Causes of failure in primary hypospadias repair: A prospective single-surgeon cohort study

ABSTRACT

OBJECTIVE: To identify the possible causes of failure in hypospadias repair and to evaluate the authors' own results in this demanding surgery. MATERIALS AND METHODS: Seventy-five consecutive boys, 3 months-15 years age underwent tubularized incised plate urethroplasty  with the corpus spongiosum as 3rd layer. Patient-related and surgeon-related factors were recorded preoperatively, intra-operatively, and postoperatively. Complications were recorded prospectively, initially after one week follow up. RESULTS: Overall complication rate was 41%. Fistula rate was 22.67%. Among the patient-related factors, meatal location (P=0.001), degree of severity of scrotal transposition (P=0.002) and atrophic proximal skin length (P=0.040) were significantly contributing to the risk of failure. The more developed the corpus spongoisum is, the risk of fistula formation decreases by 2.78 times (OR=0.36 P=0.043). CONCLUSION: Only patient-related factors primarily meatal location, degree of severity of scrotal transposition and presence of atrophic proximal skin are significantly associated with failure. Their presence would increase the risk of complication from 1.13 times to 8.5 times. The association of surgeon-related factors to the outcome of surgery varies from protective to risk.