Hypospadias Surgical Techniques and Complication Management
Summary
Hypospadias is a congenital malformation in which the urethral opening is located on the ventral aspect of the penis, often accompanied by ventral curvature (chordee) and a hooded foreskin. Surgical correction aims to restore both function and appearance, ideally before two years of age. Techniques are broadly classified into single-stage repairs—such as tubularized incised plate (TIP) urethroplasty, onlay preputial island flap urethroplasty and meatal mobilisation—and multi-stage protocols reserved for complex proximal variants. Choice of approach depends on urethral defect length, glans configuration and degree of curvature. Prevention and management of complications are integral to operative planning: urethrocutaneous fistula, meatal stenosis, glans dehiscence and wound infection remain the most frequent adverse outcomes. Strategies to reduce risks include meticulous tissue handling, multi-layer closure, preoperative hormonal stimulation to optimise penile dimensions and emerging intraoperative imaging modalities for real-time assessment of tissue perfusion. Long-term follow-up is crucial to address late-onset curvature, residual deformity and psychosexual sequelae, ensuring that repair durability and patient satisfaction are continually evaluated.
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Hypospadias Surgical Techniques and Complication Management publication trend
The graph below shows the total number of articles in hypospadias surgical techniques and complication management across all publications each year (not limited to Nature Index journals).
Technical terms
Hypospadias: A congenital displacement of the urethral meatus along the ventral penile shaft.
Chordee: Ventral curvature of the penis, often associated with fibrous tissue tethering.
Urethrocutaneous fistula: An abnormal communication between the urethral lumen and skin surface, resulting in urinary leakage.
TIP urethroplasty: Tubularized incised plate repair, involving midline incision of the urethral plate to form a neourethra.
Onlay preputial island flap: A pedicled flap of inner preputial skin laid alongside the urethral plate to reconstruct the urethra in one stage.
Meatal mobilisation (MEMO): Technique advancing and repositioning the urethral meatus without tubularisation of the plate.
Indocyanine green imaging: Fluorescent angiography technique for real-time assessment of tissue perfusion during surgery.
References
- Adult non-urethral complications after hypospadias repair in childhood: presentation, treatment and outcomes. Frontiers in Endocrinology (2023).
- Safety and Effectiveness of Meatal Mobilization (MEMO) Technique for Glandular, Coronal, and Subcoronal Hypospadias Repair in Children: A 5-Year Single-Center Study with 105 Hypospadias. Biomedicines (2024).
- Indocyanine Green (ICG)-Guided Onlay Preputial Island Flap Urethroplasty for the Single-Stage Repair of Hypospadias in Children: A Case Report. International Journal of Environmental Research and Public Health (2023).
- Urological results and patient satisfaction in adolescents after surgery for proximal hypospadias in childhood. Journal of Pediatric Urology (2020).
- The Influence of Pre-Operative Hormonal Stimulation on Hypospadias Repair. Frontiers in Pediatrics (2015).
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