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العنوان
Outcome and Complications of Hypospadias repair, A Retrospective Observational single centre study /
المؤلف
Arafa, Hisham Ahmed.
هيئة الاعداد
باحث / هشام أحمد عرفه
مشرف / طارق مصطفى الزيات
مشرف / سمير سيد محمد عزازي
الموضوع
Hypospadias repair-
تاريخ النشر
2015.
عدد الصفحات
163 p. ;
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
جراحة المسالك البولية
تاريخ الإجازة
1/1/2015
مكان الإجازة
جامعة عين شمس - كلية الطب - Urology
الفهرس
Only 14 pages are availabe for public view

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Abstract

H
ypospadias is the most common congenital anomaly of the penis, by meatal location hypospadias is classified as anterior (glanular and subcoronal), penile (distal penile and midshaft), and posterior (proximal penile, penoscrotal, scrotal, and perineal).
Urethrocutaneous fistula is the most common complication after hypospadias repair. However, there are other complications including meatal stenosis, neo-urethral stricture, balanitis xerotica obliterans, urethral diverticulum and wound dehiscence.
Our work is to present and analyze the postoperative outcome and complications of hypospadias repair and the factors influencing them at department of Urology Ain-shams university hospitals.
Our study was conducted on eighty-four patients, seven missed follow up and seventy-seven were included in the study admitted through the outpatient clinic of Urology department, Ain Shams University Hospitals through the period from January 2013 to January 2015 where All the demographic data, clinical presentation, surgical treatment were collected from the department records.
Patients included in the study were categorized into three groups as coronal, penile (including distal penile and, mid-penile hypospadias) and proximal hypospadias (including proximal penile, penoscrotal, scrotal and perineal hypospadias).
Follow-up schedule included an informative clinical examination within a period ranging from 6 months to 1 year post-operative to assess functional outcome.
In our study coronal hypospadias was the most common type in 37 cases (48.1%), followed by penile hypospadias with 33 cases (42.9%) then proximal hypospadias with 7 cases (9.1%).
Of the total study population, 17 cases (22.1%) were associated with chordee, Penile rotation was observed in 7 cases (9.1 %) and 9 cases (11.7%) were circumcised while meatal stenosis was present in 7 cases (9.1%).
In our study, the most common used procedure was Snod- grass repair with 38 cases, six cases of which were complicated, followed by longitudinal preputial flap technique used in 16 cases, five cases of which were complicated, then MAGPI used in 9 cases, none of which was complicated.
The most common complication was UCF which was observed in 11 cases with incidence rate of 14.3%, the second most common complication was disruption, observed in 7 patients with incidence rate of 9.1% to be followed by penile torsion in 3 cases (3.9 %).
On the basis of our experience with this study, we recommend improving the public health care awareness about hypospadias to be operated in the recommended age window, avoidance of circumcision of hypospadiac children and proper follow up after surgery to improve outcome.