Outcome of Adult Hypospadias Repair

Chang, Hyuk Soo; Kim, Kwang Sae

Abstract

PURPOSE
The modern era of hypospadias surgery has brought functional and cosmetic results to a high level in children. However, little data are available on the outcome of adult hypospadias repairs. The objective of this study was to evaluate the results of 46 adult patients with hypospadias repairs.
MATERIALS AND METHODS
One surgeon performed forty-six consecutive adult hypospadias repairs. The mean age at the time of surgery was 22.1 years (range 13 to 59). Follow up ranged from 3 months to 7 years (mean 11.3 months). We retrospectively analyzed surgical outcomes, with respect to previous repair, surgical procedure and complications.
RESULTS
Of 46 adult hypospadias patients, 20 had had previous repairs and 26 had had no previous repairs. Surgical procedures consisted of 7 onlay island flap, 6 pyramid, 4 transverse island flap, 2 King, 3 MAGPI, 2 Mathieu, 3 tubularized incised plate and 1 meatal advance in the group with no previous repairs. In the group that had undergone previous repairs there were 10 Thiersch-Duplay, 2 Johanson, 2 transverse island flap, 1 MAGPI, 1 King, 1 Durham-Smith, 1 Mustard, 1 meatal advance and 1 onlay island flap. Complications developed in 11 patients from the no previous repair group, including 6 fistula, 2 stricture, 4 wound infection, 2 wound dehiscence and 1 ventral curvature, and were as follows for the previous repair group; 12 fistula, 5 stricture, 3 wound infection and 4 wound dehiscence.
CONCLUSIONS
For both groups analysed, adult hypospadias repair was much less successful than childhood repair. Further studies are necessary to decrease the complications.