Cosmetic and Functional Outcomes of Two-Stage Hypospadias Repair An Objective Scoring Evaluation and Uroflowmetry
Abstract
ABSTRACT
Background: Hypospadias is a common congenital anomaly affecting the penis. Twostage repair becoming more interesting in era of tubularized–incised urethral plate (TIP). Currently the goals of hypospadias surgery have been developed; however, assessment outcomes of hypospadias repair are still an issue of discussion. Functional outcome of hypospadias repair either single or two-stage is as important as cosmetic outcome. In contemporary series, structured scoring systems (Hypospadias Objective Scoring Evaluation - HOSE and Pediatric Penile Perception Scoring -PPPS), evaluation of photographs and uroflowmetry, were used to assess results of hypospadias repair
Objectives: In this study, Hypospadias Objective Scoring Evaluation (HOSE) and uroflowmetry have been applied to assess outcomes of two-stage hypospadias repair.
Methods: Over a period of eight years, from January 1997 to December 2004, one hundred and twenty six hypospadias patients were treated, ninety of them had two-stage repairs and 36 single-stage repairs. The HOSE questionnaire and uroflowmetry were obtained to evaluate the long-term outcome of two-stage hypospadias repair
Results: The age at time of assessment ranged from 8 to 23 years, with mean follow up of 39.78 months. Thrifty five patients had proximal hypospadias and 20 had distal varieties of hypospadias. Operations performed were 37 Brackaʼs and 18 Byarʼs procedures. Of the 55 patients, had complete two stage hypospadias repair and agreed to participate in the study, nineteen patients had acceptable HOSE and 36 had non-acceptable score. Uroflow rates of 43 subjects were below the fifth centile in three patients, equivocal (between 5th and 25th centile) in four patients and above 25th centile in 36 subjects.
Conclusion: Two-stage repair is suitable technique for all types of hypospadias with versatile outcomes. HOSE and uroflowmetry are simple, easy, non-invasive and nonexpensive tools to assess long-term outcomes objectively.
Copyright (c) 2012 Iraqi Medical Journal
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