IMMEDIATE RESULTS OF URETROPLASTY IN DIFFERENT FORMS OF HYPOSPADIAS

Abstract

Objective: To summarize a ten-year experience of urethroplasty in various forms of hypospadias. Methods: The results of surgical treatment of 165 patients with hypospadias aged 2-25 years operated at the Maiwand Hospital in Kabul were analyzed. More than half of the patients (n=95; 57.6%) were residents of Kabul province, while the remaining patients (n=60; 42.4%) came from other provinces of Afghanistan. The following forms of hypospadias were identified: glanular (n=40; 24.2%), coronal (n=45; 27.3%), mid-penile (n=51; 30.9%), and scrotal (n=29; 17, 6%). Results: Most of the patients were operated using the Salinas method (n=30; 18.2%), Dupley repair (n=40; 24.2%), and their combinations (n=20; 12.1%) methods. Patients with severe penile curvature, scrotal and perineal forms of hypospadias underwent the two-stage operations. General anesthesia was mainly used for surgery, while local anesthesia with neuroleptanalgesia was applied in patients aged 15 years and above. In all cases, optical magnification and microsurgical technique were used. Satisfactory results were obtained in 140 (84.8%) patients. Urethro-cutaneous fistulas developed in 20 (12.2%) patients. Marginal flap necrosis occurred in 2 (1.2%) cases, and partial wound suppuration occurred in 3 (1.8%) cases. There were no lethal outcomes.Conclusion: The use of optical magnification and precision technique made it possible to achieve satisfactory results in the early postoperative period in 84.8% of patients. Our observations showed that circumcision in children should only be performed by an experienced surgeon, since in most cases a novice surgeon can miss the presence of hypospadias. Patients diagnosed with hypospadias, should be referred to specialized centers where successful urethroplasty operations may be performed. Keywords: Hypospadias, glanular form, coronal form, mid-penile form, scrotal form, urethroplasty, urethro-cutaneous fistula.