Our Summary

This research paper discusses a common complication following surgery for hypospadias, a birth defect in boys where the opening of the urethra is on the underside of the penis. This complication is a narrowing of the new urethra, or neourethra, and it happens more frequently when the surgery uses skin flaps to repair the urethra. These narrowings, or strictures, cause symptoms like painful urination, inability to urinate, and urinary tract infections. The diagnosis is confirmed during a procedure to look inside the urethra. The most common ways of fixing the stricture involve either a single surgery using a graft, or a two-step process using tissue from the inside of the mouth.

FAQs

  1. What are the common symptoms that suggest a stricture after hypospadias repair?
  2. How is a stricture after hypospadias repair diagnosed?
  3. What are the most common repair procedures for neourethra stricture after hypospadias surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hypospadias repair is to carefully follow post-operative instructions, including avoiding strenuous activities and keeping the surgical site clean and dry to promote proper healing and reduce the risk of complications such as infection or stricture formation. Regular follow-up appointments with the doctor are also important to monitor the healing process and address any concerns promptly.

Suitable For

Patients who are typically recommended hypospadias repair are those who have undergone previous hypospadias surgery and are experiencing complications such as stricture of the neourethra. Symptoms of stricture may include stranguria, urinary retention, and urinary tract infections. Patients may undergo urethroscopy to confirm the diagnosis of stricture before undergoing repair. Common repairs for neourethra stricture after hypospadias surgery include single-stage dorsal inlay graft and 2-stage labial mucosa replacement urethroplasty.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with hypospadias, a congenital condition where the opening of the urethra is on the underside of the penis
  • Patient may experience difficulty with urination, abnormal spraying of urine, or other urinary symptoms
  • Surgical consultation is scheduled to discuss treatment options for hypospadias repair

After hypospadias repair:

  • Patient undergoes surgical repair of the hypospadias, which may involve using skin flaps, urethral plate tubularization, or neo-plate tubularization techniques
  • Patient may experience temporary pain, swelling, and discomfort following surgery
  • Patient is monitored for complications such as urethral strictures, which can cause symptoms such as stranguria, urinary retention, and urinary tract infections
  • If a stricture is suspected, urethroscopy may be performed to confirm the diagnosis
  • Treatment for neourethral stricture after hypospadias surgery may involve single-stage dorsal inlay graft or 2-stage labial mucosa replacement urethroplasty
  • Patient undergoes follow-up appointments to monitor the success of the repair and address any ongoing symptoms or complications

What to Ask Your Doctor

  1. What are the potential complications of hypospadias repair surgery?
  2. How common is the occurrence of strictures after hypospadias repair?
  3. What are the symptoms of a stricture after hypospadias repair?
  4. How is a stricture diagnosed after hypospadias repair?
  5. What are the treatment options for a stricture after hypospadias repair?
  6. What is the success rate of repairing a stricture after hypospadias surgery?
  7. Are there any long-term effects or risks associated with a stricture after hypospadias repair?
  8. Are there any lifestyle changes or precautions I should take after undergoing hypospadias repair surgery to prevent strictures or other complications?

Reference

Authors: Snodgrass WT, Bush NC. Journal: Urol Clin North Am. 2017 Feb;44(1):105-111. doi: 10.1016/j.ucl.2016.08.014. PMID: 27908364