Repair of Consecutive Cases of Hypospadias at 37 Military Hospital

Abstract

The outcome of hypospadias repair usually will depend on the skills of the surgeon, the case load and the type of repair done. We report our results from 37 Military hospital in Accra, Ghana. Hypospadias is one of the commonest urologic congenital anomalies. It is associated with three anatomical anomalies: 1. an abnormal ventral opening of the urethral meatus; 2. Ventral curvature (chordae) of the penis; 3. A hooded foreskin. Method: This was a retrospective study of patients who had hypospadias repair between the periods of 2010 to 2017 at the 37 Military hospital. Data of patients who had hypospadias repair at the urology unit was collected. A total of 51 patients were studied out of a total of 1467 surgeries done within that period. Data on patient age, type of hypospadias, type of repair, complications were recorded. Repair was done for patients older than 6 months. Types of repair for urethral construction included; Glans Approximation procedure, (GAP); meatal advancement and glanuloplasty incorporated, (MAGPI); tubularized incised plate urethroplasty, (TIPU); Mustarde´; buccal mucosal tube tunnelled urethroplasty. For the correction of the chordae, a dermal graft was the main procedure of choice. Results: The commonest age of presentation and repair is before the age 5 years, 54.9% (28/51). The commonest types of hypospadias at presentation is coronal. The commonest complication is urethrocutaneous fistula. Conclusion: The commonest type of hypospadias is the coronal type with almost 55% of patient presenting before the age of 5 years. The commonest type of hypospadias is the coronal type (29.4%). Urethrocutaneous fistula is the commonest complication in hypospadias surgery. The use of dermal graft for the correction of severe chordae is a reliable alternative.