Is it Possible to Perform Hypospadias Surgery in Circumcised Children?

Abstract

INTRODUCTION[|]The practice of circumcision is frequently performed in hospital environment by surgeons in recent years. However hypospadias may be misdiagnosed when circumcision is performed by unqualified individuals. In this study, we aimed to determine the safety of hypospadias surgery and to investigate clinical outcomes in these patients.[¤]METHODS[|]Nine patients with distal hypospadias without chordee were included in the study. Insufficient amount of foreskin was detected in all patients because of previous circumcision. All cases underwent hypospadias repair with TIPU method. Tubularized urethra was surrounded with dartos fascia elevated from distal penile skin. Urethral catheters were applied for 10–14 days in all cases.[¤]RESULTS[|]Nine patients with mean age of 6.4+-1.80 (4–8) years were followed for a average period of 17.5 (12–24) months. During the early postoperative period, wound dehiscence was observed in skin flaps of three patients (33%). Fistula formation was determined in two patients (22%). Meatal stenosis was observed in 5 patients, but was not cllinically significant after 1 year of follow-up.[¤]DISCUSSION AND CONCLUSION[|]The most common problems encountered in these patients are insufficient dartos fascia and circulation problem in elevated skin flaps which often result in fistula formation. There are two points to be considered for hypospadias operations in these patients: closure of new urethra with surrounding fascia and elevation of skin flaps smoothly without impairing circulation, and subsequent suturing.[¤]

Keywords

• circumcision
• hypospadias
• fistula formation.