Challenges of surgical repair of hypospadias in Ile-Ife, Nigeria

Abstract

To document the presentation, outcome and challenges of management of hypospadias in a resource-limited setting. For this retrospective study we analyzed the files of all patients with hypospadias managed at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria between 1996 and 2006. The parameters studied were the patients’ bio-data, clinical presentation, treatment and outcome. During the 10-year period under review 51 cases of hypospadias were managed. The majority of the patients (n=39, 76.5%) presented within the first year of life with a mean age at presentation of 1 year and 8 months, though most of the repairs were done in the 2nd, 3rd and 4th years of life. Of the 51 patients 46 (90.2%) came from rural and semi-urban areas and 18 (35.3%) had been circumcised before presentation. Surgical repair consisted of preputial island flap in 22 patients (43.1%) followed by a peri-meatal based flap (Mathieu procedure) in 16 patients (31.4%). The MAGPI procedure was used in 5 patients (9.8%) and the Snodgrass procedure in 1 (2%). Staged repair was necessary in 7 patients (13.7%). Post-operative complications were encountered in 15 patients with urethrocutaneous fistula being the commonest one (11 patients, 21.6%). Our results show that hypospadias can be successfully managed in a low-resource setting