Contemporary outcomes of hypospadias retrieval surgery in adults.

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  • Additional Information
    • Source:
      Publisher: Blackwell Science Country of Publication: England NLM ID: 100886721 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1464-410X (Electronic) Linking ISSN: 14644096 NLM ISO Abbreviation: BJU Int Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford, UK : Blackwell Science, c1999-
    • Subject Terms:
      Hypospadias/*surgery ; Plastic Surgery Procedures/*methods ; Urethral Stricture/*surgery ; Urodynamics/*physiology ; Urologic Surgical Procedures, Male/*methods; Adult ; Follow-Up Studies ; Humans ; Hypospadias/physiopathology ; Male ; Postoperative Care/methods ; Prospective Studies ; Reoperation ; Treatment Outcome ; Urethral Stricture/physiopathology
    • Abstract:
      Objective: To describe the surgical approach and outcomes in the treatment of adult patients with complications of childhood hypospadias surgery, as such patients present a significant reconstructive challenge due to the combination of anatomical and cosmetic deformity, which often results in major functional and psychosexual sequelae.
      Patients and Methods: We analysed prospectively collected data on 79 adults with complications of childhood hypospadias surgery, who were operated on between 2004 and 2016. Of the 79 patients, 48 underwent a two-stage urethroplasty using a buccal mucosa graft, and 31 underwent a one-stage distal urethroplasty.
      Results: Patients were followed up using flexible cystoscopy (every 6-9 months). The mean (range) follow-up was 48 (12-96) months. Of the 48 patients who underwent a two-stage repair, eight (16%) needed a revision of the first-stage graft. In total, nine of the 48 patients (16%) developed fistula requiring closure after the second stage; all but one was closed successfully on the first attempt, whilst one required two attempts before closure. Only two of the 48 patients that underwent a two-stage procedure required a re-do urethroplasty within 3 years. Of the 31 patients who underwent a one-stage repair, six (19%) needed fistula closure, all of which were successful. No patient required a further urethroplasty during follow-up.
      Conclusions: Despite the significant surgical challenges found in this patient group, excellent long-term functional outcomes can be achieved. As expected there is a need for additional intervention, either for revision of the first stage or to close fistulae and less commonly for further reconstruction for stricture recurrence.
      (© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.)
    • Contributed Indexing:
      Keywords: #PedUro; #hypospadias; urethral stricture; urethroplasty
    • Publication Date:
      Date Created: 20180420 Date Completed: 20190326 Latest Revision: 20221207
    • Publication Date:
      20250114
    • Accession Number:
      10.1111/bju.14355
    • Accession Number:
      29671932