A CLINICAL STUDY OF COMPLICATIONS OF SNODGRASS URETHROPLASTY FOR HYPOSPADIAS

Abstract

Background: Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis, proximal to the end of the glans. The meatus may be located anywhere along the shaft of the penis from the glans to the perineum.

Objectives: The present study was an attempt to find out the complications of Snodgrass urethroplasty done for anterior, middle and distal hypospadias.

Methods: This was a descriptive observational study which was conducted on 50 male children having anterior, middle and distal hypospadias with age between 6 months to 12 years who underwent hypospadias repair in the Pediatric Surgery department in three year period. Postoperative complications were evaluated.

Results: The most common presenting complaints were abnormal location of meatus and cosmetic deformity. All the patients with meatal stenosis had anterior and distal hypospadias. Minimal chordee was more commonly associated with anterior and mid penile hypospadias and significant chordee was more commonly associated with proximal and mid penile hypospadias. The most common associated diseases were inguinal hernia and undescended testes. The commonest early complications were postoperative edema and pericatheter leak. Urethrocutaneous fistula in 10%, superficial penile skin necrosis in 6% and wound dehiscence developed in 4% patients.

Conclusion: A properly nourished patient with a good personal hygiene, optimum operative time with less intraoperative bleeding , adequate tissue for covering the neourethra, adequate mobilization of the graft are the bare necessities of a good surgical outcome.

Keywords: Hypospadias, Inguinal Hernia, Meatal Stenosis, Urethroplasty, Urethrocutaneous Fistula.