Abstract

Aim: To reveal alterations and results of hypospadias cases repaired with different techniques within three different periods.

Material and Methods: Between 2001-2015, files of 315 patients (mean age 5.18 years; 2 months-17 years) whose hypospadiases had been repaired by a single surgeon were retrospectively reviewed. Cases were classified into three groups based on techniques used in different times as Group 1 (2001-2008) operated without TIPU (MAGPI, Mathieu, GAP, Pyramid, Duckett and onlay island flap), Group 2 (2009-2011) operated with TIPU and other techniques (MAGPI, Mathieu, GAP, Pyramid, Duckett and onlay island flap) and Group 3 (2012-2015) operated with only TIPU.

Results: Most of the cases (n=252; 80%) had distal hypospadias. Cases of distal hypospadias were repaired using TIPU (n=99), MAGPI (n=77), Mathieu (n=39), GAP (n=22), 11 with pyramid (n=11) and onlay island flap (n=4). Cases with midshaft hypospadias were, repaired using Mathieu (n=16), TIPU (n=19) and onlay island flap (n=17), Cases with proximal types, were repaired using TIPU (n=7), Duckett (n=3) and onlay island flap (n=1). While urethral fistulas and meatal stenoses were seen in respective percentages of the cases with distal hypospadias (7.14%), midshaft hypospadias (15.38%) and in proximal hypospadiasis (27.27%). Although meatal stenosis was seen at a significantly higher rate in distal hypospadias repaired using TIPU, uretral fistulas were witnessed significantly less frequently in midshaft and penoscrotal hypospadias repaired using TIPU technique. No statistically significant difference was observed between those operated at ≤1 year and >1 year of age according to uretral fistulas and meatal stenosis (p>0.05).

Conclusion: Hypospadias can be repaired at any age, but should be operated before <1 year because of scarring. Repair using TIPU is superior to other techniques because of meatal appearance and complications such as fistulas; however, maximum effort should be paid to prevent the development of meatal stenosis in cases with distal hypospadias.