Outcomes of hypospadias repair and factors associated: A study in a tertiary care hospital

Abstract

ABSTRACT Background: Hypospadias is the most common congenital abnormality of the urethra affecting 1 in 300 live male births worldwide. The results of hypospadias surgery are still frequently unfavorable with a reported complication rate as high as 50% or above. Aims and Objective: The aim of our study was to determine the demographics and analyze the surgical management and factors influencing the postoperative outcomes of hypospadias repair. Materials and Methods: This hospital-based prospective study was conducted in the Department of Plastic and Reconstructive Surgery, Regional Institute of Medical Sciences, Imphal, Manipur, for 2 years from December 2019 to November 2021. The study was conducted on 28 male patients who underwent hypospadias repair. Demographics, operative techniques reviewed, and the outcome of hypospadias repair were evaluated for results and complications. Statistical Analysis: Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS version 21). Descriptive statistics such as mean, median, and percentage were used to summarize the data. The Chi-square test, Fisher’s exact test, and t-test were used to see the associations between variables of interest and prognosis of repair. P < 0.05 was taken statistically significant. Results: A total of 28 male patients with a mean age of 7.46 ± 5.25 standard deviation presented for hypospadias repair. Mid-penile hypospadias was the most common type in the study population accounting for 60.71% of patients, followed by penoscrotal 35.71% of cases. 82.14% of the hypospadias were associated with some degree of chordee. Meatal stenosis, cryptorchidism, and inguinal hernia were observed in 17.8%, 3.57%, and 7.14%, respectively. 46.42% of hypospadias were repaired in two stages, while 25% were subjected to tubularized incised plate repair, and 28.57% of patients were repaired with the Asopa technique. The most common complications were edema and urethrocutaneous fistula. The complications were significantly lower in the hands of specialists than residents (P = 0.037). Two-stage repair has higher complications than single-stage repair (P = 0.0001). Conclusion: Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill, and acquaintance with magnifications along with knowledge of surgical anatomy. Regular periodic audits should also be performed to improve the outcome of the hypospadias repair.