Document Type : Research Paper

Authors

1 dept of surgery college of medicine Mosul university, Iraq

2 Dep.of pediatric surgery/ Alkhansaa teaching hosp

3 al-khansa'a teaching hospital

Abstract

Background: Proximal hypospadias repair carries high complications rates. single
stage is the standard practice for management but sometimes it is not easy to perform
single stage for posterior hypospadias and here appears the need for staged surgery
in this study we assess the out coms and complications of the most commonly used
techniques in Mosul pediatric surgery center at alkhansaa teaching hospital
Objective: To assess the results of management of posterior hypospadias by
Tubularized incised plate as single stage and staged repair and to knew the most
important complications associated with these two procedures.
Methods: this is prospective study for forty patients who were admitted to Mosul
pediatric surgery center at alkhansaa teaching hospital from October 2011 till
October 2013, their age ranged from 9 month to 15 years, five of them were operated
before with complete failure, 31 patient operated by single stage Tubularized Incised
Plate technique and the other 9 by two stage technique and they were followed for
6-18 months.
Results: The total complications rate was (52%) as follow: (7) cases (17.5%)
develop meatal stenosis, (4) patients (10%) develop retrusive meatus, No one
develops stricture, (10) cases (25%) develop fistula and none of them develop
diverticulum,
the total complication rate for Single stage TIP technique was (48.3%) the total
complication rate of complications for staged surgery was (66.6%).
Conclusion: proximal hypospadias repair is very challenging with high
complication rate which need a good experience to deal with it. Single stage or
multistage procedure can be utilized to repair this type of hypospadias. Most of the
published papers has low number of cases in comparison to the anterior type which
represent 70_80% of all cases and for that reason may be the great difference in
between different centers in the incidence of complications rate.

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