COMPARISON OF THE EFFECT OF DIFFERENT SURGICAL METHODS IN PROXIMAL AND DISTAL HYPOSPADIAS

Introduction: Hypospadias is a congenital anomaly observed in approximately one in every 200 to 300 male births. To date, there is no method universally agreed upon for repair of hypospadias. The aim of our study is to retrospectively compare the methods chosen according to the location of the meatus and their outcomes in a group of 75 patients. Material and Methods: Between 2002 and 2008, seventy-five patients with primary hypospadias underwent surgical repairs. The age range of the patients was between 8 and 140 months, and the mean age was 61.8 months. The repairs in the patients with distal hypospadias were performed through urethral advancement (n=27) and the Mathieu technique (n=17). The repairs in the patients with proximal hypospadias were performed with onlay preputial island flap urethroplasty (n=8), the Asopa technique (n=19), and skin graft urethroplasty (n=4). Results: Patients where a satisfactory reconstruction was achieved were followed up for an average period of 54.6 months (range: 29-92 months). None of the patients developed any infection, hematoma, wound dehiscence or diverticula. During the follow-up period, the total complication rate was 14.6%, of which 8% were fistulae and 6.6% were meatal stenoses. The lowest complication rates were observed with the onlay preputial island flap method (25%) applied in patients with proximal hypospadias and with the urethral advancement (3.7%) applied in patients of distal hypospadias. Conclusion: In our study, the onlay preputial island flap urethroplasty in patients with proximal hypospadias and the urethral advancement in patients with distal hypospadias were found to be the most effective techniques.