Outcomes of Hypospadias Repair Based on Surgical Techniques: A 4-Year Retrospective Study

Figures & data

Figure 1 Sankey diagram visualizing the distribution of type hypospadias, surgical technique, and complications. Majority of cases were distal hypospadias and underwent TIP technique. Sixty-four% of the included patients had successful operations while 36% developed postoperative complications. TIP was applied to proximal hypospadias as well.

Table 1 Descriptive Analysis of the Clinical Features of Hypospadias

	Overall (n=119)
Presence of Urological Anomalies
Yes	20 (16.8%)
No	99 (83.2%)
Type of Hypospadias
Distal	96 (80.7%)
Glandular	18 (18.75%)
Coronal	28 (29.17%)
Sub-coronal	14 (14.58%)
Mid-shaft	14 (14.58%)
Missing Subtype	22 (22.92%)
Proximal	23 (19.3%)
Scrotal	15 (65.22%)
Penoscrotal	3 (13.04%)
Perineal	3 (13.04%)
Missing Subtype	2 (8.70%)
Age 1st Hypospadias Surgery
Mean (SD)	2.4 (2.3)
Range	0.4–13.0
Surgical Technique
TIPU	57 (48.7%)
MAGPI	19 (16.2%)
Duplay	8 (6.8%)
Koyanagi	7 (6.0%)
Duckett	6 (5.1%)
Matthieu	5 (4.3%)
Others	15 (12.8%)
Size of Urine Catheter
6 Fr	2 (1.9%)
8 Fr	100 (92.6%)
10 Fr	6 (5.6%)
Stenting duration (Days)
<=5	53 (54.6%)
>5	44 (45.4%)

Table 2 Post-Operative Complications

	Type of Hypospadias
Post Operative Complications	Distal n = 96 (81%)	Proximal n = 23 (19%)	p-value
Penile Curvature	4 (4.2%)	3 (13%)	0.13
Penile Rotation	5 (5.2%)	2 (8.7%)	0.62
Urethral Fistula	23 (24%)	7 (30%)	0.52
Meatal Stenosis	7 (7.3%)	2 (8.7%)	0.68
Urethral Stricture	6 (6.2%)	2 (8.7%)	0.65
Wound Infection	3 (3.1%)	0 (0%)	>0.99
Unfavorable cosmetic appearance	7 (7.3%)	2 (8.7%)	0.68
Glans Dehiscence	1 (1.0%)	0 (0%)	>0.99

Table 3 Comparison of Complications by Type of Hypospadias and Type of Surgery

	Type of Surgery
Complication	TIP n = 57 (49%)	MAGPI n = 19 (16%)	Duplay n = 8 (6.8%)	Koyanagi n = 7 (6.0%)	Duckett n = 6 (5.1%)	Matthieu n = 5 (4.3%)	Others n = 15 (13%)	p-value^a
Penile Curvature	3 (5.3%)	1 (5.3%)	0 (0%)	1 (14%)	0 (0%)	0 (0%)	2 (13%)	0.68
Penile Rotation	5 (8.8%)	0 (0%)	1 (12%)	0 (0%)	0 (0%)	0 (0%)	1 (6.7%)	0.77
Urethral Fistula	19 (33%)	2 (11%)	2 (25%)	1 (14%)	2 (33%)	1 (20%)	2 (13%)	0.42
Meatal Stenosis	5 (8.8%)	0 (0%)	1 (12%)	0 (0%)	0 (0%)	2 (40%)	1 (6.7%)	0.17
Urethral Stricture	6 (11%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	1 (20%)	1 (6.7%)	0.54
Wound Infection	3 (5.3%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0.88
Unfavorable cosmetic appearance	5 (8.8%)	0 (0%)	1 (12%)	1 (14%)	0 (0%)	1 (20%)	1 (6.7%)	0.44
Glans Dehiscence	1 (1.8%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	0 (0%)	>0.99
	Type of hypospadias
	Distal n = 96 (81%)				Proximal n = 23 (19%)
Penile Curvature	4 (4.2%)				3 (13%)			0.13
Penile Rotation	5 (5.2%)				2 (8.7%)			0.62
Urethral Fistula	23 (24%)				7 (30%)			0.52
Meatal Stenosis	7 (7.3%)				2 (8.7%)			0.68
Urethral Stricture	6 (6.2%)				2 (8.7%)			0.65
Wound Infection	3 (3.1%)				0 (0%)			>0.99
Unfavorable cosmetic appearance	7 (7.3%)				2 (8.7%)			0.68
Glans Dehiscence	1 (1.0%)				0 (0%)			>0.99

Notes: ^aThe Conditions for applying the χ² test not being met (at least one of the cells in the contingency table has too few theoretical observations), an exact Fishers test was performed. However, no significant associations were observed with any complication with respect to type of surgery.

Table 4 Comparison of the Urethral Stent Duration with the Postoperative Complications

		Days The Urinary Catheter Was Left
Factors n (%)		<=5 days	>5 days	Total	p
Penile Curvature	Yes	4 (7.5)	1 (2.3)	5 (5.2)	0.373^b
	No	49 (92.5)	43 (97.7)	92 (94.8)
Penile Rotation	Yes	0 (0.0)	3 (6.8)	3 (3.1)	0.090^b
	No	53 (100.0)	41 (93.2)	94 (96.9)
Urethral Fistula	Yes	9 (17.0)	16 (36.4)	25 (25.8)	0.037^a
	No	44 (83.0)	28 (63.6)	72 (74.2)
Meatal Stenosis	Yes	5 (9.4)	3 (6.8)	8 (8.2)	0.725^b
	No	48 (90.6)	41 (93.2)	89 (91.8)
Urethral Stricture	Yes	4 (7.5)	2 (4.5)	6 (6.2)	0.686^b
	No	49 (92.5)	42 (95.5)	91 (93.8)
Wound Infection	Yes	2 (3.8)	1 (2.3)	3 (3.1)	1.000^b
	No	51 (96.2)	43 (97.7)	94 (96.9)
Unfavorable cosmetic appearance	Yes	4 (7.5)	5 (11.4)	9 (9.3)	0.727^b
	No	49 (92.5)	39 (88.6)	88 (90.7)
Glans Dehiscence	Yes	0 (0.0)	1 (2.3)	1 (1.0)	0.454^b
	No	53 (100.0)	43 (97.7)	96 (99.0)

Notes: ^aChi-Square Test. ^bAt least one of the cells in the contingency table has too few theoretical observations; an exact Fisher’s test was performed.