Hui-Jing technique for one-stage severe primary hypospadias repair: Long-term analysis compared to the Cloutier/ Bracka technique

Purpose

This study aims to evaluate the long-term outcomes of the Hui-Jing technique (lingual mucosa combined with longitudinal preputial island flap onlay urethroplasty and tubularized incised plate glansplasty), a one-stage surgical technique developed by Dr. Huixia Zhou and Dr. Weijing Ye for the severe primary hypospadias repair, focusing on evaluating complication rates, functional success, and cosmetic satisfaction with comparisons to the two-stage Bracka technique.

Materials and methods

42 patients with severe hypospadias underwent surgery using the Hui-Jing technique between 2017 and 2019. Follow-up over a median of 72 months assessed complications and satisfaction using the Penile Perception Score (PPS), Hypospadias Objective Score Evaluation (HOSE), and International Index of Erectile Function-5 (IIEF-5) questionnaires. Data from 40 patients undergoing the Cloutier/Bracka technique served as a comparative cohort.

Results

Among the 42 Hui-Jing patients (median age 3 years), the mean operative time was 201 min, and the median follow-up period was 71 months. Complications occurred in 21 % of patients, with urethral stricture in 10 %, fistula in 14 %, and diverticulum in 2 %, compared to a higher complication rate in the Cloutier/Bracka group. Over 80 % of patients and their families provided high scores in HOSE and PPPS surveys, surpassing scores from the Bracka group. One patient (age>18) completed the IIEF-5 survey, achieving a score of 24, indicating normal sexual function.

Conclusions

The Hui-Jing technique provides a safe and effective one-stage approach for repairing severe hypospadias, with a lower risk of complications and higher patient satisfaction.