Complications of proximal hypospadias repair with transverse preputial island flap urethroplasty:a 15-year experience with long-term follow-up

• 来源期刊: 亚洲男性学杂志（英文版）
• 年，卷（期）: 2019,（3）
• 页码范围: 300-303
• 页数: 4页
• 语种: 英文

摘要

There is still debate regarding the optimal surgical approach for proximal hypospadias.This retrospective study aims to evaluate the long-term outcomes using transverse preputial island flap urethroplasty.A total of 320 patients were included,with a mean follow-up of 40.2 months (range:1-156 months).Complications were encountered in 125 patients (39.1％),including fistulas in 53 (16.6％),urethral strictures in 31 (9.7％),and diverticula in 41 (12.8％).The mean timing of presentation with a complication was 15.8 months (median:1.7,range:1-145),of which 79.2％ were early complications and 20.8％ were late complications.In all,20.8％ of the patients with complications presented after ＞1 year,and 12.8％ presented after ＞5 years.Univariate analysis revealed that age at the time of surgery,flap length,and location of the urethral meatus were not correlated with complications.A stricture was present in 31.7％ (13/41) of those with diverticula (P ＜ 0.001),while late urethral diverticula were accompanied by urethral strictures in 11.1％ (1/9) of cases (P=0.213).These results indicate that transverse preputial island flap urethroplasty still has a high incidence of complications,even when performed by highly experienced physicians.Most complications of hypospadias are diagnosed within 1 year postoperatively,while fistulas and urinary strictures generally occur within 2 months and diverticula tend to be present by 1 year.