Management Of Hypospadias Research Articles

Устранение дорзального и латерального искривления полового члена у детей с гипоспадией

Lateral and dorsal curvature of the penis in hypospadias in children are very rare conditions. Articles dealing with correction of these rare forms of curvature in children are not easy to find. The objective of this work was to improve the outcomes of treating children with hypospadias and rare (dorsal/lateral) forms of penile curvature. Patients and methods. The study included 49 patients with coronary and penile hypospadias, chordee with hypospadias, and also with rare forms of curvature – dorsal and lateral at 30-45 degrees. Depending on the form of penile curvature the patients were divided into 2 groups. Group 1 – 36 patients with dorsal curvature, who underwent ventral plication of the corpora cavernosa; group 2 – 13 patients with lateral curvature and lateral plication of the contralateral corpus cavernosum (9 patients had a curve to the left and 4 – to the right). Results. No penile curvature in the early post-operative period and a year afterwards was not noted in patients of both groups. Dorsal penile curvature occurs in 5% of cases, and lateral in 1.7% of cases. Conclusion. The use of the method of plication of the corpora cavernosa opposite the curvature makes it possible to obtain good functional and cosmetic outcomes of management of hypospadias. Key words: lateral curvature, dorsal curvature, hypospadias, curvature correction

Common Practice of Hypospadias Management by Pediatric Urologists in Indonesia: A Multi-center Descriptive Study from Referral Hospitals.

BACKGROUND:Hypospadias is the second most common congenital anomalies among human congenital disabilities. There are over 300 surgery techniques being introduced to treat hypospadias. The successful of hypospadias repair is assessed by several outcomes as well as complications following surgery.AIM:This study aims to show the multicenter hypospadias data in Indonesia descriptively.METHODS:All the data were compiled based on questionnaires, which were distributed to Indonesian pediatric urologists. The questionnaire includes several questions containing demographic aspect, preferred techniques being used, and complications being found regarding hypospadias repair.RESULTS:Eighteen Indonesian pediatric urologists from 12 centres involved in this study. The data were collected from June – September 2018 based on the surgeon’s experience throughout 2017. From 591 cases based on the returned questionnaire, penile-type hypospadias was the most common type of hypospadias being treated (35.7%) followed by penoscrotal (28.9%) and scrotal-type (12.9%). Moderate severity of chordee was mostly seen among all cases (40.6%). Tubularised incised plate (TIP), + Thiersch Duplay, was the most common technique being used to treat hypospadias (44.3%), followed by onlay island preputial flap (14.9%) and two-stage technique (14%). The incidence of urethrocutaneous fistulae in this study was 13.9%.CONCLUSION:This study showed how Indonesian pediatric urologists dealt with hypospadias cases. TIP + Thiersch Duplay procedure being the preferred technique used by most participants and the rate of urethrocutaneous fistulae as one of the complications was comparable with previous studies.

Efficacy of MAGPI procedure in the management of hypospadias

Background: Hypospadias is a relatively common congenital defect of male external genitalia. It is present in approximately 1 in 300 males new born. The meatus may be located anywhere along the shaft of the penis from glans to scrotum or even perineum. The objective is to study the efficacy of MAGPI procedure in the management of hypospadias.Methods: Detailed case study was done as per the proforma, in majority of cases patient’s mother were informants, thorough clinical examination was done in all cases and looked for any congenital anomalies and family history was also taken, and any drugs intake was also taken. All the cases routine investigation was done like (Hb, BT, Ct, Wt). USG was done in required cases. Routine pre-operative preparation was done like keeping nil orally, preparing parts was done. The type of surgery for each patient was assessed after clinical examination of location of meatus: Anterior, Middle, and Posterior. On discharge, the patients and mothers were advised to bring their children for regular check up to hospital.Results: Most common position of hypospadias was glanular and coronal. The most common surgery performed was Snodgrass technique and for distal and mid penile hypospadias and MAGPI for glanular type of hypospadias. MAGPI procedure was most commonly performed for glanular and coronal type of hypospadias. Other minor Complication was wound infection and penile torsion of mild degree and was managed conservatively.Conclusions: There is significant difference in outcome of hypospadias surgery done by pediatric urologist and other surgeons.

Surgical management of hypospadias in cases with concomitant disorders of sex development.

To review the surgical treatment of hypospadias (HP) associated with disorders of sex development (DSD). HP cases were assessed for DSD by gross examination for atypical external genitalia, and assessment of hormone levels and karyotype. There were 58 HP cases with concomitant DSD treated between 1999 and 2017. DSD classification, type of HP, sex assignment, hormonal abnormality, surgical strategy, and post-urethroplasty complications (post-UPC) were reviewed. DSD were sex chromosome abnormalities (n = 4), 46,XY (n = 51), 46,XX (n = 1), and 47,XY + 21 (n = 2). HP was perineal: (n = 26), scrotal: (n = 16), penoscrotal: (n = 15), and midshaft: (n = 1); repair was primary (n = 6) or staged (n = 52). Mean age at final urethroplasty (UP) was 4.12 ± 0.21 years; all cases had soft tissue interposition at UP. At mean follow-up 5.16 ± 0.56years after final UP, observed post-UPC (n = 8; 13.8%) were urethral stenosis (n = 3), urethral diverticulum (n = 2), urethrocutaneous fistula (n = 2), and curvature (n = 1). Mean onset of post-UPC was 1.24 ± 0.77years (range 0.1-6.3). The second half of our cases (n = 29; treated 2015 ~) had significantly less post-UPC (0/29; 0%) than the first half (8/29; 27.6%) (p = 0.0075). Although UP for HP + DSD was formidably challenging, we achieved a significant decrease in post-UPC through a combination of surgical techniques and experience.

Chromosomal Mutation In Isolated Hypospadias Patients Using High-Resolution Melting Curve (HRM)

Chromosomal Mutation In Isolated Hypospadias Patients Using High-Resolution Melting Curve (HRM)

Evaluation of Double Face Preputial Flap for Management of Hypospadias in Children

Background: hypospadias is a congenital anomaly in which meatal orifice opens in the vental aspect of penis instead of the glans tip. The meatal orifice may be located anywhere between the tip of the penis and the perineum.Objective: the aim of this study was to evaluate double face preputial flap for management of hypospadias in children about success rate, cosmetic result and appearance of complications such as fistula, strictures or disruption. Methodology: this study was conducted on 30 patients who were suffered from mid penile, proximal penile and peno scrotal hypospadias. The age of our cases at the time of repair were ranged between 4-12.5 years. Results: after finishing results of our study we noticed that was no statistically significant difference between results after double face preputial flap technique and ordinary transverse preputial island flap technique (Duckett's procedure) regarding fistula formation or skin infection. Conclusion: although the incidence of fistula formation was lower than that was reported in the classic Duckett repair, however, there was no statistically significant difference between results of double face preputial flap technique and current Duckett's procedure regard skin disruption and fistula formation.

Evaluation of Double Face Preputial Flap for Management of Hypospadias in Children

Background: hypospadias is a congenital anomaly in which meatal orifice opens in the vental aspect of penis instead of the glans tip. The meatal orifice may be located anywhere between the tip of the penis and the perineum.Objective: the aim of this study was to evaluate double face preputial flap for management of hypospadias in children about success rate, cosmetic result and appearance of complications such as fistula, strictures or disruption. Methodology: this study was conducted on 30 patients who were suffered from mid penile, proximal penile and peno scrotal hypospadias. The age of our cases at the time of repair were ranged between 4-12.5 years. Results: after finishing results of our study we noticed that was no statistically significant difference between results after double face preputial flap technique and ordinary transverse preputial island flap technique (Duckett's procedure) regarding fistula formation or skin infection. Conclusion: although the incidence of fistula formation was lower than that was reported in the classic Duckett repair, however, there was no statistically significant difference between results of double face preputial flap technique and current Duckett's procedure regard skin disruption and fistula formation.

Effectiveness of caudal epidural block on interaoperative blood loss during hypospadias repair: A randomized clinical trial

Intraoperative blood loss is considered to be an important issue in hypospadias surgery. Some studies have demonstrated the utility of caudal epidural block (CEB) in this regard among pediatric patients with hypospadias. Though there is evidence in favor of the use of CEB as the only anesthetic method for pediatric surgeries, it is usually used in combination with general anesthesia. In this form of use, it could have more favorable outcomes for both intra- and postoperative periods. There are few studies regarding the effectiveness of CEB on intraoperative blood loss. We aimed to evaluate the utility of CEB on blood loss, operation time, and analgesic use during hypospadias repairs of pediatric population referred to our university hospitals. In this randomized clinical trial, consecutive patients with hypospadias who were candidate for surgery were enrolled and randomly allocated to one of the two groups: group A received caudal epidural block (CEB) plus general anesthesia (GA) before surgery and group B received only GA. Intraoperative blood loss, operation time, and dose of fentanyl used during the procedure were recorded and compared. All surgeries were performed by a single pediatric urologist in two different university hospitals that was not blinded to the study groups. In this study, 57 pediatric patients with hypospadias who underwent surgical repair were studied, from which 29 and 28 patients were allocated to receive or not to receive preoperative CEB, respectively. The patients' age, weight, ASA, score and severity of hypospadias were not significantly different between the two groups. The operation time was significantly lower in the CEB before surgery group (p<0.05). The mean dose of fentanyl and volume of blood loss during procedure were lower in the CEB group, although for fentanyl it approached but did not reach statistical significance. The findings of current study indicated that caudal epidural anesthesia in addition to general anesthesia has a favorable effect on reducing blood loss during operation, operation time, and analgesic use. Our data confirm the findings of previous studies in this field. Further studies are recommended to evaluate the effect of this type of analgesia in other outcomes of hypospadias repair surgery. Our results could be used for revising existing surgical guidelines for better management of hypospadias.

Management of hypospadias in Saudi Arabia: A national survey.

Introduction:Hypospadias is one of the most common congenital anomalies of the penis. Different methods of hypospadias management are described in the literature. We try in this study to evaluate the national trends and to compare them with international practices.Materials and Methods:A multiple choice survey was distributed among a sample of national practitioners using a weblink between September and December 2017. It included questions about participants demographics, number of cases operated on per year, perioperative care and preferences, long-term follow-up, and complications. Data were analyzed and compared with international practices.Results:Results of 47 practitioners were evaluated and analyzed in this study. The majority of the participants were pediatric urologists (48.9%) and from the central province (44.7%). Most of the participants prefer to operate on patients between the ages of 1 and 2 years (48.9%) and operate at ≥20 cases per year (76.6%). Tubularized incised plate (TIP) is the preferred technique for distal penile hypospadias repair whereas staged repair is preferred for proximal cases. All participants use a form of a second layer and a stent for their repairs. The majority reported an overall complication rate of ≤10% for distal penile hypospadias (76.1%) and >10% for proximal penile cases (59.6%).Conclusion:This study helped us identify national trends in hypospadias management, which were comparable to the international trends. TIP repair is the preferred technique for distal penile hypospadias repair whereas staged repair is preferred for more complex proximal variants. Although data in this study come from reports of personal experience, it can serve as a backbone for the future prospective studies on this topic.

Glanular Hypospadias Management with Modified Circumcision and Firlit Procedure.

To document the results of using simple technique of Firlit procedure with modified circumcision for treatment of glanular hypospadias. Descriptive case series. Department of Urology, Shifa International Hospital, Islamabad, from January 2011 till May 2017. The subjects included pediatric patients who underwent repair of glanular hypospadias by using modified circumcision and Firlit procedure. Patients were analyzed for operative time, age, hospital stay, and peroperative and postoperative complications. Chart review was done for collection of data on specified proforma. There were 73 patients with mean age of 1.81 ±0.92 years. Children were discharged on the same day. None of them needed catheterization and dressing. Temporary dressing was used for mild bleeding immediate post op in 13 (17.80%) cases only. Postoperative complication such as urinary retention, fever, severe pain, or urinary tract infection were not seen in children. Meatal stenosis was not seen on a 2-24 months' follow-up. Satisfactory urine stream and good cosmesis was noted by the parents. The Firlit technique for the repair of glanular hypospadias was simple and satisfactory in terms of urine stream and cosmesis with minimal complications.

Use of Hormones, Tissue Factors and Bioengineering in the Management of Hypospadias

Hypospadiology is a rapidly evolving field. Progress in the understanding of how hormonal therapy affects the growth of the phallus has allowed surgeons to optimize the tissues for surgery. But conflicting data from a number of studies and a lack of consensus on drugs, their dosing, mode of delivery and timing of use means that the creation of protocols is unlikely to happen in the near future. Nonetheless, there is a hope and the standardization of scientific reporting will make it easier to compare data at the global level. There are reports of the increasing incidence of hypospadias and the etiology is thought to be multifactorial. Although complex interactions between genetic polymorphisms and the environment make it difficult to identify the exact factors responsible for hypospadias, the advent of massively parallel gene sequencing, large scale epigenetic screens and CRISPR technology will definitely ease the process. The knowledge of culprit genes will not only broaden our understanding of embryology and growth but will also enable us to predict and/or modify tissue healing. Advances in tissue engineering are also expected to provide a plethora of biomaterials for urethral reconstruction. The development of this field is directly linked with the elucidation of the processes of proliferation and vascularization coupled with the cataloguing of the growth factors involved. One can safely conclude that the exciting new advances in the field will have far reaching consequences on patient care and counselling.

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes.

In this article, we present the current approach to hypospadias, a review of the classification, preoperative evaluation, and factors that enable decision-making during surgery. We will then discuss patient-reported outcomes, evaluating the patients' and parents' perspectives regarding hypospadias repair.

Management of hypospadias in a resource-poor setting: The Ibadan experience

Background: Penile anomalies especially hypospadias are one of the most common genitourinary anomalies seen in newborns, and they pose a great deal of psychological stress to their mothers. This study examined our experience in the management of hypospadias. Patients: and Methods A retrospective study of all patients (Group A) managed for hypospadias from 2004 to 2013 was conducted. Data obtained included patients’ demography, their clinical presentation and management. These were analysed and compared with a similar study (Group B) conducted in this hospital four decades earlier between 1966 and 1977. Results: Forty-eight patients belonging to Group A had repair of hypospadias in comparison to the 42 patients in Group B. The mean age at presentation in Group A was 2.7 ± 4 years, and the anomaly was discovered at birth in all the patients. In contrary, Group B had 32 (76.2%) patients who presented immediately after birth and 10 (23.8%) patients who were either adolescents or adults (12–36 years) with a mean age of 18.9 years. Anterior hypospadias occurred more commonly in both groups; 10 (20.8%) patients were circumcised in Group A and 4 (9.5%) patients in Group B. Surgical site infection was the most common post-operative complication observed in both groups. The type of surgical repair was observed to have significantly influenced the outcome of surgical repair in patients in Group A (χ2 = 14.13, P = 0.05). Conclusion: Proper and successful management of hypospadias can be enhanced in this environment with adequate media advocacy directed at prompt recognition of this anomaly and avoidance of circumcision when hypospadias has been identified.

Pediatric Penile and Glans Anthropometry Nomograms: An Aid in Hypospadias Management.

Objective:To establish pediatric penile and glans anthropometry nomograms. This may be used as a reference model for penile assessment while managing hypospadias.Patients and Methods:Between October 2012 and September 2013, 263 boys of varying ages (0–16 years) were included in the study. Those with genetic, endocrine disorders, having genital anomaly, undescended testis, neonates, and infants with a nonretractile prepuce, with multiple congenital anomalies and refusal to take part in the study were excluded. Evaluated outcome variables were stretched penile length, glans circumference (GC) at coronal sulcus, glans diameter at coronal sulcus (Gdcl), mid glans diameter, and ventral glans length. Glans ratios were generated by dividing Gdcl by GC. Data were expressed as mean, median, and standard deviation. Correlation between age and variables was evaluated using nonparametric Spearman's rank correlation coefficient.Results:The patients were divided in six age groups, namely 0–1 (n = 61), 1–3 (n = 37), 3–5 (n = 36), 5–7 (n = 36), 7–12 (n = 45), and >12 years (n = 48). Gdcl was the maximum transverse glans diameter and based on it small glans size varied widely from 8.9 to 35.04 mm for various age groups. Although glans anthropometry showed age-related changes, glans ratio remained relatively constant between 0.49 and 0.53 (mean: 0.5 ± 0.051, r = 0.29). All the variables except glans ratio showed a significant positive correlation with age (r = 0.954–0.98, P < 0.01).Conclusion:Penile anthropometry nomograms provide a reference model for hypospadias. This may aid in (a) objective preoperative assessment of glans size (b) patient selection for preoperative hormonal stimulation (c) provides a yardstick for postoperative cosmesis.

Hypospadias Management; in a new Era

Hypospadias Management; in a new Era

Single stage urethroplasty for perineal hypospadias in a horse: A case report

Within the veterinary world, data regarding the surgical management of hypospadias is lacking. Reports within equines have documented resective phallectomy procedures rather than urethral reconstruction. This case report documents the first ever urethroplasty for an equine hypospadias, performed by a consultant paediatric surgeon. The urethroplasty was achieved by applying the same surgical principles mastered from paediatric urology to a horse. The indication for surgery was contact dermatitis of the hind-leg, which impaired the thoroughbred foal's racing potential. A single stage urethroplasty was performed, during which the wide urethral plate was tubularised in two layers and the urethral meatus was successfully relocated distally to open upon the glans. The urethroplasty was covered with dartos fascia and the penile shaft skin and prepuce were reconstructed. Post-operatively, urine flowed cranially and the contact dermatitis resolved. Minor superficial wound dehiscence was observed which was managed conservatively and self-resolved. Follow-up at 3 years confirmed the horse continues to void from the re-sited meatus without complication and went on to have an illustrious career within horseracing. We have documented the first reconstructive urethroplasty for hypospadias within a horse, achieved by adopting the surgical techniques normally implemented within paediatric urology with good functionality.

Factors influencing waiting time in hypospadias repair surgery.

Hypospadias is a common congenital anomaly of the urethra and phallus, which is not life threatening. It is thus less prioritised in a resource-limited setting. The aim of this study was to evaluate the management of hypospadias by our paediatric surgery unit and determine the factors affecting the delay between presentation and surgical repair while proffering possible solutions to such delay in hypospadias repair surgery. This was a retrospective review of all hypospadias repair surgeries carried out by our paediatric surgery unit over a 38-month period, evaluating the period between presentation and first surgery for each patient. Data were analysed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Released 2011, Armonk, NY, USA). Chi-square test was used to compare categorical variables and P ≤ 0.05 was considered significant. In 38 months, 47 operations for hypospadias were carried out on 42 boys. Thirty-seven patients (88.1%) had >3 months delay to surgery. The most frequent contributory factor to delay was unavailable theatre space (13 patients, 31%). Surgical outcome was good in only 16 patients (44%). Of the 16 patients with good outcome, 10 (63%) were operated between the ages of 2-4 years (P > 0.05). Multiple factors are responsible for delays in carrying out hypospadias surgery in resource-limited environments, notably securing a functional operating theatre suite in the light of more urgent conditions. To combat these delays, we recommend having dedicated hypospadias repair sessions and surgeons dedicated to hypospadias repair. Hypospadias outreach camps are also proposed.

EVALUATION DE LA PRISE EN CHARGE DE L’HYPOSPADIAS AU SERVICE DE CHIRURGIE PEDIATRIQUE DU CHU ARISTIDE LE DANTEC DE DAKAR: A PROPOS DE 39 CAS

Objective: To evaluate the outcomes of hypospadias surgery in our African context of practice. Patients and Methods: This is a retrospective study on 39 cases of hypospadias. This sample was collected over a period of 5 years from 1 June 2005 to May 31, 2010 at the department of paediatric surgery of Aristide Le Dantec Hospital in Dakar. Results: The average age of our patients was 4 years (6 months-14 years). Sixty nine percent of patients were older than 2 years. Hypospadias was anterior in 24 cases, middle in 13 cases and posterior in 2 cases. On the therapeutic level, all patients underwent a one stage repair. The surgical techniques most used were those of Mathieu (48.7%) and Duplay (23.1%). The stitches used for the urethroplasty was the PDS (5/0 to 7/0) in 10% of cases. The mean duration of urine drainage from the bladder was 4 days (3 and 7 days).The therapeutic results were considered good in 33.3% of cases, fair in 41% of cases and poor in 25.7% of cases. 53.8% of patients had complications, among those complications; urethro-cutaneous fistula was the most frequent with 57.1% of cases. Conclusion: The management of hypospadias in our working conditions is not yet satisfactory. Improving our results would be through improvement in technics and training of paediatric urologists involved in this type of surgery. Keys words: hypospadias children surgery results.

Pearls, tricks, and quirks of the reconstruction for hypospadias and chordee

s / Urological Science 26 (2015) 294e300 297 Can that save the cost with avoidance of repeated semen analysis if the first semen analysis had nonmotile sperm density <100,00/ml. Materials and Methods: From Jan 2010 to Dec. 2014 a total of 419 men underwent vasectomy for birth control in our hospital. Patients demographics and postvasectomy semen analysis results were collected retrospectively. Results: During the period of recent 5 years, 419 patients underwent vasectomy in our hospital. Most of the patients has 2 or more children after marriage. Postvasectomy semen analysis was completed within the 3-6 months after surgery. No patient has motile sperm in their PVSA. Few patients had nonmotile sperm with the concentration <100,000/ml (AUA clearance parameter). Repeated semen analysis confirm the azospermia later. The cost saving is not high. Conclusion: The AUA special clearance parameter is not applied in our hospital. The cost saving is not efficacy than the compensation of legal problem. So repeated semen analysis is still warranted in our hospital until azospermia confirmed. MP2-6: PEARLS, TRICKS, AND QUIRKS OF THE RECONSTRUCTION FOR HYPOSPADIAS AND CHORDEE Jesun Lin , Herng-Jye Jiang , Jian Ting Chen , Bai-Fu Wang , Chin-pao Chang , Mon-I. Yen , Sheng-Hsien Huang , Hon-Jen Shi , Ming-Chih Chou . Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan; 2 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Purpose: We reviewed our 33 years experience in the management of hypospadias, chordee and their complications after reconstruction in order to understand their presenting Problems. We would recommend the factors of successful techniques for this congenital disease of penis. Materials and Methods:We reviewed the records of 998 hypospadias and chordee patients between January 1981 and December 2014. The complications after reconstruction might be single or combined with several presenting problems in the same patient. This article represents a collection of recommendations, technical nuances, and innovative management techniques that have been found to contribute to the success of hypospadias and chordee surgery. We would classify the main problems of complications to be (1) 89 urethrocutaneous fistulae, (2) 36 urethral strictures, (3) 15 meatal stenosis (4) 38 remaining chordee, (5) 14 diverticula and (6) 6 hairy urethra. The penile shaft and perineum fistulae were repaired with the “pants-over-vest urethroplasty modified to the procedure of Turner-Warwick. The coronal fistulas were converted into repair for coronal hypospadias. The remaining urethral plate was tubularized with or without a relaxing midline incision (Reddy-Snodgrass). We wrapped dorsal dartos or subcutaneous flap to cover the neourethra for preventing urethrocutaneous fistula. The meatal stenosis was performed with dorsal meatotomy, Y-V glans flap, meatal skin graft and transverse meatotomy. Residual chordee were performed with dorsal plication, excision the chordee, the urethral diverticula were excised and tailored for redo-urethroplasty. Hairy urethra were resected and then urethroplasty. We performed double-tube stent and vacuum drain in subcutaneous layer for prevention of bladder spasm, hematoma and infection. Results: The over all successful rate is 85% in one stage surgery for the fresh cases. The number of redo-operations for their presenting problems of complications ranged from 1 to 8 attempts. The successful rate for urethrocutaneous fistula is 76%, for urethral strictures is 82%, for meatal stenosis is 70%, for chordee is about 70%, for diverticula is about 85%, for the hairy urethra is about 70%. We followed up the outcome of consequent surgery from 6 months to more than ten years. Conclusions: The successful surgery of the hypospadias, chordee redo operation for them requires radical correction of all deformities. It is true that“Experience is by far the best teacher. It might be said that unless the technique and subsequent good results of an individual method are transferable to others, the technique as taught is suspect”said by Dr. John W. Duckett. Moderated Poster-3

Complications of hypospadias surgery: Experience in a tertiary hospital of a developing country.

Background:Over 300 different operations have been described for the management of hypospadias. In recent times, the numbers of operations used in various centres have gradually reduced as the principles necessary to ensure adequate cosmetic and functional results with minimum complications are better understood. The aim of this article was to review the different types of operations used for managing hypospadias in a tertiary hospital in a developing country, to analyse the complications of surgery and discuss the factors that contribute to complications.Materials and Methods:Patient folders, theatre, and ward records were used to obtain the required information. The age at surgery, types of hypospadias at presentation, types of operations done and complications were analysed.Results and Conclusion:With three main types of operations, tubularised incised plate urethroplasty and meatal advancement and glanuloplasty incorporated for anterior hypospadias (glanular, coronal, subcoronal, distal, midpenile), and lateral based flap urethroplasty for posterior hypospadias (proximal penile, penoscrotal, scrotal, perineal), most hypospadias were corrected with acceptable complication rates.