Ten-year Experience of Adult Hypospadias Repairs at a Single Center / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We retrospectively evaluated the results and complications of urethroplasty in adult patients with hypospadias. MATERIALS AND METHODS: Between February 1997 and June 2007, 21 adult patients with hypospadias underwent urethroplasty. The types of hypospadias were as follows megameatus intact prepuce(MIP; n=4), subcoronal(n=5), distal penile(n=3), midshaft(n=2), penile(n=2), penoscrotal(n=2), and scrotal(n=3). Among the 21 patients, 13 were in the primary operative (group A) and 8 were in the re-operative(group B). RESULTS: The mean age of the patients was 32.4+/-6.4 years(group A, 33.1+/-6.0 years; group B, 31.1+/-7.8 years). The mean duration of catheter drainage was 8.0+/-2.4 days(group A, 7.9+/-1.8 days; group B, 8.0+/-2.1 days). The surgical procedures included tubularized incised plate urethroplasty(n=14), Thiersch-Duplay(n=3), pyramid(n=3), and transverse preputial island flap (n=1). The overall success rate was 61.9%(group A, 92.3%; group B, 12.5%). Urethrocutaneous fistulas and a meatal stricture occurred in 6 and 1 patients, respectively, with both occurring in 1 patient(38.1% overall complication rate). Fistula repairs were performed successfully in 4 patients and another fistula resolved spontaneously. The meatal strictures were treated with simple dilatation. CONCLUSIONS: Our data demonstrated a very high success rate in the treatment of primary adult hypospadias. And more careful surgical procedure is needed in patients who had history of previous failure more than 2 times because of significantly high complacation rate.