Surgical correction of severe forms of hypospadias in children

Abstract

Aim. To search for an optimal method of surgical correction of proximal forms of hypospadias in children. Methods. During the period between 1998 and 2011 at the department of urology treated were 51 children with severe forms of hypospadias. Of the 51 patients under observation 13 patients had 21 operations performed out of our medical institution, at our hospital the patients underwent 98 operations: 7 types of urethroplasty in 51 patients. Results. The best results were obtained with a tubularized incised plate urethroplasty. After this intervention significantly fewer complications developed compared to the Duplay operation (p 0.001) and the techniques involving skin flaps - the so-called «flap» methods (p 0.05). After many years of applying various techniques for correction of proximal forms of hypospadias, in the author’s arsenal remain three: the tubularized incised plate urethroplasty, the Snodgraft intervention, and the two-stage Bracka operation. All of these operations bring together one key point - urethroplasty is performed from the urethral plate. Conclusion. The formation of the urethra from the urethral plate provides a positive functional and cosmetic result.