Advantages of the anterior and mid-shaft hypospadias repair in the first year of life

Abstract

PURPOSE: Only a few studies have been performed on the evaluation of complications strictly related to the age at operation of hypospadias repair. The aim of our study was to evaluate the incidence of complications of surgical treatment of anterior and midshaft hypospadias in relation to the age at operation. MATERIALS AND METHODS: 108 patients from 2005 to 2011 were operated on by the same surgeon (AM) for anterior and mid-shaft hypospadias. The patients were divided into two groups according to their age: group A consisted of 48 patients who had undergone surgery before 12 months, group B consisted of 60 patients in whom surgery was performed after 12 months of age (2months -12 yrs). All patients were corrected with TIPU (Snodgrass technique). For the two groups was evaluated the rate ofperioperative complications (hematoma, edema, hemorrhage), suture dehiscence, fistula, stenosis. For the statistical analysis of complications was used the exact test of chi-square Fischer. RESULTS: At a mean follow-up of 36 months. Group A: 2/48 patients presented fistula after 2-6 weeks. Group B: 15/60 patients presented the following complications: 2 hematomas, 1 postoperative bleeding; 5 fistulas arising after 2-6 weeks, 3 minimal meatal regression; 4 thinning flow. The Fisher test was significant. CONCLUSIONS: The results of our study confirm that patients with hypospadias, operated within the first years of life, have a statistically lower rate of complications than patients treated at later dates. Therefore, the age is believed to be a pivotal prognostic factor for the functional and aesthetic results.