Outcomes of Management of Hypospadias at a Teaching Hospital in Nigeria

Abstract

Hypospadias is a congenital malformation of the urethra that requires surgical correction in children. This poses some challenges to the surgeon especially where facilities are lacking. There is scanty report of encounters in the management of this condition from our subregion. Hence, we retrospectively reviewed the presentation and outcome of management of hypospadias at a tertiary health facility in Nigeria between Jan 2002 and Oct. 2009.There were 61 children with hypospadias during the period of which 47 (77.1%) had urethroplasty and this comprised 11 proximal, 4 midshaft and 32 distal types. Their ages ranged between 2 months and 14 years, median= 18 months. Ten patients declined surgery and 4 are awaiting intervention because of age and size of penis. Co-morbidities were ambiguous genitalia 3, Down's syndrome 1, undescended testis 3 and 2 haemoglobin SS patients. Five patients presented with circumcised hypospadias. Various techniques of urethroplasty were done with improvised equipments due to resource limitation. There was no mortality but complication rate was 36.7% which included 9 post- urethroplasty fistulas and 2 with complete dehiscence that needed a secondary repair. There were 3 post operative morbidity out of 5 circumcised hypospadias (p=0.127). Length of hospital stay was between 1 and 18 days (median 7.8 days). In conclusion, there is need for public education about hypospadias presentations to prevent delay referral and undue circumcision. Provision of appropriate equipments will facilitate better outcome of paediatric urethroplasty.