Le traitement de l’hypospadias postérieur au CHU de Treichville (Abidjan)

Abstract

The hypospadias procedure are many (more than 300 different procedures) and varied, because of the difficulty of the treatment. To evaluate our results with two stages and one stage procedure urethroplasty for proximal hypospadias and to recommend two stages procedures for posterior hypospadias with important curvature. We retrospectively reviewed the medical record of 35 patients operated on for proximal hypospadias between January 1997 and April 2005. Their age varied between 9 month and 15 years. The hypospadias were proximal penile hypospadias in 31 cases, scrotal hypospadias in 2 cases, and perineal hypospadias in 2 cases. Sixteen patients were treated by one procedure (Onlay, Duckett, or Duplay). The other nineteen were operated on by two stages procedure. In the first stage we corrected the curvature and transferred the prepucial tissue on the ventral aspect of the penis. The second stage was performed six month later by urethroplasty. For the one stage procedure, the fistula's rate was 25% and the complication's rate was 37%. For the two stages procedure the fistula's rate was 15%, and the rate of complication was 26%. The total rate of fistula was 20%, and the total rate of complication was 31%. In this short series the fistula rate was higher in the group of children who had one stage procedure than the group of two stage procedure. We prefer the two stages procedure for the treatment of perineal and scrotal hypospadias with important curvature.