Long-Term Complications of Hypospadias Repair: A Ten-Year Experience from Northern Zone of Tanzania

Background: Hypospadias is one of the commonest congenital penile abnormalities in newborn males. The external urethral opening can be located anywhere from the glans penis along the ventral aspect of the shaft of the penis up to the scrotum or the perineum in extreme cases. The condition has a huge impact on the patient's psychological, emotional and sexual well-being.

Aim: To determine the proportion of patients who develop long-term complications after hypospadias repair and its associated risk factors.

Methods: This was a hospital-based analytical cross-sectional study, conducted at KCMC Urology Institute from January 2009 to December 2018 and all children were followed up for 1-year post-operatively. A structural data sheet was used to collect information from patients' files. Study parameters include age, location of hypospadias, surgical technique, surgeon experience, chordee, suture size, materials to assess the association with long-term complications.

Results: A total of 254 patients were included in the study, the majority were aged more than 2 years (71.83%) with mean age at operation (SD) of 4.74 ± 2.99 years. Distal types were the most common type of hypospadias (125 patients; 50%), and 51 patients (20%) had severe chordee. Tubularized incised plate (TIP) repair was the most common technique (130 patients; 51.59%). The number of patients with long-term complications following hypospadias repair was 156 (61.60%) and urethrocutaneous fistula (UCF) accounted for 40.5%. The surgeon's experience, location of hypospadias, surgical technique and associated chordee were significant predictors of long-term complications of hypospadias repair.

Conclusion: Tubularized incised plate urethroplasty is a safe and reliable method of hypospadias repair. Proximal hypospadias with severe chordee still remain a challenge.