Comparison of One and Two Stage Repairs in 83 Cases of Hypospadias

Doo, Hwan Woo; Kim, Young Gon

Abstract

The majority of hypospadias repairs can now be accomplished in one stage, providing a better result with reduced morbidity. To evaluate the efficacy of one stage repairs of hypospadias, a total of 83 patients treated with various urethroplasty technique was stratified according to 2 different stage repairs of hypospadias and compared to clinical outcome during the period of the last 15 years. The study included the age of the patients, anatomical variants of the hypospadias, accompanying congenital anomaly, the technique used, postoperative complication and management, success rate according to the technique used and the methods of urinary diversion. The method of repair was based on individual patient pathology. Transverse preputial island flap was the most common operation performed (n=24) followed by parameatal-based flap (n=15), meatal advancement and granuloplasty repair (MAGPI) in one stage repairs. Thiersch-Duplay (n=8), Belt-Fuqua (n=3), Byars (n=3), Modified Denis-Brown (n=7) techniques were performed in two stage repairs. Of the 83 cases of hypospadias, one stage repairs were done in 62 cases and two stage repairs in 21 cases and their successful outcome, defined as a controllable urinary stream, an acceptable cosmetic appearance and functional erection, was achieved in 60% and 51% respectively. The postoperative complication were fistula in 25 cases (18 in one stage repairs/7 in two stage repairs), stricture in 6 (4/2), wound dehiscence in 2 (1/1), diverticulum in 1 (1/0), persistent chordee in 1 (1/0). There were no significant difference between one and two stage repairs in success rate (60%/ 51%), so we thought that one stage hypospadias repairs could be applicable in most cases of hypospadias and gave satisfactory cosmetic and functional results with a low incidence of serious complications and low costs.