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KMID : 0365819830230010071
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Journal of Pusan Medical College
1983 Volume.23 No. 1 p.71 ~ p.83
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Results and Postoperative Evaluation of the Hypospadias Repair
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Abstract
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During eleven and a half years from Jan. 1971 to Jun. 1982, one hundred and five patients of hypo spadias underwent surgical treatments with one and two stage repairs in the Department of Urology,Busan National University Hospital. The author had the opportunity to evaluate 33 of these patients, especially in the aspects of location of external urethral meatus, penile shape, penile direction during erection, spermiogram, penile length, condition of voiding, urinalysis and urethrographic finding..
The results of urethroplasty of each method and follow-up study were summarized as follows:
1. The average age of patients who had two stage repair was 5.5 years for chordectomy. The-average age of patients with one stage hypospadias repair was 5.0 years.
2. Among 74 patients with two stage repair, chordectomy was performed on 36 patients by the Byars method, 27 by the Blair method, 8 by the Glenn-Anderson method, 2 by the Nesbit method and 1 by the Mays method. Secondary urethroplasty was performed by the Denis-Browne-Crawford method on 74 patients. Among 31 patients with one stage repair, 13 patients were managed by the Allen-Spence method, 12 by the Hodgson method, 3 by the Duckett method, 1 by the Devine-Horton method and 2 by the Denis-Browne-Crawford hypospadias repair as one stage for the patients who had hypospadias without chordee.
3 Sixty-two of 74 patients with two stage repair were corrected successfully, but fistula developed in 7 patients(9. 5%) and urethral stricture in 5 (6. 7%). The success rate of the Allen-Spence method was 92.3 per cent (12 of 13 patients), the Hodgson method 83.3 per cent (10 of 12) and the Duckett method 100 per cent (3 of 3). One patient treated by the Devine-Horton method failed due to fistula formation.
4. Twenty-three of 33 patients who returned to the hospital for follow-up study had been managed by two stage repair. Among them, one patient treated by the Mays chordectomy and the Denis Browne-Crawford hypospadias repair was satisfactory for the external urethral meatus located at the tip of the glans, but the remaining patients were unsatisfactory for the meatal location. Three patients treated by the Duckett method, 2 of 5 patients treated by the Hodgson method, and 2 treated by the Allen-Spence method were satisfactory for the meatal location. The remaining three patients treated by the Hodgson method were unsatisfactory for the meatal location which was below the coronal sulcus.
5. Most of the patients were satisfactory for the penile shape and size, the direction of the penis, during erection and the condition of voiding. The spermiogram was normal in 2 adults, one of whom fathered a son.
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