Comparative Outcome Analysis of Single Vs. Staged Proximal Hypospadias Repair in Children Treated at Tikur Anbessa Specialized Hospital and Menilik II Hospital from 2010 To 2020 G.C
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Date
2023-10
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Addis Ababa University
Abstract
Introduction: Long-term surveillance show proximal hypospadias repair has a higher
complication rate (50% to 68%) than distal hypospadias repair (5% to 10%). In present study,
we aim to identify and compare the complication rate between single stage hypospadias repair
and staged hypospadias repair.
Methods: A retrospective chart review study of boys undergoing proximal hypospadias repair
between January 2010 and December 2020 G.C. in Tikur Anbessa specialized and
Comprehensive Hospital and its affiliate Menilik Comprehensive Hospital. Pearson Chi-square
and logistic regression analyses were performed to assess associations and effect size,
respectively.
Results: A total of 75 patients were included, with a median age at surgery of 36.0 months.
Forty-six in single stage group (Long tubularized incised late (TIP) 30, Transverse Ventral
Preputial Flap (TVPF) 15, and Onlay Island Flap (OIF) 1) and 29 in staged group (staged
preputial island flap 27, and staged preputial graft 2). The overall complication rate was 70.6%
(53/75 patients), 32/46 (69.6%) single stage repair, and 21/29 (72.4%) staged repair. There was
a significant preference toward staged hypospadias repair in last 4 years of the study period.
Reoperation for glans dehiscence was significantly higher in the staged group (31.0% vs. 4.3%,
P = 0.002). Overall complication rate and urethrocutaneous fistula (UCF) were significantly
higher in TVPF when compared with Long TIP, 93.3% vs. 56.7% and 73.3% vs. 26.7%,
respectively.
Conclusion: We found a high complication rate for both single stage and two stage repairs.
Higher complication rate in our report warrants further investigation and risk identification to
achieve satisfactory outcomes.
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Keywords
Proximal hypospadias, single vs. staged repair, sub-Saharan Africa, resource- limited setting