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11–14 APRIL, 2018, HELSINKI, FINLAND
12:00–12:03
S8-4 (PP)
ADULT NON-URETHRAL COMPLICATIONS AFTER
HYPOSPADIAS REPAIR IN CHILDHOOD
Vladimir KOJOVIC
1
, Marta BIZIC
2
, Borko STOJANOVIC
2
, Marko BENCIC
2
,
Vojkan VUKADINOVIC
3
, Zoran KRSTIC
3
, Gradimir KORAC
4
and
Miroslav DJORDJEVIC
3
1) Institute for Mother and Child Health "dr Vukan Cupic", Urology, Belgrade, SERBIA - 2) University Children's Hospital,
Urology, Belgrade, SERBIA - 3) School of Medicine, University of Belgrade, University Children's Hospital, Urology,
Belgrade, SERBIA - 4) University Children's Hospital, Anesthesiology, Belgrade, SERBIA
PURPOSE
Urethral complications after hypospadias repair are the most common, but there is another group of
postoperative complications defined as "non-urethral" complications that carry a risk of multistage
surgeries. Aims of this study are to present treatment of these complications and to highlight their
impact on patients' life.
MATERIAL AND METHODS
Between March 2003 and May 2017, 95 patients, aged 6.5 to 40 years (mean 19) underwent
surgical repair for non-urethral complications after hypospadias repair in childhood: glans deformity
(36), residual curvature (46) and trapped penis (32). Some patients had two or more complications
at the time of corrective surgery. Mean period after first hypospadias repair was 13.6 years. Glans
repair was performed in 29 patients by creation of conically shaped glans with wide glans wings
creation, while in 7 cases "double-faced" skin flap was used to enlarge small and deformed glans.
Residual curvature was repaired by tunica plication in all cases, while in 25 cases additional urethral
reconstruction was needed. Trapped penis was repaired using vascularized genital skin flaps or
free skin grafts as one or two stage repair.
RESULTS
Mean follow-up was 64 months (ranged 5–174 months). One-stage surgery repair was successful
in 78 patients, while 17 patients required additional surgery. Twelve patients underwent two-stage
penile skin reconstruction due to lack of genital skin and five patients underwent repeated correction
of the penile curvature due to its late onset.
CONCLUSIONS
Non-urethral complications after hypospadias repair carry a risk of repeated surgeries and may
lead to severe sexual and psychological dysfunction. Active surgical treatment should enable full
sexual functionality. Long-term follow-up of these patients should be extended until beginning of
their sexual activity and even in their early adulthood.