Staged segmental urethroplasty for scrotal/perineal hypospadias: a new concept

Pediatr Surg Int. 2016 Apr;32(4):403-9. doi: 10.1007/s00383-015-3844-3. Epub 2015 Dec 9.

Abstract

Purpose: We report the efficacy of staged segmental urethroplasty (SSUP) versus non-staged urethroplasty (NSUP) for treating scrotal/perineal hypospadias (SPH).

Methods: Between 1997 and 2015, 29 SPH patients underwent UP (SSUP: n = 15; NSUP: n = 14). Incidences of urethrocutaneous fistula (UF), stenosis of the neourethra (SNU), diverticula formation, and residual chordee (RC) were compared. Differences were statistically significant if p < 0.05.

Results: The difference in mean age at NSUP (3.2 ± 1.3 years) and at the final stage of SSUP (5.5 ± 2.4 years) was significant (p < 0.05). Mean operative times for NSUP and SSUP (total for all stages) were not significantly different (231.5 ± 117.5 versus 272.5 ± 99.4 min); however, the incidence of postoperative complications was significantly less in SSUP (n = 1; UF) compared with NSUP (n = 6; 2 cases of UF, 3 cases of SNU, and 1 case of RC; (p < 0.05). Mean follow-up was significantly shorter in SSUP; 1.4 ± 1.2 years versus 7.0 ± 4.5 years in NSUP (p < 0.05).

Conclusion: SSUP would appear to be effective for treating SPH because of a significantly lower incidence of UF, SNU and RC during the first postoperative year, the period when complications have been reported to arise most frequently.

Keywords: Complications; Hypospadias; Scrotal/penoscrotal hypospadias; Staged segmental urethroplasty.

MeSH terms

  • Child
  • Child, Preschool
  • Humans
  • Hypospadias / surgery*
  • Male
  • Penis / surgery*
  • Perineum
  • Scrotum
  • Surgical Flaps
  • Urethra / abnormalities
  • Urethra / surgery*
  • Urologic Surgical Procedures, Male* / adverse effects