The Outcomes of Urethroplasty for Hypospadias Repair in M. Djamil Hospital, Padang, Indonesia
Pande Made Wisnu Tirtayasa *
Department of Surgery, Division of Urology, Universitas Indonesia, Jakarta, Indonesia
Yevri Zulfiqar
Department of Surgery, Division of Urology, M. Djamil Hospital / Faculty of Medicine, University of Andalas, Padang, Indonesia
Alvarino .
Department of Surgery, Division of Urology, M. Djamil Hospital / Faculty of Medicine, University of Andalas, Padang, Indonesia
*Author to whom correspondence should be addressed.
Abstract
Background: Hypospadias is believed to result from arrested penile development, leaving a proximal urethral meatus. It has challenged generations of reconstructive surgeons trying to extend the urethra with the goal of restoring as normal function and appearance as possible. It is commonly written that more than 200 urethroplasty techniques have been described.
Methods: We retrospectively review the medical records of patients with hypospadias that has been done urethroplasty for hypospadias repair in M. Djamil Hospital from January 2012 to January 2014. The inclusion criteria were all medical records of patients with hypospadias who underwent urethroplasty. The medical records with uncompleted data were excluded. Patients were followed-up by coming to the urology office in M. Djamil Hospital and by phone calling. The successful of therapy defines as no complications based on history taking and physical examination. The techniques used in the study were tubularized incised plate (TIP) technique, Koyanagi technique, onlay island preputial flap technique, transverse island preputial flap technique, and other techniques.
Results: Fifty-four hypospadias cases were included in the study, with 27 (50%) cases had underwent TIP technique, 15 (23.1%) cases underwent Koyanagi technique, 5 (7.7%) cases underwent onlay island preputial flap technique, 4 (6.2%) underwent transverse island preputial flap technique, and 3 (4.6%) cases underwent other techniques as their therapy for hypospadias. The positions of the meatus were in the glans (11.1%), distal shaft (13%), middle shaft (33.3%), proximal shaft (22.2%) and scrotal (20.4%). The overall complications were 13 (24.1%) cases include wound dehiscence 6 (46.2%) cases, fistulae 2 (15.4%) cases, difficult to urinate 2 (15.4%) cases, penile torsion 1 (7.6%) case, and hematoma 2 (15.4%) cases.
Conclusions: Hypospadias repair remains challenging based on urethroplasty techniques and complications following it. Surgical correction of hypospadias is individualized with the aims of achieving proper urinary function with adequate cosmesis.
Keywords: Hypospadia, urethroplasty, outcome, complication