[Hypospadias surgery--etiology of complications]

Abstract

Introduction & objective: Hypospadias surgery carries a hole list of precocious and late complications which may occur even years later after surgery such as a very late fistula or a recurrent chordee. The aim of this article was to investigate the reasons, why a significant number of patients with different types of hypospadias presents the same kind of postoperative complications.

Materials and methods: Records of 51 boys who underwent surgery for different types of hypospadias were reviewed. Primary repair was performed in 41 patients. 12 (29.4%) of them had postoperative complications. 10 boys had previously between 1 to 7 repairs. The complications were those mentioned in the literature (fistulas, stenoses, megalo-urethra and relapse of the ventral curvature). The etiology of the complications was evaluated according to the type of hypospadias, the surgical technique used for the initial corrective surgery and postoperative care.

Results: The original malformation had been miss-classified in 10% of the cases; technical mistakes occurred in 70% of the cases; complications derived from the complexity of the repair procedure were documented in 10% of the cases, and in 10% of the cases the cause was complex: technical and postoperative care mistakes.

Conclusions: Complications after hypospadias surgery appears due to five main reasons which usually coexist. In order to prevent complications, an accurate classification must be made, the surgical procedure has to be chosen accordingly, the surgical technique must be perfect and the postoperative care adequate.