Category: Reconstruction: Outcomes & Complications

MP14-13 - The treatment strategy for urethral strictures of male patients after failed hypospadias repair- 10 years' experience

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

Hypospadias is a common urinary congential disease. The only effective treatment for hypospadias is surgical repair. Though most surgical repair can reach a successful short-term result, more and more studies indicated that some serious complications occurred more when the follow up time become longer, especially for urethral strictures. When urethral strictures occurred in patients who received hypospadias repair, the repair could be challenge because of the poor condition of the urethral tissue. In this article, we shared our experience on the treatment for urethral strictures of male patients who received previous hypospadias repair.


Methods :

There were 46 patients who was diagnosis as urethral stricture with previous hypospadias surgical repair history in Western china hospital from 2006-2016. The diagonosis of urethral strictures was based on the urethrography. Based on the total length and the situation of other accompany complications (such as urethrocele, urethratresia, hairy neourethra or lichen sclerosus) of the strictures, patients were divided into three group: endoscopic/ dilation group, one stage surgical repair group and two stage surgical repair group. The success of operation was definited as the significant improvement from the preoperative urethrography to the postoperative urethrography and improvement of the symptom of urination.


Results :

The average age for the patients was 26.5-year-old (14-55). There were 20 patients received one-stage repair ,14 patients received two-stage repair and 12 patients received endoscopic treatment based on our strategy. There were two patients who changed the surgery during the operation because of the poor condition of urethral plate. All patients successfully removed the catheter and could urinate smoothly, there were no graft necrosis, coronary fistula, scrotal flap necrosis, hematoma or other complications happened in the hospital day. The one month urethrography showed all of the patients’ strictures had been significantly relieved. The total successful rate of our surgical repair, one-stage repair and two-stage repair was 83.3%(25/30), 88.9%(16/18) and 75%(9/12) respectively.16/30 patients had coition after surgery. 28/30 admitted in our follow-up that they were much confidence in their sexual function after operation.


Conclusions :

We describe our experience on the urethral strictures after primary hypospadias repair. Our strategy provided a relatively high successfully results with minimal morbidity.

Yuntian Chen

Student
Department of Urology, West China Hospital, Sichuan University
Chengdu, Sichuan, China (People's Republic)

Chen Yuntian, student in the urology department in sichuan university, western china hospital.

Banghua Liao

Chengdu, Sichuan, China (People's Republic)

Kunjie Wang

Chengdu, Sichuan, China (People's Republic)

Hong Li

Chengdu, Sichuan, China (People's Republic)