Adolescent and Adult Hypospadias Repair: A Retrospective Study

Abstract

Introduction: There is a general consensus that results of hypospadias repair surgery, done on children, seem to have a better outcome when compared to the adults. Hypospadias cases in adults can present as primary or with complications resulting from an attempted repair. Aim: To assess any difference in outcome of surgeries done among the adolescent and adult population and to evaluate the use of a Tunica Vaginalis (TV) second layer barrier flap in preventing complications such as urethrocutaneous fistula. Materials and Methods: This was a single centre retrospective observational assessment of the adolescent and adult hypospadias surgeries conducted at a Tertiary Care Hospital from January 2016 to July 2019. The assessment was based on the presentation, site of hypospadias meatus, previous surgery and development of any complications or recurrence. Routine surgeries as per the hospital protocol were done in these patients. Follow-up was done for the next 12 months. For data analysis tables, columns and pie charts were used. Fisher’s-exact test was used to find the association and calculate the p-value with the help of SPSS 21.0 software. Results: Total 28 patients were assessed, of which 17 patients were adolescents (mean age 14.6±1.66 years) and 11 (mean age 22.7±3.51 years) were adult. There was no significant (p-value 0.581) difference in the final outcome of hypospadias repair surgery between the adolescent and adult population. Use of TV interposition barrier flap prevented development of complications. Urethrocutaneous fistula was the most common form of complication noted in both the groups overall rate of complication was 14.2%. Conclusion: When hypospadias repair in adolescents and adults is done in a systematic and meticulous fashion, the outcome was satisfactory and there was no significant difference in outcome among the two age groups. Use of TV flap as a second layer interposition can improve the outcome in such patients.