OBJECTIVES: To evaluate the results of one-stage and multistage urethroplasty in adults with complications following multiple failed hypospadias repairs. METHODS: Sixty adults underwent reconstructive surgery of the following complications after hypospadias repair: stricture (34), residual hypospadias (26), fistula (18), meatal stenosis (11), penile curvature (9), hair (4), diverticula (2), and stone (1). A total of 36% of the patients had one complication and 64% had two or more complications. Twenty-nine patients underwent one-stage repair with buccal or skin grafts or direct repair, and 31 underwent multistage repairs with buccal or skin grafts. RESULTS: Mean follow-up was 33.8 mo. Of the 60 cases, 45 (75%) had a final successful outcome and 15 (25%) failed. One-stage repair provided 24 (82.7%) successes and 5 (17.3%) failures. Multistage repair provided 21 (67.7%) successes and 10 (32.3%) failures. Buccal mucosa grafts provided 81% of success in one-stage procedures and 82.3% in multistage procedures. Penile skin grafts provided 80% of success in one-stage procedures and 50% in multistage procedures. CONCLUSIONS: Adults with complications following childhood hypospadias repair are still a difficult population to treat with a high failure rate for reoperative surgery.
OBJECTIVES: To evaluate the results of one-stage and multistage urethroplasty in adults with complications following multiple failed hypospadias repairs. METHODS: Sixty adults underwent reconstructive surgery of the following complications after hypospadias repair: stricture (34), residual hypospadias (26), fistula (18), meatal stenosis (11), penile curvature (9), hair (4), diverticula (2), and stone (1). A total of 36% of the patients had one complication and 64% had two or more complications. Twenty-nine patients underwent one-stage repair with buccal or skin grafts or direct repair, and 31 underwent multistage repairs with buccal or skin grafts. RESULTS: Mean follow-up was 33.8 mo. Of the 60 cases, 45 (75%) had a final successful outcome and 15 (25%) failed. One-stage repair provided 24 (82.7%) successes and 5 (17.3%) failures. Multistage repair provided 21 (67.7%) successes and 10 (32.3%) failures. Buccal mucosa grafts provided 81% of success in one-stage procedures and 82.3% in multistage procedures. Penile skin grafts provided 80% of success in one-stage procedures and 50% in multistage procedures. CONCLUSIONS: Adults with complications following childhood hypospadias repair are still a difficult population to treat with a high failure rate for reoperative surgery.
Authors: Stefan Tritschler; Alexander Roosen; Claudius Füllhase; Christian G Stief; Herbert Rübben Journal: Dtsch Arztebl Int Date: 2013-03-29 Impact factor: 5.594
Authors: Patrick J Bastian; Margit Mayer; Stefan Tritschler; Alexander Roosen; Philipp Nuhn; Ricarda M Bauer; Christian Gozzi Journal: World J Urol Date: 2011-10-12 Impact factor: 4.226