the outcomes and complications after repairing redo and cripple hypospadias in children. Hypospadias is a birth defect in boys where the opening of the urethra is not located at the tip of the penis. In this study, 31 children who had undergone previous surgeries three to five times were operated on by a single surgeon. The surgical procedure involved penile straightening and grafting of the ventral surface.

The results showed a success rate of 56% after the second surgery, with complications in 11 children. However, after additional treatment for penoscrotal fistulae (a condition where an abnormal connection develops between the penis and scrotum), the overall success rate increased to 72%.

The study concluded that the repair of redo and cripple hypospadias using staged graft repair in children could achieve a satisfactory success rate of 72%. The main complication was glanular dehiscence (a condition where the glans penis or the head of the penis splits open), but this was not considered a significant concern by the parents of the children involved in the study. The lowest complication rate occurred among those with a more distal (or lower) urethral opening, but this was not statistically significant.

FAQs

  1. What is hypospadias and how is it repaired?
  2. What was the success rate of the hypospadias repair surgery according to the research?
  3. What were the main complications noted in the study after the hypospadias repair surgery?

Doctor’s Tip

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

Suitable For

Patients who are typically recommended hypospadias repair are those who have a congenital urethral anomaly where the opening of the urethra is not located at the tip of the penis. This includes children with mild to severe forms of hypospadias, as well as those who have undergone previous surgeries that were unsuccessful in correcting the condition. Additionally, patients with complications such as penoscrotal fistulae may also be recommended for hypospadias repair.

It is important for patients to be evaluated by a urologist or pediatric surgeon to determine the best course of treatment for their specific case of hypospadias. Staged graft repair, as mentioned in the study, may be recommended for patients with redo or cripple hypospadias to achieve a satisfactory success rate and minimize complications.

Timeline

Before hypospadias repair:

  1. Diagnosis of hypospadias at birth or during early childhood.
  2. Consultation with a pediatric urologist to discuss treatment options.
  3. Pre-operative evaluations and tests to assess the severity of the condition.
  4. Surgical planning and discussion with the parents about the procedure.

After hypospadias repair:

  1. Recovery period following surgery, which may involve pain management and monitoring for complications.
  2. Follow-up appointments with the surgeon to assess healing and address any concerns.
  3. Gradual improvement in urinary function as the urethra heals and the opening is in the correct location.
  4. Long-term monitoring for potential complications, such as fistula formation or stricture development.
  5. Psychological support for the child and family to address any emotional or social challenges related to the condition and its treatment.

What to Ask Your Doctor

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

  1. What is the success rate of the surgical procedure for hypospadias repair in children who have undergone multiple surgeries?
  2. What are the potential complications associated with this type of surgery, and how are they typically managed?
  3. How many surgeries will be needed to achieve a successful repair in my child’s case?
  4. What is the expected recovery time after the surgery, and when can my child resume normal activities?
  5. Are there any long-term implications or risks associated with hypospadias repair surgery?
  6. What is the experience of the surgeon in performing this type of procedure, and how many similar surgeries have they successfully completed?
  7. Are there any alternative treatment options available for hypospadias repair, and if so, what are the pros and cons of each option?
  8. What follow-up care will be needed after the surgery, and how frequently will my child need to be monitored?
  9. How can I best support my child during the recovery process, and are there any specific precautions or care instructions I should be aware of?
  10. What is the expected outcome for my child after undergoing hypospadias repair surgery, and what are the chances of a successful outcome based on their specific case?

Reference

Authors: Badawy H, Soliman A, Moussa A, Youssef M, Fahmy A, Dawood W, Elmesiry M, Assem A, Elsayed S, Abulfotooh Eid A, Orabi S. Journal: J Pediatr Urol. 2019 Apr;15(2):151.e1-151.e10. doi: 10.1016/j.jpurol.2019.01.002. Epub 2019 Jan 18. PMID: 30833176