New Suggestions for Correction of the Severe Hypospadias Complications

Abstract

Background: Severe hypospadias complications are defined as large urethral fistulae, chordee recurrence, and severe scar or skin defect limiting urethral reconstruction from the penis skin, and complications persisting in spite of multiple operations. In this study, new flap techniques applied on six patients with severe hypospadias complications have been introduced. Methods: The 6 patients with hypospadias surgery complicationsand a mean age of 15.5 years, had undergone hypospadias repair operations an average of 4.5 times. Four cases had undergone repair using the Kutlay technique, one was repaired by island-formed penile skin flap, and the remaining case was repaired using a groin flap prefabricated by skin graft. Results: In one of the patients, meatal stenosis was found in the first postoperative month. It was treated by continuous and intermittent urethral catheterization. In another patient, purulent drainage was observed secondary to postoperative soft tissue infection. A 0.2 cm urethra-cutaneous fistula was observed on the subcoronal region in the postoperative sixth month in this patient. Other patients had no chordee recurrence, fistula, urethral stenosis or other complications. Conclusions: In patients with severe hypospadias complications, case-specific and reliable treatment options that may repair each component of the deformity should be used. As the severity of the deformity increases, more complicated and multiple-session techniques may be preferred for treatment.