Different surgical procedures for hypospadia:a report of 48 cases

Objective: To observe and summarize the therapeutic effects and complications of different surgical procedures for treatment of hypospadia so as to provide basis for patients to choose a suitable pattern. Methods: Different surgical procedures were applied to 48 patients with hypospadia. Duckett was adopted by 23 cases,Denis-Browne 3 cases,Duplay 10 cases,MAGPI 1 case, Duckett + Duplay 3 cases,scrotal septal vascular pediclen flap 3 cases and Hodgson 5 cases. The success rate and the complication of each procedure were analyzed retrospectively. Results: Of the 23 cases treated by Duckett,one-stage success was achieved in 18 cases, urinary fistula occurred in 3 cases,anastomotic stricture in one case and skin edge necrosis in one case; of the 3 cases treated by DenisBrowne,2 cases achieved successful results and 1 developed urethral stricture; of the 10 cases adopting Duplay,one-stage success was achieved in 7 cases and urinary fistula occurred in 3 cases; the operation was successful in the one case treated by MAGP; of the 3 cases adopting Duckett + Duplay,the operation was successful in 1 case,urinary fistula occurred in 1case and anastomotic stricture in 1 case; of the 3 cases treated by scrotal septal vascular pediclenflap,successful result was achieved in 2 cases and urinary fistula occurred in one case; of the 5 cases adopting Hodgson,4 cases achieved good results and urinary fistula occurred in 1 case. Conclusions: Different surgical procedures should be applied to different types of hypospadia. To most patients receiving the therapy for the first time,Duckett and Hodgson procedures should be taken as the first choice; patients receiving the penis diorthosis surgery for the second time may choose Duplay or Denis-Browne; patients having experienced failed operations or lacking external genital organ skin source should consider using dissociation substitution tissues(cheek mucous membrane,tongue mucous membrane and so on).