Hypospadias

Abstract

Hypospadias is one of the most common congenital anomalies in men. We searched the recent literature (since 1 January 2011) using the following keywords in the title or abstract: hypospadia or hypospadias, in order to provide the reader with an updated view of the subject. Early repair is recommended; distal forms are mainly treated by the tubularized incised plate technique; however, meatal stricture concerns are still noticed, limiting its use on proximal forms. The debate of proximal primary repair in either one or two stages is still ongoing. Minor modifications for preparing the distal bed for the urethroplasty in two stages are presented. One-stage repairs, either with reconstruction of the urethral plate (three-in-one concept) or simply with the onlay to tunica albuginea (Rigamonti), is a viable option with over 70% success in one surgery. The importance of barriers, such as tunica vaginalis and dartos flap, was reassessed and flow rates may indicate obstructive voiding patterns after 1-year follow-up. Further experience and comparative studies for distal and proximal hypospadias are required. Long-term data may indicate the appropriate procedure selected for primary repair.