Complications of proximal hypospadias repair with transverse preputial island flap urethroplasty: a 15-year experience with long-term follow-up.
- Author:
Chao-Xu WANG
1
;
Wei-Ping ZHANG
1
;
Hong-Cheng SONG
1
Author Information
- Publication Type:Research Support, Non-U.S. Gov't
- Keywords: diverticulum; fistula; follow-up; hypospadias; late complications; urethral stricture
- MeSH: Age Factors; Child; Child, Preschool; Diverticulum/therapy*; Follow-Up Studies; Humans; Hypospadias/surgery*; Incidence; Infant; Male; Postoperative Complications/therapy*; Retrospective Studies; Surgical Flaps; Urethra/surgery*; Urethral Stricture/therapy*; Urologic Surgical Procedures, Male/methods*
- From: Asian Journal of Andrology 2019;21(3):300-303
- CountryChina
- Language:English
- Abstract: There is still debate regarding the optimal surgical approach for proximal hypospadias. This retrospective study aims to evaluate the long-term outcomes using transverse preputial island flap urethroplasty. A total of 320 patients were included, with a mean follow-up of 40.2 months (range: 1-156 months). Complications were encountered in 125 patients (39.1%), including fistulas in 53 (16.6%), urethral strictures in 31 (9.7%), and diverticula in 41 (12.8%). The mean timing of presentation with a complication was 15.8 months (median: 1.7, range: 1-145), of which 79.2% were early complications and 20.8% were late complications. In all, 20.8% of the patients with complications presented after ≥1 year, and 12.8% presented after ≥5 years. Univariate analysis revealed that age at the time of surgery, flap length, and location of the urethral meatus were not correlated with complications. A stricture was present in 31.7% (13/41) of those with diverticula (P < 0.001), while late urethral diverticula were accompanied by urethral strictures in 11.1% (1/9) of cases (P = 0.213). These results indicate that transverse preputial island flap urethroplasty still has a high incidence of complications, even when performed by highly experienced physicians. Most complications of hypospadias are diagnosed within 1 year postoperatively, while fistulas and urinary strictures generally occur within 2 months and diverticula tend to be present by 1 year.
