Management of 220 adolescents and adults with complications of hypospadias repair during childhood
Adam S. Howea, Moneer K. Hannaa,b
a Division of Pediatric Urology, Cohen Children's Medical Center of New York, Hofstra Northwell School of Medicine, Long Island, NY, USA; b Department of Urology, Weill Cornell Medical Center, New York, NY, USA
Management of 220 adolescents and adults with complications of hypospadias repair during childhood
Adam S. Howea, Moneer K. Hannaa,b
a Division of Pediatric Urology, Cohen Children's Medical Center of New York, Hofstra Northwell School of Medicine, Long Island, NY, USA; b Department of Urology, Weill Cornell Medical Center, New York, NY, USA
摘要 Objective: The goal of hypospadias repair is to achieve normal voiding and good penile cosmesis with minimal complications. Some urethroplasties deteriorate from childhood to adolescence and late stage failures have been reported. We report our experience with adult patients who have had a previous repair during childhood and present with a late complication.Methods: We reviewed the records of 220 patients aged 15-39 years old with a history of hypospadias repair who presented to our clinic. Forty-five patients with chordee, 39 with urethral strictures, 11 urethral fistulae, five with hairy urethras, three with urethral diverticula, and 117 patients with an abnormal glans or subterminal meatus were repaired.Results: Median follow-up was 14 months. Two patients had persistent chordee. Island skin flap urethroplasty afforded one patient with a urethral fistula and another with a recurrent urethral stricture, while the buccal mucosa group had one fistula which healed spontaneously and two recurrent strictures. For the patients undergoing glanular repairs, seven had dehiscence or breakdown of the repair. All other operations were successful..Conclusion: Complications of childhood hypospadias repair may present later in life as some urethroplasties deteriorate with time. We now recommend to parents of children with repaired proximal hypospadias to come for follow-up as their child transitions to adolescence.
Abstract: Objective: The goal of hypospadias repair is to achieve normal voiding and good penile cosmesis with minimal complications. Some urethroplasties deteriorate from childhood to adolescence and late stage failures have been reported. We report our experience with adult patients who have had a previous repair during childhood and present with a late complication.Methods: We reviewed the records of 220 patients aged 15-39 years old with a history of hypospadias repair who presented to our clinic. Forty-five patients with chordee, 39 with urethral strictures, 11 urethral fistulae, five with hairy urethras, three with urethral diverticula, and 117 patients with an abnormal glans or subterminal meatus were repaired.Results: Median follow-up was 14 months. Two patients had persistent chordee. Island skin flap urethroplasty afforded one patient with a urethral fistula and another with a recurrent urethral stricture, while the buccal mucosa group had one fistula which healed spontaneously and two recurrent strictures. For the patients undergoing glanular repairs, seven had dehiscence or breakdown of the repair. All other operations were successful..Conclusion: Complications of childhood hypospadias repair may present later in life as some urethroplasties deteriorate with time. We now recommend to parents of children with repaired proximal hypospadias to come for follow-up as their child transitions to adolescence.
通讯作者:
Adam S. Howe,E-mail address:adamo.howe@gmail.com
E-mail: adamo.howe@gmail.com
引用本文:
Adam S. Howe, Moneer K. Hanna. Management of 220 adolescents and adults with complications of hypospadias repair during childhood[J]. Asian Journal of Urology, 2017, 4(1): 14-17.
Adam S. Howe, Moneer K. Hanna. Management of 220 adolescents and adults with complications of hypospadias repair during childhood. Asian Journal of Urology, 2017, 4(1): 14-17.
[1] Prat D, Natasha A, Polak A, Koulikov D, Prat O, Zilberman M, et al. Surgical outcome of different types of primary hypospadias repair during three decades in a single center. Urology 2012;79:1350e3. [2] Lee OT, Durbin-Johnson B, Kurzrock EA. Predictors of secondary surgery after hypospadias repair; a population based analysis of 5000 patients. J Urol 2013;190:251e5. [3] Nesbit RM. Operation for correction of distal penile curvature with and without hypospadias. J Urol 1967;7:720e2. [4] Baskin LS, Erol A, Li YW, Cunha GR. Anatomical studies of hypospadias. J Urol 1998;160:108e15. [5] Cambareri GM, Hanna MK. Approach to the adult hypospadias patient. In:Wood HM, Wood D, editors. Transition and lifelong care in congenital urology, current clinical urology. Switzerland:Springer International Publishing; 2015. p. 35e42. [6] Hanna MK, Cambareri GM. The adult hypospadias patient:technical challenges in adulthood. In:Wood HM, Wood D, editors. Transition and lifelong care in congenital urology, current clinical urology. Switzerland:Springer International Publishing; 2015. p. 77e96. [7] Snodgrass W, Villanueva C, Bush NC. Duration of follow-up to diagnose hypospadias urethroplasty complications. J Ped Urol 2014;10:208e11. [8] Fam M, Hanna MK. Resurfacing the penis in 215 hypospadias cripples. In:Presentation at the society for pediatric urology, AUA meeting. San Diego; 2016. [9] Barbagli G, Perovic S, Djinovic R, Sansalone S, Lazzeri M. Retrospective descriptive analysis of 1,176 patients with failed hypospadias repair. J Urol 2010;183:207e11.
Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26
-32
.
