Redo hypospadias repair by a single surgeon after failed
hypospadias surgeries: Experience from a developing country
DOI: https://doi.org/10.36811/gju.2020.110010 GJU: October-2020: Page No: 17-23
Page: 17
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Global Journal of Urology
Research Article Open Access
Redo hypospadias repair by a single surgeon after failed hypospadias
surgeries: Experience from a developing country
Md. Abdullah Al Farooq, MA Mushfiqur Rahman and Tanvir Kabir Chowdhury*
Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chattogram, Bangladesh
*Corresponding Author: Tanvir Kabir Chowdhury, KB Fazlul Kader road, Chattogram 4203,
Bangladesh, Tel: +8801771477766; Email: ivan_tanvir@yahoo.com
Received Date: Aug 13, 2020 / Accepted Date: Oct 06, 2020/ Published Date: Oct 10, 2020
Abstract
Background: Hypospadias surgeries are often complicated with fistulas, meatal stenosis and
disruptions. We report our series of redo surgeries for failed primary repairs.
Methods: We prospectively observed all the redo hypospadias repairs done by the principal author
between 2013 and 2017. Thiersch-Duplay urethroplasty was done if the urethral plate was adequately
wide and intact; tubularized incised plate (TIP) urethroplasty was performed if the urethral plate was
intact but, narrower than 8 mm; 2 stage procedures were done with oral mucosal graft (OMG) if the
urethral plate was deficient or scarred with significant chordee.
Result: There was a total of 31 patients. Age ranged from 18 months to 15 years (mean 8.05 ±4.27
years). Sixteen (51.61%) patients underwent only one surgery, 10 (32.26%) patients underwent 2
surgeries, 2 patients (6.45%) underwent 3 surgeries, and 3 patients (9.68%) underwent 4 surgeries
prior to presenting to us before our redo surgeries.We had performed TIP urethroplasty in 16
(51.61%) patients, meatal based flap urethroplasty in 12 (38.71%), OMG followed by urethroplasty
in 2 (6.45%), and repair of urethra-cutaneous (UC) fistula in 1 (3.23%) patient. Ten (32.26%)
Complications occurred in 8 (25.80%) patients. Unsuccessful repair was noted in 03 (9.67%) patients
(UC fistula 1, glans dehiscence with UC fistula 1, and glans dehiscence 1).
Conclusion: Thiersch-Duplay and TIP repair can be successfully performed in redo Hypospadias
surgeries with acceptable complication rate. OMG graft can be reserved for cases with gross scarring
of the urethral plate.
Keywords: Failed hypospadias repair; Tubularized incised plate urethroplasty; Thiersch-Duplay;
Outcome
Cite this article as: Abdullah Al Farooq, MA Mushfiqur Rahman, Tanvir Kabir Chowdhury. 2020.
Redo hypospadias repair by a single surgeon after failed hypospadias surgeries: Experience from a
developing country. Glob J Urol. 2: 17-23.
Copyright: This is an open-access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited. Copyright © 2020; Abdullah Al Farooq
Introduction
Hypospadias is one the most common
abnormalities in children with an incidence of
one in every 250 live births. Unfortunately,
unlike some other congenital anomalies, the
results of hypospadias repair are not always
successful and failed hypospadias repair is a
problem worldwide. In spite of the use of
evolving new techniques, newly available fine
and better suture materials, and use of