|کد مقاله||کد نشریه||سال انتشار||مقاله انگلیسی||ترجمه فارسی||نسخه تمام متن|
|5688698||1599253||2017||6 صفحه PDF||سفارش دهید||دانلود کنید|
ObjectiveTo describe the spectrum of adult presentations with hypospadias-related complications and examine the effect of childhood surgical repair on these adult presentations.MethodsA retrospective chart review over a 10-year period, from August 2004 to December 2014, demonstrated 93 adult patients who presented to a reconstructive urologist with complications related to hypospadias. Patients were divided into 2 groups: those with no prior hypospadias surgery (Group 1, Nâ=â19) and those who underwent surgical correction as a child (Group 2, Nâ=â74). Charts were reviewed for age at presentation, initial complaints, history of repair, and surgical intervention required.ResultsThe mean age at presentation was 34.6âÂ±â0.6 years. Overall, lower urinary tract symptoms (LUTS) (49%) was the most common presenting complaint, followed by spraying (24%), urethrocutaneous fistula (18%), recurrent urinary tract infections (UTIs) (15%), and chordee (14%). Comparison demonstrated that Group 2 patients were more likely to present with LUTS (55% vs 26%; Pâ=â.038) and recurrent UTIs (19% vs 0%; Pâ=â.050). There was a trend toward Group 1 patients presenting more commonly with cosmetic dissatisfaction (16% vs 4%; Pâ=â.06). Urethral stricture was demonstrated more commonly in Group 2 (47% vs 11%; Pâ=â.0043). Of these, strictures were significantly longer in the previous surgery group (5.5âÂ±â0.6âcm vs 3.0âÂ±â0.6âcm, Pâ=â.019).ConclusionCorrection of hypospadias as a child likely increases the future risk of urethral stricture, recurrent UTIs, and subsequent LUTS, with a trend toward improving patient satisfaction with cosmesis compared to nonsurgical management. Follow-up of hypospadias repair patients should extend into adulthood, as a significant portion of adult presentations ultimately require surgical intervention.
Journal: Urology - Volume 99, January 2017, Pages 281-286