Repair of hypospadias in Mosul paediatric surgery centre : analysis of 125 cases

الملخص EN

Aim : A retrospective study of 125 cases with different types of hypospadias.

Evaluation of the surgical procedure for each type to choose the suitable techniques for each problem.

Patients & methods : 125 cases of hypospadias were admitted and treated at Al-Khansa'a Paediatric Surgery centre in Mosul during the Period from Jan.

2005 to Feb.

2007.

Their age ranged between 6 months to 12 years.

All types of Hypospadias were managed using different techniques.

Majority of them were distal type.

The surgical repair varies according to the type of hypospadias.

Catheters were used for different periods according to the procedure used.

Hospitalization period also varied according to the severity and techniques used.

Results : The types of hypospadias varied from glanular to penoscrotal.

Glanular were 14 patients, coronal and sub coronal were 48 patients, distal penile were 37, mid shafts were 18 patients, proximal and peno-scrotal type were 8 patients.

The types of repair used were, MAGPI in 41patients ( 33,6 %), TIP technique in 75 patients (60 %), Mathiew technique in 4 patients (3,2 %), and Onlay tube flab in 5 patients (4 %).

Associated problems found with hypospadias repair were ; Circumcision in ten patients (six coronal, three subcoronal and distal hypospadias, and only one case with proximal hypospadias).

Chordee found in eight patients.

Torsion of the shaft of penis in 5 patients (four with mild degree and only one with severe degree).

Major complications such as stenosis in 18 patients, fistula in 16 patients and flap or skin necrosis in 3 patients.

Conclusions : There is no single procedure which could be used for all types of hypospadias, but the TIP techniques can be used for a wide range of hypospadias from coronal up to penoscrotal type and this techniques is simple, quick, single stage procedure, and it offers good functional and cosmetic results.

The presence of circumcision prior to the repair is not a problem in repairing distal hypospadias but it could be a problem in the proximal type.