Ten-year Experience of Adult Hypospadias Repairs at a Single Center

Abstract

Purpose: We retrospectively evaluated the results and complications of urethroplasty in adult patients with hypospadias. Materials and Methods: Between February 1997 and June 2007, 21 adult patients with hypospadias underwent urethroplasty. The types of hypospadias were as follows: megameatus intact prepuce (MIP; n=4), subcoronal (n=5), distal penile (n=3), midshaft (n=2), penile (n=2), penoscrotal (n=2), and scrotal (n=3). Among the 21 patients, 13 were in the primary operative (group A) and 8 were in the re-operative (group B). Results: The mean age of the patients was 32.4±6.4 years (group A, 33.1±6.0 years; group B, 31.1±7.8 years). The mean duration of catheter drainage was 8.0±2.4 days (group A, 7.9±1.8 days; group B, 8.0±2.1 days). The surgical procedures included tubularized incised plate urethroplasty (n=14), Thiersch-Duplay (n=3), pyramid (n=3), and transverse preputial island flap (n=1). The overall success rate was 61.9% (group A, 92.3%; group B, 12.5%). Urethrocutaneous fistulas and a meatal stricture occurred in 6 and 1 patients, respectively, with both occurring in 1 patient (38.1% overall complication rate). Fistula repairs were performed successfully in 4 patients and another fistula resolved spontaneously. The meatal strictures were treated with simple dilatation. Conclusions: Our data demonstrated a very high success rate in the treatment of primary adult hypospadias. And more careful surgical procedure is needed in patients who had history of previous failure more than 2 times because of significantly high complacation rate. (Korean J Urol 2008;49:1144-1148) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏